Comprehensive energy demand and usage data for building automation.

Buildings are essential in satisfying our daily need for comfort (privacy, protection from weather, etc.) and are responsible for almost half of the world's total energy consumption. Research at the interface of room comfort and energy efficiency is of critical societal importance. At the same time, there is a lack of publicly available data to optimize important building functions automatically. It is only through data-driven approaches that building automation becomes financially affordable and achieves widespread adoption. In this publication, measurement data from three buildings of the NEST platform are made publicly available. The dataset includes detailed information on energy consumption (electricity, heating, cooling, domestic hot water), building operation (set points, valve openings, windows), and occupant practice (e.g., presence, operation of blinds and kitchen, showering patterns). All data have been measured over four years and with a temporal resolution of 1 minute. This combination of information allows learning the function of different building types (office and residential) and thus addresses important research gaps.

Impact of a Genetic Diagnosis for a Child's Autism on Parental Perceptions.

Genetic testing is recommended as part of an autism assessment, and most parents support genetic testing for their minor children. However, the impact on parents of receiving a monogenetic/ copy number variant diagnosis for autism in their child is not well understood. To explore this, we surveyed and interviewed parents of children in the SPARK study, a study of autism that includes genetic testing. Surveys were administered one month before and one and 12 months after parents received their child's genetic result. Interviews were conducted approximately one month after results disclosure. A genetic diagnosis (GD) for their child appeared to reduce parents' sense of self-blame and feelings of guilt, and this impact was relatively stable. The data also indicate a modest impact on parents' actions related to the condition, perceptions of themselves, and some aspects of life planning for their child, as measured by quantitative instruments at one month and 12 months after receipt of results. Other measures of parental identity and expectations for their child, in contrast, showed little change following receipt of genetic findings. Overall, parents who were told that no GD was identified showed minimal changes in their responses over time. These results suggest a discernable but relatively limited impact of genetic test results on parents of children with autism. These results should be reassuring to clinicians caring for children with autism and are consistent with studies in other areas of medicine that have suggested that genetic results tend to have fewer effects-negative or positive-than were anticipated.

CNS tuberculoma in an immunocompetent patient: A case report of multi-drug hypersensitivity to RIPE therapy.

Background: Tuberculosis (TB) is the second leading cause of death due to an infectious disease worldwide (World Health Organization, 2022 [1]). The first line treatment of TB involves the concurrent use of four drugs: rifampin, isoniazid, pyrazinamide, and ethambutol (RIPE). Given the rising threat of multidrug resistant TB, it is crucial to understand how TB can be treated when first line treatment is not an option. Case presentation: We report a rare case of multi-drug hypersensitivity to RIPE therapy in an immunocompetent patient with an unusual presentation of CNS tuberculoma. The patient presented to an outside hospital four months prior with weakness, numbness, imbalance, and speech difficulties. A CT of the head revealed a mass in the left parietal lobe that demonstrated chronic necrotizing granulomatous inflammation with positive cultures for M. tuberculosis. The patient was started on a regimen of rifampin 600 mg daily, isoniazid 300 mg daily, pyrazinamide 2000 mg daily, ethambutol 1200 mg daily, and pyridoxine 50 mg daily. However, the patient developed drug hypersensitivity reactions to both rifampin and ethambutol with subsequent failed desensitization to rifabutin. She was ultimately discharged from the hospital on a regimen of isoniazid, pyridoxine, pyrazinamide, and moxifloxacin with plans for outpatient follow-up. Conclusions: This case highlights a rare clinical presentation of multiple drug hypersensitivity in the setting of a CNS tuberculoma and the importance of identifying the offending agents early in the course of treatment and adjusting the drug regimen accordingly. Desensitization should be attempted, but if ineffective, then alternative drug regimens should be formulated on a case-by-case basis.

Objective and Subjective Neighborhood Crime Associated with Poor Sleep among Young Sexual Minority Men: a GPS Study.

Sleep disparities in sexual minority male (SMM) populations have received relatively little attention but they may be critical to explaining other health disparities seen among SMM, via neural or hormonal pathways. Recent research suggests that crime may be a psychosocial stressor that contributes to sleep disparities but that finding has been based on subjective measures of crime. We conducted the P18 Neighborhood Study of 250 SMM in New York City, including 211 with adequate GPS tracking data. We used the GPS tracking data to define daily path area activity spaces and tested the associations of violent crime in those activity spaces and in the subject's residential neighborhood, perceived neighborhood safety, and witnessing crime with a subjective measure of sleep. Using quasi-Poisson regression, adjusted for individual and neighborhood socio-demographics, we found that SMM who witnessed more types of crime experienced significantly more nights of poor sleep over the course of a month (RR: 1.16, 95%CI: 1.05-1.27, p-value: < 0.01). We did not find any associations between violent crime rates in either the activity area or residential area and sleep. Our findings support the conclusion that personal exposure to crime is associated with sleep problems and provide further evidence for the pathway between stress and sleep. The lack of association between neighborhood crime levels and sleep suggests that there must be personal experience with crime and ambient presence is insufficient to produce an effect.

Treating in Place: Acute Care for Long-Stay Residents in Nursing Facilities Under a CMS Initiative.

BACKGROUND/OBJECTIVES: Nursing facility (NF) residents are commonly hospitalized, and many of these hospitalizations may be avoidable. A Centers for Medicare & Medicaid Services (CMS) initiative enables participating NFs to bill Medicare for providing on-site acute care to long-stay residents diagnosed with one of six ambulatory care sensitive conditions (pneumonia, congestive heart failure, chronic obstructive pulmonary disease, dehydration, skin infection, and urinary tract infection) that account for many avoidable hospitalizations. This study describes the frequency of initiative-related treatment for the six conditions, both on site and in the hospital, and the health status of residents who were treated. DESIGN: We used the Minimum Data Set V3.0 and Medicare data to identify eligible residents, detect on-site treatment under the initiative as well as in-hospital treatment both before and during the initiative, and measure health status. SETTING: Participating NFs during fiscal years 2017 to 2018. PARTICIPANTS: There were 47,202 long-stay NF residents from 260 facilities in seven states. INTERVENTION: CMS initiative to reduce avoidable hospitalizations among NF residents-payment reform. MEASUREMENTS: Percentage per year who received on-site treatment (2017-2018), and who received in-hospital treatment (2014-2018), for the six conditions. RESULTS: Each year, approximately 20% of residents received treatment on site during 2017 to 2018, and under 10% received treatment in the hospital during 2014 to 2018, with little change over these years. Residents treated on site had less chronic illness than those treated in the hospital. CONCLUSION: Although the initiative sought to reduce hospitalizations, in-hospital treatment for the six conditions did not substantially change after initiative implementation, despite substantial new billing for on-site treatment for those conditions. These findings suggest that many residents treated on site would likely not have been hospitalized even absent the initiative. The residents treated on site tended to have fewer chronic conditions than those treated in the hospital.

Reducing pain associated with arterial punctures for blood gas analysis.

Arterial punctures for arterial blood gases (ABGs) analysis are described as the most painful laboratory procedure and are performed without the benefit of pain management. This study originated from one nurse's concern about the level of pain her hospitalized patients endured when she drew their ABGs. A review of the literature found that ABG pain relief has not been studied in hospitalized patients. Therefore, this study explored the question "Can the pain of arterial blood gas draws be reduced through the use of infiltration with a local anesthetic agent?" This study compared the pain scores of 40 hospitalized patients who received either no intervention or one of three analgesic interventions (infiltration of 0.7 ml 1% lidocaine, 0.7 ml buffered 1% lidocaine, or 0.7 ml of bacteriostatic saline at the arterial puncture site). Results showed that, although lidocaine and buffered lidocaine are effective in reducing the pain associated with the arterial puncture, plain lidocaine was the only intervention in which the pain rating score for the overall experience was significantly diminished. This study is limited by partial randomization, small sample size, and patient duress; however, it provides a foundation for further nursing research that explores methods to reduce the pain associated with this very painful procedure. Future studies should be directed at larger, diverse populations, multiple operators, and comparison of interventions to topical analgesics and nonpharmacological measures.

Microscopic Origin of the Non-Newtonian Viscosity of Semiflexible Polymer Solutions in the Semidilute Regime.

One of the great goals in polymer physics is to relate the various macroscopic features of polymeric fluids with the microscopic behavior of single chains. Here, we directly visualize the conformational dynamics of individual semiflexible polymers in a semidilute solution above the overlap concentration under shear. We observe that the tumbling dynamics are significantly slowed down, in marked contrast to the case of a dilute solution, due to steric interactions with neighboring filaments. The observed macroscopic shear thinning effect can be rationalized by a simple model based on the single filament dynamics.

A simple method for the removal of dissolved organic matter and δ15N analysis of NO3(-) from freshwater.

RATIONALE: Stable isotopes of nitrogen in nitrate (NO(3)(-)) are frequently used to identify nitrate sources and to study nitrogen (N) transformation processes, but the measurement methods available are generally rather labor intensive and/or costly, and dissolved organic matter (DOM) can interfere with the δ(15)N signature of nitrate. We therefore have developed a simple cleanup procedure for freshwater samples with low nitrate and high DOM concentrations. METHODS: Nitrate and DOM are extracted from a freeze-dried water sample by using a concentrated sodium hydroxide solution. By the subsequent addition of acetone, two liquid layers are formed, and nitrate migrates into the acetone while DOM remains in the concentrated NaOH solution, thus separating the nitrate from the DOM. For nitrogen isotope analysis, purified nitrate salts are combusted at 1030 °C to produce N(2) gas in an elemental analyzer (EA) coupled to an isotope ratio mass spectrometer (IRMS). RESULTS: With this novel technique up to 99% of DOM could be removed from river water and soil solutions. The method has been tested for sample amounts as small as 4 µmol NO(3)(-) with a precision of <0.1‰ (1SD). Nitrate standards are reproduced accurately without any blank correction. CONCLUSIONS: The benefits of this method are the lack of interferences derived from DOM on the δ(15)N signature and the ease of sample preparation.

A new isolation procedure of nitrate from freshwater for nitrogen and oxygen isotope analysis.

The nitrogen (δ(15)N) and oxygen isotope (δ(18)O) analysis of nitrate (NO(3)(-)) from aqueous samples can be used to determine nitrate sources and to study N transformation processes. For these purposes, several methods have been developed; however, none of them allows an accurate, fast and inexpensive analysis. Here, we present a new simple method for the isolation of nitrate, which is based on the different solubilities of inorganic salts in an acetone/hexane/water mixture. In this solvent, all major nitrate salts are soluble, whereas all other oxygen-bearing compounds such as most inorganic carbonates, sulfates, and phosphates are not. Nitrate is first concentrated by freeze-drying, dissolved in the ternary solvent and separated from insoluble compounds by centrifugation. Anhydrous barium nitrate is then precipitated in the supernatant solution by adding barium iodide. For δ(18)O analysis, dried Ba(NO(3))(2) samples are directly reduced in a high-temperature conversion system to CO and measured on-line using isotope ratio mass spectrometry (IRMS). For δ(15)N analysis, samples are combusted in an elemental analyzer (EA) coupled to an IRMS system. The method has been tested down to 20 µmol NO(3)(-) with a reproducibility (1SD) of 0.1‰ for nitrogen and 0.2-0.4‰ for oxygen isotopes. For nitrogen we observed a small consistent (15) N enrichment of +0.2‰, probably due to an incomplete precipitation process and, for oxygen, a correction for the incorporation of water in the precipitated Ba(NO(3))(2) has to be applied. Apart from being robust, this method is highly efficient and low in cost.