Traffic simulation in 3D world

This paper is the result of more than three months of research completed at the School of the Built Environment, Virtual Environment Suite. This study focusing on measuring the impacts of a change in the infrastructure using a 3D traffic simulation model. Various aspects about the research area and the simulation model were explained. Details on technical aspects of the simulation and the modelling are also given. The focus will lay on motor traffic and thus especially on the changes in traffic circulation as a result of relocating the car access of the City Site. The impacts of the infrastructure changes will be analysed, by simulating the current situation as well as the future situation. Comparison of the different simulations will show the impacts

Environmental and nutrient conditions influence fucoxanthin productivity of the marine diatom Phaeodactylum tricornutum grown on palm oil mill effluent

Palm oil mill effluent (POME) is a type of wastewater posing large problems when discharged in the environment. Yet, due to its high nutrient content, POME may offer opportunities for algal growth and subsequent harvesting of high-value products. The marine diatom Phaeodactylum tricornutum is a potential feedstock diatom for bioactive compounds such as the carotenoid fucoxanthin, which has been shown to have pharmaceutical applications. The aim of this paper was to evaluate the growth and fucoxanthin productivity of P. tricornutum grown on POME, as a function of light intensity, temperature, salinity, and nutrient enrichment. High-saturating irradiance (300molphotonsm(-2)s(-1)) levels at 25 degrees C showed highest growth rates but decreased the fucoxanthin productivity of P. tricornutum. Box-Behnken response surface methodology revealed that the optimum fucoxanthin productivity was influenced by temperature, salinity, and the addition of urea. Nutrient enrichment by phosphorus did not enhance cell density and fucoxanthin productivity, while urea addition was found to stimulate both. We conclude that POME wastewater, supplemented with urea, can be considered as the potential medium for P. tricornutum to replace commercial nutrients while producing high amounts of fucoxanthin.</p

Out-of-hospital Administration of Mannitol to Head-injured Patients Does Not Change Systolic Blood Pressure

Objective: To determine the effect of out-of-hospital mannitol administration on systolic blood pressure (BP) in the head-injured multiple-trauma patient. Methods: This was a prospective, randomized, double-blind, placebo-controlled clinical trial involving a university-based helicopter air medical service and level-1 trauma center hospital. Endotracheally intubated head-trauma victims with Glasgow Coma Scale (GCS) scores < 12 were enrolled from November 22, 1991, to November 20, 1992, if evaluated by the participating aeromedical transport team within 6 hours of injury. Patients were excluded if they were <18 years old, had already received mannitol or another diuretic, were potentially pregnant, or were receiving CPR. All patients were intubated prior to study drug (mannitol [1 g/ kg] or normal saline) use. Pulse and BP were measured every 15 minutes for 2 hours following study drug administration. Results: A total of 44 patients were enrolled. After exclusion of 3 patients who did not meet all inclusion criteria, there were 20 patients in the mannitol group and 21 patients in the placebo group. The groups were similar at baseline in age, pulse, systolic BP (baseline mannitol: 124 ± 47 mm Hg; placebo: 128 ± 32 mm Hg), GCS score, and Injury Severity Scale score. Systolic BP did not change significantly throughout the observation period in either group. This study had 83% power to detect a mean systolic BP drop to <90 mm Hg. Conclusion: Out-of-hospital administration of mannitol did not significantly change systolic BP in this group of head-injured multiple-trauma patients.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73904/1/j.1553-2712.1996.tb03528.x.pd

Hemicraniectomy after middle cerebral artery infarction with life-threatening Edema trial (HAMLET). Protocol for a randomised controlled trial of decompressive surgery in space-occupying hemispheric infarction

<p>Abstract</p> <p>Background</p> <p>Patients with a hemispheric infarct and massive space-occupying brain oedema have a poor prognosis. Despite maximal conservative treatment, the case fatality rate may be as high as 80%, and most survivors are left severely disabled. Non-randomised studies suggest that decompressive surgery reduces mortality substantially and improves functional outcome of survivors. This study is designed to compare the efficacy of decompressive surgery to improve functional outcome with that of conservative treatment in patients with space-occupying supratentorial infarction</p> <p>Methods</p> <p>The study design is that of a multi-centre, randomised clinical trial, which will include 112 patients aged between 18 and 60 years with a large hemispheric infarct with space-occupying oedema that leads to a decrease in consciousness. Patients will be randomised to receive either decompressive surgery in combination with medical treatment or best medical treatment alone. Randomisation will be stratified for the intended mode of conservative treatment (intensive care or stroke unit care). The primary outcome measure will be functional outcome, as determined by the score on the modified Rankin Scale, at one year.</p

Clinical Trials in Head Injury

Traumatic brain injury (TBI) remains a major public health problem globally. In the United States the incidence of closed head injuries admitted to hospitals is conservatively estimated to be 200 per 100,000 population, and the incidence of penetrating head injury is estimated to be 12 per 100,000, the highest of any developed country in the world. This yields an approximate number of 500,000 new cases each year, a sizeable proportion of which demonstrate signficant long-term disabilities. Unfortunately, there is a paucity of proven therapies for this disease. For a variety of reasons, clinical trials for this condition have been difficult to design and perform. Despite promising pre-clinical data, most of the trials that have been performed in recent years have failed to demonstrate any significant improvement in outcomes. The reasons for these failures have not always been apparent and any insights gained were not always shared. It was therefore feared that we were running the risk of repeating our mistakes. Recognizing the importance of TBI, the National Institute of Neurological Disorders and Stroke (NINDS) sponsored a workshop that brought together experts from clinical, research, and pharmaceutical backgrounds. This workshop proved to be very informative and yielded many insights into previous and future TBI trials. This paper is an attempt to summarize the key points made at the workshop. It is hoped that these lessons will enhance the planning and design of future efforts in this important field of research.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63185/1/089771502753754037.pd

The management of diabetic ketoacidosis in children

The object of this review is to provide the definitions, frequency, risk factors, pathophysiology, diagnostic considerations, and management recommendations for diabetic ketoacidosis (DKA) in children and adolescents, and to convey current knowledge of the causes of permanent disability or mortality from complications of DKA or its management, particularly the most common complication, cerebral edema (CE). DKA frequency at the time of diagnosis of pediatric diabetes is 10%–70%, varying with the availability of healthcare and the incidence of type 1 diabetes (T1D) in the community. Recurrent DKA rates are also dependent on medical services and socioeconomic circumstances. Management should be in centers with experience and where vital signs, neurologic status, and biochemistry can be monitored with sufficient frequency to prevent complications or, in the case of CE, to intervene rapidly with mannitol or hypertonic saline infusion. Fluid infusion should precede insulin administration (0.1 U/kg/h) by 1–2 hours; an initial bolus of 10–20 mL/kg 0.9% saline is followed by 0.45% saline calculated to supply maintenance and replace 5%–10% dehydration. Potassium (K) must be replaced early and sufficiently. Bicarbonate administration is contraindicated. The prevention of DKA at onset of diabetes requires an informed community and high index of suspicion; prevention of recurrent DKA, which is almost always due to insulin omission, necessitates a committed team effort