Energy Ratings Hit Commercial Real Estate - California Lights the Way

The Energy Star Program has been extremely successful for consumer appliances and electronics, but can this success translate to commercial real estate? In the United States, commercial buildings account for nearly nineteen percent of energy-related carbon dioxide emissions. Consequently, energy rating of buildings has become an increasingly attractive way to combat pollution and lower energy consumption. Despite this, the United States does not yet have a federal policy requiring energy usage disclosure for buildings. This has left state and local governments to lead the way in innovative and effective reporting regimes. California\u27s response to this regulatory vacuum is Assembly Bill 1103 (AB 1103), which requires commercial buildings to be rated using the Environmental Protection Agency\u27s Energy Star Program. While AB 1103 has yet to go into effect, its success can be predicted by the advances and setbacks experienced by similar legislation internationally. This article contrasts existing commercial energy rating systems against AB 1103 in an attempt to project its potential successes and pitfalls

Immunization in Patients With Multiple Sclerosis

Multiple sclerosis (MS) is an autoimmune disease of the central nerv-ous system characterized by inflammatory demyelination and some axonal damage. An overactive or dysfunctional immune response to self-antigen is believed to be the pathogenic mechanism and therefore the treatment of MS often involves immunosuppressive therapy. Be-cause of altered immune function in patients with MS, questions arise about risk of infections in this population and the safety and efficacy of common immunizations. The risk of MS exacerbation with common infections and safety and efficacy of immunization are reviewed along with the available guidelines for use of vaccines in patients with MS

Clinical Diagnosis of Placenta Accreta and Clinicopathological Outcomes

Objective To investigate the association between the intraoperative diagnosis of placenta accreta at the time of cesarean hysterectomy and pathological diagnosis. Study Design This is a retrospective cohort study of all patients undergoing cesarean hysterectomy for suspected placenta accreta from 2000 to 2016 at Barnes-Jewish Hospital. The primary outcome was the presence of invasive placentation on the pathology report. We estimated predictive characteristics of clinical diagnosis of placenta accreta using pathological diagnosis as the correct diagnosis. Results There were 50 cesarean hysterectomies performed for suspected abnormal placentation from 2000 to 2016. Of these, 34 (68%) had a diagnosis of accreta preoperatively and 16 (32%) were diagnosed intraoperatively at the time of cesarean delivery. Two patients had no pathological evidence of invasion, corresponding to a false-positive rate of 4% (95% confidence interval [CI]: 0.5%, 13.8%) and a positive predictive value of 96% (95% CI: 86.3%, 99.5%). There were no differences in complications among patients diagnosed intraoperatively compared with those diagnosed preoperatively. Conclusion Most patients undergoing cesarean hysterectomy for placenta accreta do have this diagnosis confirmed on pathology. However, since the diagnosis of placenta accreta was made intraoperatively in nearly a third of cesarean hysterectomies, intraoperative vigilance is required as the need for cesarean hysterectomy may not be anticipated preoperatively

Modeling of Capacitor Impedance in Switching Converters

Switched capacitor (SC) converters are gaining acceptance as alternatives to traditional, inductor-based switching power converters. Proper design of SC converters requires an understanding of all loss sources and their impacts on circuit operation. In the present work, an equivalent resistance method is developed for analysis, and equivalent resistance formulae are presented for various modes of operation. Quasiresonant converters are explored and compared to standard SC converters. Comparisons to inductor-based switching power converters are made. A number of capacitor technologies are evaluated and compared for applications to both SC converters and inductor-based converters. The resulting model can be used to accurately predict and optimize converter performance in the design phase

Intraorbital foreign body projectile as a consideration for unilateral pupillary defect

Intraorbital foreign bodies are frequently the result of high-velocity injuries with varying clinical presentations. The resultant diagnosis, management, and outcome depend on the type of foreign body present, anatomical location, tissue disruption, and symptomatology. A patient who presented to the Emergency Department with a large intraorbital foreign body projectile that was not evident clinically, but found incidentally on computed tomography and subsequent plain films is reported. The emergency room physician needs to be aware of the differential diagnosis of a unilateral irregular pupil with or without visual acuity changes. The differential diagnosis for any trauma patient with an irregular pupil with significant visual loss must include intraorbital foreign body and associated injury to the optic nerve directly or via orbital compartment syndrome secondary to hemorrhage and/or edema. Patients with significantly decreased visual acuity may benefit from emergent surgical intervention. In patients with intact visual acuity, the patient must be monitored closely for any visual changes as this may require emergent surgical intervention

Not a melting pot: Plant species aggregate in their non-native range

Aim Plant species continue to be moved outside of their native range by human activities. Here, we aim to determine whether, once introduced, plants assimilate into native communities or whether they aggregate, thus forming mosaics of native- and alien-rich communities. Alien species might aggregate in their non-native range owing to shared habitat preferences, such as their tendency to establish in high-biomass, species-poor areas. Location Twenty-two herbaceous grasslands in 14 countries, mainly in the temperate zone. Time period 2012-2016. Major taxa studied Plants. Methods We used a globally coordinated survey. Within this survey, we found 46 plant species, predominantly from Eurasia, for which we had co-occurrence data in their native and non-native ranges. We tested for differences in co-occurrence patterns of 46 species between their native (home) and non-native (away) range. We also tested whether species had similar habitat preferences, by testing for differences in total biomass and species richness of the patches that species occupy in their native and non-native ranges. Results We found the same species to show different patterns of association depending on whether they were in their native or non-native range. Alien species were negatively associated with native species; instead, they aggregated with other alien species in species-poor, high-biomass communities in their non-native range compared with their native range. Main conclusions The strong differences between the native (home) and non-native (away) range in species co-occurrence patterns are evidence that the way in which species associate with resident communities in their non-native range is not species dependent, but is instead a property of being away from their native range. These results thus highlight that species might undergo important ecological changes when introduced away from their native range. Overall, we show origin-dependent associations that result in novel communities, in which alien-rich patches exist within a mosaic of native-dominated communities

Dark Matter in the Coming Decade: Complementary Paths to Discovery and Beyond

In this report we summarize the many dark matter searches currently being pursued through four complementary approaches: direct detection, indirect detection, collider experiments, and astrophysical probes. The essential features of broad classes of experiments are described, each with their own strengths and weaknesses. The complementarity of the different dark matter searches is discussed qualitatively and illustrated quantitatively in two simple theoretical frameworks. Our primary conclusion is that the diversity of possible dark matter candidates requires a balanced program drawing from all four approaches.Comment: Report prepared for the Community Summer Study (Snowmass) 2013, on behalf of Cosmic Frontier Working Groups 1-4 (CF1: WIMP Dark Matter Direct Detection, CF2: WIMP Dark Matter Indirect Detection, CF3: Non-WIMP Dark Matter, and CF4: Dark Matter Complementarity); published versio

A Powassan virus domain III nanoparticle immunogen elicits neutralizing and protective antibodies in mice

Powassan virus (POWV) is an emerging tick borne flavivirus (TBFV) that causes severe neuroinvasive disease. Currently, there are no approved treatments or vaccines to combat POWV infection. Here, we generated and characterized a nanoparticle immunogen displaying domain III (EDIII) of the POWV E glycoprotein. Immunization with POWV EDIII presented on nanoparticles resulted in significantly higher serum neutralizing titers against POWV than immunization with monomeric POWV EDIII. Furthermore, passive transfer of EDIII-reactive sera protected against POWV challenge in vivo. We isolated and characterized a panel of EDIII-specific monoclonal antibodies (mAbs) and identified several that potently inhibit POWV infection and engage distinct epitopes within the lateral ridge and C-C\u27 loop of the EDIII. By creating a subunit-based nanoparticle immunogen with vaccine potential that elicits antibodies with protective activity against POWV infection, our findings enhance our understanding of the molecular determinants of antibody-mediated neutralization of TBFVs