Understanding Sustainable Architecture is a review of the assumptions, beliefs, goals and bodies of knowledge that underlie the endeavour to design (more) sustainable buildings and other built ...developments.
Much of the available advice and rhetoric about sustainable architecture begins from positions where important ethical, cultural and conceptual issues are simply assumed. If sustainable architecture is to be a truly meaningful pursuit then it must be grounded in a coherent theoretical framework. This book sets out to provide that framework. Through a series of self-reflective questions for designers, the authors argue the ultimate importance of reasoned argument in ecological, social and built contexts, including clarity in the problem framing and linking this framing to demonstrably effective actions. Sustainable architecture, then, is seen as a revised conceptualisation of architecture in response to a myriad of contemporary concerns about the effects of human activity.
The aim of this book is to be transformative by promoting understanding and discussion of commonly ignored assumptions behind the search for a more environmentally sustainable approach to development. It is argued that design decisions must be based on both an ethical position and a coherent understanding of the objectives and systems involved. The actions of individual designers and appropriate broader policy settings both follow from this understanding.
The Advanced Laser Interferometer Gravitational-wave Observatory (LIGO) detectors have completed their initial upgrade phase and will enter the first observing run in late 2015, with detector ...sensitivity expected to improve in future runs. Through the combined efforts of on-site commissioners and the Detector Characterization Group of the LIGO Scientific Collaboration, interferometer performance, in terms of data quality, at both LIGO observatories has vastly improved from the start of commissioning efforts to present. Advanced LIGO has already surpassed Enhanced LIGO in sensitivity, and the rate of noise transients, which would negatively impact astrophysical searches, has improved. Here we give details of some of the work which has taken place to better the quality of the LIGO data ahead of the first observing run.
Colorectal cancers are one of the most prevalent tumour types worldwide and, despite the emergence of targeted and biologic therapies, have among the highest mortality rates. The Personalized ...OncoGenomics (POG) program at BC Cancer performs whole genome and transcriptome analysis (WGTA) to identify specific alterations in an individual's cancer that may be most effectively targeted. Informed using WGTA, a patient with advanced mismatch repair-deficient colorectal cancer was treated with the antihypertensive drug irbesartan and experienced a profound and durable response. We describe the subsequent relapse of this patient and potential mechanisms of response using WGTA and multiplex immunohistochemistry (m-IHC) profiling of biopsies before and after treatment from the same metastatic site of the L3 spine. We did not observe marked differences in the genomic landscape before and after treatment. Analyses revealed an increase in immune signalling and infiltrating immune cells, particularly CD8+ T cells, in the relapsed tumour. These results indicate that the observed anti-tumour response to irbesartan may have been due to an activated immune response. Determining whether there may be other cancer contexts in which irbesartan may be similarly valuable will require additional studies.
We present a catalog of emissive point sources detected in the SPT-SZ survey, a contiguous 2530 square degree area surveyed with the South Pole Telescope (SPT) from 2008-2011 in three bands centered ...at 95, 150, and 220 GHz. The catalog contains 4845 sources measured at a significance of 4.5 or greater in at least one band, corresponding to detections above approximately 9.8, 5.8, and 20.4 mJy in 95, 150, and 220 GHz, respectively. The spectral behavior in the SPT bands is used for source classification into two populations based on the underlying physical mechanisms of compact, emissive sources that are bright at millimeter wavelengths: synchrotron radiation from active galactic nuclei and thermal emission from dust. The latter population includes a component of high-redshift sources often referred to as submillimeter galaxies (SMGs). In the relatively bright flux ranges probed by the survey, these sources are expected to be magnified by strong gravitational lensing. The survey also contains sources consistent with protoclusters, groups of dusty galaxies at high redshift undergoing collapse. We cross-match the SPT-SZ catalog with external catalogs at radio, infrared, and X-ray wavelengths and identify available redshift information. The catalog splits into 3980 synchrotron-dominated and 865 dust-dominated sources, and we determine a list of 506 SMGs. Ten sources in the catalog are identified as stars. We calculate number counts for the full catalog, and synchrotron and dusty components, using a bootstrap method and compare our measured counts with models. This paper represents the third and final catalog of point sources in the SPT-SZ survey.
OBJECTIVETo determine the effect of low-dose aspirin vs placebo on incident all-cause dementia, incident Alzheimer disease (AD), mild cognitive impairment (MCI), and cognitive decline in older ...individuals.
METHODSAspirin in Reducing Events in the Elderly (ASPREE) was a double-blind, placebo-controlled trial of low-dose aspirin. In the United States and Australia, community-dwelling individuals aged ≥70 years (US minorities ≥65 years) and free of cardiovascular disease, physical disability, and diagnosed dementia were enrolled. Participants were randomized 1:1–100 mg daily aspirin or placebo. The Modified Mini-Mental State Examination, Hopkins Verbal Learning Test–Revised, Symbol Digit Modalities Test, and Controlled Oral Word Association Test assessed cognition at baseline and over follow-up. Additional cognitive testing was performed in participants with suspected dementia (“trigger”) based on within-study assessments or clinical history. Dementia was adjudicated according to DSM-IV criteria. National Institute on Aging–Alzheimer’s Association criteria were used for AD and MCI subclassification.
RESULTSA total of 19,114 participants were followed over a median 4.7 years and 964 triggered further dementia assessments. There were 575 adjudicated dementia cases, and 41% were classified as clinically probable AD. There was no substantial difference in the risk of all dementia triggers (hazard ratio HR, 1.03; 95% confidence interval CI, 0.91–1.17), probable AD (HR, 0.96; 95% CI, 0.74–1.24), or MCI (HR, 1.12; 95% CI, 0.92–1.37) between aspirin and placebo. Cognitive change over time was similar in the aspirin and placebo groups.
CONCLUSIONSThere was no evidence that aspirin was effective in reducing risk of dementia, MCI, or cognitive decline. Follow-up of these outcomes after initial exposure is ongoing.
CLASSIFICATION OF EVIDENCEThis study provides Class II evidence that for healthy older individuals, low-dose aspirin does not significantly reduce the incidence of dementia, probable AD, MCI, or cognitive decline.
CLINICALTRIALS.GOV IDENTIFIERNCT01038583.
The Systolic Blood Pressure Intervention (SPRINT) randomized trial demonstrated that intensive blood pressure management resulted in slower progression of cerebral white matter hyperintensities, ...compared with standard therapy. We assessed longitudinal changes in brain functional connectivity to determine whether intensive treatment results in less decline in functional connectivity and how changes in brain functional connectivity relate to changes in brain structure.
Five hundred forty-eight participants completed longitudinal brain MR imaging, including resting-state fMRI, during a median follow-up of 3.84 years. Functional brain networks were identified using independent component analysis, and a mean connectivity score was calculated for each network. Longitudinal changes in mean connectivity score were compared between treatment groups using a 2-sample
test, followed by a voxelwise
test. In the full cohort, adjusted linear regression analysis was performed between changes in the mean connectivity score and changes in structural MR imaging metrics.
Four hundred six participants had longitudinal imaging that passed quality control. The auditory-salience-language network demonstrated a significantly larger decline in the mean connectivity score in the standard treatment group relative to the intensive treatment group (
= .014), with regions of significant difference between treatment groups in the cingulate and right temporal/insular regions. There was no treatment group difference in other networks. Longitudinal changes in mean connectivity score of the default mode network but not the auditory-salience-language network demonstrated a significant correlation with longitudinal changes in white matter hyperintensities (
= .013).
Intensive treatment was associated with preservation of functional connectivity of the auditory-salience-language network, while mean network connectivity in other networks was not significantly different between intensive and standard therapy. A longitudinal increase in the white matter hyperintensity burden is associated with a decline in mean connectivity of the default mode network.
BACKGROUND: Little is known about childhood factors and adult obesity. A previous study found a strong association between childhood neglect and obesity in young adults. OBJECTIVE: To estimate ...associations between self-reported abuse in childhood (sexual, verbal, fear of physical abuse and physical) adult body weight, and risk of obesity. DESIGN: Retrospective cohort study with surveys during 1995-1997. PATIENTS: A total of 13 177 members of California health maintenance organization aged 19-92 y. MEASUREMENTS: Body weight measured during clinical examination, followed by mailed survey to recall experiences during first 18 y of life. Estimates adjusted for adult demographic factors and health practices, and characteristics of the childhood household. RESULTS: Some 66% of participants reported one or more type of abuse. Physical abuse and verbal abuse were most strongly associated with body weight and obesity. Compared with no physical abuse (55%), being 'often hit and injured' (2.5%) had a 4.0 kg (95% confidence interval: 2.4-5.6 kg) higher weight and a 1.4 (1.2-1.6) relative risk (RR) of body mass index (BMI)30. Compared with no verbal abuse (53%), being 'often verbally abused' (9.5%) had an RR of 1.9 (1.3-2.7) for BMI40. The abuse associations were not mutually independent, however, because the abuse types strongly co-occurred. Obesity risk increased with number and severity of each type of abuse. The population attributable fraction for 'any mention' of abuse (67%) was 8% (3.4-12.3%) for BMI30 and 17.3% (-1.0-32.4%) for BMI40. CONCLUSIONS: Abuse in childhood is associated with adult obesity. If causal, preventing child abuse may modestly decrease adult obesity. Treatment of obese adults abused as children may benefit from identification of mechanisms that lead to maintenance of adult obesity.
SETTING: Recently, Mycobacterium tuberculosis isolates have been described that test phenotypically susceptible to rifampicin (RMP) yet harbour genotypic rpoB mutations.OBJECTIVE: 1) To investigate ...the impact of such mutations on clinical outcomes among RMP-susceptible
isolates, and 2) to determine the prevalence of rpoB mutations among isoniazid (INH) monoresistant isolates at our laboratory and to describe the association between the presence of these mutations and clinical outcomes.METHODS: M. tuberculosis isolates were screened for
mutations in the rpoB gene using the Cepheid GeneXpert® MTB/RIF assay. Clinical correlation was made by reviewing patient case notes.RESULTS: Isolates from 94 patients were found to have INH-resistant, RMP-susceptible profiles. Clinical information was available for 52 patients,
including three whose isolates had rpoB mutations. All three of these patients had treatment failures, compared to two of 49 patients whose isolates did not have rpoB mutations (P = 0.0005).DISCUSSION: We demonstrate a significant association between the presence of
rpoB gene mutations that are not detected at the current RMP critical concentration and treatment failure. We suggest that a review of the current RMP critical concentration is warranted to ensure that RMP is not used inappropriately for the treatment of phenotypically occult multidrug-resistant
tuberculosis.
Transrectal ultrasound (TRUS)—guided prostate biopsy is currently considered the standard technique for obtaining tissue to make a histological diagnosis of prostatic carcinoma. Infectious ...complications following TRUS-guided prostate biopsy are well described, and are reportedly increasing in incidence. The role of antibiotic prophylaxis in reducing post—TRUS biopsy infections is now established, and many guidelines suggest that fluoroquinolone antimicrobials are the prophylactic agents of choice. Of note, however, recent reports suggest an emerging association between TRUS biopsy and subsequent infection with fluoroquinolone-resistant Escherichia coli. Against this background, we provide an overview of the epidemiology, prevention, and treatment of infectious complications following TRUS biopsy, in the wider context of increasing global antimicrobial resistance.
The Planck cosmic microwave background temperature data are best fit with a ΛCDM model that mildly contradicts constraints from other cosmological probes. The South Pole Telescope (SPT) 2540 SPT-SZ ...survey offers measurements on sub-degree angular scales (multipoles ) with sufficient precision to use as an independent check of the Planck data. Here we build on the recent joint analysis of the SPT-SZ and Planck data in Hou et al. by comparing ΛCDM parameter estimates using the temperature power spectrum from both data sets in the SPT-SZ survey region. We also restrict the multipole range used in parameter fitting to focus on modes measured well by both SPT and Planck, thereby greatly reducing sample variance as a driver of parameter differences and creating a stringent test for systematic errors. We find no evidence of systematic errors from these tests. When we expand the maximum multipole of SPT data used, we see low-significance shifts in the angular scale of the sound horizon and the physical baryon and cold dark matter densities, with a resulting trend to higher Hubble constant. When we compare SPT and Planck data on the SPT-SZ sky patch to Planck full-sky data but keep the multipole range restricted, we find differences in the parameters ns and . We perform further checks, investigating instrumental effects and modeling assumptions, and we find no evidence that the effects investigated are responsible for any of the parameter shifts. Taken together, these tests reveal no evidence for systematic errors in SPT or Planck data in the overlapping sky coverage and multipole range and at most weak evidence for a breakdown of ΛCDM or systematic errors influencing either the Planck data outside the SPT-SZ survey area or the SPT data at .
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