Longitudinal weight changes, length of survival, and energy requirements of long-term care residents with dementia

OBJECTIVE: We hypothesized that institutionalized patients with dementia, who frequently have feeding problems and require supervised and assisted feeding, would lose more weight during their residency than nondemented, independently functioning residents and have compromised survival. To test this hypothesis, we examined the survival and longitudinal changes in weight of two cohorts of institutionalized residents with dementia and compared these cohorts with a cohort of nondemented residents. We also measured the resting energy expenditures of a subset of the subjects with dementia as an indicator of their energy needs. DESIGN: A longitudinal cohort study with retrospective baseline chart review and subsequent follow-up of monthly weights and mortality over 4 years. SETTING: A 725-bed long-term care institution with specified levels of care. SUBJECTS: Two cohorts of residents with dementia, one consisting of subjects who required total care throughout their institutional stay (n = 31) and another group who did not initially require total care (n = 48); these were compared with a cohort with normal mentation who were functionally independent in their daily activities (n = 26). The total number of subjects was 105. MEASUREMENTS: Demographics, medical problems, and medications by chart review; functional and mental status evaluations; longitudinal monthly weights and mortality for the 48-month study period; and resting energy expenditures by indirect calorimetry. MAIN RESULTS: Residents with dementia had lower weights on admission and throughout their stay than nondemented, independently functioning residents, and they were more likely to have a weight loss of 10 lbs or more at some point during the 4-year study period. However, their mean weights did not change during the study period. The mean survival from admission of those demented residents who died was more than 3 years. Resting energy expenditures of women residents with advanced dementia were 12% lower than predicted from the Harris Benedict equations. CONCLUSION: Dementia is not necessarily associated with unremitting weight loss during institutionalization despite the frequent occurrence of feeding difficulties and temporary weight loss. This may be caused partly by the lower than expected resting energy expenditures and, hence, energy needs of affected residents as their dementia progresses. Demented residents weighed significantly less than nondemented, independently functioning residents throughout their institutional stay. Nevertheless, nursing staff are able to maintain weight and survival for extended periods even in very impaired residents.     

Reliability and scale effect in toughness of concrete structures

In the present work, the distribution of the random toughness characteristics (i.e. critical energy release rate, G_1c) has been evaluated on the basis of experimental observations. Fracture test results from three groups of geometrically similar concrete specimens of size (width×total depth×thickness), 420×420×50–1680×1680×200 mm³, made with different maximum aggregate size of 9.5, 19, 38, and 76 mm were analyzed using a recently proposed distribution of extremes. In applications of probability, it is important to use an appropriate distribution type and adequate techniques for estimating the parameters of distribution. In this study, a new type distribution of minima is employed for probability computations. It was noticed that the entropy of distribution increases with the crack length, i.e. the uncertainty of toughness, G_1c, value increases with crack length. A non-linear reduction of the maximum allowable splitting force with the defect size, a, was noticed. For large specimens, the maximum allowable splitting load is more sensitive to the required reliability level than that for small specimens. Reliability increases with aggregate size when all other conditions were constant.     

Impulse breakdown voltages of triggered multistage vacuum gap

Several sealed-off triggered vacuum gaps are connected in series to improve hold-off voltage. The characteristics of impulse breakdown voltage of these series-connected gaps are investigated experimentally. The sum hold-off voltage of series-connected gaps decreases to a unit hold-off voltage when the maximum value of voltage division ratio across the gaps increases to unity. Self-breakdown probability of the series-connected gaps is always higher than that of a single gap under the same conditions. Hence, stage efficiency of the multistage gap decreases with increasing number of stages. Its value is 90 percent with 2-stage gap and 75 percent with 5-stage gap, respectively, under the same voltage division ratio and the same gap length (2.0 mm) in each stage. Triggered breakdown voltage of 2- or 3- stage gap is several hundred volts when all gaps are triggered simultaneously at the peak of the main impulse wave and a working voltage range is nearly 100 percent in this case. The working voltage range decreases with number of stages. Its value is 45 percent with 3-stage gap and 15 percent with 5-stage gap, respectively, when one triggered gap is fired for switching.     

Simulation and experimental analyses of electromagnetic transients behaviors of lightning surge on vertical conductors

Simulation of very fast surge phenomena in a three-dimensional (3-D) structure requires a method based on Maxwell's equations, such as the finite-difference time-domain (FDTD) method or the method of moments, because circuit-equation-based methods cannot handle the phenomena. This paper uses a method of thin-wire representation of the vertical conductor system for the FDTD method which is suitable for the 3-D surge simulation. The thin-wire representation is indispensable to simulate electromagnetic surges on wires or steel frames in which the radius is smaller than a discretized space step used in the FDTD simulation. In this paper, a general surge analysis program named the virtual surge test lab based on the Maxwell's equations formulated by the FDTD method, is used to simulate the surge phenomena of a vertical conductor, including the effects of horizontal wave incidence and vertical wave incidence. Experimental results on the reduced scale model have been presented in order to compare among the simulation results by the FDTD method and the results using numerical electromagnetic code based on the MoM.     

Proposal for st-Routing Protocol

A routing protocol chooses one of the several paths (routes) from a source node to a destination node in the computer network, to send a packet of information. In this paper, we propose a new routing protocol, which we call st-routing protocol, based on st-numbering of a graph. The protocol fits well in noisy environments where robustness of routing using alternative paths is a major issue. The proposed routing protocol provides a systematic way to retry alternative paths without generating any duplicate packets. The protocol works for only those networks that can be represented by biconnected graphs.     

Hierarchical Fuzzy Systems Integrated with Particle Swarm Optimization for Daily Reference Evapotranspiration Prediction: a Novel Approach

Water Resources Management - Reference evapotranspiration (ET0) is a crucial element for deriving irrigation scheduling of major crops. Thus, precise projection of ET0 is essential for better...     

A systematic review on emperor penguin optimizer

Neural Computing and Applications - Emperor Penguin Optimizer (EPO) is a recently developed metaheuristic algorithm to solve general optimization problems. The main strength of EPO is twofold....     

RFID-based interactive multimedia system for the children

In this paper, we present an interactive edutainment system for the children that leverages multimedia and RFID technologies in a seamless manner. The proposed system allows children to learn about new objects/entities by tapping on physical objects through a specially designed RFID-Bluetooth based Tangible User Interface (TUI) tool. The output of the system is delivered as a set of appropriate multimedia representations related to the objects being tapped. The TUI uses RFID technology for object identification and Bluetooth communication to transmit data to the computer where the system??s software is running. We incorporated our system in three games that allow children of different ages to benefit from the system??s functionalities and encourage them to interact with it.     

Determining trust in media-rich websites using semantic similarity

Significant growth of multimedia content on the World Wide Web (or simply ??Web??) has made it an essential part of peoples lives. The web provides enormous amount of information, however, it is very important for the users to be able to gauge the trustworthiness of web information. Users normally access content from the first few links provided to them by search engines such as Google or Yahoo!. This is assuming that these search engines provide factual information, which may be popular due to criteria such as page rank but may not always be trustworthy from the factual aspects. This paper presents a mechanism to determine trust of websites based on the semantic similarity of their multimedia content with already established and trusted websites. The proposed method allows for dynamic computation of the trust level of websites of different domains and hence overcomes the dependency on traditional user feedback methods for determining trust. In fact, our method attempts to emulate the evolving process of trust that takes place in a user??s mind. The experimental results have been provided to demonstrate the utility and practicality of the proposed method.