Repeatability of \u3cem\u3eIn Vivo\u3c/em\u3e Parafoveal Cone Density and Spacing Measurements

Purpose. To assess the repeatability and measurement error associated with cone density and nearest neighbor distance (NND) estimates in images of the parafoveal cone mosaic obtained with an adaptive optics scanning light ophthalmoscope (AOSLO).Methods. Twenty-one participants with no known ocular pathology were recruited. Four retinal locations, approximately 0.65[degrees] eccentricity from the center of fixation, were imaged 10 times in randomized order with an AOSLO. Cone coordinates in each image were identified using an automated algorithm (with or without manual correction) from which cone density and NND were calculated. Owing to naturally occurring fixational instability, the 10 images recorded from a given location did not overlap entirely. We thus analyzed each image set both before and after alignment.Results. Automated estimates of cone density on the unaligned image sets showed a coefficient of repeatability of 11,769 cones/mm2 (17.1%). The primary reason for this variability appears to be fixational instability, as aligning the 10 images to include the exact same retinal area results in an improved repeatability of 4358 cones/mm2 (6.4%) using completely automated cone identification software. Repeatability improved further by manually identifying cones missed by the automated algorithm, with a coefficient of repeatability of 1967 cones/mm2 (2.7%). NND showed improved repeatability and was generally insensitive to the undersampling by the automated algorithm.Conclusions. As our data were collected in a young, healthy population, this likely represents a best-case estimate for corresponding measurements in patients with retinal disease. Similar studies need to be carried out on other imaging systems (including those using different imaging modalities, wavefront correction technology, and/or image analysis software), as repeatability would be expected to be highly sensitive to initial image quality and the performance of cone identification algorithms. Separate studies addressing intersession repeatability and interobserver reliability are also needed

La bourgeoisie parisienne au début du xixe siècle : le cas du faubourg Saint-Marcel

Malgré sa réputation de pauvreté, le faubourg Saint-Marcel à Paris abritait des bourgeois fort riches et fut l’un des berceaux de la croissance industrielle de la ville au XIXe siècle. Cet article montre le rôle de la Révolution et de l’Empire dans l’essor des bourgeois du quartier, presque sans exception des nouveaux venus. Les conditions économiques, sociales et politiques de la période étaient favorables à la création d’une bourgeoisie parisienne : une classe définie non par une « essence » économique ou culturelle mais par la création d’identités – dans un cadre géographique spécifique – liées aux idéologies, aux pratiques culturelles et aux rapports sociaux qui se sont développés à cette époque.Despite its reputation for poverty, the Faubourg Saint-Marcel in Paris was home to some very wealthy bourgeois and was one of the most important industrial areas of the city in the early 19th century. This article shows the role played by the Revolution and the Empire in the rise of these bourgeois, who were almost without exception newcomers. The economic, social and political conditions of the period were favorable for the formation of a Parisian bourgeoisie : of a class that was not defined by universal economic or cultural traits but by the creation of new identities—in a specific geographical context—linked to the particular ideologies, cultural practices and social relations of this historical moment

Intensive care utilisation and outcomes after high-risk surgery in Scotland: a population based cohort study.

Chief Scientist’s Office Scotland (grant no. CHZ/821/4)

How to Make 8,1,2-closo-MC2B9 Metallacarboranes

Three examples of the rare 8,1,2-closo-MC2B9 isomeric form of an icosahedral metallacarborane have been isolated as unexpected trace products in reactions. Seeking to understand how these were formed we considered both the nature of the reactions that were being undertaken and the nature of the coproducts. This led us to propose a mechanism for the formation of the 8,1,2-closo-MC2B9 species. The mechanism was then tested, leading to the first deliberate synthesis of an example of this isomer. Thus, deboronation of 4-(η-C5H5)-4,1,8-closo-CoC2B10H12 selectively removes the B5 vertex to yield the dianion [nido-(η-C5H5)CoC2B9H11]2−, oxidative closure of which affords 8-(η-C5H5)-8,1,2-closo-CoC2B9H11 in moderate yield

Soundscape evaluation in Han Chinese Buddhist temples

In this study, surveys were conducted at four typical Han Chinese Buddhist temples. These surveys were then analyzed to identify the subjective and objective factors of soundscape evaluation. Field measurements of the four temples’ sound levels were taken over the course of an entire day, and the representative sounds in temples were recorded. Soundscape evaluation questionnaire surveys were distributed at the temples. The analytical results of the questionnaire and measurement data showed that the sound preferences in temples are significantly correlated with sharpness value of the sounds in terms of psychoacoustic parameters, and the average sound levels at the four temples over the course of an entire day were between 47.0 and 52.7 dBA, and approximately 70% of those surveyed tended to evaluate the temples’ soundscapes as comfortable and harmonious. Regarding the objective factors, there was a significant correlation between the measured sound levels and the soundscape evaluations. When the sound level of a temple was higher than 60 dBA, respondents were more likely to feel uncomfortable, and the correlation between the sound level and the evaluation of acoustic comfort substantially increased. Regarding the subjective factors, the respondent’s age, occupation, religious belief, purpose, frequency of visiting the temples, and educational level significantly correlated with the soundscape evaluation with correlation coefficients ranging from 0.13 to 0.35

Dealing with Disasters: Environmental History of Early Modern Cities (Edo, Istanbul, London, Pest, and Prague)

List of ContributorsForeword Introduction The Ordinary and the Extraordinary in Early Modern Cities / Koichi Watanabe trans. by Hisashi Kuboyama Part I: Aspects of Urban Disasters Chapter 1 Typhoon Damage in 1856 Edo: Integrating Archaeology, Climatology and History / Koichi Watanabe, Junpei Hirano, Hiroyuki Ishigami, and Masumi Zaiki trans. by Hisashi Kuboyama Chapter 2 The Great Flood in Pest, 1838 / Csaba Katona Chapter 3 Fire Disasters in European Cities, 1600-1800 David Garrioch Comment Disaster of Beijing in the Qing Dynasty 1644-1911 / Akira Horichi trans. by Yoko Onodera Part II: Disasters and Responses Chapter 4 Prevent the Big Water. Flood Control Measures in Prague (Bohemia) Issued by Public Administrative Bodies in Late 18th Century / Ondřej Hudeček Chapter 5 Citizens’ Awareness of Firefighting in Edo: Analysing Eighteenth-Century Textbooks on Firefighting / Reiji Iwabuchi trans. by Hisashi Kuboyama Part III: Infrastructure as Artificial Nature Chapter 6 The Ordinary Made Extraordinary: The Archaeology of Water Management in a Global City / Sophie Jackson Chapter 7 Management and Civil Engineering of Urban Water Supply and Sewage System in Edo as Seen from Archaeological Excavation / Hiroyuki Ishigami trans. by Mina Ishizu Chapter 8 Dredging the Edo Castle\u27s Moat: a Case of the Okayama-Domain Dredging in 1765 / Reiji Iwabuchi trans. by Naoko Nomoto Chapter 9 Canal, Dredging and Sedimentation in the Lowland Area of East Edo: Considering Physical and Spatial Characteristics of Canals in a Historical Context / Genki Takahashi trans. by Hisashi Kuboyama Part IV: Hinterland and Nature Chapter 10 Flooding in Edo and the Tone-gawa River and Tama-gawa River Systems / Koichi Watanabe trans. by Hisashi Kuboyama Chapter 11 The Great Edo Flood of 1742 and the Okutama Valley / Koichi Watanabe trans. by Hisashi Kuboyama Chapter 12 The Deluge of Istanbul in 1563: a Case of Flood Where There Was No River / Kazuaki Sawai trans. by Yoko Onodera Chapter 13 Storms, Flooding and the Development of London 1300-1500 / Matthew Davies Chapter 14 Bridging London’s River’s General Situation of London, the Thames, the Bridge / Vanessa Hardin

The role of noise in clinical environments with particular reference to mental health care: a narrative review

Background: There is a large literature suggesting that noise can be detrimental to health and numerous policy documents have promoted noise abatement in clinical settings. Objectives: This paper documents the role of noise in clinical environments and its deleterious effects with a particular focus on mental health care. Our intention however, is to go beyond the notion that noise is simply undesirable and examine the extent to which researchers have explored the meaning of sound in hospital settings and identify new opportunities for research and practice. Data sources and review methods: This is a narrative review which has grouped the literature and issues in the field into themes concerning the general issues of noise in health care; sleep noise and hospital environments; noise in intensive care units; implications for service users and staff; and suggestions for new ways of conceptualising and researching clinical soundscapes. Data sources comprised relevant UK policy documents and the results of a literature search of Pubmed, Scopus and Web of Knowledge using terms such as noise, health, hospital, soundscape and relevant additional terms derived from the papers retrieved. In addition the references of retrieved articles were scanned for additional relevant material and historical items significant in shaping the field. Results: Excess unwanted noise can clearly be detrimental to health and impede recovery, and this is clearly recognised by policymakers especially in the UK context. We use the literature surveyed to argue that it is important also to see the noise in clinical environments in terms of the meaning it conveys and rather than merely containing unwanted sound, clinical environments have a ‘soundscape’. This comprises noises which convey meaning, for example about the activities of other people, the rhythms of the day and the nature of the auditory community of the hospital. Unwanted sound may have unwanted effects, especially on those who are most vulnerable, yet this does not necessarily mean that silence is the better option. Therefore it is our contention that it is important to begin thinking about the social functions of sound in the mental health environment. Conclusions: Whilst it can be stressful, sound can also be soothing, reassuring and a rich source of information about the environment as well. It may be used to secure a degree of privacy for oneself, to exclude others or as a source of solidarity among friends and colleagues. The challenge then is to understand the work that sound does in its ecological context in health care settings

"Getting Participants' Voices Heard: Using mobile, participant led, sound-based methods to explore place making"

Varieties of sound-based research methods have been used for exploring participants’ relations with environment, space and place. For example, soundwalking, field recording and audio guides have all been employed to help research participants become attuned to the sonic environment. Some of these have been used as participant-led approaches, enabling participants to devise walking routes and produce their own soundscape compositions. This paper explores these various uses and reports on two primary research collaborations that adopt mobile, participant-led approaches, in which participants negotiate the precise nature of the research collaboration. Furthermore, it examines diverse methods for disseminating soundscape recordings that emerge from such projects. The examples presented here reveal that sound-based research can be employed to do more than attune participants to sonic environments. This research highlights instances of productive, participant led research that reveal diverse strategies for disseminating this work. There are many channels and media through which sound work can be made available to a wider audience, across disciplines and beyond academia. Reflexively adopted, dissemination through web and social media, exhibition spaces and other public events offer researchers and their participants a performative complement to the publication of work via journal articles

Co-infection and ICU-acquired infection in COIVD-19 ICU patients: a secondary analysis of the UNITE-COVID data set

Background: The COVID-19 pandemic presented major challenges for critical care facilities worldwide. Infections which develop alongside or subsequent to viral pneumonitis are a challenge under sporadic and pandemic conditions; however, data have suggested that patterns of these differ between COVID-19 and other viral pneumonitides. This secondary analysis aimed to explore patterns of co-infection and intensive care unit-acquired infections (ICU-AI) and the relationship to use of corticosteroids in a large, international cohort of critically ill COVID-19 patients.Methods: This is a multicenter, international, observational study, including adult patients with PCR-confirmed COVID-19 diagnosis admitted to ICUs at the peak of wave one of COVID-19 (February 15th to May 15th, 2020). Data collected included investigator-assessed co-infection at ICU admission, infection acquired in ICU, infection with multi-drug resistant organisms (MDRO) and antibiotic use. Frequencies were compared by Pearson's Chi-squared and continuous variables by Mann-Whitney U test. Propensity score matching for variables associated with ICU-acquired infection was undertaken using R library MatchIT using the "full" matching method.Results: Data were available from 4994 patients. Bacterial co-infection at admission was detected in 716 patients (14%), whilst 85% of patients received antibiotics at that stage. ICU-AI developed in 2715 (54%). The most common ICU-AI was bacterial pneumonia (44% of infections), whilst 9% of patients developed fungal pneumonia; 25% of infections involved MDRO. Patients developing infections in ICU had greater antimicrobial exposure than those without such infections. Incident density (ICU-AI per 1000 ICU days) was in considerable excess of reports from pre-pandemic surveillance. Corticosteroid use was heterogenous between ICUs. In univariate analysis, 58% of patients receiving corticosteroids and 43% of those not receiving steroids developed ICU-AI. Adjusting for potential confounders in the propensity-matched cohort, 71% of patients receiving corticosteroids developed ICU-AI vs 52% of those not receiving corticosteroids. Duration of corticosteroid therapy was also associated with development of ICU-AI and infection with an MDRO.Conclusions: In patients with severe COVID-19 in the first wave, co-infection at admission to ICU was relatively rare but antibiotic use was in substantial excess to that indication. ICU-AI were common and were significantly associated with use of corticosteroids

Clinical and organizational factors associated with mortality during the peak of first COVID-19 wave: the global UNITE-COVID study

Purpose: To accommodate the unprecedented number of critically ill patients with pneumonia caused by coronavirus disease 2019 (COVID-19) expansion of the capacity of intensive care unit (ICU) to clinical areas not previously used for critical care was necessary. We describe the global burden of COVID-19 admissions and the clinical and organizational characteristics associated with outcomes in critically ill COVID-19 patients. Methods: Multicenter, international, point prevalence study, including adult patients with SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) and a diagnosis of COVID-19 admitted to ICU between February 15th and May 15th, 2020. Results: 4994 patients from 280 ICUs in 46 countries were included. Included ICUs increased their total capacity from 4931 to 7630 beds, deploying personnel from other areas. Overall, 1986 (39.8%) patients were admitted to surge capacity beds. Invasive ventilation at admission was present in 2325 (46.5%) patients and was required during ICU stay in 85.8% of patients. 60-day mortality was 33.9% (IQR across units: 20%–50%) and ICU mortality 32.7%. Older age, invasive mechanical ventilation, and acute kidney injury (AKI) were associated with increased mortality. These associations were also confirmed specifically in mechanically ventilated patients. Admission to surge capacity beds was not associated with mortality, even after controlling for other factors. Conclusions: ICUs responded to the increase in COVID-19 patients by increasing bed availability and staff, admitting up to 40% of patients in surge capacity beds. Although mortality in this population was high, admission to a surge capacity bed was not associated with increased mortality. Older age, invasive mechanical ventilation, and AKI were identified as the strongest predictors of mortality