Architecture, ethics and sustainability - an exploration

Globally we are grappling with the concept of sustainability. What does it mean and how should we respond to ensure that the planet and its ecosystems survive? While the problem of living in a sustainable way must be addressed by all sectors of society, architects are arguably in the \u27front line\u27 because of the impact of buildings in terms of resource use and waste generation. Most definitions of sustainability are unhelpful because of their wordiness, lack of detail or ambiguity. Others distort the concept of sustainability to allow business-as-usual (i.e. unsustainable) activity to continue. Using one particular model of sustainability, this paper explores the apparent contradictions between architectural practice in the residential sector, \u27sustainable\u27 housing and the desire to behave ethically. The paper begins with definitions of sustainability and ethics, together with some guiding principles. The literature examining the ethics of sustainable architecture is then reviewed. Two indicators are suggested to make a broad-brush assessment of sustainability. Current practice in Australian residential architectural design, both mainstream and \u27green\u27, is then critiqued against these indicators. Finally, some practical options for a practising architect faced with a client, who wants an \u27unsustainable\u27 house, are briefly explored.<br /

Structural properties of discs and bulges of early-type galaxies

We have used the EFAR sample of galaxies to study the light distributions of early-type galaxies. We decompose the 2D light distribution of the galaxies in a flattened spheroidal component with a Sersic radial light profile and an inclined disc component with an exponential light profile. We show that the brightest, bulge dominated elliptical galaxies have a fairly broad distribution in the Sersic profile shape parameter n_B, with a median of about 3.7 and a sigma of ~0.9. Other galaxies have smaller n_B values, meaning that spheroids are in general less concentrated than the n_B=4 de Vaucouleurs-law profile. The results of our light decompositions are robust, even though without kinematic information we cannot prove that the spheroids and discs are really pressure- and rotation-supported stellar systems. If we assume that the detected spheroids and discs are indeed separate components, we can draw the following conclusions: 1) the spheroid and disc scale sizes are correlated; 2) bulge-to-total luminosity ratios, bulge effective radii, and bulge n_B values are all positively correlated; 3) the bivariate space density distribution of elliptical galaxies in the (luminosity, scale size)-plane is well described by a Schechter luminosity function in and a log-normal scale-size distribution at a given luminosity; 4) at the brightest luminosities, the scale size distribution of elliptical galaxies is similar to those of bright spiral galaxies; at fainter luminosities the elliptical scale size distribution peaks at distinctly smaller sizes than the spiral galaxy distribution; and 5) bulge components of early-type galaxies are typically a factor 1.5 to 2.5 smaller than the disks of spiral galaxies, while disc components of early-type galaxies are typically twice as large as the discs of spiral galaxies. [abridged]Comment: 16 pages, 18 figures. Accepted for publication in the MNRA

Diagnostic performance of stress myocardial perfusion imaging for coronary artery disease: a systematic review and meta-analysis

Objectives: To determine and compare the diagnostic performance of stress myocardial perfusion imaging (MPI) for the diagnosis of obstructive coronary artery disease (CAD), using conventional coronary angiography (CCA) as the reference standard. Methods: We searched Medline and Embase for literature that evaluated stress MPI for the diagnosis of obstructive CAD using magnetic resonance imaging (MRI), contrast-enhanced echocardiography (ECHO), single-photon emission computed tomography (SPECT) and positron emission tomography (PET). Results: All pooled analyses were based on random effects models. Articles on MRI yielded a total of 2,970 patients from 28 studies, articles on ECHO yielded a sample size of 795 from 10 studies, articles on SPECT yielded 1,323 from 13 studies. For CAD defined as either at least 50 %, at least 70 % or at least 75 % lumen diameter reduction on CCA, the natural logarithms of the diagnostic odds ratio (lnDOR) for MRI (3.63; 95 % CI 3.26–4.00) was significantly higher compared to that of SPECT (2.76; 95 % CI 2.28–3.25; P = 0.006) and that of ECHO (2.83; 95 % CI 2.29–3.37; P = 0.02). There was no significant difference between the lnDOR of SPECT and ECHO (P = 0.52). Conclusion: Our results suggest that MRI is superior for the diagnosis of obstructive CAD compared with ECHO and SPECT. ECHO and SPECT demonstrated similar diagnostic performance

The first steps in the development of a cancer-specific patient-reported experience measure item bank (PREM-item bank):towards dynamic evaluation of experiences

Objective: Since the implementation of value-based healthcare, there has been a growing emphasis on utilizing patient-reported experience measures (PREMs) to enhance the quality of care. However, the current PREMs are primarily generic and static, whereas healthcare is constantly evolving and encompasses a wide variety of aspects that impact care quality. To continuously improve care requires a dynamic PREM. The aim of this study was to propose an item bank for the establishment of a dynamic and care-specific patient-reported evaluation. Methods: In co-creation with patients, a mixed methods study was conducted involving: (1) an explorative review of the literature, (2) a focus group analysis with (ex-)patients, (3) qualitative analyses to formulate themes, and (4) a quantitative selection of items by patients and experts through prioritization. Results: Eight existing PREMs were evaluated. After removing duplicates, 141 items were identified. Through qualitative analyses of the focus group in which the patient journey was discussed, eight themes were formulated: “Organization of healthcare,” “Competence of healthcare professionals,” “Communication,” “Information &amp; services,” “Patient empowerment,” “Continuity &amp; informal care,” “Environment,” and “Technology.” Seven patients and eleven professionals were asked to prioritize what they considered the most important items. From this, an item bank with 76 items was proposed. Conclusion: In collaboration with patients and healthcare professionals, we have proposed a PREM-item bank to evaluate the experiences of patients’ receiving cancer care in an outpatient clinic. This item bank is the first step to dynamically assess the quality of cancer care provided in an outpatient setting.</p

Commentary on the WHO classification of tumors of lymphoid tissues (2008): “Gray zone” lymphomas overlapping with Burkitt lymphoma or classical Hodgkin lymphoma

The 2008 WHO Classification of Tumors of Haematopoietic and Lymphoid Tissues has introduced two new categories of high-grade B-cell lymphomas: entities in which features of diffuse large B-cell lymphoma (DLBCL) overlap with Burkitt lymphoma (DLBCL/BL) or classical Hodgkin lymphoma (DLBCL/HL). The DLBCL/BL category encompasses cases that resemble Burkitt lymphoma morphologically, but have one or more immunophenotypic or molecular genetic deviations that would exclude it from the BL category; conversely, some cases have immunophenotypic and/or genetic features of BL, but display cytologic variability unacceptable for BL. Many of the cases in the DLBCL/BL category contain a translocation of MYC as well as either BCL2 or BCL6 (so-called double-hit lymphomas) and have a very aggressive clinical behavior. The DLBCL/HL category encompasses lymphomas that exhibit the morphology of classical Hodgkin lymphoma but the immunophenotype of DLBCL, or vice versa. Most DLBCL/HL cases described present as mediastinal masses, but this category is not limited to mediastinal lymphomas. These new categories acknowledge the increasing recognition of cases that display mixed features of two well-established diseases. Whether the existence of such cases reflects shortcomings of our current diagnostic armamentarium or a true disease continuum in which such hybrid or intermediate neoplasms actually exist remains to be determined

Commentary on the WHO classification of tumors of lymphoid tissues (2008): indolent B cell lymphomas

The 4th edition of the World Health Organization classification of tumors of hematopoietic and lymphoid tissues introduces many new items to the classification scheme of the so-called indolent B cell lymphomas. New proposed entities, such as splenic B cell lymphoma/leukemia, unclassifiable, splenic diffuse red pulp small B cell lymphoma, hairy cell leukemia variant, pediatric follicular lymphoma, and pediatric marginal zone lymphoma have been coined, and some definitions of established diseases, such as chronic lymphocytic leukemia or Waldenström’s macroglobulinemia have been revised. One aspect of major importance is the recent description of small clonal B cell populations, in part with a CLL phenotype, and their relationship to B-CLL. Some new subtypes or variants of follicular lymphoma with distinct clinicopathologic and/or molecular genetic characteristics have been described, including primary follicular lymphomas of the duodenum and pediatric follicular lymphomas. Furthermore, the impact of some probably early, or precursor lesions, such as follicular lymphoma in situ is discussed. Overall, we succinctly discuss the essential elements of the revisions made in the updated classification, and we identify potential opportunities for refinement of new or provisional categories in subsequent classifications

Gedanken Worlds without Higgs: QCD-Induced Electroweak Symmetry Breaking

To illuminate how electroweak symmetry breaking shapes the physical world, we investigate toy models in which no Higgs fields or other constructs are introduced to induce spontaneous symmetry breaking. Two models incorporate the standard SU(3)_c x SU(2)_L x U(1)_Y gauge symmetry and fermion content similar to that of the standard model. The first class--like the standard electroweak theory--contains no bare mass terms, so the spontaneous breaking of chiral symmetry within quantum chromodynamics is the only source of electroweak symmetry breaking. The second class adds bare fermion masses sufficiently small that QCD remains the dominant source of electroweak symmetry breaking and the model can serve as a well-behaved low-energy effective field theory to energies somewhat above the hadronic scale. A third class of models is based on the left-right--symmetric SU(3)_c x SU(2)_L x SU(2)_R x U(1)_{B-L} gauge group. In a fourth class of models, built on SU(4)_{PS} x SU(2)_L x SU(2)_R gauge symmetry, lepton number is treated as a fourth color. Many interesting characteristics of the models stem from the fact that the effective strength of the weak interactions is much closer to that of the residual strong interactions than in the real world. The Higgs-free models not only provide informative contrasts to the real world, but also lead us to consider intriguing issues in the application of field theory to the real world.Comment: 20 pages, no figures, uses RevTeX; typos correcte

Effects of increasing dietary wheat middlings on nursery pig performance from 15 to 50 lb

A total of 210 pigs (PIC 327 × 1050, initially 15.12 lb BW) were used in a 35-d trial to evaluate the effects of increasing dietary wheat middlings (midds) on growth performance of 15- to 50-lb nursery pigs. Pens of pigs were balanced by initial BW and randomly allotted to 1 of 5 dietary treatments with 6 replications per treatment. The 5 corn-soybean meal–based diets contained 0, 5, 10, 15, or 20% midds. Pigs were fed in a 2-phase feeding program from d 0 to 14 and d 14 to 35. Diets were not balanced for energy; thus, as midds increased, dietary energy concentrations decreased. From d 0 to 14, midds had no effect on growth performance; however, from d 14 to 35, pigs fed increasing midds had decreased ADG (linear, P \u3c 0.02) and poorer F/G (linear, P \u3c 0 .004). Furthermore, pigs fed increasing midds had lower (linear, P \u3c 0.05) feed cost/pig, revenue/pig, and income over feed cost (IOFC), and a tendency for increased (quadratic, P \u3c 0.07) feed cost/lb gain. Overall (d 0 to 35), increasing dietary midds worsened F/G (quadratic, P \u3c 0.01), driven by poorer F/G for pigs fed 15 and 20% midds. We also observed a quadratic effect (P \u3c 0.004) for feed cost/lb gain, with inclusion rates of 0 and 20% having the highest value. Caloric efficiency responded in a quadratic manner (P \u3c 0.01) on both an ME and NE basis with improved caloric effi¬ciencies at intermediate levels (mainly 5%) of dietary middlings compared with 0 and 20% inclusions. These data suggest that the inclusion of midds at levels up to 15% do not negatively affect performance in 15- to 50-lb nursery pigs. Although we observed a linear decrease in overall IOFC, both inclusion rates of 5 and 10% were numerically more profitable than the control.; Swine Day, Manhattan, KS, November 15, 201

Evidence for Recipient-Derived Cells in Peribiliary Glands and Biliary Epithelium of the Large Donor Bile Ducts After Liver Transplantation

Introduction Chimerism after orthotopic liver transplantation (OLT) has largely been investigated in intrahepatic cellular constituents. However, little is known about chimerism in the extrahepatic and large intrahepatic bile ducts. Our aim was to evaluate the presence and extent of chimerism after OLT in the peribiliary glands (PBG) and the luminal epithelium of the large donor bile ducts. Methods For this study, we examined six extrahepatic and large intrahepatic bile ducts from livers that were re-transplanted. In all cases there was a sex-mismatch between donor and recipient (female donor organ and male recipient), which allowed to discriminate between donor- and recipient-derived cells. Specimens from female to female transplants were used as negative controls and male to male transplants as positive controls. Fluorescencein situhybridization (FISH) for Y and X chromosomes was performed and the percentage of XY positive cells was determined among biliary epithelial cells. Immunohistochemistry was used to correlate chimerism with histological features. Results Cholangiocellular chimerism in all studied specimens ranged from 14 to 52%. The degree of chimerism was not associated with biliary damage. Marked chimerism was present at 5 days post-OLT. Ki-67-positivity was detected in 1-8% of the epithelial cells at the time of liver re-transplantation, and this correlated inversely with the degree of chimerism. Conclusion Recipient-derived cholangiocytes are present in the large bile ducts of the donor liver after OLT. The presence of chimerism in the large bile ducts suggests that recipient-derived cells may play a role in biliary regeneration following ischemia-induced injury during OLT