The overall framework of our investigation is provided by topos theory. Direct proofs of the main results are given, but the specialist will recognize toposophical ideas in the background. Indeed, the duality between syntax and semantics is really a manifestation of that between algebra and geometry in the two directions of the geometric morphisms that lurk behind our formal theory. Along the way, we give an elementary proof of Butz and Moerdijk's result in logical terms.

ObjectivesTo investigate changes in ulcer healing time and antibiotic treatment in Sweden following the introduction of the Registry of Ulcer Treatment (RUT), a national quality registry, in 2009.DesignA statistical analysis of RUT data concerning the healing time and antibiotic treatment for patients with hard-to-heal ulcers in Sweden between 2009 and 2012.SettingRUT is a national web-based quality registry used to capture areas of improvement in ulcer care and to structure wound management by registering patients with hard-to-heal leg, foot and pressure ulcers. Registration includes variables such as gender, age, diagnosis, healing time, antibiotic treatment, and ulcer duration and size.PopulationEvery patient with a hard-to-heal ulcer registered with RUT between 2009 and 2012 (n=1417) was included.Main outcome measuresStatistical analyses were performed using Stata V.12.1. Healing time was assessed with the Kaplan-Meier analysis and adjustment was made for ulcer size. A log-rank test was used for equality of survivor functions.ResultsAccording to the adjusted registry in December 2012, patients’ median age was 80 years (mean 77.5 years, range 11–103 years). The median healing time for all ulcers, adjusted for ulcer size, was 146 days (21 weeks) in 2009 and 63 days (9 weeks) in 2012 (p=0.001). Considering all years between 2009 and 2012, antibiotic treatment for patients with hard-to-heal ulcers was reduced from 71% before registration to 29% after registration of ulcer healing (p=0.001).ConclusionsHealing time and antibiotic treatment decreased significantly during 3 years after launch of RUT.

The risk of malnutrition significantly increases the risk of mortality in older people. Moreover, risk of malnutrition and ADL dependence together explain a significantly poorer survival rate; however, the importance of this interaction decreased in the multivariable model and risk of malnutrition and ADL dependence independently explained a significant risk of mortality.

a financial contribution per month was granted to 100 individuals with severe mental illnesses for a 9-month period. Assessments of the subjects were made before the start of the intervention and after 7 months' duration. A comparison group including treatment as usual only was followed using the same instruments. Significant improvements were found for depression and anxiety, social networks, and sense of self. No differences in functional level were found. Social initiatives may have treatment and other beneficial effects and should be integrated into working contextually with persons with severe mental illnesses.

BackgroundThis study evaluated the efficacy and safety of the novel AspireAssist® Aspiration Therapy System for treatment of obesity, and its effect on patient’s quality of life.MethodsA prospective observational study with 25 obese subjects, mean age 48 years (range 33–65), was performed. A custom gastrostomy tube (A-tube, Aspire Bariatrics) was percutaneously inserted during a gastroscopy performed under conscious sedation. Drainage and irrigation of the stomach were performed 3 times daily, 20 min after each meal, for 1–2 years. Efficient aspiration required thorough chewing of ingested food. Treatment included a cognitive behavioral weight loss program.ResultsMean body mass index (BMI) at inclusion was 39.8 kg/m2 (range 35–49). After 1 year mean (SD) BMI was 32.1 kg/m2 (5.4), p < 0.01, and excess weight loss was 54.4% (28.8), p < 0.01. Quality of life, as measured with EQ-5D, improved from 0.73 (0.27) to 0.88 (0.13), p < 0.01. After 2 years BMI was 31.0 kg/m2 (5.1), p < 0.01, and excess weight loss was 61.5% (28.5), p < 0.01. There were no serious adverse events or electrolyte disorders. Compliance was 80% after 1 year and 60% after 2 years.ConclusionsAspiration therapy is an efficient and safe treatment for obesity, and weight reduction improves quality of life. Excess weight was approximately halved in a year, with weight stability if treatment was continued.Trial registrationTrial Register ISRCTN 49958132. Retrospectively registered 28/02/2014.

We study the detection and delay performance impacts of a feature-based physical layer authentication (PLA) protocol in mission-critical machine-type communication (MTC) networks. The PLA protocol uses generalized likelihood-ratio testing based on the line-of-sight (LOS), single-input multipleoutput channel-state information in order to mitigate impersonation attempts from an adversary node. We study the detection performance, develop a queueing model that captures the delay impacts of erroneous decisions in the PLA (i.e., the false alarms and missed detections), and model three different adversary strategies: data injection, disassociation, and Sybil attacks. Our main contribution is the derivation of analytical delay performance bounds that allow us to quantify the delay introduced by PLA that potentially can degrade the performance in mission-critical MTC networks. For the delay analysis, we utilize tools from stochastic network calculus. Our results show that with a sufficient number of receive antennas (approx. 4-8) and sufficiently strong LOS components from legitimate devices, PLA is a viable option for securing mission-critical MTC systems, despite the low latency requirements associated to corresponding use cases. Furthermore, we find that PLA can be very effective in detecting the considered attacks, and in particular, it can significantly reduce the delay impacts of disassociation and Sybil attacks.Index Terms-Delay performance, low-latency machine-type communication, wireless physical layer security, physical layer authentication.

In this study, substantial weight loss was achieved with few complications using the AspireAssist system, suggesting its potential as an attractive therapeutic device for obese patients. Trial Register ISRCTN 49958132.

Resource use and costs for topical treatment of hard-to-heal ulcers based on data from the Swedish Registry of Ulcer Treatment (RUT) were analysed in patients recorded in RUT as having healed between 2009 and 2012, in order to estimate potential cost savings from reductions in frequency of dressing changes and healing times. RUT is used to capture areas of improvement in ulcer care and to enable structured wound management by registering patients with hard-to-heal leg, foot and pressure ulcers. Patients included in the registry are treated in primary care, community care, private care, and inpatient hospital care. Cost calculations were based on resource use data on healing time and frequency of dressing changes in Swedish patients with hard-to-heal ulcers who healed between 2009 and 2012. Per-patient treatment costs decreased from SEK38 223 in 2009 to SEK20 496 in 2012, mainly because of shorter healing times. Frequency of dressing changes was essentially the same during these years, varying from 1·4 to 1·6 per week. The total healing time was reduced by 38%. Treatment costs for the management of hard-to-heal ulcers can be reduced with well-developed treatment strategies resulting in shortened healing times as shown in RUT.