407 research outputs found
Towards a Vitruvian Shape Grammar for Procedurally Generating Classical Roman Architecture
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On quasi-uniform space valued semi-continuous functions
Get PDFsummary:F. van Gool [Comment. Math. Univ. Carolin. {\bf 33} (1992), 505--523] has introduced the concept of lower semicontinuity for functions with values in a quasi-uniform space (R,\Cal U). This note provides a purely topological view at the basic ideas of van Gool. The lower semicontinuity of van Gool appears to be just the continuity with respect to the topology T(\Cal U) generated by the quasi-uniformity \Cal U, so that many of his preparatory results become consequences of standard topological facts. In particular, when the order induced by \Cal U makes into a continuous lattice, then T(\Cal U) agrees with the Scott topology on and, thus, the lower semicontinuity reduces to a well known concept
Sensitivity of the corneal-plane refractive compen- sation to change in power and axial position of an intraocular lens
Get PDFIf an intraocular lens is displaced or if its power is changed what are the consequences for the refractive compensation of the eye? Gaussian optics is used to obtain explicit formulae for the sensitivityof the corneal-plane refractive compensation (also called the refraction, refractive state, etc) to change in power and axial displacement of a thin intraocular lens implanted in a simple eye. In particular, for a pseudophakic Gullstrand simplified eye withintraocular lens placed 5 mm behind the cornea the sensitivity to errors in the power of the intraocular lens is about 71 . 0 − 71 for an intraocular lens of power for an intraocular lens of power 20 D, that is, the refractive compensation decreases by about 0.71 dioptres per dioptre increase in the power of the intraocular lens. More generally the sensitivity is approximately ( ) I m 0037 . 0 63 . 0 F − − 0.63 ( 003 . 0 63 . 0 − − (0.0037m)FI
where FI is the power of the intraocular lens. Also for Gullstrand’s simplified eye the sensitivity of refractive compensation to axial displacement of the intraocular lens is approximately linear in FI
, about (64D) FI, in fact. That is, for each dioptre of the power of the intraocular lens the refractive compensation increases by about 0.064 dioptres per millimetre of axial displacement towards the
retina
Prion protein amyloidosis with divergent phenotype associated with two novel nonsense mutations in PRNP.
No full textHaloperidol prophylaxis in critically ill patients with a high risk for delirium
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125507.pdf (Publisher’s version ) (Open Access)ABSTRACT: INTRODUCTION: Delirium is associated with increased morbidity and mortality. We implemented a delirium prevention policy in intensive care unit (ICU) patients with a high risk of developing delirium, and evaluated if our policy resulted in quality improvement of relevant delirium outcome measures. METHODS: This study was a before/after evaluation of a delirium prevention project using prophylactic treatment with haloperidol. Patients with a predicted risk for delirium of >/= 50%, or with a history of alcohol abuse or dementia, were identified. According to the prevention protocol these patients received haloperidol 1 mg/8 h. Evaluation was primarily focused on delirium incidence, delirium free days without coma and 28-day mortality. Results of prophylactic treatment were compared with a historical control group and a contemporary group that did not receive haloperidol prophylaxis mainly due to non-compliance to the protocol mostly during the implementation phase. RESULTS: In 12 months, 177 patients received haloperidol prophylaxis. Except for sepsis, patient characteristics were comparable between the prevention and the historical (n = 299) groups. Predicted chance to develop delirium was 75 +/- 19% and 73 +/- 22%, respectively. Haloperidol prophylaxis resulted in a lower delirium incidence (65% vs. 75%, P = 0.01), and more delirium-free-days (median 20 days (IQR 8 to 27) vs. median 13 days (3 to 27), P = 0.003) in the intervention group compared to the control group. Cox-regression analysis adjusted for sepsis showed a hazard rate of 0.80 (95% confidence interval 0.66 to 0.98) for 28-day mortality. Beneficial effects of haloperidol appeared most pronounced in the patients with the highest risk for delirium. Furthermore, haloperidol prophylaxis resulted in less ICU re-admissions (11% vs. 18%, P = 0.03) and unplanned removal of tubes/lines (12% vs. 19%, P = 0.02). Haloperidol was stopped in 12 patients because of QTc-time prolongation (n = 9), renal failure (n = 1) or suspected neurological side-effects (n = 2). No other side-effects were reported. Patients who were not treated during the intervention period (n = 59) showed similar results compared to the untreated historical control group. CONCLUSIONS: Our evaluation study suggests that prophylactic treatment with low dose haloperidol in critically ill patients with a high risk for delirium probably has beneficial effects. These results warrant confirmation in a randomized controlled trial. TRIAL REGISTRATION: clinicaltrial.gov Identifier: NCT01187667
Biomarkers associated with delirium in critically ill patients and their relation with long-term subjective cognitive dysfunction; indications for different pathways governing delirium in inflamed and noninflamed patients
Get PDFIntroduction: Delirium occurs frequently in critically ill patients and is associated with disease severity and infection. Although several pathways for delirium have been described, biomarkers associated with delirium in intensive care unit (ICU) patients is not well studied. We examined plasma biomarkers in delirious and nondelirious patients and the role of these biomarkers on long-term cognitive function.Methods: In an exploratory observational study, we included 100 ICU patients with or without delirium and with ("inflamed”) and without ("noninflamed”) infection/systemic inflammatory response syndrome (SIRS). Delirium was diagnosed by using the confusion-assessment method-ICU (CAM-ICU). Within 24 hours after the onset of delirium, blood was obtained for biomarker analysis. No differences in patient characteristics were found between deliriousand nondelirious patients. To determine associations between biomarkers and delirium, univariate and multivariatelogistic regression analyses were performed. Eighteen months after ICU discharge, a cognitive-failure questionnaire was distributed to the ICU survivors.Results: In total, 50 delirious and 50 nondelirious patients were included. We found that IL-8, MCP-1, procalcitonin (PCT), cortisol, and S100-b were significantly associated with delirium in inflamed patients (n = 46). In the noninflamed group of patients (n = 54), IL-8, IL-1ra, IL-10 ratio Ab1-42/40, and ratio AbN-42/40 were significantly associated with delirium. In multivariate regression analysis, IL-8 was independently associated (odds ratio, 9.0; 95% confidence interval (CI), 1.8 to 44.0) with delirium in inflamed patients and IL-10 (OR 2.6; 95% CI 1.1 to 5.9), and Ab1-42/40 (OR, 0.03; 95% CI, 0.002 to 0.50) with delirium in noninflamed patients. Furthermore, levels of several amyloid-b forms, but not human Tau or S100-b, were significantly correlated with self-reported cognitive impairment 18 months after ICU discharge, whereas inflammatory markers were not correlated to impaired longterm cognitive function.Conclusions: In inflamed patients, the proinflammatory cytokine IL-8 was associated with delirium, whereas in noninflamed patients, antiinflammatory cytokine IL-10 and Ab1-42/40 were associated with delirium. This suggests that the underlying mechanism governing the development of delirium in inflamed patients differs from that in noninflamed patients. Finally, elevated levels of amyloid-b correlated with long-term subjective cognitive-impairment delirium may represent the first sign of a (subclinical) dementia process. Future studies must confirm these results
Located Lexicon: a project that explores how user generated content describes place
No full textThis extended conference paper explores the use and potential of location data in social media contexts. The research involved a series of experiments undertaken to assess the extent to which location information is present in exchanges, directly or indirectly. A prototype application was designed to exploit the insight obtained from the data-gathering experiments. This enabled us to develop a method and toolkit for searching, extracting and visualising mass-generated data for open source use. Ultimately, we were able to generate insights into data quality and ‘scale of query’ for emerging pedagogical research in learning swarms and distributed learners
Thin lenses of asymmetric power
Get PDFIt is generally supposed that thin systems, including refracting surfaces and thin lenses, have powers that are necessarily symmetric. In other words they have powers which can be represented assymmetric dioptric power matrices and in the familar spherocylindrical form used in optometry and ophthalmology. This paper shows that this is not correct and that it is indeed possible for a thin system to have a power that is not symmetric and which cannot be expressed in spherocylindrical form. Thin systems of asymmetric power are illustratedby means of a thin lens that is modelled with small prisms and is chosen to have a dioptric power ma-trix that is antisymmetric. Similar models can be devised for a thin system whose dioptric power matrix is any 2 2 × matrix. Thus any power, symmetric, asymmetric or antisymmetric, is possible for a
thin system. In this sense our understanding of the power of thin systems is now complete
Human prion diseases in the Netherlands (1998-2009):clinical, genetic and molecular aspects
Get PDFPrion diseases are rare and fatal neurodegenerative disorders that can be sporadic, inherited or acquired by infection. Based on a national surveillance program in the Netherlands we describe here the clinical, neuropathological, genetic and molecular characteristics of 162 patients with neuropathologically confirmed prion disease over a 12-year period (1998-2009). Since 1998, there has been a relatively stable mortality of Creutzfeldt-Jakob disease (CJD) in the Netherlands, ranging from 0.63 to 1.53 per million inhabitants per annum. Genetic analysis of the codon 129 methionine/valine (M/V) polymorphism in all patients with sporadic CJD (sCJD) showed a trend for under-representation of VV cases (7.0%), compared with sCJD cohorts in other Western countries, whereas the MV genotype was relatively over-represented (22,4%). Combined PrP(Sc) and histopathological typing identified all sCJD subtypes known to date, except for the VV1 subtype. In particular, a "pure" phenotype was demonstrated in 60.1% of patients, whereas a mixed phenotype was detected in 39.9% of all sCJD cases. The relative excess of MV cases was largely accounted for by a relatively high incidence of the MV 2K subtype. Genetic analysis of the prion protein gene (PRNP) was performed in 161 patients and showed a mutation in 9 of them (5.6%), including one FFI and four GSS cases. Iatrogenic CJD was a rare phenomenon (3.1%), mainly associated with dura mater grafts. Three patients were diagnosed with new variant CJD (1.9%) and one with variably protease-sensitive prionopathy (VPSPr). Post-mortem examination revealed an alternative diagnosis in 156 patients, most commonly Alzheimer's disease (21.2%) or vascular causes of dementia (19.9%). The mortality rates of sCJD in the Netherlands are similar to those in other European countries, whereas iatrogenic and genetic cases are relatively rare. The unusual incidence of the VV2 sCJD subtype compared to that reported to date in other Western countries deserves further investigation
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