Verification of design calculations of a wind catcher/tower natural ventilation system with performance testing in real building

A wind catcher/tower natural ventilation system was installed in a seminar room in the building of the School of Construction Management and Engineering, the University of Reading in the UK . Performance was analysed by means of ventilation tracer gas measurements, indoor climate measurements (temperature, humidity, CO2) and occupant surveys. In addition, the potential of simple design tools was evaluated by comparing observed ventilation results with those predicted by an explicit ventilation model and the AIDA implicit ventilation model. To support this analysis, external climate parameters (wind speed and direction, solar radiation, external temperature and humidity) were also monitored. The results showed the chosen ventilation design provided a substantially greater ventilation rate than an equivalent area of openable window. Also air quality parameters stayed within accepted norms while occupants expressed general satisfaction with the system and with comfort conditions. Night cooling was maximised by using the system in combination with openable windows. Comparisons of calculations with ventilation rate measurements showed that while AIDA gave reasonably correlated results with the monitored performance results, the widely used industry explicit model was found to over estimate the monitored ventilation rate.

PINCER trial: a cluster randomised trial comparing the effectiveness and cost-effectiveness of a pharmacist-led IT-based intervention with simple feedback in reducing rates of clinically important errors in medicines management in general practices

Background: Medication errors in general practice are an important source of potentially preventable morbidity and mortality. Building on previous descriptive, qualitative and pilot work, we sought to investigate the effectiveness, cost-effectiveness and likely generalisability of a complex pharm acist-led IT-based intervention aiming to improve prescribing safety in general practice. Objectives: We sought to: • Test the hypothesis that a pharmacist-led IT-based complex intervention using educational outreach and practical support is more effective than simple feedback in reducing the proportion of patients at risk from errors in prescribing and medicines management in general practice. • Conduct an economic evaluation of the cost per error avoided, from the perspective of the National Health Service (NHS). • Analyse data recorded by pharmacists, summarising the proportions of patients judged to be at clinical risk, the actions recommended by pharmacists, and actions completed in the practices. • Explore the views and experiences of healthcare professionals and NHS managers concerning the intervention; investigate potential explanations for the observed effects, and inform decisions on the future roll-out of the pharmacist-led intervention • Examine secular trends in the outcome measures of interest allowing for informal comparison between trial practices and practices that did not participate in the trial contributing to the QRESEARCH database. Methods Two-arm cluster randomised controlled trial of 72 English general practices with embedded economic analysis and longitudinal descriptive and qualitative analysis. Informal comparison of the trial findings with a national descriptive study investigating secular trends undertaken using data from practices contributing to the QRESEARCH database. The main outcomes of interest were prescribing errors and medication monitoring errors at six- and 12-months following the intervention. Results: Participants in the pharmacist intervention arm practices were significantly less likely to have been prescribed a non-selective NSAID without a proton pump inhibitor (PPI) if they had a history of peptic ulcer (OR 0.58, 95%CI 0.38, 0.89), to have been prescribed a beta-blocker if they had asthma (OR 0.73, 95% CI 0.58, 0.91) or (in those aged 75 years and older) to have been prescribed an ACE inhibitor or diuretic without a measurement of urea and electrolytes in the last 15 months (OR 0.51, 95% CI 0.34, 0.78). The economic analysis suggests that the PINCER pharmacist intervention has 95% probability of being cost effective if the decision-maker’s ceiling willingness to pay reaches £75 (6 months) or £85 (12 months) per error avoided. The intervention addressed an issue that was important to professionals and their teams and was delivered in a way that was acceptable to practices with minimum disruption of normal work processes. Comparison of the trial findings with changes seen in QRESEARCH practices indicated that any reductions achieved in the simple feedback arm were likely, in the main, to have been related to secular trends rather than the intervention. Conclusions Compared with simple feedback, the pharmacist-led intervention resulted in reductions in proportions of patients at risk of prescribing and monitoring errors for the primary outcome measures and the composite secondary outcome measures at six-months and (with the exception of the NSAID/peptic ulcer outcome measure) 12-months post-intervention. The intervention is acceptable to pharmacists and practices, and is likely to be seen as costeffective by decision makers.

A gene variation (rs12691) in the CCAT/enhancer building α modulates glucose metabolism in metabolic syndrome

Background and aims CCAAT/enhancer-binding protein alpha (CEBPA) is a transcription factor involved in adipogenesis and energy homeostasis. Caloric restriction reduces CEBPA protein expression in patients with metabolic syndrome (MetS). A previous report linked rs12691 SNP in CEBPA to altered concentration of fasting triglycerides. Our objective was to assess the effects of rs12691 in glucose metabolism in Metabolic Syndrome (MetS) patients. Methods and results Glucose metabolism was assessed by static (glucose, insulin, adiponectin, leptin and resistin plasma concentrations) and dynamic (disposition index, insulin sensitivity index, HOMA-IR and acute insulin response to glucose) indices, performed at baseline and after 12 weeks of 4 dietary interventions (high saturated fatty acid (SFA), high monounsaturated fatty acid (MUFA), low-fat and low-fat-high-n3 polyunsaturated fatty acid (PUFA)) in 486 subjects with MetS. Carriers of the minor A allele of rs12691 had altered disposition index (p = 0.0003), lower acute insulin response (p = 0.005) and a lower insulin sensitivity index (p = 0.025) indicating a lower insulin sensitivity and a lower insulin secretion, at baseline and at the end of the diets. Furthermore, A allele carriers displayed lower HDL concentration. Conclusion The presence of the A allele of rs12691 influences glucose metabolism of MetS patients. Clinical Trials Registry number NCT00429195.

Soil factors associated with zinc deficiency in crops and humans

Zinc deficiency is the most ubiquitous micronutrient deficiency problem in world crops. Zinc is essential for both plants and animals because it is a structural constituent and regulatory co-factor in enzymes and proteins involved in many biochemical pathways. Millions of hectares of cropland are affected by Zn deficiency and approximately one-third of the human population suffers from an inadequate intake of Zn. The main soil factors affecting the availability of Zn to plants are low total Zn contents, high pH, high calcite and organic matter contents and high concentrations of Na, Ca, Mg, bicarbonate and phosphate in the soil solution or in labile forms. Maize is the most susceptible cereal crop, but wheat grown on calcareous soils and lowland rice on flooded soils are also highly prone to Zn deficiency. Zinc fertilizers are used in the prevention of Zn deficiency and in the biofortification of cereal grains.

Causes of the apparent scale independence of fractal indices associated with forest fragmentation in Bolivia

In a recent investigation, Landsat TM and ETM+ data were used to simulate different resolutions of remotely-sensed images (from 30 to 1100 m) and to analyze the effect of resolution on a range of landscape metrics associated with spatial patterns of forest fragmentation in Chapare, Bolivia since the mid-1980s. Whereas most metrics were found to be highly dependent on pixel size, several fractal metrics (DLFD, MPFD, and AWMPFD) were apparently independent of image resolution, in contradiction with a sizeable body of literature indicating that fractal dimensions of natural objects depend strongly on image characteristics. The present re-analysis of the Chapare images, using two alternative algorithms routinely used for the evaluation of fractal dimensions, shows that the values of the box-counting and information fractal dimensions are systematically larger, sometimes by as much as 85%, than the "fractal" indices DLFD, MPFD, and AWMFD for the same images. In addition, the geometrical fractal features of the forest and non-forest patches in the Chapare region strongly depend on the resolution of images used in the analysis. The largest dependency on resolution occurs for the box-counting fractal dimension in the case of the non-forest patches in 1993, where the difference between the 30 and I 100 m-resolution images corresponds to 24% of the full theoretical range (1.0 to 2.0) of the mass fractal dimension. The observation that the indices DLFD, MPFD, and AWMPFD, unlike the classical fractal dimensions, appear relatively unaffected by resolution in the case of the Chapare images seems due essentially to the fact that these indices are based on a heuristic, "non-geometric" approach to fractals. Because of their lack of a foundation in fractal geometry, nothing guarantees that these indices will be resolution-independent in general. (C) 2006 International Society for Photogrammetry and Remote Sensing, Inc. (ISPRS). Published by Elsevier B.V. All rights reserved.