Retrofit solutions for solid wall dwellings in England: the impact of uncertainty upon the energy performance gap

This study seeks to evaluate the impact of uncertainty in the pre-retrofit thermal performance of solid walls of English dwellings on post-retrofit energy use. Five dwelling archetypes, broadly representative of English solid wall properties, were modelled pre- and post-retrofit, under different wall insulation scenarios, using dynamic thermal simulation. Findings indicate that whilst solid wall insulation could result in a significant reduction of space heating demand, uncertainties in the pre-retrofit solid wall U-value could lead to a gap between the anticipated and actual energy performance. Specifically, results show that if the current U-value assumption of 2.1 W/m2K is indeed an overestimation of the in-situ U-value of solid walls, then the anticipated carbon savings could be significantly reduced by up to 65%. Practical application: The performance gap observed in this study revealed that the actual carbon savings arising from the retrofit of solid wall properties could be significantly lower than predicted. This will not only affect UK Government carbon reduction targets but it can also result in a lack of confidence amongst stakeholders who may consequently doubt the effectiveness of energy retrofit measures, thus reducing their uptake. Uncertainties regarding solid wall U-values may necessitate the re-examination of the carbon targets set for the retrofit of solid wall dwellings and the exploration of alternative ways to further reduce their carbon emissions, e.g. by specifying higher insulation thicknesses

Biological activity of the aqueous extract of Lychnophora pinaster Mart

Lyophilized aqueous extract (LAE) from Lychnophora pinaster Mart (Asteraceae) aerial parts was evaluated in the search of possible biological activities. LAE exhibited trypanocidal activity (113.62 μg/mL), but could not inhibit 5-lipoxygenase in vitro (17% of inhibition). LAE chemical characterization by HPLC with UV-Diode Array Detector showed the presence of caffeic acid, isochlorogenic acid, vitexin, isovitexin and quercetin, in comparison with authentic samples

A bootstrap method to investigate the variability of overheating risk against the future climate uncertainty in dwellings

Future overheating risk in dwellings can be potentially mitigated by minimising the variability of overheating hours against uncertainties in future climate via robust optimisation. However, the estimation of this variability value through the utilisation of percentile-based probabilistic weather data has yet to be sufficiently investigated. In this simulation-based study, the bootstrap method is used to quantify the accuracy of the variability estimation via percentilebased weather data. The results indicate significant overheating risk in regulation-compliant houses. An increased degree of difficulty is also suggested in obtaining accurate estimations when considering time periods further in the future and when assuming higher carbon emissions. In addition, the skew normal distribution can be used for a simpler and faster estimation, but the underlying uncertainties must be strengthened throughout its implementation

Association between Mortality Due to Nasopharyngeal Carcinoma and Race in the United States from 2007 to 2016

Publisher Copyright: © This work is licensed under a Creative Commons Attribution-Non Commercial 4.0 International LicenseBackground: Asians and Pacific Islanders (API) exhibit increased incidence of nasopharyngeal carcinoma (NPC). However, they are often excluded when the disease is studied. Risk-factors and incidence are well-researched while cancer-specific mortality trends remain unclear. We aimed to determine whether insurance status modifies the association between race and cancer-specific mortality in NPC patients. Methods: This retrospective cohort study used secondary data analysis from the Surveillance, Epidemiology, and End Results Program database. Patients ≥18 years with histologically confirmed primary NPC from 2007 - 2016 were included. The main outcome assessed was 5-year survival and the main exposure variable was race (API, white, black). Insurance status was classified into uninsured, any Medicaid, and insured (with any insurance). Potential confounders included age, sex, marital status, stage at diagnosis, and surgical treatment. Adjusted Cox regression analysis was used to calculate hazard ratios (HR) and corresponding 95% confidence intervals (CI). Results: 1610 patients were included (72.98% male, 27.02% female). 49.8% were API, 40.5% were Whites, and 9.8% Blacks. Maximum follow-up was 5-years. The adjusted hazards of 5-year cancer-specific death for API and Blacks compared with Whites were 0.77 (95% CI 0.62 – 0.96) and 0.92 (95% CI 0.65 – 1.31), respectively. Cases decreased with age in API and Blacks. 8.2% of cases had localized disease, 45.3% had local spread, and 44.6% had distant metastasis. Insurance status did not modify the association between race and mortality. Conclusion: Race is an important prognostic factor to account for in NPC patients.Peer reviewe

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

An experimental protocol for mimicking pathomechanisms of traumatic brain injury in mice

Traumatic brain injury (TBI) is a result of an outside force causing immediate mechanical disruption of brain tissue and delayed pathogenic events. In order to examine injury processes associated with TBI, a number of rodent models to induce brain trauma have been described. However, none of these models covers the entire spectrum of events that might occur in TBI. Here we provide a thorough methodological description of a straightforward closed head weight drop mouse model to assess brain injuries close to the clinical conditions of human TBI

Decreased levels of soluble cd44 in a high-risk population following a smoking cessation program

Tobacco is a risk factor of head and neck cancer (HNC) and smoking cessation alone may reduce HNC risk by 70%. Soluble CD44 (solCD44), a cell surface receptor linked to cell proliferation and migration, and total protein (TP) levels can detect early HNC. This study aims to determine whether salivary solCD44 and TP levels in oral rinses change following a smoking cessation program. 150 smokers provided oral rinse samples at baseline and at a 12-month follow-up after participation in a smoking cessation program. Assays to measure levels of solCD44, TP, and cotinine, a metabolite used as a biomarker of tobacco exposure, were completed. A paired-samples t-test was used to determine whether there was a statistically significant (p \u3c 0.05) mean difference in biomarker levels before and after the program. Baseline and at 12-month follow-up data were available for 88 subjects, 21 of whom quit smoking entirely. Mean levels of solCD44 significantly decreased by 0.412 ng/mL from baseline to the 12-month follow-up, p = 0.010. There was no significant difference in mean TP levels, p = 0.975. Mean cotinine levels decreased significantly by 74.7 ng/mL, p = 0.035. This is the first work demonstrating an association between smoking cessation and decreased solCD44 levels in oral rinses. Decreased expression of the tumorigenic CD44 may be one mechanism by which smoking cessation lowers cancer risk