Highlight: Yale University Art Gallery

Modern architecture, with its exposed concrete, glass, and steel expanses, does not age gracefully. The Yale University Art Gallery, designed by architecture great Louis Kahn, is no exception. As Yale's first modernist building, completed in 1953, and Kahn's first major commission and collaboration with pioneering lighting designer, Richard Kelly, the gallery is an important part of American architecture. Yet, despite its iconic status, the building suffered numerous architectural indignities in the years following its completion, including the insertion of permanent gallery partitions, which divided Kahn's open plan, and the enclosure of an exterior court, which blocked daylight to the lower galleries.

Liberty relighting, 20 years later

Recognized around the world as a powerful beacon for freedom, hope, and opportunity, the Statue of Liberty's light is not just metaphorical: her dramatic illumination is a perfect example of American ingenuity and engineering. Since the statue's installation in New York Harbor in 1886, lighting engineers and designers had struggled to illuminate the 150-foot copper-clad monument in a manner becoming an American icon. It took the thoughtful and creative approach of Howard Brandston-a legend in his own right-to solve this lighting challenge. In 1984, the designer was asked to give the statue a much-needed lighting makeover in preparation for its centennial. In order to avoid the shortcomings of previous attempts, he studied the monument from every angle and in all lighting conditions, discovering that it looked best in the light of dawn. Brandston determined that he would need 'one lamp to mimic the morning sun and one lamp to mimic the morning sky.' Learning that no existing lamps could simulate these conditions, Brandston partnered with General Electric to develop two new metal halide products. With only a short time for R&D, a team of engineers at GE's Nela Park laboratories assembled a 'top secret' testing room dedicated to the Statue of Liberty project. After nearly two years of work to perfect the new lamps, the 'dawn's early light' effect was finally achieved just days before the centennial celebrations were to take place in 1986. 'It was truly a labor of love,' he recalls.

Salt in the desert: A comparison of clinical versus serum-calculated osmolality determination of dehydration

Background: Clinicians frequently use their own judgement to assess patient’s hydration status although there is limited evidence for the diagnostic utility of any individual clinical symptom. Hence, the aim of this study was to compare the diagnostic accuracy of clinically assessed dehydration in older hospital patients (using multiple symptoms), versus dehydration measured using serum-calculated osmolality (CO) as the reference standard. Method: Participants were 44 hospital patients aged ≥ 60 years. Dehydration was assessed clinically and pathologically (CO) within 24 hours of admission and at study exit. Indicators of diagnostic accuracy were calculated. Results: Clinicians identified 27% of patients as dehydrated at admission, and 19% at exit, compared to 19% and 16% using CO. Agreement between the measures was fair at admission and poor at exit. Clinical assessment showed poor sensitivity for predicting dehydration with reasonable specificity. Conclusions: Compared to the use of CO, clinical assessment of dehydration in older patients was poor. Given that failure to identify dehydration in this population may have serious consequences, we recommend that clinicians do not rely upon their own assessments without also using the reference standard.

Associations between dehydration, cognitive impairment and frailty in older hospitalized patients: An exploratory study

An exploratory study was undertaken to assess the prevalence of dehydration in older patients (aged ≥60 years) with and without cognitive impairment (CI) admitted to hospital and to examine associations between dehydration, CI and frailty. Forty-four patients participated and dehydration was assessed within 24 hours of admission and at day 4 or at discharge, whichever occurred first (study exit). Patients’ cognitive function and frailty status were assessed using validated instruments. Twenty-seven (61%) patients had CI and 61% were frail. The prevalence of dehydration at admission was 29% (n=12) and 19% (n=6) at study exit and dehydration status did not differ according to either CI status or frailty status. Within the non-CI group, however, significantly more frail than fit patients were dehydrated at admission (p=0.03). These findings indicate that dehydration is common amongst older hospital patients, and that frailty may increase the risk for dehydration in cognitively intact older patients.