Adding value and meaning to coheating tests

Purpose: The coheating test is the standard method of measuring the heat loss coefficient of a building, but to be useful the test requires careful and thoughtful execution. Testing should take place in the context of additional investigations in order to achieve a good understanding of the building and a qualitative and (if possible) quantitative understanding of the reasons for any performance shortfall. The paper aims to discuss these issues. Design/methodology/approach: Leeds Metropolitan University has more than 20 years of experience in coheating testing. This experience is drawn upon to discuss practical factors which can affect the outcome, together with supporting tests and investigations which are often necessary in order to fully understand the results. Findings: If testing is approached using coheating as part of a suite of investigations, a much deeper understanding of the test building results. In some cases it is possible to identify and quantify the contributions of different factors which result in an overall performance shortfall. Practical implications: Although it is not practicable to use a fully investigative approach for large scale routine quality assurance, it is extremely useful for purposes such as validating other testing procedures, in-depth study of prototypes or detailed investigations where problems are known to exist. Social implications: Successful building performance testing is a vital tool to achieve energy saving targets. Originality/value: The approach discussed clarifies some of the technical pitfalls which may be encountered in the execution of coheating tests and points to ways in which the maximum value can be extracted from the test period, leading to a meaningful analysis of the building's overall thermal performance

How do people with knee osteoarthritis perceive and manage flares? A qualitative study

Background Acute flares in people with osteoarthritis (OA) are poorly understood. There is uncertainty around the nature of flares, their impact, and how these are managed. Aim To explore understandings and experiences of flares in people with knee OA, and to describe self-management and help-seeking strategies. Design & setting Qualitative interview study of people with knee OA in England. Method Semi-structured interviews were undertaken with 15 people with knee OA. Thematic analysis was applied using constant comparison methods. Results The following four main themes were identified: experiencing pain; consequences of acute pain; predicting and avoiding acute pain; and response to acute pain. People with OA described minor episodes that were frequent, fleeting, occurred during everyday activity, had minimal impact, and were generally predictable. This contrasted with severe episodes that were infrequent, had greater impact, and were less likely to be predictable. The latter generally led to feelings of low confidence, vulnerability, and of being a burden. The term ‘flare’ was often used to describe the severe events but this was applied inconsistently and some would describe a flare as any increase in pain. Participants used numerous self-management strategies but tended to seek help when these had been exhausted, their symptoms led to emotional distress, disturbed sleep, or pain experience worse than usual. Previous experiences shaped whether people sought help and who they sought help from. Conclusion Severe episodes of pain are likely to be synonymous with flares. Developing a common language about flares will allow a shared understanding of these events, early identification, and appropriate management

Party Wall Cavity Barrier Effective Edge Seal Testing for ARC Building Solutions Ltd

ARC Building Solutions Ltd manufacture, market and distribute a range of party wall cavity barriers. Part L of the Building Regulations (HM Government, 2013) stipulates that when cavity barriers are used for edge sealing purposes, then the seal must be effective at restricting air flow between the party wall cavity and the external wall cavity or external environment (Figure 1). The Building Control Alliance (2011) describes how an edge seal is to be judged as being effective in a qualitative manner. However, there is currently no standard test for quantitatively demonstrating the effectiveness of edge sealing using a cavity barrier product. ARC Building Solutions Ltd wished to quantify the effectiveness of the edge seal that could be achieved using the Company’s products under test conditions. This information could prove useful when engaging designers, building control bodies and warranty providers. As there is currently no quantitative benchmark for what is deemed to be an effective edge seal this project aimed to compare the performance of a recognised ‘current practice’ solution against ARC Building Solutions Ltd.’s T-Barrier, and as far as possible compare these to an accepted effective edge seal for a number of different party wall and external wall cavity widths. In addition to this comparative testing, this project may also assist in the development and application of a standardised ‘Edge Seal Test’ for which there is understood to be no current standard or specific precedent. Whilst the test rig may not be fully representative of the actual construction of a party wall/external wall junction in situ, it is hoped that the results may provide insight as to how the performance of these products may compare in real building situations

Gender difference in symptomatic radiographic knee osteoarthritis in the Knee Clinical Assessment – CAS(K): A prospective study in the general population

<p>Abstract</p> <p>Background</p> <p>A recent study of adults aged ≥50 years reporting knee pain found an excess of radiographic knee osteoarthritis (knee ROA) in symptomatic males compared to females. This was independent of age, BMI and other clinical signs and symptoms. Since this finding contradicts many previous studies, our objective was to explore four possible explanations for this gender difference: X-ray views, selection, occupation and non-articular conditions.</p> <p>Methods</p> <p>A community-based prospective study. 819 adults aged ≥50 years reporting knee pain in the previous 12 months were recruited by postal questionnaires to a research clinic involving plain radiography (weight-bearing posteroanterior semiflexed, supine skyline and lateral views), clinical interview and physical examination. Any knee ROA, ROA severity, tibiofemoral joint osteoarthritis (TJOA) and patellofemoral joint osteoarthritis (PJOA) were defined using all three radiographic views. Occupational class was derived from current or last job title. Proportions of each gender with symptomatic knee ROA were expressed as percentages, stratified by age; differences between genders were expressed as percentage differences with 95% confidence intervals.</p> <p>Results</p> <p>745 symptomatic participants were eligible and had complete X-ray data. Males had a higher occurrence (77%) of any knee ROA than females (61%). In 50–64 year olds, the excess in men was mild knee OA (particularly PJOA); in ≥65 year olds, the excess was both mild and moderate/severe knee OA (particularly combined TJOA/PJOA). This male excess persisted when using the posteroanterior view only (64% vs. 52%). The lowest level of participation in the clinic was symptomatic females aged 65+. Within each occupational class there were more males with symptomatic knee ROA than females. In those aged 50–64 years, non-articular conditions were equally common in both genders although, in those aged 65+, they occurred more frequently in symptomatic females (41%) than males (31%).</p> <p>Conclusion</p> <p>The excess of knee ROA among symptomatic males in this study seems unlikely to be attributable to the use of comprehensive X-ray views. Although prior occupational exposures and the presence of non-articular conditions cannot be fully excluded, selective non-participation bias seems the most likely explanation. This has implications for future study design.</p

The structure of the hexameric atrazine chlorohydrolase AtzA

Atrazine chlorohydrolase (AtzA) was discovered and purified in the early 1990s from soil that had been exposed to the widely used herbicide atrazine. It was subsequently found that this enzyme catalyzes the first and necessary step in the breakdown of atrazine by the soil organism Pseudomonas sp. strain ADP. Although it has taken 20 years, a crystal structure of the full hexameric form of AtzA has now been obtained. AtzA is less well adapted to its physiological role (i.e. atrazine dechlorination) than the alternative metal-dependent atrazine chlorohydrolase (TrzN), with a substrate-binding pocket that is under considerable strain and for which the substrate is a poor fit

Reflections on retrofits: Overcoming barriers to energy efficiency among the fuel poor in the United Kingdom

To meet targets on fuel poverty, energy efficiency and carbon emissions existing homes need to be more energy efficient. We report the results of a participatory action research project to explore the challenges associated with energy efficiency retrofit programmes and ways to better implement future schemes. Six focus groups were held with 48 participants from a range of energy efficiency roles. Data were analysed thematically using the research question “What are the challenges presented by implementing energy efficiency retrofit programmes”. We identified four themes in the data: Funding mechanisms; Predicting performance; Installation; and People. Challenges include funding mechanisms for retrofit programmes resulting in insufficient time to plan, publicise, implement and evaluate a scheme and insufficient flexibility to specify the most appropriate intervention for individual homes. Site workers sometimes need to adapt retrofit designs because of insufficient detail from the designer and can equate quality of installation with quality of finish. Landlords and occupier behaviour can impact on the programme's success and there is a need for greater information on benefits for landlords and for energy behaviour change interventions run alongside retrofit programmes for occupiers. There is a need for outcome evaluations of retrofit schemes with the results shared with stakeholders

A randomized trial of deferred stenting versus immediate stenting to prevent no- or slow-reflow in acute ST-segment elevation myocardial infarction (DEFER-STEMI)

Objectives: The aim of this study was to assess whether deferred stenting might reduce no-reflow and salvage myocardium in primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). Background: No-reflow is associated with adverse outcomes in STEMI. Methods: This was a prospective, single-center, randomized, controlled, proof-of-concept trial in reperfused STEMI patients with ≥1 risk factors for no-reflow. Randomization was to deferred stenting with an intention-to-stent 4 to 16 h later or conventional treatment with immediate stenting. The primary outcome was the incidence of no-/slow-reflow (Thrombolysis In Myocardial Infarction ≤2). Cardiac magnetic resonance imaging was performed 2 days and 6 months after myocardial infarction. Myocardial salvage was the final infarct size indexed to the initial area at risk. Results: Of 411 STEMI patients (March 11, 2012 to November 21, 2012), 101 patients (mean age, 60 years; 69% male) were randomized (52 to the deferred stenting group, 49 to the immediate stenting). The median (interquartile range [IQR]) time to the second procedure in the deferred stenting group was 9 h (IQR: 6 to 12 h). Fewer patients in the deferred stenting group had no-/slow-reflow (14 [29%] vs. 3 [6%]; p = 0.006), no reflow (7 [14%] vs. 1 [2%]; p = 0.052) and intraprocedural thrombotic events (16 [33%] vs. 5 [10%]; p = 0.010). Thrombolysis In Myocardial Infarction coronary flow grades at the end of PCI were higher in the deferred stenting group (p = 0.018). Recurrent STEMI occurred in 2 patients in the deferred stenting group before the second procedure. Myocardial salvage index at 6 months was greater in the deferred stenting group (68 [IQR: 54% to 82%] vs. 56 [IQR: 31% to 72%]; p = 0.031]. Conclusions: In high-risk STEMI patients, deferred stenting in primary PCI reduced no-reflow and increased myocardial salvage