Nursing home food services linked with risk of malnutrition.

PURPOSE: Links between food service characteristics and residents' risk of malnutrition were examined. METHODS: Cognitively intact residents meeting inclusion criteria and living in one of 38 participating nursing homes were randomly sampled. The final sample consisted of 132 residents, who were screened for risk of malnutrition and completed a face-to-face interview questionnaire about dining experiences. Additional data came from participants' medical charts, and each institution's food service manager completed a written questionnaire. Frequencies and logistic regressions were used to describe the sample and to examine relationships between risk of malnutrition and food service characteristics. RESULTS: Overall, 37.4% of participants were at risk of malnutrition. Food service factors, including food packages, lids, and dishes that were difficult to manipulate (b=0.285, p=0.009), bulk food-delivery systems (b=1.329, p=0.036), overall food satisfaction (b=0.253, p=0.044), menu cycle length (b=-2.162, p=0.003), and porcelain dishes (b=-0.345, p=0.052), all were significantly associated with risk of malnutrition. CONCLUSIONS: Our findings clearly show a need for nursing homes to modify certain aspects of food service that may increase the risk of malnutrition among cognitively intact residents.     

Clinical trial of retrograde warm blood reperfusion versus standard cold topical irrigation of transplanted hearts

BACKGROUND: A prospective, randomized clinical study involving 34 patients undergoing heart transplantation compared myocardial preservation of donor hearts maintained with continuous reperfusion with retrograde warm blood cardioplegia during surgical implantation versus the standard cold topical irrigation. METHODS: Hearts in both groups were arrested with a standard crystalloid solution and maintained in a cold saline solution during transportation. In the retrograde group, cardioplegia was administered through a catheter in the coronary sinus during surgical implantation. An average of 471 +/- 30 mL of hyperkalemic crystalloid solution diluted 1:4 in warm blood from the oxygenator was infused. In the standard group, the heart was kept cold by topical irrigation of cold saline solution and was reperfused only when the ascending aorta was unclamped. RESULTS: Preoperative characteristics of donors and recipients were similar in the two cohorts. Ischemic time average 139 +/- 12 minutes in the retrograde group compared with 130 +/- 11 minutes in the standard group (p = 0.57). Cardiopulmonary bypass time averaged 89 +/- 4 minutes in the retrograde group and 110 +/- 12 minutes in the standard group (p = 0.12). Defibrillation at reperfusion was performed in 4 patients (4/17, 24%) in the retrograde group and 12 patients (12/18, 67%) in the standard group (p = 0.01). There were no deaths in the retrograde group (0/17), whereas in the standard group, 3 patients (3/17) died of early graft failure (p = 0.11). Four early graft failures occurred in the standard group (p = 0.06). Two patients (2/17, 12%) were weaned from bypass with ventricular assist devices in the standard group. The number of subendocardial necrotic cells in the first two weekly endomyocardial biopsy specimens averaged 2.7 +/- 0.8 cells/mm2 in the retrograde group and 5.9 +/- 2.4 cells/mm2 in the standard group (p = 0.12). CONCLUSIONS: Retrograde warm blood reperfusion appears to improve the initial recovery of transplanted hearts. The technique is easy to use and may be a useful approach to graft protection during surgical implantation.     

Fast point spread function computation from aperture functions in high-resolution positron emission tomography

The problem of extracting point spread functions from detector aperture functions in high-resolution PET is addressed. In the limit of very small size detectors relative to the ring dimensions, assumptions are made that lead to a fast and simple computation model yielding point spread functions with negligible errors due to the reconstruction algorithm. The methods allows one to assess accurately the intrinsic performance of a PET tomograph, and it appears to be adequate to relate the imaging capabilities in every point of the camera reconstruction field to the geometric and physical characteristics of the detection system. The method was developed as an investigation tool to help design the next generation of very-high-resolution PET tomographs.     

焊接过程微机控制系统中线性隔离电路的研究

本文以MOC5010为基础元件,根据焊接过程微机控制系统的特点,设计了用于电流电压检测及数字控制回路中的线性光电耦合电路,实验结果及实际应用证明:该电路良好地达到了预期的目的。     

A stationary sampling scheme for multilayer positron tomographs

A stationary sampling scheme applicable to tomographic instruments incorporating two or more detector layers is described and tested. In this concept, the detectors in adjacent layers are angularly offset by half the interdetector distance. By reconstructing in one single slice all lines of response defined by two adjacent rings of detectors, a fourfold increase in the number of coincidence lines is obtained and a uniform sampling distance equal to one-quarter the interdetector spacing is achieved. Whereas this is obtained at the expense of a 100% degradation of the resolution in the axial direction, with the recent breed of PET (positron emission tomography) scanners using nearly square cross section detectors, the resolution loss may be tolerable in many situations. In addition, normal reconstruction of the individual coincidence planes is always possible. The sampling concept was investigated experimentally with the help of the Universite de Sherbrooke PET camera simulator.     

GD&T-Based Characterization of Short-Range Non-contact 3D Imaging Systems

We present a series of test metrics, artifacts, and procedures for characterizing and verifying the operating limits of a short-range non-contact three-dimensional imaging system. These metrics have been designed to correspond to dimensioning and tolerancing metrics that are widely used in industry (e.g. automotive, aerospace, etc.). We introduce operating limit metrics that correspond with the geometric dimensioning and tolerancing (GD&T) metrics of Form (Flatness and Circularity), Orientation (Angularity), Location (Sphere, Corner, and Hole Position Errors), and Size (Diameter, Sphere-spacing, Plane-spacing and Angle Errors). An example is presented to illustrate how these metrics, artifacts, and associated test procedures can be used in practice.     

Alpha‐Lipoic Acid Supplementation Reduces mTORC1 Signaling in Skeletal Muscle from High Fat Fed,Obese Zucker Rats

The mammalian target of rapamycin (mTOR) signaling pathway is hyperactive in liver, adipose and skeletal muscle tissues of obese rodents. Alpha‐lipoic acid (αLA) has been well accepted as a weight‐loss treatment, though there are limited studies on its effect on mTOR signaling in high‐fat fed, obese rodents. Therefore, the goal of this study was to determine mTOR signaling and oxidative protein alterations in skeletal muscle of high‐fat fed, obese rats after αLA supplementation. Phosphorylation of the mTOR substrate, eukaryotic initiation factor (eIF) 4E‐binding protein 1 (4E‐BP1) and eIF4B were significantly reduced (p < 0.05) in muscle from αLA supplemented rats. Activation of AMP‐activated protein kinase (AMPK), an mTOR inhibitory kinase, was higher (p < 0.05) in the αLA group. Protein expression of markers of oxidative metabolism, acetyl CoA carboxylase (ACC), cytochrome c oxidase IV (COX IV), peroxisome proliferator‐activated receptor (PPAR), and PPAR gamma coactivator 1‐alpha (PGC‐1α) were significantly higher (p < 0.05) after αLA supplementation compared to non‐supplemented group. Our findings show that αLA supplementation limits the negative ramifications of consuming a high fat diet on skeletal muscle markers of oxidative metabolism and mTORC1 signaling.     

Multitasking across generations: Multitasking choices and difficulty ratings in three generations of Americans

This study investigated whether changes in the technological/social environment in the United States over time have resulted in concomitant changes in the multitasking skills of younger generations. One thousand, three hundred and nineteen Americans from three generations were queried to determine their at-home multitasking behaviors. An anonymous online questionnaire asked respondents to indicate which everyday and technology-based tasks they choose to combine for multitasking and to indicate how difficult it is to multitask when combining the tasks. Combining tasks occurred frequently, especially while listening to music or eating. Members of the “Net Generation” reported more multitasking than members of “Generation X,” who reported more multitasking than members of the “Baby Boomer” generation. The choices of which tasks to combine for multitasking were highly correlated across generations, as were difficulty ratings of specific multitasking combinations. The results are consistent with a greater amount of general multitasking resources in younger generations, but similar mental limitations in the types of tasks that can be multitasked.     

Genotype-phenotype analysis in four families with mutations in beta-myosin heavy chain gene responsible for familial hypertrophic cardiomyopathy

The effects of two progestogen-only pills containing either 75 microgram desogestrel (DSG) or 30 microgram levonorgestrel (LNG) on hemostasis were investigated in a double-blind, randomized, controlled study of seven treatment cycles in 78 healthy women. DSG reduced factor VII activity (p < 0.05) and prothrombin fragment 1+2 (p < 0.05) and increased protein S (p < 0.001). LNG reduced factor VII activity (p < 0.01) and plasminogen activity (p < 0.01) and increased tissue-plasminogen activator (t-PA) (p < 0.05). At the end of the post-treatment cycle with DSG, protein S (p < 0.01) and t-PA (p < 0.05) were increased and plasminogen activity was decreased (p < 0.05), whereas with LNG, t-PA was increased (p < 0.001) and prothrombin fragment 1+2 (p < 0.05) and plasminogen activity (p < 0.001) were decreased. Between-group comparisons revealed higher values for DSG regarding the anticoagulatory parameter protein S at cycle 7 (p < 0.01) and post-treatment assessments (p < 0.05), and the fibrinolytic parameter plasmin-antiplasmin complex was higher with DSG at cycle 7 (p < 0.05) and at post-treatment (p < 0.05). Both preparations had comparable and potentially favorable effects of hemostasis, and may offer suitable hormonal contraception to women with a personal or family history of venous thromboembolic diseases.     

Effects of cold and warm blood cardioplegia assessed by myocardial pH and release of metabolic markers

The optimal temperature of blood cardioplegia remains controversial. Interstitial myocardial pH was monitored online with a probe that was inserted in the anterior wall of the left ventricle. Venous pH, lactate production, and creatine kinase and troponin T release were measured in coronary sinus blood obtained in 14 dogs after ischemic arrest periods of 5, 10, 20, and 40 minutes with warm (n = 7; mean myocardial temperature, 35 degrees +/- 2 degrees C) and cold (n = 7; mean myocardial temperature, 12 degrees +/- 1 degree C) blood cardioplegic protection. Blood cardioplegic solution was delivered at a rate of 100 mL/min during the 10 minutes between each ischemic arrest. The interstitial myocardial pH decreased significantly (p < 0.05) from 7.1 +/- 0.3 to 6.53 +/- 0.3 after ischemia in animals perfused with warm blood cardioplegia and from 7.04 +/- 0.3 to 6.64 +/- 0.1 in those receiving cold blood cardioplegic protection; however, the difference between the groups was not significant (p > 0.05). Lactate production and creatine kinase and troponin T release increased significantly after ischemia, but there was no difference in the changes between the warm and cold blood cardioplegia groups. In conclusion, ischemia caused significant changes in all variables measured, and these changes were directly proportional to the duration of ischemia. However, there was no significant difference (p > 0.05) in the myocardial metabolic changes between the warm and cold blood cardioplegia groups in terms of the duration of ischemic arrest studied.(ABSTRACT TRUNCATED AT 250 WORDS)