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Arctic climates provide unique challenges for designers of HVAC, plumbing, and thermal energy systems. The importance of considering the operation outside air temperatures, system reliability, and building resiliency cannot be understated. The paper describes best practice examples of robust and reliable systems with the emphasis on their redundancy, durability, and functionality. The paper also discusses the most common heating and ventilation system approaches used in arctic climate with the emphasis on the importance of a maintenance program that allows building operators to successfully troubleshoot and maintain buildings in the arctic. More detailed discussion of concepts presented in this paper can be found in the Guide [1] where these concepts are illustrated by best practice examples from U.S. military bases in Alaska and Søndre Strømfjord, the international airport of Greenland that previously was used as a U.S. military base. The paper results from experts’ discussions during the Consultation Forum “Thermal Energy Systems Resilience in Cold/Arctic Climates” [2] and research conducted under the IEA EBC Annex 73, the Environmental Security Technology Certification Program (ESTCP) Project “Technologies Integration to Achieve Resilient, Low-Energy Military Installations” and U.S. Army Program project 633734T1500 under Military Engineering Technology Demonstration. The paper is complementary to the ASHRAE Cold Climate Design Guide [3] with a focus on resilience of thermal energy systems.

Applying pesticides in mixture can bring about an increased level ofperformance which can be of benefit to manufacturers who make use ofthis phenomenon when formulating products. The interactions that occur can also bring about adverse effects on performance and possibly on the safety of the product to users, consumers and the environment. Because of this a product containing a mixture of active substances must be considered by registration authorities. Each discipline in theregulatory process must consider the likelihood of an interaction occurring and, as a result, request and examine the necessary data to support approval for that mixed product. Within the European Communitythe requirements are laid down in Directives that have been introduced to harmonise the regulatory process across Member States. The requirements of these Directives are described as an example of the regulatory process. [ABSTRACT FROM AUTHOR]

Background: Elevated depression symptoms have been associated with higher insulin resistance in adolescents, and consequently, greater risk for type 2 diabetes (T2D). Mindfulness-based intervention (MBI) may be suited for adolescents at risk for T2D given its potential to decrease depression and improve stress-related behavior/physiology underpinning insulin resistance. To prepare for a future multisite efficacy randomized controlled trial, a rigorous, multisite, pilot and feasibility study is needed to test this approach. The current paper describes the design and protocol for a multisite, pilot and feasibility randomized controlled trial of six-week MBI, cognitive-behavioral therapy (CBT), and health education (HealthEd) group interventions, to assess multisite fidelity, feasibility, and acceptability., Methods: Participants are N = 120 adolescents ages 12-17, with body mass index (BMI) ≥85th percentile, elevated depression symptoms (20-item Center for Epidemiologic Studies-Depression Scale total score > 20), and family history of diabetes. Enrollment occurs across four United States (US) sites, two in Colorado, one in Washington, D·C., and one in Maryland. Group interventions are delivered virtually by trained psychologists and co-facilitators. Assessments occur at baseline, six-week follow-up, and one-year follow-up., Results: Primary outcomes are intervention implementation fidelity, based upon expert ratings of audio-recorded sessions (≥80% adherence/competence), and recruitment feasibility, based upon percentage enrollment of eligible youth (≥80%). Secondary outcomes are intervention training fidelity/feasibility/acceptability, recruitment timeframe, and retention/assessment feasibility., Conclusion: Findings will inform optimization of training, recruitment, intervention delivery, retention, and assessment protocols for a multisite, efficacy randomized controlled trial evaluating MBI for decreasing depression and improving insulin resistance in adolescents at risk for developing T2D., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Inc.)

This paper describes dosimetry measurements performed prior to departments entering patients into the START Trial, a breast fractionation trial. Absolute and relative doses were measured in semi-anatomical breast and chest wall phantoms, as part of a quality assurance programme visit. Doses were measured using an ionization chamber and the resulting distributions were compared with those calculated by the department. The mean ratio of measured to calculated dose at the START reference point was found to be 0.981 for the breast phantom and 0.978 for the chest wall phantom. This average measured dose was significantly less than the prescribed dose (p < 0.001). Differences were found between 2D and 3D planning systems and for departments using cobalt 60 beams. A number of departments had deviations of greater than 4%, which was the tolerance applied for this trial. It is essential for dose measurements of this type to be performed for randomized clinical trials involving radiotherapy, particularly where dose fractionation regimes are being compared.

Pentoxifylline (oxpentifylline) is a methylxanthine derivative with potent hemorrheologic properties. In the United States it is marketed for the treatment of intermittent claudication. Human and animal studies have shown that pentoxifylline therapy results in a variety of physiological changes at the cellular level, which may be important in treating a diverse group of human afflictions. Immune modulation includes increased leukocyte deformability and chemotaxis, decreased endothelial leukocyte adhesion, decreased neutrophil degranulation and release of superoxides, decreased production of monocyte-derived tumor necrosis factor, decreased leukocyte responsiveness to interleukin 1 and tumor necrosis factor, inhibition of T and B lymphocyte activation, and decreased natural killer cell activity. Hypercoagulable states improve through decreased platelet aggregation and adhesion, increased plasminogen activator, increased plasmin, increased antithrombin III, decreased fibrinogen, decreased alpha 2-antiplasmin, decreased alpha 1-antitrypsin, and decreased alpha 2-macroglobulin. Wound healing and connective tissue disorders may respond to an increase in fibroblast collagenases and decreased collagen, fibronectin, and glycosaminoglycan production. Fibroblast responsiveness to tumor necrosis factor is also diminished. Potential medical uses of pentoxifylline are reviewed.