Catholic University of Leuven

About: Catholic University of Leuven is a based out in . It is known for research contribution in the topics: Population & Insulin. The organization has 13028 authors who have published 16890 publications receiving 742761 citations.

Intensive Insulin Therapy in Critically Ill Patients

Abstract: Background Hyperglycemia and insulin resistance are common in critically ill patients, even if they have not previously had diabetes. Whether the normalization of blood glucose levels with insulin therapy improves the prognosis for such patients is not known. Methods We performed a prospective, randomized, controlled study involving adults admitted to our surgical intensive care unit who were receiving mechanical ventilation. On admission, patients were randomly assigned to receive intensive insulin therapy (maintenance of blood glucose at a level between 80 and 110 mg per deciliter) or conventional treatment (infusion of insulin only if the blood glucose level exceeded 215 mg per deciliter and maintenance of glucose at a level between 180 and 200 mg per deciliter). Results At 12 months, with a total of 1548 patients enrolled, intensive insulin therapy reduced mortality during intensive care from 8.0 percent with conventional treatment to 4.6 percent (P<0.04, with adjustment for sequential analyses). The ...

An analysis of approximations for maximizing submodular set functions--I

Abstract: LetN be a finite set andz be a real-valued function defined on the set of subsets ofN that satisfies z(S)+z(T)źz(SźT)+z(SźT) for allS, T inN. Such a function is called submodular. We consider the problem maxSźN{a(S):|S|≤K,z(S) submodular}. Several hard combinatorial optimization problems can be posed in this framework. For example, the problem of finding a maximum weight independent set in a matroid, when the elements of the matroid are colored and the elements of the independent set can have no more thanK colors, is in this class. The uncapacitated location problem is a special case of this matroid optimization problem. We analyze greedy and local improvement heuristics and a linear programming relaxation for this problem. Our results are worst case bounds on the quality of the approximations. For example, whenz(S) is nondecreasing andz(0) = 0, we show that a "greedy" heuristic always produces a solution whose value is at least 1 ź[(K ź 1)/K]K times the optimal value. This bound can be achieved for eachK and has a limiting value of (e ź 1)/e, where e is the base of the natural logarithm.

Tissue fractionation studies. 6. Intracellular distribution patterns of enzymes in rat-liver tissue

Abstract: more acidic solutions, with pH < 7 0, a few seconds elapsed before equilibrium was attained. Taking into account the ionization of the haem-linked group on MetMb and the higher oxidation state, the variation of Kb,. with pH is shown to confirm the conclusion that 2 moles ofH+ are liberated/mole of acidic MetMb. Using 6-1 for the pK of the group in MetMb as established in other studies, the results give apK of75 for the group in the higher oxidation state at 200 and I= 0 04. 3. The variation of KRb, with temperature gives AHO = 10-0 ± 2*0 kcal./g.mol.: if the ionization of the haem-linked group is allowed for, the value 9*0 ± 1.0 kcal./g.mol. is obtained. 4. The dependence of Kob. on ionic strength is in accord with a change in charge from + 1 on MetMb to zero on the higher oxidation state. 5. The results are shown to favour the ferryl ion structure, or an isomer of this structure, for the higher oxidation state. The isomeric structures would, in general, require the presence of another ionizing group in myoglobin, but no evidence for such an ionization could be found. With other direct evidence favouring the ferryl ion structure this is to be preferred, and the higher oxidation state may provisionally be named ferrylmyoglobin.

Intensive insulin therapy in the medical ICU.

Abstract: Background Intensive insulin therapy reduces morbidity and mortality in patients in surgical intensive care units (ICUs), but its role in patients in medical ICUs is unknown. Methods In a prospective, randomized, controlled study of adult patients admitted to our medical ICU, we studied patients who were considered to need intensive care for at least three days. On admission, patients were randomly assigned to strict normalization of blood glucose levels (80 to 110 mg per deciliter [4.4 to 6.1 mmol per liter]) with the use of insulin infusion or to conventional therapy (insulin administered when the blood glucose level exceeded 215 mg per deciliter [12 mmol per liter], with the infusion tapered when the level fell below 180 mg per deciliter [10 mmol per liter]). There was a history of diabetes in 16.9 percent of the patients. Results In the intention-to-treat analysis of 1200 patients, intensive insulin therapy reduced blood glucose levels but did not significantly reduce in-hospital mortality (40.0 percent in the conventional-treatment group vs. 37.3 percent in the intensive-treatment group, P = 0.33). However, morbidity was significantly reduced by the prevention of newly acquired kidney injury, accelerated weaning from mechanical ventilation, and accelerated discharge from the ICU and the hospital. Although length of stay in the ICU could not be predicted on admission, among 433 patients who stayed in the ICU for less than three days, mortality was greater among those receiving intensive insulin therapy. In contrast, among 767 patients who stayed in the ICU for three or more days, in-hospital mortality in the 386 who received intensive insulin therapy was reduced from 52.5 to 43.0 percent (P = 0.009) and morbidity was also reduced. Conclusions Intensive insulin therapy significantly reduced morbidity but not mortality among all patients in the medical ICU. Although the risk of subsequent death and disease was reduced in patients treated for three or more days, these patients could not be identified before therapy. Further studies are needed to confirm these preliminary data. (ClinicalTrials.gov number, NCT00115479.)

The causes of land-use and land-cover change: moving beyond the myths

Abstract: Common understanding of the causes of land-use and land-cover change is dominated by simplifications which, in turn, underlie many environment-development policies. This article tracks some of the major myths on driving forces of land-cover change and proposes alternative pathways of change that are better supported by case study evidence. Cases reviewed support the conclusion that neither population nor poverty alone constitute the sole and major underlying causes of land-cover change worldwide. Rather, peoples’ responses to economic opportunities, as mediated by institutional factors, drive land-cover changes. Opportunities and