Associations of physical activity and quality of life in parapneumonic effusion patients

Introduction Little is known about activity behaviours and quality of life (QoL) of patients with parapneumonic pleural effusions (PPE) after hospital discharge. This study is a secondary analysis of a randomised trial (dexamethasone versus placebo) for hospitalised patients with PPE. We: 1) described the patients’ activity behaviour patterns and QoL measured at discharge and at 30 days post-discharge; and 2) examined the association between activity behaviours and QoL scores. Methods Activity behaviour (7-day accelerometry; Actigraph GT3X+) and QoL (Medical Outcomes Study Short-Form 36) were assessed. Repeated measures analysis of covariance controlling for baseline values and a series of linear regression models were undertaken. Results 36 out of 53 eligible participants completed accelerometry assessments. Despite modest increases in light physical activity (+7.5%) and some domains of QoL ( \u3e 2 points) from discharge to 30 days post-discharge, patients had persistently high levels of sedentary behaviour ( \u3e 65% of waking wear time) and poor QoL ( ⩽ 50 out of 100 points) irrespective of treatment group ( p=0.135–0.903). Increasing moderate-to-vigorous physical activity was associated with higher scores on most QoL domains ( p=0.006–0.037). Linear regression indicates that a clinically important difference of 5 points in physical composite QoL score can be achieved by reallocating 16.1 min·day−1 of sedentary time to moderate-to-vigorous physical activity. Conclusion Patients with PPE had low levels of physical activity and QoL at discharge and 30 days post-discharge irrespective of treatment. Moderate-to-vigorous physical activity participation was associated with higher QoL scores. Increasing moderate-to-vigorous physical activity following discharge from the hospital may be associated with improvements in QoL. © The authors 2023

The Energy-Saving Potential of Air-Side Economisers in Modular Data Centres: Analysis of Opportunities and Risks in Different Climates

This study examines the feasibility of utilising outside air for ‘free cooling’ in modular data centres through the implementation of an air-side economiser, as an alternative to traditional mechanical cooling systems. The objective is to offset the energy consumption associated with cooling by leveraging the natural cooling capacity of the ambient air. To investigate this potential, a 90-kW modular data centre is employed as the base case for model validation and analysis of energy reduction possibilities. The research employs dynamic thermal modelling techniques to assess the efficacy of the air-side economiser in four distinct climatic zones: Stockholm, Dubai, San Francisco, and Singapore, representing diverse worldwide climates. The model is meticulously calibrated and validated using power usage effectiveness (PUE) values obtained from the Open Compute Project. Simulation runs are conducted to evaluate the energy-reduction potential achievable with the air-side economiser compared to conventional mechanical air-conditioning systems. The results indicate significant energy reductions of up to 86% in moderate climates, while minimal reductions are observed in dry and hot climates. This comprehensive analysis offers valuable insights into the intricate relationship between modular data centres, their operational characteristics, and the viability of employing air-side economisers for free cooling and energy efficiency across different climatic conditions. The contribution of this publication to this field of science lies in its exploration of the practicality and energy-saving potential of air-side economisers in modular data centres. By utilising dynamic thermal modelling and empirical validation, this study provides evidence-based insights into the effectiveness of this cooling strategy, shedding light on its applicability in various climates. The findings contribute to the understanding of energy-efficient cooling solutions in data-centre design and operation, paving the way for more sustainable practices in the field

Australasian Malignant PLeural Effusion (AMPLE)-3 trial: Study protocol for a multi-centre randomised study comparing indwelling pleural catheter (±talc pleurodesis) versus video-assisted thoracoscopic surgery for management of malignant pleural effusion

Introduction: Malignant pleural effusions (MPEs) are common. MPE causes significant breathlessness and impairs quality of life. Indwelling pleural catheters (IPC) allow ambulatory drainage and reduce hospital days and re-intervention rates when compared to standard talc slurry pleurodesis. Daily drainage accelerates pleurodesis, and talc instillation via the IPC has been proven feasible and safe. Surgical pleurodesis via video-assisted thoracoscopic surgery (VATS) is considered a one-off intervention for MPE and is often recommended to patients who are fit for surgery. The AMPLE-3 trial is the first randomised trial to compare IPC (±talc pleurodesis) and VATS pleurodesis in those who are fit for surgery. Methods and analysis: A multi-centre, open-labelled randomised trial of patients with symptomatic MPE, expected survival of ≥ 6 months and good performance status randomised 1:1 to either IPC or VATS pleurodesis. Participant randomisation will be minimised for (i) cancer type (mesothelioma vs non-mesothelioma); (ii) previous pleurodesis (vs not); and (iii) trapped lung, if known (vs not). Primary outcome is the need for further ipsilateral pleural interventions over 12 months or until death, if sooner. Secondary outcomes include days in hospital, quality of life (QoL) measures, physical activity levels, safety profile, health economics, adverse events, and survival. The trial will recruit 158 participants who will be followed up for 12 months. Ethics and dissemination: Sir Charles Gairdner and Osborne Park Health Care Group (HREC) has approved the study (reference: RGS356). Results will be published in peer-reviewed journals and presented at scientific meetings. Discussion: Both IPC and VATS are commonly used procedures for MPE. The AMPLE-3 trial will provide data to help define the merits and shortcomings of these procedures and inform future clinical care algorithms. Trial registration: Australia New Zealand Clinical Trial Registry ACTRN12618001013257. Registered on 18 June 2018. Protocol version: Version 3.00/4.02.1

Non-invasive assessment of trabecular bone structural anisotropy: relevance to mechanical anisotropy.

Although there are now many theories describing empirical relationships between strength properties of bone and various explanatory variables, the need for improved non-invasive diagnostic techniques to assess bone fragility is of core importance in clinical problems such as osteoporosis. The aim of this thesis was to develop non-invasive radiological methods to assess trabecular bone architecture. Measures of structural anisotropy and bone structure from X-ray or radiological projections have been developed. The first measure, the projected mean intercept length (PMIL), allows extraction of the total bone surface (BS/TV) and the mean intercept length (MIL) from projections of trabecular structure. The second measure, the line projection deviation (LPD), is a technique that quantifies the preferential alignment of trabecular bone from projections of the trabecular structure. Hence, in combination, the PMIL and LPD allow non-invasive extraction of BS/TV and more detailed preferential alignment from projections of the trabecular structure. In this thesis the PMIL and LPD are introduced and their properties explored. The PMIL and LPD are used to examine the anisotropy and architectural properties of a number of human vertebral body trabecular bone samples. When used in combination with clinical densitometry, these measures improve explanation of the variance in strength, elastic modulus and toughness of vertebral body trabecular bone samples by up to 40% when compared to densitometric values alone. While µCT can provide the information needed to access trabecular architecture, it cannot be used in clinical settings since its high radiation dose makes it only applicable to small objects ex-vivo. At present, clinically available CT does not provide sufficient resolution to resolve trabecular structures. Thus, the methods described in this thesis will allow estimates of structural parameters from plain X-rays, providing for the first time, the possibility of clinical use of such estimates.Thesis (Ph.D.) -- School of Medical Sciences, 200

Wintertime indoor temperatures in social housing dwellings in England and the impact of dwelling characteristics

This paper presents one of the largest wintertime indoor temperature surveys of English social housing dwellings. Half hourly temperatures were measured in living rooms and main bedrooms of 124 social housing dwellings located in central England. Indoor temperatures were analysed for two distinct periods of “heating season” and “winter” during the assumed occupied hours of 08:00–20:00 for living rooms and 20:00–08:00 for bedrooms. The mean living room and bedroom temperatures when occupied were 19.0 °C and 18.7 °C respectively during the heating season and 18.6 °C and 18.2 °C during the winter. The mean living room temperature during the winter was 2.4 °C lower than the minimum living room temperature of 21 °C recommended by the World Health Organisation (WHO). The living rooms and bedrooms spent 39% and 46% of their occupied hours respectively below 18 °C which is recommended by the Public Health England as a reasonable minimum indoor temperature for homes in winter. Older properties built before 1982 were found at significantly higher risk of low temperatures. The study discusses the need for a method to assess the risk of underheating in homes particularly in social housing dwellings which accommodate vulnerable groups of people who are often less able to tolerate or to adapt to low temperatures

Expected and observed changes to architectural parameters of trabecular bone with aging - A comparison of measurement techniques

Danvers, US

Rhenium-188 radiosynovectomy for chronic haemophilic synovitis: Evaluation of its safety and efficacy in haemophilic patients

Introduction: Radiocolloids labelled with less costly and more accessible radionuclides such as rhenium-188 are of interest to developing countries compared with those labelled with rhenium-186 and yttrium-90. Aim: This study was aimed to evaluate the efficacy and safety of radiosynovectomy using rhenium-188 in patients with chronic haemophilic synovitis and recurrent hemarthrosis. Methods: In this quasi-experimental prospective study, 20 haemophilic patients were evaluated at preinjection, and at 1, 3, 6 and 12 months after injection. Magnetic resonance imaging (MRI) was done to measure synovial thickness and to calculate Denver score. Joint radiographs were taken to measure the Pettersson score. The Gilbert questionnaire, Functional Independence Score in Hemophilia (FISH) and visual analogue scale (VAS) for pain were completed, and the number of bleeding episodes and factor consumption were recorded at each follow-up visit. Results: The number of bleeding episodes, the amount of factor consumption per month, VAS pain scores and synovial thickness decreased significantly over time (P <.05). Gilbert and FISH scores showed significant improvement (P <.001). However, Pettersson score and Denver score showed no significant changes after injection. Minor complications including temporary pain and swelling occurred in 20% of patients, and no major complication was observed after rhenium-188 injection. Conclusion: Our results indicated high clinical impact, efficacy, safety and low invasion of rhenium-188 in radiosynovectomy of haemophilic patients. Considering the availability and relatively low cost of rhenium-188 in developing countries, this can be a good treatment option for haemophilic patients with recurrent hemarthrosis, particularly when the synovial hypertrophy is not massive yet

The energy-saving potential of air-side economisers in modular data centres: analysis of opportunities and risks in different climates

This study examines the feasibility of utilising outside air for ‘free cooling’ in modular data centres through the implementation of an air-side economiser, as an alternative to traditional mechanical cooling systems. The objective is to offset the energy consumption associated with cooling by leveraging the natural cooling capacity of the ambient air. To investigate this potential, a 90-kW modular data centre is employed as the base case for model validation and analysis of energy reduction possibilities. The research employs dynamic thermal modelling techniques to assess the efficacy of the air-side economiser in four distinct climatic zones: Stockholm, Dubai, San Francisco, and Singapore, representing diverse worldwide climates. The model is meticulously calibrated and validated using power usage effectiveness (PUE) values obtained from the Open Compute Project. Simulation runs are conducted to evaluate the energy-reduction potential achievable with the air-side economiser compared to conventional mechanical air-conditioning systems. The results indicate significant energy reductions of up to 86% in moderate climates, while minimal reductions are observed in dry and hot climates. This comprehensive analysis offers valuable insights into the intricate relationship between modular data centres, their operational characteristics, and the viability of employing air-side economisers for free cooling and energy efficiency across different climatic conditions. The contribution of this publication to this field of science lies in its exploration of the practicality and energy-saving potential of air-side economisers in modular data centres. By utilising dynamic thermal modelling and empirical validation, this study provides evidence-based insights into the effectiveness of this cooling strategy, shedding light on its applicability in various climates. The findings contribute to the understanding of energy-efficient cooling solutions in data-centre design and operation, paving the way for more sustainable practices in the field