Long Term Performance Of Passive House Buildings

Long term experience with Passive House buildings is illustrated with two early large scale projects, a school and an office building located in Germany. Those were monitored in lump energy performance (school, commissioned 2004) and great detail (office, commissioned 2002) respectively. Moreover, they give an indication of the characteristics of such buildings subject to changes in usage intensity. Both buildings generally performed as expected with the school facing occasional overheating in the summer due to inflexible shading controls. Following an extension in schooling hours the addition of a canteen was required and the ventilation system was adapted to the changed usage. Nevertheless the building’s user comfort and energy performance remain high,despite exceeding the Passive House primary energy target slightly due to increased electricity consumption. The office likewise meets the calculated efficiency in operation. The ground coupled cooling worked well despite greatly increased internal heat gains due to unexpected usage. This extra heat input did not, however, exhaust the geothermal (passive) cooling capacity for the future. Thermal comfort proved near optimal at all times, despite a very simple control regime of the one-circuit concrete core activation system for heating and cooling. In the last section air tightness design and measurement experience in the UK and particularly the question of long-term stability of the airtight building envelope is assessed. It was found that measurement results are not only repeatable in relatively short intervals such as a few months. The data available suggests stability of the airtight envelope over many years. Attention is required as regards the leakage of party walls of terraced buildings which need to be integrated in the overall airtightness concept. A high permeability of party walls in terraced buildings with a common airtight envelope presents a challenge for measuring air tightness. Long-term series of airtightness measurements exist for the Kranichstein House in Darmstadt/Germany and prove the stability of the chosen airtightness concept. Moreover, results for 17 early Passive House buildings in Germany in eight locations and various construction types revisited in 2001 (1.4 to 10 years after the initial airtightness test) suggest stability of air tightness values over time. Great advances have since been made in materials and methods available and the general understanding in the industry. This is supported by a large sample of 2934 Passive House projects of varied construction materials, locations, sizes and usages that yielded an average air tightness test result as low as n50 = 0.41 h-1

Temperature in housing: stratification and contextual factors

Overheating in new and retrofit low carbon dioxide homes is a growing issue in the UK due to climate change and other factors, with 99% of existing housing predicted to be at medium to high risk if summer temperatures become 1·4°C warmer. A year-long field study in two residential developments in the north of England monitored housing at three different scales: two-storey houses and three- and ten-storey blocks of flats. This revealed significant temperature stratification in the staircase zone, which allows a stack effect, as well as temperature differences between dwellings depending on their location in the building, both for summer and winter conditions even in the low-rise housing. Further investigation revealed that albedo and east–west orientation also contributed to non-linear overheating. Analyses of inhabitants’ thermal comfort and security practices as well as occupancy patterns also challenge the regulatory modelling used to predict building performance. It is suggested that these additional physical as well as user factors in residential developments need further investigation and should now be considered in relation to thermal comfort modelling

The role of the fat mass and obesity associated gene (FTO) in breast cancer risk

<p>Abstract</p> <p>Background</p> <p>Obesity has been shown to increase breast cancer risk. <it>FTO </it>is a novel gene which has been identified through genome wide association studies (GWAS) to be related to obesity. Our objective was to evaluate tissue expression of FTO in breast and the role of FTO SNPs in predicting breast cancer risk.</p> <p>Methods</p> <p>We performed a case-control study of 354 breast cancer cases and 364 controls. This study was conducted at Northwestern University. We examined the role of single nucleotide polymorphisms (SNPs) of intron 1 of <it>FTO </it>in breast cancer risk. We genotyped cases and controls for four SNPs: rs7206790, rs8047395, rs9939609 and rs1477196. We also evaluated tissue expression of FTO in normal and malignant breast tissue.</p> <p>Results</p> <p>We found that all SNPs were significantly associated with breast cancer risk with rs1477196 showing the strongest association. We showed that FTO is expressed both in normal and malignant breast tissue. We found that <it>FTO </it>genotypes provided powerful classifiers to predict breast cancer risk and a model with epistatic interactions further improved the prediction accuracy with a receiver operating characteristic (ROC) curves of 0.68.</p> <p>Conclusion</p> <p>In conclusion we have shown a significant expression of FTO in malignant and normal breast tissue and that <it>FTO </it>SNPs in intron 1 are significantly associated with breast cancer risk. Furthermore, these <it>FTO </it>SNPs are powerful classifiers in predicting breast cancer risk.</p

Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study

Background No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. Methods The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. Findings 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7–9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46–0·99]), obesity (0·50 [0·34–0·74]) and invasive mechanical ventilation (0·42 [0·23–0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74–1·00]), at 5 months (0·74 [0·64–0·88]) to 1 year (0·75 [0·62–0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. Interpretation The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. Funding UK Research and Innovation and National Institute for Health Research

Large-scale phenotyping of patients with long COVID post-hospitalization reveals mechanistic subtypes of disease

One in ten severe acute respiratory syndrome coronavirus 2 infections result in prolonged symptoms termed long coronavirus disease (COVID), yet disease phenotypes and mechanisms are poorly understood1. Here we profiled 368 plasma proteins in 657 participants ≥3 months following hospitalization. Of these, 426 had at least one long COVID symptom and 233 had fully recovered. Elevated markers of myeloid inflammation and complement activation were associated with long COVID. IL-1R2, MATN2 and COLEC12 were associated with cardiorespiratory symptoms, fatigue and anxiety/depression; MATN2, CSF3 and C1QA were elevated in gastrointestinal symptoms and C1QA was elevated in cognitive impairment. Additional markers of alterations in nerve tissue repair (SPON-1 and NFASC) were elevated in those with cognitive impairment and SCG3, suggestive of brain–gut axis disturbance, was elevated in gastrointestinal symptoms. Severe acute respiratory syndrome coronavirus 2-specific immunoglobulin G (IgG) was persistently elevated in some individuals with long COVID, but virus was not detected in sputum. Analysis of inflammatory markers in nasal fluids showed no association with symptoms. Our study aimed to understand inflammatory processes that underlie long COVID and was not designed for biomarker discovery. Our findings suggest that specific inflammatory pathways related to tissue damage are implicated in subtypes of long COVID, which might be targeted in future therapeutic trials