7 research outputs found
MBL2 and Hepatitis C Virus Infection among Injection Drug Users
<p>Abstract</p> <p>Background</p> <p>Genetic variations in <it>MBL2 </it>that reduce circulating levels and alter functional properties of the mannose binding lectin (MBL) have been associated with many autoimmune and infectious diseases. We examined whether <it>MBL2 </it>variants influence the outcome of hepatitis C virus (HCV) infection.</p> <p>Methods</p> <p>Participants were enrolled in the Urban Health Study of San Francisco Bay area injection drug users (IDU) during 1998 through 2000. Study subjects who had a positive test for HCV antibody were eligible for the current study. Participants who were positive for HCV RNA were frequency matched to those who were negative for HCV RNA on the basis of ethnicity and duration of IDU. Genotyping was performed for 15 single nucleotide polymorphisms in <it>MBL2</it>. Statistical analyses of European American and African American participants were conducted separately.</p> <p>Results</p> <p>The analysis included 198 study subjects who were positive for HCV antibody, but negative for HCV RNA, and 654 IDUs who were positive for both antibody and virus. There was no significant association between any of the genetic variants that cause MBL deficiency and the presence of HCV RNA. Unexpectedly, the <it>MBL2 </it>-289X promoter genotype, which causes MBL deficiency, was over-represented among European Americans who were HCV RNA negative (OR = 1.65, 95% CI 1.05–2.58), although not among the African Americans.</p> <p>Conclusion</p> <p>This study found no association between genetic variants that cause MBL deficiency and the presence of HCV RNA. The observation that <it>MBL2 </it>-289X was associated with the absence of HCV RNA in European Americans requires validation.</p
A thermodynamic analysis of a novel bidirectional district heating and cooling network
We evaluate an ambient, bidirectional thermal network, which uses a single circuit for both district heating and cooling. When in net more cooling is needed than heating, the system circulates from a central plant in one direction. When more heating is needed, the system circulates in the opposite direction. A large benefit of this design is that buildings can recover waste heat from each other directly. We analyze the thermodynamic performance of the bidirectional system. Because the bidirectional system represents the state-of-the-art in design for district systems, its peak energy efficiency represents an upper bound on the thermal performance of any district heating and cooling system. However, because any network has mechanical and thermal distribution losses, we develop a diversity criterion to understand when the bidirectional system may be a more energy-efficient alternative to modern individual-building systems. We show that a simple model of a low-density, high-distribution loss network is more efficient than aggregated individual buildings if there is at least 1 unit of cooling energy per 5.7 units of simultaneous heating energy (or vice versa). We apply this criterion to reference building profiles in three cities to look for promising clusters
Recommended from our members
Listening Beyond Auscultating: A Quality Initiative to Improve Communication Scores in the Hospital Consumer Assessment of Health Care Practitioners and Systems Survey
IntroductionPhysician communication is critical to patient care. However, integration of sound communication practice with clinical workflows has proven difficult. In this quality improvement initiative, medical students used the rapid improvement model to test interventions that could enhance patients' perception of listening by physicians as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems survey.MethodsLiterature review and process analysis yielded 42 potential interventions, of which 24 were feasible for implementation. Small-scale testing established the 4 most promising interventions; pilot testing was subsequently undertaken on the entire Medicine service. Patient and physician feedback guided further refinement. The final intervention used a structured reminder embedded in the electronic health record to direct physicians to begin interviews by eliciting patient concerns.ResultsPatient concerns elicited after implementation included pain symptoms (28%), disease or treatment course (16%), and discharge planning (10%). In the Hospital Consumer Assessment of Healthcare Providers and Systems survey, physician listening scores rose from a 2014 average of 73.6% to 77% in 2015.DiscussionAmong 24 tested interventions, an open-ended question was most feasible and had the greatest perceived impact by hospitalists and patients. A structured reminder embedded in required electronic medical record documentation facilitated the behavioral change without being overly burdensome to physicians and established a mechanism to enact change in practice.ConclusionMedical students used established improvement methods to promote patient-centered care and align patient and physician agendas, providing a strategy to improve hospitalized patients' perceptions of physician listening
Turning Paris into reality at the University of California
The Paris Agreement highlights the need for local climate leadership. The University Of California's approach to deep decarbonization offers lessons in efficiency, alternative fuels and electrification. Bending the emissions curve globally requires efforts that blend academic insights with practical solutions