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.     

An expert system for XPLE cable deterioration diagnosis and life forecasting

The recent increase in the demand for power in urban areas has caused changes in the way power is supplied. Underground distribution systems have been introduced for convenience in urban areas and to prevent injuries in case of a crisis. As a result, many new types of power cables are being used. One type, XPLE cables (also called CV cables) have been rapidly taking the place of conventional cables such as OF or SL cables since the 1960s because of their relatively easy installation and maintainability. However, distribution cables used under severe environmental conditions deteriorate rapidly (due mainly to water treeing), and some cables experience insulation breakdown. Therefore, many diagnostic methods have been developed, though they have not been very effective. By combining methods, a high reliability can be achieved in comparison to the use of a single method. However, processing the data is difficult for on-site personnel, so many experts are required. But there is a lack of qualified experts, hence we have turned to the development of expert systems.     

Development of flexible displays using back‐channel‐etched In–Sn–Zn–O thin‐film transistors and air‐stable inverted organic light‐emitting diodes

We developed flexible displays using back‐channel‐etched In–Sn–Zn–O (ITZO) thin‐film transistors (TFTs) and air‐stable inverted organic light‐emitting diodes (iOLEDs). The TFTs fabricated on a polyimide film exhibited high mobility (32.9 cm²/Vs) and stability by utilization of a solution‐processed organic passivation layer. ITZO was also used as an electron injection layer (EIL) in the iOLEDs instead of conventional air‐sensitive materials. The iOLED with ITZO as an EIL exhibited higher efficiency and a lower driving voltage than that of conventional iOLEDs. Our approach of the simultaneous formation of ITZO film as both of a channel layer in TFTs and of an EIL in iOLEDs offers simple fabrication process.     

Cylindrical coils created with 3D X-ray lithography and metallization

The demand for microactuators is increasing recently. The key technology to realizing practical microactuators is microfabrication process. In the production of microminiature components, the technologies for processing high-aspect-ratio structures are essential. As one of these technologies, the LIGA process is widely known. Our laboratory researches the LIGA process to three-dimensional microfabrication and established the cylindrical-microcoil production process. In this paper, we have fabricated the cylindrical-microcoil for the solenoidal electromagnetic type microactuator. We designed and analyzed microactuators, and fabricated and evaluated microactuator coils produced by the combination of three-dimensional X-ray lithography and level copper plating. We succeeded in creating threaded groove-shaped structures with 10 μm line width, 20 μm pitch, and aspect ratio of 5 on the surface of an acrylic pipe by means of three-dimensional X-ray lithography. As a measure to suppress void generation, which is one of the shortcomings of electrolytic plating processes, the sputtering apparatus and plating equipment were improved, a pretreatment process was additionally provided, and the actual electrolytic plating method was improved. As a result, a void-free metallic deposit could be formed on a thin coil line. The processing technology enables the formation of thin-wire coil lines whose current paths feature a large allowable current-carrying capacity, enabling the production of miniature, high-output microactuators.     

Fabrication of large area diffraction grating using LIGA process

X-ray imaging is a very important technology in the fields of medical, biological, inspection, material science, etc. However, it is not enough to get the clear X-ray imaging with low absorbance. We have produced a diffraction gratings for obtaining high resolution X-ray phase imaging, such as X-ray Talbot interferometer. In this X-ray Talbot interferometer, diffraction gratings were required to have a fine, high accuracy, high aspect ratio structure. Then, we succeeded to fabricate a high aspect ratio diffraction grating with a pitch of 8 μm and small area using a deep X-ray lithography technique. We discuss that the diffraction gratings having a narrow pitch and an large effective area to obtain imaging size of practical use in medical application. If the pitch of diffraction gratings were narrow, it is expected high resolution imaging for X-ray Talbot interferometer. We succeeded and fabricated the diffraction grating with pitch of 5.3 μm, Au height of 28 μm and an effective area of 60 × 60 mm².     

Fabrication of 5.8‐in. OTFT‐driven flexible color AMOLED display using dual protection scheme for organic semiconductor patterning

Abstract— A 5.8‐in. wide‐QQVGA flexible color active‐matrix organic light‐emitting‐diode (AMOLED) display consisting of organic thin‐film transistors (OTFTs) and phosphorescent OLEDs was fabricated on a plastic film. To reduce the operating voltage of the OTFTs, Ta₂O₅ with a high dielectric constant was employed as a gate insulator. Pentacene was used for the semiconductor layer of the OTFTs. This layer was patterned by photolithography and dry‐etched using a dual protection layer of poly p‐xylylene and SiO₂ film. Uniform transistor performance was achieved in the OTFT backplane with QQVGA pixels. The RGB emission layers of the pixels were formed by vacuum deposition of phosphorescent small molecules. The resulting display could clearly show color moving images even when it was bent and operated at a low driving voltage (below 15 V).     

Fabrication of X-rays mask with carbon membrane for diffraction gratings

We have produced diffraction gratings for obtaining high resolution X-ray phase imaging, such as X-ray Talbot interferometer. These diffraction gratings were required to have a fine, high accuracy, high aspect ratio structure. Therefore, we decided to use the X-rays lithography technique that used synchrotron radiation of the directivity for a manufacture process. The accuracy of the completed structure depends largely on the accuracy of the X-ray mask. In our group, a resin material is conventionally used for the membrane of large X-ray masks. However, X-ray masks comprising a resin membrane have the disadvantage that, after several cycles of X-ray exposure, they crease and sag due to X-ray-derived heat. As a substitute for the conventional resin membrane, we experimentally fabricated a new X-ray mask using a carbon wafer membrane. The newly fabricated X-ray mask was subjected to X-ray exposure experiment. We succeeded in making the structure body which was almost shape. And the experimental results verified that the new mask did not deteriorate even when used repeatedly, demonstrating that it was highly durable.     

Fabrication of high hardness Ni mold with electroless nickel–boron thin layer

The nickel electroforming method using a high-concentration nickel sulfamate bath is commonly used to fabricate micro metal molds in the LIGA process; however, this method does not produce micro metal molds of sufficient hardness. One means of improving the hardness of micro metal molds made using the nickel electroforming method is to include additives in the nickel plating solution. Another method is nickel alloy plating or a similar technique. In this research, we used a nickel–boron (Ni–B) electroless alloy plating method to obtain a hard nickel plated film having hardness of 832 Hv. It was also ascertained that Ni–B electroless alloy plated film retains its high hardness even during heat treatment in conditions of 250°C for 1 h. To deal with the high stresses developed in high-hardness plated films, we proposed double-layer nickel electroforming. This method is covered and used on conventional nickel electroforming layer by high hardness micro mold. High hardness micro metal mold using double-layer was fabricated by nickel electroforming and Ni–B electroless alloy plating method.     

Crystal orientation changes of Ag thin films on the Si(111) substrate due to tribo-assisted recrystallization

Crystal orientation changes of Ag thin films due to the tribo-assisted recrystallization have been studied using grazing incidence X-ray diffraction with synchrotron radiation. After preparation of an Si(111) √3 × √3-Ag surface, a 5-nm-thick Ag film was deposited on the surface at the substrate temperature of 303 K in an ultra-high vacuum chamber. The friction experiments were carried out using a diamond pin-on-plate type tribometer just after the Ag deposition in the same UHV chamber. We found that the coefficient of friction of the Ag films on the Si(111) √3 × √3-Ag surface decreases from 0.07 to 0.03, with increasing reciprocal sliding cycles. In synchronization with the coefficient change, Ag{100} grains are gradually disappearing. As a result, the Ag{111} grains cover the entire surface after 50 sliding cycles. Moreover, we found that the domain size of the Ag{111} grains increases with increasing reciprocal sliding cycles by measuring the rocking curve width. These results directly show that the Ag(111) plane is the sliding plane of friction and the coefficient of friction of Ag films is determined by the fraction of the Ag(111) grains in the Ag films. Moreover, to clarify the reaction between the Ag film and the Si substrate due to the tribo-assisted recrystallization, the substrate strain has been studied by an extremely asymmetric X-ray diffraction technique using synchrotron radiation.     

Recombinant Long-Acting Thioredoxin Ameliorates AKI to CKD Transition via Modulating Renal Oxidative Stress and Inflammation

An effective strategy is highly desirable for preventing acute kidney injury (AKI) to chronic kidney disease (CKD) transition. Thioredoxin-1 (Trx), a redox-active protein that has anti-oxidative and anti-inflammatory properties, would be a candidate for this but its short half-life limits its clinical application. In this study, we examined the renoprotective effect of long-acting Trx that is comprised of human albumin and Trx (HSA-Trx) against AKI to CKD transition. AKI to CKD mice were created by renal ischemia-reperfusion (IR). From day 1 to day 14 after renal IR, the recovery of renal function was accelerated by HSA-Trx administration. On day 14, HSA-Trx reduced renal fibrosis compared with PBS treatment. At the early phase of fibrogenesis (day 7), HSA-Trx treatment suppressed renal oxidative stress, pro-inflammatory cytokine production and macrophage infiltration, thus ameliorating tubular injury and fibrosis. In addition, HSA-Trx treatment inhibited G2/M cell cycle arrest and apoptosis in renal tubular cells. While renal Trx protein levels were decreased after renal IR, the levels were recovered by HSA-Trx treatment. Together, HSA-Trx has potential for use in the treatment of AKI to CKD transition via its effects of modulating oxidative stress and inflammation.