Capability and deficiency of the simplified model for energy calculation of commercial buildings in the Brazilian regulation

This paper provides a preliminary assessment on the accuracy of the Brazilian regulation simplified model for commercial buildings. The first step was to compare its results with BESTEST. The study presents a straightforward approach to apply the BESTEST in other climates than the original one (Denver, Colorado, USA). The second step consisted on applying the simplified model for common buildings, and compare the results with those obtained using a state of the art building energy simulation (BES) program. Significant errors were found when comparing the simplified model with BESTEST and the common buildings analyzed

Exploring cultural perspectives of physical activity among transnational African immigrants

Background: The overall foreign born population is increasing significantly in the US. The African-born population represent fastest rising immigrant group in the US since the 2000s. Transnational African Immigrants (TAIs) are a subset of African immigrants with a unique ability to sustain multi-national ties. African Americans (AAs) and African Immigrants possess two distinct historical backgrounds that affect their respective cultural practices, yet African immigrants are often grouped into the same category in health research, not taking into account their different ethos and cultural identities. Their ethos and their cultural identities also influence the health behavior choices that they make such as participation in physical activity. Physical activity has the potential to improve health and well-being, and prevent or delay the onset of chronic disease and disabilities. Studies have shown that different factors can facilitate and/or to prevent physical activity in different population and age groups. However, there is a dearth in information regarding physical activity and its determinants within the Transnational African Immigrant population. Purpose: The objectives of this study were to explore: (1) TAIs understanding of the concept of PA; (2) TAIs interpretation of the socio-cultural contexts in which they chose (or chose not) to be physically active, and; (3) their visualization of PA opportunities and barriers in their respective communities. Methods: The study utilized the PEN-3 cultural model to support an inductive approach. A qualitative research design was conducted that involved a two-pronged interview process after completion of a demographic questionnaire. Semi-structured interviews were conducted with 24 Transnational African Immigrants (11 males, 13 females), discussing physical activity followed by a photo-elicitation process where participants were presented photographs related to physical activity in order to evoke richer information. Questions were asked pertaining to their perceptions of their cultural beliefs and attitudes towards physical activity. Results: Three themes emerged from the analysis of photos and in-depth interviews: (1) We are not the same; (2) Physical activity is good, but…; (3) A culture of physical inactivity. Participants reported perceived factors such as cultural differences, lack of education, employment and transnational responsibilities that influence their choices in regards to physical activity participation. Participants also highlighted activities intertwined with their culture such as dancing as a form of physical activity that they prefer to engage in and find satisfying. Participants call for culturally tailored approaches to their community. Discussion: The findings of this study revealed the following: 1) The concept of transnational responsibilities factoring into time constraints for PA participation; 2) The socio-cultural differences between TAIs and AAs; 3) The importance of dancing within the TAI culture; and 4) The possible misconception of the causes of chronic diseases within the TAI community. Results of the study increase our understanding, and also add to the literature on African Immigrant health for the reason that it highlights the impact of transnational activities towards potential health choices. It can contribute in future developments and implementation of culturally competent initiatives to improve promotion of physical activity in this respective community. This study also elicits important information regarding the socio-cultural factors influencing physical activity behavior within the TAI community and how it can inform intra-racial interactions within the overall Black population, further proving that there is not a one-size-fit all approach to addressing health disparities within the Black population.

Self-Awareness After Brain Injury:Relation with Emotion Recognition and Effects of Treatment

Item does not contain fulltextSelf-awareness is often impaired after acquired brain injury (ABI) and this hampers rehabilitation, in general: unrealistic reports by patients about their functioning and poor motivation and compliance with treatment. We evaluated a self-awareness treatment that was part of a treatment protocol on executive dysfunction (Spikman, Boelen, Lamberts, Brouwer, & Fasotti, 2010). A total of 63 patients were included, aged 17-70, suffering non-progressive ABI, and minimum time post-onset of 3 months. Self-awareness was measured by comparing the patient's Dysexecutive Questionnaire (Wilson, Alderman, Burgess, Emslie, & Evans, 1996) score with that of an independent other. As emotion recognition is associated with self-awareness and influences the effect of rehabilitation treatment, we assessed this function using the Facial Expressions of Emotion-Stimuli and Tests (Young, Perrett, Calder, Sprengelmeyer, & Ekman, 2002). Results showed that patients in the experimental treatment group (n = 29) had better self-awareness after training than control patients (n = 34). Moreover, our results confirmed that the level of self-awareness before treatment was related to emotion recognition. Hence, self-awareness can improve after neuropsychological treatment fostering self-monitoring. Since neuropsychological treatment involves social learning, impairments in social cognition should be taken into account before starting and during treatment.8 p

Snake prices and crocodile appetites: Aquatic wildlife supply and demand on Tonle Sap Lake, Cambodia

Commercial trade is a major driver of over-exploitation of wild species, but the pattern of demand and how it responds to changes in supply is poorly understood. Here we explore the markets for snakes from Tonle Sap Lake in Cambodia to evaluate future exploitation scenarios, identify entry points for conservation and, more generally, to illustrate the value of multi-scale analysis of markets to traded wildlife conservation. In Cambodia, the largest driver of snake exploitation is the domestic trade in snakes as crocodile food. We estimate that farmed crocodiles consume between 2.7 and 12.2 million snakes per year. The market price for crocodiles has been in decline since 2003, which, combined with rising prices for their food, has led to a reduced frequency of feeding and closure of small farms. The large farms that generate a disproportionate amount of the demand for snakes continue to operate in anticipation of future market opportunities, and preferences for snakes could help maintain demand if market prices for crocodiles rise to pre 2003 levels. In the absence of a sustained demand from crocodile farms, it is also possible that alternative markets will develop, such as one for human snack food. The demand for snakes, however, also depends on the availability of substitute resources, principally fish. The substitutability and low price elasticity of demand offers a relatively sustainable form of consumerism. Given the nature of these market drivers, addressing consumer preferences and limiting the protection of snakes to their breeding season are likely to be the most effective tools for conservation. This study highlights the importance of understanding the structure of markets and the behaviour of consumer demand prior to implementing regulations on wildlife hunting and trade

Complex SCN8A DNA-abnormalities in an individual with therapy resistant absence epilepsy

Background De novo SCN8A missense mutations have been identified as a rare dominant cause of epileptic encephalopathy. We described a person with epileptic encephalopathy associated with a mosaic deletion of the SCN8A gene. Methods Array comparative genome hybridization was used to identify chromosomal abnormalities. Next Generation Sequencing was used to screen for variants in known and candidate epilepsy genes. A single nucleotide polymorphism array was used to test whether the SCN8A variants were in cis or in trans. Results We identified a de novo mosaic deletion of exons 2–14 of SCN8A, and a rare maternally inherited missense variant on the other allele in a woman presenting with absence seizures, challenging behavior, intellectual disability and QRS-fragmentation on the ECG. We also found a variant in SCN5A. Conclusions The combination of a rare missense variant with a de novo mosaic deletion of a large part of the SCN8A gene suggests that other possible mechanisms for SCN8A mutations may cause epilepsy; loss of function, genetic modifiers and cellular interference may play a role. This case expands the phenotype associated with SCN8A mutations, with absence epilepsy and regression in language and memory skills

The long-acting somatostatin analogue octreotide alleviates symptoms by reducing posttranslational conversion of prepro-glucagon to glucagon in a patient with malignant glucagonoma, but does not prevent tumor growth

A 52-year-old female with metastatic glucagonoma secreting glucagon and chromogranin A was treated with the somatostatin analogue octreotide for 2 years without any additional tumor-reducing interventions. Before therapy plasma glucagon was above 8 μg/l (normal <0.2) and within 2 days 3 × 200 μg octreotide daily suppressed plasma glucagon to 2.2-2.5 μg/l. Concomitantly, chromogranin A dropped from 0.85 mg/l (normal <0.1) to 0.2. After 3 weeks the preexisting disabling necrolytic migratory erythema had vanished completely, and weight loss was temporarily stopped. During therapy chromogranin A and plasma glucagon rose, exceeding pretreatment levels after 3 and 14 months, respectively. After 1 year the erythema recurred, responding only transiently to increasing doses of octreotide. The patient died after 2 years of therapy of tumor cachexy despite very highdosesof octreotide (4 × 600 μg/day). Throughout treatment octreotide did not prevent tumor growth, as demonstrated by computed tomography and sonography. Determination of immunoreactive glucagon before and during octreotide therapy in fractions of plasma samples subjected to gel chromatography revealed a reduction in the ratio of glucagon to preproglucagon from 1.83 (before) to 0.56 (during therapy), indicating inhibition of posttranslational processing of preproglucagon by octreotide, thereby reducing circulating bioactive glucagon. In summary, octreotide induced a remission of clinical symptoms by inhibiting posttranslational conversion of preproglucagon to glucagon but did not prevent tumor growth. Therefore, octreotide is a valuable therapy for rapid relief of clinical symptoms, thereby improving the possibilities for other tumor-reducing therapies

A case of antibody formation against octreotide visualized with ¹¹¹In-octreotide scintigraphy

A case of antibody formation in a patient with carcinoid syndrome is described. The patient was treated with octreotide in dosages up to 1.5 mg/day. Serum samples were analysed for the presence of octreotide antibodies before and after 20 months of octreotide treatment. In-vivo 111In-octreotide scintigraphy was performed before and during therapy, and after antibodies had developed. Before treatment, no serum antibodies against octreotide were detected. After 20 months of treatment, they were detectable up to a 1:115 serum dilution. The serum binding of 125I-Tyr3-octreotide was blocked by adding excess unlabelled Tyr3-octreotide, indicating the presence of specific octreotide antibodies. Before treatment, a normal distribution of radioactivity in the spleen and kidneys, irregular uptake in the liver due to metastases, and a hot spot in the lower abdomen were found during 111In-octreotide scintigraphy. After antibodies had developed, increased radioactivity over the heart and high background radioactivity in the abdomen with only faint visualization of the spleen, liver, and kidneys were found, indicating a prolonged presence of 111In-octreotide in the blood resulting from its being bound to antibodies. Increased radioactivity was also seen at the injection sites of the drug in the upper legs. In-vitro incubation of biopsy tissue from this site with 125I-Tyr3-octreotide revealed diffuse guanosine triphosphate (GTP) independent specific binding non-G-protein linked binding of labelled octreotide. This report describes the characteristic abnormalities during in-vivo 111In-octreotide scintigraphy in a patient with octreotide antibodies. These consisted of high background radioactivity due to prolonged circulation of antibody coupled 111In-octreotide together with visualization of the injection sites, which most probably results from local accumulation of antibodies.</p

Physiological and pathophysiological role of somatostatin receptors in the human thymus

This is a review summarizing the physiological and pathophysiological role of somatostatin receptors in the human thymus

Effect of changes in antibiotic prescribing on patient outcomes in a community setting: A natural experiment in Australia

© 2002 by the Infectious Diseases Society of America.This study examined whether a significant change in antibiotic use caused by an Australian government directive targeted at amoxicillin with clavulanic acid (AC) was associated with changes in prescription share, health care costs, and patient outcomes. We used an integrated database of computerized general practice medical records, which included data regarding 34,242 patients and 318,234 recorded patient visits. There were 15,303 antibiotic prescriptions provided to 9921 patients during a 4-year period, with AC prescribed for 1453 (14.6%) of these patients. A total of 5125 patient outcomes were identified. There was a shift away from best-practice antibiotic prescribing, and a significant association was identified between the rate and cost of process-of-care and patient outcomes and the decrease in AC-prescription share. This policy initiative created unintended changes in prescribing behavior, increased costs to the government, and a trend toward poorer patient outcomes. Detailed analyses are required before instigating initiatives aimed at changing clinicians' prescribing behavior.Justin Beilby, John Marley, Don Walker, Nicole Chamberlain, and Michelle Burke for the FIESTA Study Grou