What does the future hold for utility electricity efficiency programs?

This study develops projections of future spending and savings from electricity efficiency programs funded by electric utility customers in the United States through 2030 based on three scenarios. Our analysis relies on detailed bottom-up modeling of current state energy efficiency policies, demand-side management and integrated resource plans, and regulatory decisions. The three scenarios represent a range of potential outcomes given the policy environment at the time of the study and uncertainties in the broader economic and state policy environment in each state. We project spending to increase to $8.6 billion in 2030 in the medium scenario, about a 45 percent increase relative to 2016 spending. In the high case, annual spending increases to$11.1 billion in 2030 and remains relatively flat in the low case ($6.8 billion in 2030). Our analysis suggests that electricity efficiency programs funded by utility customers will continue to impact load growth significantly at least through 2030, as savings as a percent of retail sales are forecast at 0.7 percent in the medium scenario and 0.98 percent in the high scenario

New distinguished classes of spectral spaces: a survey

In the present survey paper, we present several new classes of Hochster's spectral spaces "occurring in nature", actually in multiplicative ideal theory, and not linked to or realized in an explicit way by prime spectra of rings. The general setting is the space of the semistar operations (of finite type), endowed with a Zariski-like topology, which turns out to be a natural topological extension of the space of the overrings of an integral domain, endowed with a topology introduced by Zariski. One of the key tool is a recent characterization of spectral spaces, based on the ultrafilter topology, given in a paper by C. Finocchiaro in Comm. Algebra 2014. Several applications are also discussed

Macular telangiectasia type 2 - Visual acuity, disease endstage and the MacTel Area. MacTel Project Report No. 8

Purpose: To report the visual acuity measures from the MacTel registry study and to investigate and describe phenotypic findings in eyes with substantial vision loss due to MacTel type 2 Design: Cross-sectional multi-center study. Subjects: Participants of the Natural History Observation (and Registry) of MacTel Study. Methods: Best–corrected visual acuity (BCVA) data, retinal imaging data and clinical data were accessed from the MacTel study databases in May 2019. Main Outcome Measures: Frequency distribution of BCVA and its relation to age. Morphological changes in eyes with very late disease stages, defined by a BCVA ≤ 20/200. Average retinal thickness of ETDRS fields on OCT. Dimensions of the area affected by MacTel (MacTel area). Results: BCVA was ≤20/50 in 37.3% and ≤20/200 in 3.8% of 4449 eyes of 2248 patients. 18.4% and 0.7% of all patients had bilateral BCVA ≤20/50 and ≤20/200, respectively. There was an asymmetry between right and left eyes (median BCVA 71 versus 74 letters), a finding supported by more advanced morphological changes in right eyes. BCVA correlated with participant’s age, but the effect size was small. If a neovascularization or macular hole was present, bilateral occurrence was frequent (33% or 17%, respectively), and BCVA was >20/200 (79% or 78% respectively) or ≥20/50 (26% or 13%, respectively). Eyes with advanced disease (BCVA ≤20/200) showed the following characteristics: 1) Atrophy of the foveal photoreceptor layer with or without associated subretinal fibrosis; 2) an affected area, termed here the “MacTel area”, limited to a horizontal diameter not exceeding the distance between the temporal optic disc margin and foveal center, and the vertical diameter not exceeding approximately 0.85 times this distance. Exceptions were eyes with large active or inactive neovascular membranes; 3) reduced retinal thickness measures within the MacTel area; and 4) less frequent retinal greying and more frequent hyperpigmentations compared to eyes with better BCVA. Conclusions: Severe vision loss is rare in MacTel and is related to photoreceptor atrophy in most people. Results indicate disease asymmetry with slightly worse vision and more advanced disease manifestation in right eyes. MacTel-related neurodegeneration does not spread beyond the limits of the “MacTel area”

Increasing confidence and changing behaviors in primary care providers engaged in genetic counselling.

BackgroundScreening and counseling for genetic conditions is an increasingly important part of primary care practice, particularly given the paucity of genetic counselors in the United States. However, primary care physicians (PCPs) often have an inadequate understanding of evidence-based screening; communication approaches that encourage shared decision-making; ethical, legal, and social implication (ELSI) issues related to screening for genetic mutations; and the basics of clinical genetics. This study explored whether an interactive, web-based genetics curriculum directed at PCPs in non-academic primary care settings was superior at changing practice knowledge, attitudes, and behaviors when compared to a traditional educational approach, particularly when discussing common genetic conditions.MethodsOne hundred twenty one PCPs in California and Pennsylvania physician practices were randomized to either an Intervention Group (IG) or Control Group (CG). IG physicians completed a 6 h interactive web-based curriculum covering communication skills, basics of genetic testing, risk assessment, ELSI issues and practice behaviors. CG physicians were provided with a traditional approach to Continuing Medical Education (CME) (clinical review articles) offering equivalent information.ResultsPCPs in the Intervention Group showed greater increases in knowledge compared to the Control Group. Intervention PCPs were also more satisfied with the educational materials, and more confident in their genetics knowledge and skills compared to those receiving traditional CME materials. Intervention PCPs felt that the web-based curriculum covered medical management, genetics, and ELSI issues significantly better than did the Control Group, and in comparison with traditional curricula. The Intervention Group felt the online tools offered several advantages, and engaged in better shared decision making with standardized patients, however, there was no difference in behavior change between groups with regard to increases in ELSI discussions between PCPs and patients.ConclusionWhile our intervention was deemed more enjoyable, demonstrated significant factual learning and retention, and increased shared decision making practices, there were few differences in behavior changes around ELSI discussions. Unfortunately, barriers to implementing behavior change in clinical genetics is not unique to our intervention. Perhaps the missing element is that busy physicians need systems-level support to engage in meaningful discussions around genetics issues. The next step in promoting active engagement between doctors and patients may be to put into place the tools needed for PCPs to easily access the materials they need at the point-of-care to engage in joint discussions around clinical genetics

Humans store about 1.5 megabytes of information during language acquisition

We introduce theory-neutral estimates of the amount of information learners possess about how language works. We provide estimates at several levels of linguistic analysis: phonemes, wordforms, lexical semantics, word frequency and syntax. Our best guess is that the average English-speaking adult has learned 12.5 million bits of information, the majority of which is lexical semantics. Interestingly, very little of this information is syntactic, even in our upper bound analyses. Generally, our results suggest that learners possess remarkable inferential mechanisms capable of extracting, on average, nearly 2000 bits of information about how language works each day for 18 years

Butyrate down-regulates CD44 transcription and liver colonisation in a highly metastatic human colon carcinoma cell line

Over-expression of the adhesion molecule CD44 and its splice variants, especially CD44v6, is associated with poor prognosis and metastasis. We aimed at regulating the expression of CD44 in the highly metastatic human colon cancer cell line HM7 and thereby affecting its metastatic ability. HM7 cells show constitutive expression of CD44 standard and variants isoforms, which were significantly down-regulated by treatment with butyrate. Butyrate significantly inhibited transcription of the CD44 gene and abolished epidermal growth factor-mediated up-regulation of the reporter gene luciferase subcloned upstream to the CD44 promoter (−1.1 kb) and transfected to HM7 cells. Nuclear proteins from butyrate-treated cells bound to an epidermal growth factor receptor element motif present in the CD44 promoter. Epidermal growth factor receptor element-site directed mutations eliminated the inducibility of the luciferase reporter gene and did not allowed binding of nuclear proteins harvested from butyrate-treated cells. Butyrate induced CD44 gene repression by specifically interacting with an epidermal growth factor receptor element nuclear transcriptional factor. This interaction affects CD44 transcriptional activity vis-à-vis in vivo metastatic ability of HM7 cells. These results provide additional insight into the anticarcinogenic properties of butyrate

Particulate air pollution and survival in a COPD cohort

<p>Abstract</p> <p>Background</p> <p>Several studies have shown cross-sectional associations between long term exposure to particulate air pollution and survival in general population or convenience cohorts. Less is known about susceptibility, or year to year changes in exposure. We investigated whether particles were associated with survival in a cohort of persons with COPD in 34 US cities, eliminating the usual cross-sectional exposure and treating PM₁₀as a within city time varying exposure.</p> <p>Methods</p> <p>Using hospital discharge data, we constructed a cohort of persons discharged alive with chronic obstructive pulmonary disease using Medicare data between 1985 and 1999. 12-month averages of PM₁₀were merged to the individual annual follow up in each city. We applied Cox's proportional hazard regression model in each city, with adjustment for individual risk factors.</p> <p>Results</p> <p>We found significant associations in the survival analyses for single year and multiple lag exposures, with a hazard ratio for mortality for an increase of 10 μg/m³PM₁₀over the previous 4 years of 1.22 (95% CI: 1.17–1.27).</p> <p>Conclusion</p> <p>Persons discharged alive for COPD have substantial mortality risks associated with exposure to particles. The risk is evident for exposure in the previous year, and higher in a 4 year distributed lag model. These risks are significantly greater than seen in time series analyses.</p

CD98hc facilitates B cell proliferation and adaptive humoral immunity.

The proliferation of antigen-specific lymphocytes and resulting clonal expansion are essential for adaptive immunity. We report here that B cell-specific deletion of the heavy chain of CD98 (CD98hc) resulted in lower antibody responses due to total suppression of B cell proliferation and subsequent plasma cell formation. Deletion of CD98hc did not impair early B cell activation but did inhibit later activation of the mitogen-activated protein kinase Erk1/2 and downregulation of the cell cycle inhibitor p27. Reconstitution of CD98hc-deficient B cells with CD98hc mutants showed that the integrin-binding domain of CD98hc was required for B cell proliferation but that the amino acid-transport function of CD98hc was dispensable for this. Thus, CD98hc supports integrin-dependent rapid proliferation of B cells. We propose that the advantage of adaptive immunity favored the appearance of CD98hc in vertebrates