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Optimum use of natural light in buildings requires knowledge of the luminance distribution of the sky. Since the introduction of the CIE Standard General Skies, several methods have been proposed to find the frequency distribution of sky types. This paper presents a method whereby the ratio of the luminances of two sky elements and the ratio of the luminance of one sky element to the horizontal illuminance can be used in the determination of sky type. [ABSTRACT FROM AUTHOR]

Background: We sought to assess health professionals' satisfaction with the National Pressure Injury Advisory Panel staging system (NPUAP)., Methods: A paper survey assessing the satisfaction with the NPUAP was distributed to participants of a national wound care meeting. A total of 88 surveys were completed. Results were tabulated using SPSS., Results: The survey response rate was 50%. Nearly all respondents (95.0%) used NPAUP for documentation. 75.3% indicated that a better staging system was needed. When participants were asked to evaluate their current staging system, 63.5% stated that the system does not adequately reflect patient's clinical condition, 61.6% felt that the current staging system was not easily reproducible, 58.0% believed that the current staging system was generally easy-to-use, and 43.9% indicated that it is unable to suggest management recommendations. When asked about an ideal classification system, the respondents proposed incorporating tissue necrosis (97.6%), depth of tissue involvement (96.3%), discharge documentation (92.5%), presence of osteomyelitis (90%), local infection (88.8%), and systemic infection (80.0%). Overall, 67.0% of the participants wanted to use a classification system that would reflect the progress of injury healing and could be used to indicate the need for intervention., Discussion: Health care workers caring for pressure injury patients indicated dissatisfaction with the NPAUP., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Kidney transplantation in allosensitized recipients has recently increased. Studies performing cost analysis of desensitization protocols are scarce., Material/methods: We performed an actual cost comparison between kidney transplantation following desensitization and maintenance hemodialysis. Group A (n=35) consisted of allosensitized recipients who underwent desensitization using immunoadsorption and/or plasmapheresis, intravenous immunoglobulin and anti-CD20 antibody who were followed for ≥ 2 years. Group B (n=49) consisted of matched patients who remained on hemodialysis throughout the study period. Actual costs of donor care, surgical procedures, out-patient visits, in-hospital admissions, medications, hemodialysis, immunoadsorption, plasmapheresis, and laboratory and radiology investigations were calculated. Health care services were provided by a single institution., Results: Mortality rate was similar between both groups. The average 4-year actual total cost was $210,779 in group A and $317,186.3 in group B; respectively (p=0.017). Average total cost per patient in group A was $186,608; $14,233; $5,536; $4,402 in the first, second, third and fourth years after transplantation respectively while the average total annual cost per patient in group B was $79,296. The total cost in both groups became equal by month 31. The predicted annual cost savings in group A after 31 months was $33,943., Conclusions: Despite using costly desensitization protocols, kidney transplantation in sensitized patients provides long-term cost savings compared to maintenance hemodialysis.