Gender and the heat pump transition

Decarbonisation in moderate and cold climates is reliant on the replacement of existing heating technologies with electric heat pumps. Heat pumps work differently from incumbent technologies, including in how they are controlled, their distribution of heat around the home and their space requirements. Despite evidence that domestic practices and interests associated with women played an important role in previous heating transitions, policy and research have not yet considered how heat pumps might interact with traditionally gendered needs and concerns. This could have significant implications for the success of the heat pump transition. This synthesis uses a framework of evidenced heating needs, incorporating wellbeing, resources, ease of use and relational dynamics, to structure a narrative literature review on how experiences of heat pumps may be gendered. Indicative evidence suggests that heat pumps have the potential to improve female thermal comfort, but that other possibly gendered heating needs such as minimising perceived waste and easy controllability are not always addressed. Amidst a lack of empirical studies exploring women’s needs, and whether they are met by heat pumps, a series of recommendations is provided for multidisciplinary research on the topic and to enhance consideration of gendered needs and experiences in policy development

An Empirical Energy Demand Flexibility Metric for Residential Properties

Shifting from heating using fossil fuel combustion to electrified heating, dominated by heat pumps, is central to many countries’ decarbonisation strategy. The consequent increase in electricity demand, combined with that from electric vehicles, and the shift from non-renewable to renewable generation requires increased demand flexibility to support system operation. Demand side response through interrupting heating during peak demands has been widely proposed and simulation modelling has been used to determine the technical potential. This paper proposes an empirical approach to quantifying a building’s potential to operate flexibly, presenting a metric based on measured temperature drop in a dwelling under standard conditions after heating is switched off, using smart meter and internal temperature data. A result was derived for 96% of 193 homes within a test dataset, mean temperature drop of 1.5 °C in 3 h at 15 °C inside-outside temperature differential. An empirical flexibility metric may support decision making and decarbonisation. For households it may support the transition to heat pumps, enabling time of use costs and tariffs to be better understood and system to be specified by installers. Electricity system stakeholders, such as aggregators and DNOs may use it to identify the potential for demand response, managing local networks, infrastructure and aggregation

Living with demand response: Insights from a field study of DSR using heat pumps

Demand response with domestic heat pumps has gained interest in recent years. It is seen as a possible solution to the need to balance electricity grids that are sourcing a higher proportion of their electricity from variable low-carbon electricity sources. Although many modelling studies suggest that demand response with heat pumps will be successful, we have little knowledge of their real-world impacts, including the impact on indoor conditions and the perception of these. This study compares what happened in three homes of early adopters of heat pumps with demand-side response (DSR). In the three households, the operation of the heat pump was constrained from 4pm to 7pm to provide demand response. Drawing on technical monitoring, we report on indoor conditions in the home and heat pump operation. Drawing on interviews and informed by social practice theory, we explore how comfort at home is experienced and achieved. The focus of the study is on the indoor conditions as the material background for daily practices, and on how these are sensed, interpreted, and created through comfort practices. The analysis of the results revealed that air and surface temperatures dropped during demand response (air temperature dropped 0.3-1.1 degrees in 3 hours). However, these changes were sensed and interpreted differently by different participants: (1) not perceived, (2) noticed but tolerated without affecting DSR or (3) not tolerated. Although material adjustments were common in (2) and (3), the nature of the adjustment depended on the know-how of the participants and the meaning associated with temperature changes; for example, (2) adopted new materials (e.g., clothes) while (3) changed the operation of the heat pump to produce more acceptable indoor conditions. The findings challenge conventional modelling assumptions that demand response is unnoticed by people if the indoor temperature remains within the limits of steady-state models of thermal comfort and reveal how demand response is negotiated and incorporated into daily practices

The feasibility and acceptability of an early intervention in primary care to prevent chronic fatigue syndrome (CFS) in adults:randomised controlled trial

Background Chronic fatigue syndrome (CFS, also known as myalgic encephalomyelitis (ME)) is defined as fatigue that is disabling, is accompanied by additional symptoms and persists for ≥ 4 months. Treatment of CFS/ME aims to help patients manage their symptoms and make lifestyle adjustments. We do not know whether intervening early in primary care (< 4 months after onset of fatigue) can prevent the development of CFS/ME. Methods This was a feasibility randomised controlled trial with adults (age ≥ 18 years) comparing usual care with usual care plus an early intervention (EI; a combination of psycho-education and cognitive behavioural therapy, CBT). This study took place in fourteen primary care practices in Bristol, England and aimed to identify issues around recruitment and retention for a full-scale trial. It was not powered to support statistical analysis of differences in outcomes. Integrated qualitative methodology was used to explore the feasibility and acceptability of recruitment and randomisation to the intervention. Results Forty-four patients were recruited (1 August 2012–November 28, 2013), falling short of our predicted recruitment rate of 100 patients in 8 months. Qualitative data from GPs showed recruitment was not feasible because it was difficult to identify potential participants within 4 months of symptom onset. Some referring GPs felt screening investigations recommended by NICE were unnecessary, and they had difficulty finding patients who met the eligibility criteria. Qualitative data from some participant interviews suggested that the intervention was not acceptable in its current format. Although the majority of participants found parts of the intervention acceptable, many reported one or more problems with acceptability. Participants who discontinued the intervention or found it problematic did not relate to the therapeutic model, disliked telephone consultations or found self-reflection challenging. Conclusions A randomised controlled trial to test an early intervention for fatigue in adults in primary care is not feasible using this intervention and recruitment strategy

Characterization of gene mutations and copy number changes in acute myeloid leukemia using a rapid target enrichment protocol

Prognostic stratification is critical for making therapeutic decisions and maximizing survival of patients with acute myeloid leukemia. Advances in the genomics of acute myeloid leukemia have identified several recurrent gene mutations whose prognostic impact is being deciphered. We used HaloPlex target enrichment and Illumina-based next generation sequencing to study 24 recurrently mutated genes in 42 samples of acute myeloid leukemia with a normal karyotype. Read depth varied between and within genes for the same sample, but was predictable and highly consistent across samples. Consequently, we were able to detect copy number changes, such as an interstitial deletion of BCOR, three MLL partial tandem duplications, and a novel KRAS amplification. With regards to coding mutations, we identified likely oncogenic variants in 41 of 42 samples. NPM1 mutations were the most frequent, followed by FLT3, DNMT3A and TET2. NPM1 and FLT3 indels were reported with good efficiency. We also showed that DNMT3A mutations can persist post-chemotherapy and in 2 cases studied at diagnosis and relapse, we were able to delineate the dynamics of tumor evolution and give insights into order of acquisition of variants. HaloPlex is a quick and reliable target enrichment method that can aid diagnosis and prognostic stratification of acute myeloid leukemia patients.This project was funded by the Wellcome Trust. NB is a fellow of the European Hematology Association and was supported by the Academy of Medical Sciences. EP is a European Hematology Association Advanced Research Fellow. GV is a Wellcome Trust Senior Fellow in Clinical Science. IV is funded by Spanish Ministerio de Economía y Competitividad subprograma Ramón y Cajal

Testing bespoke management of foraging habitat for European turtle doves Streptopelia turtur

Agri-environment schemes (AES) are increasingly being employed to mitigate biodiversity loss in agricultural environments. The European Turtle Dove Streptopelia turtur is an obligate granivorous bird in rapid decline within both the UK (−96% since 1970) and across continental Europe (−77% since 1980), despite widespread uptake of AES. Here, we assess the efficacy of a potentially new, sown agri-environment option designed to provide abundant, accessible seed for S. turtur during the breeding season. During summer 2011 we compared vegetation structure and seed provision on trial plots to control habitat types (existing agri-environment options thought to potentially provide S. turtur foraging habitat) to assess whether trial plots performed better for foraging S. turtur than control habitats. In September 2011 all trial plots were topped (cut) and half of a subset of trial plots were then scarified (60% of soil surface disturbed). Vegetation structure on topped, and topped and scarified trial plots was measured during summer 2012 to determine which management regime was most effective in maintaining suitable sward structure and seed provision into the second year. No control habitat type produced as much seed important in S. turtur diet as trial plots at any point during year one. Trial plots provided accessible vegetation structure early in the season with no difference in vegetation metrics between trial plots and previously published data on S. turtur foraging locations. However, to allow later access, management is required during mid-June to open up the sward through localized topping or scarification. Vegetation structure during year two was generally too dense to attract foraging S. turtur. However, scarifying trial plots during the September following sowing encouraged self-seeding of Fumaria officinalis (a plant species historically forming a significant proportion of S. turtur diet during the breeding season) into the second year, with this species present in 16% of scarified trial plots compared to only 4% of topped trial plots during year two. Thus, autumn scarification, possibly followed by topping or scarification of part of the trial plots in June, is necessary for trial plots to provide more seed and access for S. turtur than existing agri-environment options during year two. We recommend modifications to our original seed mix in order to reduce vegetation density and improve vegetation structure. The study provides an example of the need to strike the right balance between food abundance and accessibility, through vegetation structure, when designing agri-environment scheme management options that provide food for birds

Tolerability and Clinical Activity of Post-Transplantation Azacitidine in Patients Allografted for Acute Myeloid Leukemia Treated on the RICAZA Trial

AbstractDisease relapse is the major causes of treatment failure after allogeneic stem cell transplantation (SCT) in patients with acute myeloid leukemia (AML). As well as demonstrating significant clinical activity in AML, azacitidine (AZA) upregulates putative tumor antigens, inducing a CD8+ T cell response with the potential to augment a graft-versus-leukemia effect. We, therefore, studied the feasibility and clinical sequelae of the administration of AZA during the first year after transplantation in 51 patients with AML undergoing allogeneic SCT. Fourteen patients did not commence AZA either because of transplantation complications or withdrawal of consent. Thirty-seven patients commenced AZA at a median of 54 days (range, 40 to 194 days) after transplantation, which was well tolerated in the majority of patients. Thirty-one patients completed 3 or more cycles of AZA. Sixteen patients relapsed at a median time of 8 months after transplantation. No patient developed extensive chronic graft-versus-host disease. The induction of a post-transplantation CD8+ T cell response to 1 or more tumor-specific peptides was studied in 28 patients. Induction of a CD8+ T cell response was associated with a reduced risk of disease relapse (hazard ratio [HR], .30; 95% confidence interval [CI], .10 to .85; P = .02) and improved relapse-free survival (HR, .29; 95% CI, .10 to .83; P = .02) taking into account death as a competing risk. In conclusion, AZA is well tolerated after transplantation and appears to have the capacity to reduce the relapse risk in patients who demonstrate a CD8+ T cell response to tumor antigens. These observations require confirmation in a prospective clinical trial

Monitoring and evaluation of malaria in pregnancy – developing a rational basis for control

Monitoring and evaluation of malaria control in pregnancy is essential for assessing the efficacy and effectiveness of health interventions aimed at reducing the major burden of this disease on women living in endemic areas. Yet there is no currently integrated strategic approach on how this should be achieved. Malaria control in pregnancy is formulated in relation to epidemiological patterns of exposure. Current emphasis is on intermittent preventive treatment (IPTp) during pregnancy with sulphadoxine-pyrimethamine in higher transmission areas, combined with insecticide treated bed nets (ITNs) and case management. Emphasis in lower transmission areas is primarily on case management. This paper discusses a rational basis for monitoring and evaluation based on: assessments of therapeutic and prophylactic drug efficacy; proportional reductions in parasite prevalence; seasonal effects; rapid assessment methodologies; birthweight and/or anaemia nomograms; case-coverage methods; maternal mortality indices; operational and programmatic indicators; and safety and pharmacovigilance of antimalarials in pregnancy. These approaches should be incorporated more effectively within National Programmes in order to facilitate surveillance and improve identification of high-risk women. Systems for utilizing routinely collected data should be strengthened, with greater attention to safety and pharmacovigilance with the advent of artemisinin combination therapies, and prospects of inadvertent exposures to artemisinins in the first trimester. Integrating monitoring activities within malaria control, reproductive health and adolescent-friendly services will be critical for implementation. Large-scale operational research is required to further evaluate the validity of currently proposed indicators, and in order to clarify the breadth and scale of implementation to be deployed