The prevalence of keratoconus in northern Poland: A cross-sectional study of patients from a primary healthcare practice

IntroductionKeratoconus is defined as central and/or paracentral corneal thinning and steepening with consequent irregular astigmatism. To date, no prospective study has reported its prevalence in Central Europe. This study aimed to evaluate the prevalence of keratoconus assessed with Scheimpflug imaging in a profile of general medicine practice in Poland.MethodsThis cross-sectional study collected data by inviting all patients aged 10–80 years subscribed to a single general practitioner in the Elbląg area, Poland. Corneal measurements were performed using a rotating Scheimpflug corneal tomography system. Three masked examiners established the diagnosis of keratoconus in the right or left eye. Fleiss’ kappa coefficient (κ) was used to qualitatively analyze the interexaminer agreement.ResultsOf 1,705 patients invited to the study, 771 agreed to participate (45.2%). The mean age of the 728 patients (60.6% female and 39.4% male) with gradable images in at least one eye was 53.6 ± 16.5 years. All of the examiners classified the same four cases as keratoconus (0.549%, 549 per 100,000, 95% confidence interval 150 to 1,400 per 100,000), of which two were bilateral. Fleiss’ kappa showed almost perfect agreement among the three examiners regarding the diagnostic decision (κ = 0.784, 95% confidence interval 0.750 to 0.817, p < 0.001). The keratoconus cases were all women (p = 0.106), aged 48, 69, 70, and 71 years old.ConclusionThe prevalence of keratoconus in this area was higher than that previously demonstrated in many European countries. Underestimation of the prevalence has been postulated but never demonstrated.     

Managerial agency (re)producing project governance structure and context: Public-private partnerships in the Netherlands

Project managers activate their agentic powers in the (re)production of project governance structure and the institutional context of projects. By examining three ongoing Public Private Partnership (PPP) projects within the Dutch policy path, we provide evidence that managers aim to improve their working conditions when enacting three project governing practices: upscaling issues, adapting, and reproducing. Additionally, we show that public project managers mobilized as a group of interest within the public parent organization are able to influence the policy context and improve their control position for future PPP agreements. We identify "emerging associativity" and "ideological legitimization" as core processes of managerial agency, deployed in project practice and influencing institutional contexts.     

From Product to Process: Building on Urban-Think Tank’s Approach to the Informal City

Adriana Navarro-Sertich interviews a pioneer of the informal in architecture, co-founder and co-director of Urban-Think Tank (U-TT) Alfredo Brillembourg . Brillembourg explains how U-TT's work seeks to connect informal settlements with the formal city, enabling inhabitants to access services and infrastructure. U-TT is now taking the lessons it has learnt in working in Latin American cities, such as Caracas and São Paulo, elsewhere in the world with the aim of ‘working globally and acting locally’. Copyright © 2011 John Wiley & Sons, Ltd.     

Camouflage as Aesthetic Sustainability

A textile approach to architecture offers unique opportunities to explore a structure's surface and texture. Through a discussion of the history of the technique of camouflage and her own projects with Design Research and Development (DR_D), Dagmar Richter demonstrates the potential for surface enrichment to exceed mere ornament or patterning. A ‘performative texture’, camouflage interacts with its context mimicking the natural and effectively disguising whatever it covers. With a now long military association, camouflage also provides anything but a neutral background for its cover. Copyright © 2006 John Wiley & Sons, Ltd.     

Filling the Voids with Popular Imaginaries

In the last few years, the emergence of a burgeoning middle class in Brazil has transformed the country into one of the fastest growing consumer markets in the world. For MMBB Arquitetos, based in São Paulo, social mobility and the upgrading of urban infrastructure represent a unique opportunity to develop the city. Fernando de Mello Franco of MMBB describes the practice's strategy for ‘urbanising’ much needed new infrastructure. A canal with a public park can be inserted, for instance, alongside a new drainage system, providing necessary social adhesion in a fragile urban culture. Copyright © 2011 John Wiley & Sons, Ltd.     

Exploring N-best solution space for heat integrated hydrogen regeneration network using sequential graph-theoretic approach

To achieve the ever-stringent sustainable goals, this paper aims to synthesize a heat integrated hydrogen regeneration network (HIHRN) using a graph-theoretic-based sequential method. Firstly, the optimal and near-optimal structures for a hydrogen regeneration networks (HRN) are determined using P-graph model with consideration of both impurity and pressure constraints. These networks are then used as inputs in P-HENS software to generate a list of optimal and near-optimal heat exchanger network (HEN) structures. An eight source and sink problem is used to demonstrate the effectiveness of the proposed method. There are 199,677 feasible HIHRN structures identified, while the 6 near-optimal solutions which are within 0.05% tolerance of the optimal network cost (i.e., less than 33.04 M$/y) are presented together with the top four HEN designs that can offer comparable costs (～115,500 $/y). In addition, the impacts of pressure swing adsorber (PSA) pressure drop consideration and minimum temperature difference on the optimal design are also presented.     

Prediction of non-woven geotextiles’ reduction factors for damage caused by the drop of backfill materials

The need for sustainable solutions in geotechnical works has encouraged the investigation of recycled construction and demolition wastes (RCDW) as backfill material. The possible damages caused by the launching (dropping) process of this “new” backfill material (RCWD) must be quantified for its combined use with geosynthetics. This study evaluated the influence of the backfill's grain-size distribution and the geotextile's mass per unit area in the damages caused by the launch of RCDW material and aimed to provide a prediction equation of the reduction factors. Five RCDW materials were launched from 1.0-m and 2.0-m height over five non-woven polyester needle-punched geotextile and specimens were exhumed to be tested under tensile. Databases were created with the results and subjected to machine learning to obtain a prediction equation for the reduction factor's values. The results show that the damages caused by the dropping height are complex. The 1.0-m increase in the drop height and the increase in the geotextile's mass per unit area cannot be associated with an increase in the damage. The geotextiles were more affected by the backfills with uniform gradation. A reduction factor's prediction equation is presented considering the three variables investigated (geotextile, drop height and backfill material classification). The artificial neural network is a more interesting solution than multiple linear regression since it does not possess several application criteria and provides more accurate predictions.