A framework to identify and prioritise the key sustainability indicators: Assessment of heating systems in the built environment

Sustainability indicators (SIs) are important instruments to quantify, analyse, and communicate complex sustainability information, with a history of application in energy research. It is critical to identify an effective set of indicators which can holistically evaluate the energy systems encompassing the three facets of sustainability: environment, economy, and society. However, the literature has been lacking in either proportionally representing the sustainability dimensions or reflecting the stakeholders’ preferences. This paper develops a framework to identify and prioritise a set of SIs, critically reviewed to ensure reflection of a wide array of factors and conceptions of what sustainability entails. The developed framework utilises a series of methods within three phases: identification, refinement, and prioritisation. Applying the proposed framework to building heating technologies, a set of 22 SIs consisting of 4 economic, 8 environmental, and 10 social indicators were identified. According to the results, the economic indicators of Operation & Maintenance Cost and Net Present Value were found to be the most impactful factors, while environmental SIs contribute the most to the overall sustainability weight. The identified indicators apply to the assessment of heating systems and policies, and the proposed framework could more broadly support analysis of key sustainability criteria in various fields

Planning energy interventions in buildings and tackling fuel poverty: Can two birds be fed with one scone?

Energy retrofitting and renovations are an inseparable part of decarbonisation strategies in the building sector. These measures are often tied up with several social factors that can potentially impact the wellbeing of households and the community if the end-user requirements are not carefully considered. Fuel poverty is one of these social factors that is an essential consideration for designing effective, just, and user-centred interventions, but it is often overlooked in engineering processes. Therefore, this article seeks to re-connect the notion of fuel poverty to practice by bringing it forward from the post-intervention assessments to the design and decision-making stages. To do so, a new indicator, Potential Fuel Poverty Index (PFPI), is developed to obtain the likelihood of fuel poverty that future interventions can pose to the households. The PFPI presents a more targeted analysis of fuel poverty by reflecting the socio-spatial characterisation of the households. Using the PFPI, fuel poverty can be observed as a design/decision factor at the early stages of sketching interventions, in conjunction with other economic, environmental, and technical factors. Finally, the utility of the developed method is demonstrated using a real case study in the UK, assessing the impact of heat decarbonisation through heat pumps on fuel poverty

PVC-LOT-004-D-137

This article discusses the role of embodiment in judgment and choice to (a) attain clarity on conceptual and methodological issues by presenting a literature review of prior empirical research on embodiment, (b) gain an integrative view on the topic of embodiment in judgment and choice by proposing somatic marker theory as a unifying conceptual framework for bridging cognition and affect in terms of embodiment, and (c) discuss and clarify ideas and directions for further research on the topic

Rare Germline DICER1 Variants in Pediatric Patients With Cushing's Disease: What Is Their Role?

Context: The DICER1 syndrome is a multiple neoplasia disorder caused by germline mutations in the DICER1 gene. In DICER1 patients, aggressive congenital pituitary tumors lead to neonatal Cushing's disease (CD). The role of DICER1 in other corticotropinomas, however, remains unknown. Objective: To perform a comprehensive screening for DICER1 variants in a large cohort of CD patients, and to analyze their possible contribution to the phenotype. Design, setting, patients, and interventions: We included 192CD cases: ten young-onset (age <30 years at diagnosis) patients were studied using a next generation sequencing panel, and 182 patients (170 pediatric and 12 adults) were screened via whole-exome sequencing. In seven cases, tumor samples were analyzed by Sanger sequencing. Results: Rare germline DICER1 variants were found in seven pediatric patients with no other known disease-associated germline defects or somatic DICER1 second hits. By immunohistochemistry, DICER1 showed nuclear localization in 5/6 patients. Variant transmission from one of the parents was confirmed in 5/7 cases. One patient had a multinodular goiter; another had a family history of melanoma; no other patients had a history of neoplasms. Conclusions: Our findings suggest that DICER1 gene variants may contribute to the pathogenesis of non-syndromic corticotropinomas. Clarifying whether DICER1 loss-of-function is disease-causative or a mere disease-modifier in this setting, requires further studies.This work was supported by the Intramural Research Programs of Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and National Institute for Neurological Diseases and Stroke, National Institutes of Health, a grant from the Basque Department of Education (IT795-13), a grant from the Basque Department of Health (GV2018111082), the Merck Serono Research award from Fundacion Salud 2000 (15-EP-004) and the Jose Igea 2018 grant, sponsored by Pfizer, from Fundacion Sociedad Espanola de Endocrinologia Pediatrica (SEEP)

The validity of the index of vulnerable homes : evidence from consumers vulnerable to energy poverty in the UK

Energy poverty is a multidimensional issue, and this means that it is difficult to understand the different levels of vulnerability to this phenomenon and its relationship with households’ quality of life. This paper presents the validation of an innovative index for the analysis of vulnerability to energy poverty according to monetary, energy and thermal comfort factors: The Index of Vulnerable Homes (IVH). The IVH goes beyond the use of single self-reported indicators of thermal comfort, and instead uses the adaptive thermal-comfort model defined in the normative UNE EN 15251:2007 to assess thermal comfort in relation to energy poverty. Furthermore, it has the potential to evaluate societal impacts of current energy poverty policies by providing the economic analysis of different situations of vulnerability. The IVH is validated by comparing its results to those obtained from a survey conducted in a small-scale study undertaken in Salford, UK. To this end, evidence from households living in terraced houses built before 1980 is used to analyse health status in terms of vulnerability to energy poverty vulnerability according to their monetary situation and the characteristics of the dwelling. In the end, the results show good agreement between both the IVH’s assessment and households’ evidence, leading to consider the IVH as a suitable approach to understanding different levels of vulnerability to energy poverty

High incidence of PTSD diagnosis and trauma-related symptoms in a trauma exposed bipolar I and II sample

Post-traumatic stress disorder (PTSD) is an established comorbidity in Bipolar Disorder (BD), but little is known about the characteristics of psychological trauma beyond a PTSD diagnosis and differences in trauma symptoms between BD-I and BD-II. (1) To present characteristics of a trauma-exposed BD sample; (2) to investigate prevalence and trauma symptom profile across BD-I and BD-II; (3) to assess the impact of a lifetime PTSD diagnosis vs. a history of trauma on BD course; and (4) to research the impacts of sexual and physical abuse. This multi-center study comprised 79 adult participants with BD with a history of psychological trauma and reports baseline data from a trial registered in Clinical Trials (; ref: NCT02634372). Clinical variables were gathered through clinical interview, validated scales and a review of case notes. The majority (80.8%) of our sample had experienced a relevant stressful life event prior to onset of BD, over half of our sample 51.9% had a lifetime diagnosis of PTSD according to the Clinician Administered PTSD scale. The mean Impact of Event Scale-Revised scores indicated high levels of trauma-related distress across the sample, including clinical symptoms in the PTSD group and subsyndromal symptoms in the non-PTSD group. Levels of dissociation were not higher than normative values for BD. A PTSD diagnosis (vs. a history of trauma) was associated with psychotic symptoms [2(1) = 5.404, p = 0.02] but not with other indicators of BD clinical severity. There was no significant difference between BD-I and BD-II in terms of lifetime PTSD diagnosis or trauma symptom profile. Sexual abuse significantly predicted rapid cycling [2(1) = 4.15, p = 0.042], while physical abuse was not significantly associated with any clinical indicator of severity. Trauma load in BD is marked with a lack of difference in trauma profile between BD-I and BD-II. Although PTSD and sexual abuse may have a negative impact on BD course, in many indicators of BD severity there is no significant difference between PTSD and subsyndromal trauma symptoms. Our results support further research to clarify the role of subsyndromic PTSD symptoms, and highlight the importance of screening for trauma in BD patients

Long daytime napping is associated with increased adiposity and type 2 diabetes in an elderly population with metabolic syndrome

Research examining associations between objectively-measured napping time and type 2 diabetes (T2D) is lacking. This study aimed to evaluate daytime napping in relation to T2D and adiposity measures in elderly individuals from the Mediterranean region. A cross-sectional analysis of baseline data from 2190 elderly participants with overweight/obesity and metabolic syndrome, in the PREDIMED-Plus trial, was carried out. Accelerometer-derived napping was measured. Prevalence ratios (PR) and 95% confidence intervals (CI) for T2D were obtained using multivariable-adjusted Cox regression with constant time. Linear regression models were fitted to examine associations of napping with body mass index (BMI) and waist circumference (WC). Participants napping ≥90 min had a higher prevalence of T2D (PR 1.37 (1.06, 1.78)) compared with those napping 5 to <30 min per day. Significant positive associations with BMI and WC were found in those participants napping ≥30 min as compared to those napping 5 to <30 min per day. The findings of this study suggest that longer daytime napping is associated with higher T2D prevalence and greater adiposity measures in an elderly Spanish population at high cardiovascular risk

Quality indicators for patients with traumatic brain injury in European intensive care units

Background: The aim of this study is to validate a previously published consensus-based quality indicator set for the management of patients with traumatic brain injury (TBI) at intensive care units (ICUs) in Europe and to study its potential for quality measur

Changing care pathways and between-center practice variations in intensive care for traumatic brain injury across Europe

Purpose: To describe ICU stay, selected management aspects, and outcome of Intensive Care Unit (ICU) patients with traumatic brain injury (TBI) in Europe, and to quantify variation across centers. Methods: This is a prospective observational multicenter study conducted across 18 countries in Europe and Israel. Admission characteristics, clinical data, and outcome were described at patient- and center levels. Between-center variation in the total ICU population was quantified with the median odds ratio (MOR), with correction for case-mix and random variation between centers. Results: A total of 2138 patients were admitted to the ICU, with median age of 49 years; 36% of which were mild TBI (Glasgow Coma Scale; GCS 13–15). Within, 72 h 636 (30%) were discharged and 128 (6%) died. Early deaths and long-stay patients (> 72 h) had more severe injuries based on the GCS and neuroimaging characteristics, compared with short-stay patients. Long-stay patients received more monitoring and were treated at higher intensity, and experienced worse 6-month outcome compared to short-stay patients. Between-center variations were prominent in the proportion of short-stay patients (MOR = 2.3, p < 0.001), use of intracranial pressure (ICP) monitoring (MOR = 2.5, p < 0.001) and aggressive treatme

CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative

Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research