bluuebunny/crossref_metadata_2025 huggingface dataset:
De la distinction affectif/intellectuel à une théorie de la phrase modalisée. Représentations mentales et opérations linguistiques chez Charles Bally
Authors: Curea Anamaria
Published: June 2018

Dans l’histoire des théories énonciatives du XXe siècle, Charles Bally est l’auteur de la première « théorie générale de l’énonciation », bien que son nom ait été rarement évoqué par les théoriciens de ce champ. Dans le cadre de la réflexion sur l’articulation entre représentations et opérations chez plusieurs linguistes de l’énonciation, dans un rapport plus ou moins étroit avec une image saussurienne, nous envisageons d’éclairer les points les plus révélateurs qui ont conduit Bally de la stylistique à la théorie de l’énonciation, en poursuivant un fil qui va de la distinction entre « impressions » et « idées pures » (Précis 1905) à l’opposition affectif/intellectuel (Traité 1909), puis au traitement de l’expressivité linguistique en tant que mécanisme (Le langage et la vie 1926) pour arriver à la théorie de l’énonciation, où il définit la modalité. Dans ce parcours, nous évoquons son interprétation originale de concepts et de conceptualités saussuriennes, ainsi que la position de Saussure à l’égard du statut de l’affectif dans la linguistique.
Vorstellung, Darstellung, Bedeutung. L’héritage sémantique de la sémiotique
Authors: Samain Didier
Published: June 2018

L’association chez Saussure et ses prédécesseurs immédiats d’un héritage empiriste et d’une approche combinatoire des faits linguistiques a rendu difficile l’édification d’une théorie satisfaisante de la signification (Bedeutung), le plus souvent comprise comme résultant d’un empilement de représentations mentales (Vorstellungen). Une difficulté face à laquelle le signe saussurien fait plutôt figure d’échappatoire. Certains contemporains ont toutefois privilégié une autre approche, centrée sur la Darstellung (soit la « représentation », entendue cette fois comme technique de figuration et non plus comme phénomène cognitif). Si différents qu’aient été les objets grammaticaux ainsi traités, ces tentatives ont pour point commun de postuler l’existence de propriétés organisationnelles spécifiques au représentant lui-même, et d’argumenter par là en faveur de la motivation du signe. Elles partagent toutefois avec les théories centrées sur la Vorstellung une orientation essentiellement sémantique, ce qui circonscrit de facto leur sémiotique.
The use of substations with PCM heat accumulators in district heating system
Authors: Nogaj Kinga , Turski Michał , Sekret Robert
Published: June 2018

The main objective of the article is to indicate the directions of development of new generations of supplying buildings with heat, by using phase change materials, referring to the technical possibilities of applying available heat storage technologies. As a detailed objective of the work, the determination of the impact of using a PCM accumulator on the temperature of the heat carrier on the return in the substation of the district heating system was adopted. Range work included determination of parameters of heat distribution network as a function of outdoor air temperature range of -20°C to +12°C. As the analysis object, the heat substation has been selected with the following parameters: supply 80°C and return 60°C. It was found that thanks to the use of PCM accumulators on heat substations, it is possible to save energy by up to approx. 6.7% and achieve economic benefits in the form of a payback period of approx. 13 years. In addition, it was found that the introduction of the PCM accumulator into the heating system allows the return temperature in the heating network to be obtained at a temperature level consistent with the adopted control table for external temperatures of the standard heating season.
Quantification of the internal space climate
Authors: Häupl Peter , Hansel Frank
Published: June 2018

A practicable model and program CLIMT is put forward for determining the hourly values of indoor air temperature and the interior air humidity in relation to the external climate, the building parameters (geometry, material properties), the ventilation and the use of the internal space (interior heat sources, moisture sources and heating system). In order to generate the outdoor climatic dates (temperature, relative humidity, short and long wave radiation, precipitation, wind velocity and direction, driving rain) for the simulation a climate generator CLIG has been developed additionally. The results have been validated with measurements in actual buildings.
Gypsum partitions in medical rooms
Authors: Kania Tomasz , Nowak Henryk
Published: June 2018

In the time of intensive industry development, our natural environment will not manage alone with millions of tons of pollutants introduced into the atmosphere. The more harmful substances we are able to adapt, the smaller are the side effects of our activities. Synthetic gypsum is being produced as the by-product of processes aimed at protecting the environment against the harmful effects of sulphur dioxide from the energy industry. Gypsum products are being mainly used for making non-loadbearing walls inside buildings and for finishing the surfaces of internal partitions. Medical facilities, due to special conditions of use, must meet a wide range of requirements in this regard. Paper presents selected requirements for medical rooms in the field of acoustic insulation of walls from airborne sounds and protection of users against harmful ionizing radiation. The methods of execution of the partitions with the use of gypsum products that meet these requirements have been presented.
Concrete properties in diaphragm walls embedded in non-cohesive soils
Authors: Czopowska-Lewandowicz Magdalena
Published: June 2018

Although diaphragm walls are massive and responsible structures whose building history has many years' tradition, the discovery of a variety of material faults is still common throughout their exploitation. Some of the most common ones are associated with the occurrence of leaks along the wall surface. This paper reports on the results of a study conducted into concrete quality in an existing building structure. The issues identified in this case include the potential penetration of groundwater and particles suspended in non-cohesive soils into the bentonite suspension and into the concrete mixture. The scope of the analysis also involved the possible occurrence of a mixing zone of bentonite suspension with the concrete mixture. The solutions presented in this paper were practically tested using an existing structure and the results confirm that the adopted approach needs to be thoroughly researched. The laboratory specimens derived from an unreinforced diaphragm wall were subjected to the following tests: concrete bulk density in the air-dried state, water absorption by concrete, depth of water penetration under pressure, compressive strength and determination of the quantitative phase composition test using X-ray diffraction method. The results clearly demonstrate the decrease of the concrete quality applied in a monolithic diaphragm wall in comparison to the reference samples taken at the phase when it was built. Due to the fact that it was impossible to identify the impact of the particular variables on the investigated structure, this paper focuses on their descriptive assessment. This discussion is based on the analysis of the results defining the physical and mechanical properties of the examined concrete coupled with observations made by the author and insights derived from literature.
Optimization of ventilation system in the open office space
Authors: Suszanowicz Dariusz
Published: June 2018

The paper presents the results of study into the air parameters in open space offices. As office workers spend about 1/3 of the day in such spaces, it is important to provide them with the right climate comfort, and that is determined, most importantly, by: the temperature and humidity of the air, quality of the air, and the concentration of CO2. Two objects of study were selected - both of them open space facilities, each with a different intensity of use. In the course of study, measurements were taken on the basis of which the distributions of temperature, humidity, and concentrations of CO2 in the entire volume of the space were determined. Also the empirical coefficients of CO2 emission by the office workers were marked out, dependent on the volume of the working area and the number of people using it. The coefficients were developed at optimal working parameters of fans in the ventilation system; the criterion for optimization being heat loss in the office caused by discharge of the used heated air into the atmosphere. The results of the study have also shown that the use of personal ventilation (PV) with an installed recuperator for heat recovery from the used air discharged from the room significantly improves the energy efficiency of an open space office building.
Interpretation of the results of monitoring of the displacement of the Tresna dam in 2016
Authors: Lach Stanisław
Published: June 2018

Impounding structures are exposed to complex loads. Utilized in various conditions, they are subjected to different kinds of studies and longterm displacement surveys, as they could be exposed to the disturbance of stability principles. Building structures must be verified for safety not only at the operational stage, but at the design stage as well. Therefore, prototype tests are carried out to avoid construction failures and their consequences in the future [1]. The aim of the paper is to assess the technical conditions and level of safety of the Tresna dam located on the Żywiecki Reservoir based on the results of monitoring of the displacement in 2016. The obtained results were confronted with data on displacements from the period 2005- 2015. The scope of the research concerns mainly the issue of displacements monitored in the shell of the dam, the bottom outlet, the building of the hydroelectric power plant, the intake tower and the retaining wall. In addition to the measurements carried out at the dam also displacements on the area of the landslide near the building were monitored.
The influence of type of cement on the degradation of microstructure and transport properties of cement mortars exposed to frost induced damage
Authors: Wieczorek Alicja , Koniorczyk Marcin
Published: June 2018

The purpose of the study is to understand how the cyclic water freezing (0, 25, 50, 75, 100 and 150 freeze-thaw cycles) impacts microstructure and transport properties of cement-based materials. Tests were conducted on cement mortars with different water/cement ratios (w/c=0.45 and 0.40) and on two types of cement (CEM I and CEM III) without air-entraining admixtures. The changes of pore size distribution and open porosity were investigated by means of mercury intrusion porosimetry. Additionally, the relationship between intrinsic permeability and the water absorption coefficient of cement mortar samples was analysed. The water absorption coefficient and gas permeability were determined using capillary absorption test and the modified RILEMCembureau method. The evolution of transport coefficients with growing number of freeze-thaw cycles were determined on the same sample. It was also established that change of pore structure (a decrease of small pore volume <100nm and increase of larger pores >100nm) induces an increase of water transport parameters such as permeability and water absorption coefficient. The higher gas permeability corresponds to the higher internal damage. In particular, it is associated with the change of cement mortar microstructure, which indicates damage of narrow channels in the pore structure of cement mortars.
Energy performance of building heating - theory and reality on the example of educational buildings
Authors: Lis Piotr , Lis Anna
Published: June 2018

The calculative methods, which are adopted in various fields of engineering, are usually a certain kind of theoretical approximation of reality. The deviations from a full consistency of actual conditions and theoretical assumptions occur also in case of building heating. This work presents the selected results of examinations connected with an annual energy consumption CH and annual final energy demand Qk,H for heating and conducted on the group of educational buildings. The presented analysis and its results regard the group including 46 of 50 educational buildings, which form a municipal group of the buildings of this type. The purpose of presented analysis was to examine the influence of possible occurrence and level of differences between the annual energy consumption CH and annual final energy demand Qk,H for heating of examined buildings. The realization of this purpose is the basis for further research and analysis aimed at determining the dominant reasons of mentioned differences, establishing their level and propose a calculative method for reducing the differences between the values "picturing" the thermal needs of educational buildings in actual (energy consumption CH) and theoretical (final energy demand Qk,H) conditions.
Tap water as a source of indoor radon in houses
Authors: Klosok-Bazan Iwona , Boguniewicz-Zablocka Joanna , Naddeo Vincenzo , Domanowska Alina
Published: June 2018

Outdoors, radon is quickly diluted to very low, not problematic concentrations but indoors, it can concentrate significantly. Places that are particularly exposed to an increased radon concentration from water sources are places where water is dispersed, e.g. bathrooms or areas in water treatment facilities. The aim of the paper is to present the calculation of radon escaping from water into the indoor area at home on the example of Mokre village. Mokre is supplied with water from an underground source containing radon 222 Rn in concentration of about 200 Bq/L. The obtained data has been compared with WHO recommendation (WHO, 2009) and literature review. Considering that 300 Bq·m-3 are equivalent to 10 mSv per year, which is equal to receiving approximately an annual full chest CT (computed tomography), the risk resulting from the emission of radon from tap water in Mokre has been assessed to be insignificant.
The battery of silos for rapeseed - the impact of the building quality and exploitation conditions on the technical state of the object
Authors: Wróbel Krystyna , Kubiszyn Wiesław
Published: June 2018

The subject of the paper is a battery of silos for rapeseed located in Oil Factory in Bodaczów. It consists of 24 cylindrical silos with capacity of 500 tons and 14 star-shaped chambers between them with a capacity of 100 tons each. The silos were supported on the supporting structure in the form of permeating ring beams and columns. The height of a single silo is 25 m, and the diameter about 6.0 m. Detailed macroscopic tests were performed on the battery of silos. Destructive and sclerometric in-situ quality tests and pull-off test were performed on the concrete, the degree of concrete carbonation was estimated. The position of the reinforcement in the concrete structure and the corrosion of the reinforcement steel were determined. Static and strength calculations were carried out. Based on the results the technical condition of the object was estimated as poor, locally due to the significant loss of concrete and structural reinforcement it was estimated as imminent failure. The article presents the results of these tests, describes the reasons for the poor technical condition of the structure and presents solutions to restore its functional efficiency. A comprehensive repair of the battery of silos is currently underway applying the proposed solutions.
Cement-fly ash mortars durability, with fly ash from fluidized bed boilers and conventional combustion, exposed to aggressive environment influence
Authors: Janowska-Renkas Elżbieta , Kowalska Jolanta , Janus Grzegorz , Kaliciak Agnieszka
Published: June 2018

The study shows results of research on the aggressive environment impact (1, 3 and 5% HCl solution) on durability of cement mortars with fraction from 30 to 45% by mass of fly ashes from the fluidized bed combustion (FBC fly ash) and conventional fly ashes used separately and in the form of a mixture. The impact of aggressive environments on durability of cement and ash mortars was tested for aperiod of 365 days, by testing the compressive strength, linear changes, mass loss and porosity. It was demonstrated that mortars with the content of FBC fly ashes, after 365 days of tests showed the higher resistance to aggressive environment impact. It is confirmed by e.g. their higher compressive strength, and thus the reduced total porosity. Reduction of total porosity content (<50 nm) was accompanied by the increased compressive strength, which in the aqueous environment was in favour of cement mortars, and in the aggressive environment in favour of cement and ash mortars. It was demonstrated that the content of pores < 200 nm was lower for mortars with FBC fly ashes and mixtures of ashes regardless of environment the mortars were stored in. A beneficial impact of FBC fly ashes was found on physical properties of mortars, i.e. reduction of the shrinkage, lower mass loss and reduced destruction of mortars in the acid corrosion environment. That effect was especially beneficial for the mortar with higher (45% by mass) content of FBC fly ashes, regardless of aggressive character of the environment.
The uncertainty of a dynamic modulus of elasticity measuring in view of nondestructive tests of concrete compressive strength
Authors: Jurowski Krystian , Kaleta Alina , Krępa Bronisław
Published: June 2018

In this work, the evaluation of measurement uncertainty of concrete dynamic elastic modulus testing method was conducted. The dynamic test was carried out using impulse excitation and modal analysis method, which can be used to determine the compressive strength of concrete in a non-destructive way. The tests were conducted using concrete samples in order to determine the practical usefulness of the mentioned method. It has been demonstrated that the impulse excitation and modal analysis method is characterized by very good repeatability.
A study of selected properties of autoclaved bricks.
Authors: Komisarczyk Katarzyna , Dachowski Ryszard
Published: June 2018

This research investigated the possibility of using material with different share as an addition to prepare autoclaved bricks. Modifiers are searched, thanks to which the obtained materials will indicate potential suitability of modified products for exposure to activity of moisture and highly loaded building elements, e.g. basement walls. As the modifier was used: highly-efficient chemical agent of polymer, silicate and lithium compounds. The amount of water necessary to thicken the mixture was replaced by a modifier. Introduction of modifier in the form of chemical agent into lime-sand mixture causes the increase of the compressive strength by more than 4 MPa in relation to the reference sample, using 1% of additive. In each analyzed case it reduces the water absorption of finished products. The results of compressive strength and water absorption show different values after 21 days and 24 months from the autoclaving process, the longer the time from the moment of production of products, the better result. Regardless of the amount of applied modifier, the distribution of pores is presented in similar way, the number of macropores was noted at level of around 70%.
Time-frequency analysis of acoustic emission signals generated by cement-fiber boards during bending test
Authors: Adamczak-Bugno Anna , Świt Grzegorz , Krampikowska Aleksandra
Published: June 2018

Fiber-cement building materials have been used in civil engineering for over one hundred years. Contemporary fiber-cement boards are made of natural raw materials such as cement, cellulose fibers, PVA and water. Materials made of fiber-cement are used in construction as a building and finishing material for elevations, internal walls and roofs, hence are exposed to environmental conditions such as rainfall and temperature changes, in particular, frequent temperature transition through 0°C in a 24 hour cycle (cyclic freezing-thawing). In addition, fibrous cement materials, primarily used as cladding elements, are exposed to exceptional conditions, which include the high temperature caused by fire. The article presents the results of experimental tests of bending strength of cement-fiber boards subjected to environmental factors and exceptional factors. The paper also presents a proposal to use a nondestructive method of acoustic emission (AE) based on time-frequency analysis for testing fiber-cement boards. Interesting research results were obtained, which allowed to trace the differences in the mechanisms of material destruction under the influence of various factors.
Modelling of elastic-plastic behavior of cables
Authors: Shimanovsky Oleksandr
Published: June 2018

The paper describes general calculation theory and elasticplastic behavior of cables - bearing elements of suspension structural systems. It is mentioned that this theory is based almost on the same assumptions as the theory of cable calculation at behavior of material in elastic range, excluding additional supposition in the part of idealization of real dependence between stresses and deformations on account of difficulties with using the latter in actual structures design. For that reason, this dependence is replaced with a model in the form of analytic curve or, as it is accepted to say in this case, a diagram, which is built according to some simple mathematic rule, reflecting element behavior conditions and characteristics of its material. It is stated that four main models of material behavior are used in practice: elastic-plastic, elastic-plastic with linear hardening, rigid-plastic and rigid-plastic with linear hardening. Conditions of occurrence of plastic deformations in all behavior stages of cable cross section are determined. Interrelations for geometrically and physically nonlinear task of the cable at active loading are provided. Methods are given and limit values of loads acting on the cable are determined. Equations defining parameters of cable deflected mode in all deformation phases and conditions of changing phases of cable behavior are given.
Reinforcement of brick historic buildings threatened by structural damages or by failure
Authors: Kruszka Leopold
Published: June 2018

The paper presents selected aspects of reinforcing the brick cultural heritage buildings, particularly load-carrying elements of those structures. In some cases the operational phase of many load-bearing elements of the historical buildings is shrinking or has used up. The crucial task while carrying out construction works related to reinforcing or repair of the load-bearing structure is to ensure safety. This safety should be assured regarding both the structure itself and its users. The design concept also needs to include recommendations and instructions of the conservatorinspector. The proposed scope of technical assessment and analysis of the load-bearing structures of buildings is presented on selected examples. The performed diagnostics process allowed to properly determine the occurred hazards and on this basis to properly design and carry out repair of damaged elements of structure [1]. The first of the analysed cases concerns the barracks facility near the Makowiecka Street in Przasnysz. Another example described in this paper is the brick dome of the church building of St. Anne in Wilanów district in Warsaw. The damages and failure identification process, as well as taken measures and proposed methods of reinforcement of the structure are presented with reference to the both above mentioned examples.
Unconscious decisions causing a failure condition of the 19th century brick ceiling
Authors: Bajno Dariusz , Grzybowska Agnieszka , Tews Rafał
Published: June 2018

The article describes a hazard caused by deformation of a brick vault located under the dungeons of the gate tower of Zamek Górny in Opole at the turn of the 13th and the 14th centuries, which was used as a school building until 2017. The hazard identified in 2013 was found on the ground level of the building in a communication route of the heavy traffic load. Visual inspections and tests have demonstrated that the existing situation was caused by civil works performed at the dungeon level nearly 6 years earlier due to an unconsidered decision on removing debris and a backfill which filled entirely the lower tower storeys. The above actions resulted in removal of the base of the floor ‘laid on the ground’ in the 19th century [2][4]. In this article, an analysis was carried out to verify possibilities of unbelievable strength of the artificially formed flat vault, which was previously the floor supported on a debris and sand base.
Application of the aggregated calculation algorithm EA FAHP and fuzzy TOPSIS methods in the evaluation of railway culverts serviceability
Authors: Fabianowski Dariusz , Jakiel Przemysław
Published: June 2018

Managing maintenance systems of railway culverts constitutes a typical multiple criteria decision related problem which arises from the necessity to allocate limited financial resources to repair work. Culverts are ranked on the basis of evaluation of their level of structure degradation obtained with the use of a properly created set of criteria. In order to fully present the specific character of the issue under scrutiny, an innovative approach has been proposed using the aggregated calculation algorithm which combines the EA FAHP and Fuzzy TOPSIS methods. It is a decision- making and calculation model which allows to reflect the actual evaluation processes, as well as to take into account the diversity of solutions with respect to materials applied in the structures of railway culverts.
Behaviour of corrugated steel plate bridge with high soil cover under seismic excitation
Authors: Maleska Tomasz , Beben Damian
Published: June 2018

The design codes and calculation methods related to the corrugated steel plate (CSP) bridges and culverts say only on the minimum soil height. This value is connected with the bridge span and shell height. In the case of static and dynamic loads (like passing the vehicles), such approach seems to be reasonable. However, it is important to know how the CSP bridges with high the soil covers behave under the seismic loads. This paper is presented the result of numerical study of CSP bridge with different high cover under seismic excitation. The analysed CSP railway bridge in the cross section has two closed pipe-arches. The span of shells is 4.40 m and the height of shells is 2.80 m. The load-carrying structure was constructed as two shells assembled from CSP sheets, designed with a depth of 0.05 m, pitch of 0.15 m, and plate thickness of 0.003 m. The real soil cover depth over the CSP structure (including ballast, blanket and backfill) equals 2.40 m. In this study two heights of soil cover were analysed (2.40 m and 5.00 m). Numerical analysis was conducted using the DIANA program based on finite element method (FEM). A linear model with El Centro records and Time History was used to analyse the problem.
Environmental interactions to composite elements of all-GFRP Kolding Footbridge
Authors: Stankiewicz Beata
Published: June 2018

Structural integrity of a composite material embraces contributions from: materials science and engineering, processing science, design and fabrication technology. It combines a number of interacting factors: the criticality of the application, the accessibility for and ability to inspect vital parts and components, the intended use including load spectrum and time, the consequences of impact, fatigue, temperature and hostile environment, the nature of inherent flaws, the constituent properties of the material system utilized, and it takes into account human factors. Glass fibre-reinforced polymer GFRP pultruded profiles have great potential in the construction industry, presenting certain advantages when compared with traditional materials, including the potentially improved durability under fluctuating levels of environmental factors. The contribution presents analysis of GFRP composite, acquired from cablestayed Fiberline Bridge exploited for 20 years in the fjord area of Kolding, Denmark. The differential scanning calorimetry (DSC) experiments were performed in the GFRP composite bridge material, in order to determine the mass variation and the energy changes suffered by the materials, as a function of temperature and time. Dynamic mechanical analysis (DMA) was allowed to detect thermal effects based on changes in the modulus or damping behavior. Tensile and flexural tests let to observe the decomposition process and had taken information of basic stress parameters of GFRP material used in Kolding Footbridge. Aforementioned analyses of durability are necessary to examine and monitoring for environmentally aged composites bridge elements.
Analytical modelling of a three-layer wall system of strengthening for large-panel slab buildings by means of bonded anchors
Authors: Szlendak Jerzy K. , Jablonska-Krysiewicz Agnieszka , Tomaszewicz Dariusz
Published: June 2018

The goal of the article is to elaboration analytical models describing a new system of reinforcing three-layer walls of large-panel buildings with bonded anchors. The use of this type of fasteners that bond the façade texture layer to the structural slab is necessary due to the low durability of previously used suspension elements. Various bonded anchorage systems were considered. The new anchorage systems were designed as two-anchors systems (horizontal anchor and diagonal anchors) and three-anchors systems (horizontal anchor and two diagonal anchors). The inclinations of these anchors are in the range of 30°-60° in relation to the surface of the element. For the above types of reinforcements, analytical models have been developed that take into account the change of strength parameters of the resin and steel from which the anchors were made, the interaction of materials resin-steel and resin-concrete and the effect of the simultaneous action of pull-out and shearing forces. Moreover, was assumed the simultaneous destruction of fasteners two- and three-anchors. The elaborated analytical models will be used to determine the load-bearing capacity of the new connector system, which will allow the elaboration of guidelines for strengthening three-layer walls of largepanel slab buildings.
Conscious approach to urban and extra-urban space restructuring as seen in the designs of Architecture students
Authors: Gil-Mastalerczyk Joanna
Published: June 2018

In education of architects and urban planners, it is important to rely on interdisciplinary approach to many factors involved in the process. Especially in the built environment context, the awareness of the interaction of different components is of key importance. In their future work, architecture students need to have responsible and socially-oriented standpoint. It will be demonstrated in the creation of architectural objects in the natural landscape surroundings, and in the attitude to different type of architectural and urban spaces. Safety, the use of natural resources, the relations between architecture and the surrounds, the evaluation of the environmental components and their impact on the creative process are extremely important. The paper discusses examples of space solutions in the urban areas and those located outside cities. Those solutions involve daring architectural and urban forms that make use of the natural environment assets, and also quality architectural work and design. The presence of such objects is a response to the demand from the society, consequently it seems reasonable to explore the issues related to architectural education.
Alzheimer in the City
Authors: Dartigues Jean-François
Published: June 2018

Alzheimer’s disease was described in 1906, but it was only in 1987 that it was recognized as a public health problem with the actions of patient family associations. Despite successive Alzheimer plans, it remains a neglected and under-diagnosed disease. The lack of curative treatment and a clash of views between general practitioners and specialists explain these findings. Paradoxically, despite this neglect, Alzheimer’s disease is receding in the city. This is the proof that prevention is possible.
Zunehmende Anforderung an medizinisches Fachpersonal
Authors: Lenden Claudia
Published: June 2018

In unserer Gesellschaft wächst die Anzahl der Älteren und durch wesentlich bessere Behandlungsmöglichkeiten auch die Anzahl älterer Menschen mit Diabetes mellitus Typ 1. Gleichzeitig steigt der Anteil der Menschen mit Demenz, sodass es immer häufiger Menschen mit beiden Erkrankungen gibt. Ist dies der Fall, sind Ärzte, Diabetesberater und Pflegepersonal besonders herausgefordert.
Editorial zum Themenheft „Stoffwechsel“
Authors: Frommer Klaus , Reuss-Borst Monika
Published: June 2018

Liebe Leserin, lieber Leser,

beim Thema Stoffwechsel und Rheuma denken vermutlich die meisten von Ihnen zuallererst an Adipositas und Arthrose. Doch die Verbindung zwischen Metabolismus/Stoffwechsel und Rheuma ist deutlich breiter gefächert. Stoffwechselerkrankungen, altersbedingte metabolische Veränderungen bzw. allgemein verschiedene Metabolite können Risikofaktor, Ursache oder kontributiver Faktor von rheumatischen Erkrankungen sein.
VivaBack-Entwickler Valentin Rosegger im Gespräch – „Wir haben ein 24-Stunden-EKG für den Rücken entwickelt“
Authors: Pilacek Robert
Published: June 2018

Die Österreicher Valentin Rosegger und Dr. Robert Pilacek haben das System VivaBack und die gleichnamige Firma gegründet. Mit drei Sensoren an Sternum, Sakrum und Oberschenkel analysiert VivaBack über 24 Stunden die Wirbelsäulenbewegung. Die Entwickler sehen darin Chancen in Prävention, Therapie und der Forschung.
Hypnose bei Schmerz
Authors: Thomaßen Dorothea
Published: June 2018

Die Wirksamkeit der Hypnose insbesondere bei psychischen und sozialen Faktoren somatischer Erkrankungen ist seit 2003 anerkannt. Sie wird erfolgreich bei
medizinischen Eingriffen, akuten Notfällen und chronischen Krankheiten angewandt. Während die moderne Schulmedizin sich an überindividuellen Norm- und
Messwerten orientiert, arbeitet Hypnose mit und in der subjektiven Wirklichkeit des Patienten. Die Hypnotherapie nutzt spontane und bewusst herbeigeführte
hypnotische Prozesse beim Patienten im medizinischen Alltag, um sie therapeutisch zu nutzen. Dabei werden vorübergehende Zustandsveränderungen (Trance) zur
akuten und langfristigen Schmerzreduktion initiiert.
Cannabinoid-Verordnungen in der Praxis
Authors: Kuhlen Isabel
Published: June 2018

Seit März 2017 kann der Wirkstoff Cannabis unter gesetzlich festgelegten Voraussetzungen verordnet werden. Allerdings ist die Verordnung genehmigungspflichtig durch die GKV. In der Praxis bestehen häufig noch Unsicherheiten, nicht alle Anträge werden genehmigt oder die Genehmigung zeitlich befristet, was nach einem aktuellen Eilverfahren nicht mehr zulässig ist.

Der Artikel erläutert die gesetzlichen Grundlagen, die Voraussetzungen für die Verordnungsfähigkeit von Cannabinoiden, was bei der Antragstellung zu beachten ist und welche Fristen vonseiten der GKV für die Genehmigung gelten.
Zum Stellenwert der Gesundheitsökonomie in Deutschland
Authors: Potempa Christoph , Rychlik Reinhard
Published: June 2018

Die vorliegende Auswertung untersucht den Status Quo zum Stellenwert der Gesundheitsökonomie in Deutschland. Die Ergebnisse basieren auf einem Survey, der 2017
in Vorbereitung auf die 10. Jahrestagung der Deutschen Gesellschaft für Gesundheitsökonomie (DGGÖ) durch das Institut für Empirische Gesundheitsökonomie (IfEG)
mit insgesamt 152 Verantwortlichen aus unterschiedlichen, für das Gesundheitswesen relevanten, Institutionen durchgeführt wurde.

Bereits in den Teilnahmequoten fanden sich erste Hinweise darauf, dass die Gesundheitsökonomie für die Krankenkassen, Politik und Krankenhäuser einen insgesamt
höheren Stellenwert einnimmt als für die Ärzteschaft. Die Ergebnisse der Einstellungsfragen zur Gesundheitsökonomie verstärkten diesen Eindruck zusätzlich.

Die stärkste Zustimmung erhielten dabei insgesamt jene Positionen, die dem Gesundheitswesen einen zunehmenden Fokus auf Kosteneinsparungen attestierten. So
sollen ökonomische Vorgaben den Befragten zufolge die medizinische Entscheidungsfreiheit in keinem Fall beeinflussen dürfen. Darüber hinaus wurden
Lebensqualitätsmessungen als essenzieller Bestandteil gesundheitsökonomischer Evaluationen herausgestellt und deutlich auf die Notwendigkeit einer erhöhten
Transparenz im Gesundheitswesen hingewiesen. Insbesondere im Zusammenhang mit diesen Thesen waren teilweise widersprüchliche Positionen zwischen den Ärzten und
sonstigen Entscheidungsträgern zu beobachten. So vertreten z. B. große Teile der Ärzteschaft die Position, dass die Gesundheitsökonomie zwar Kosten einsparen
kann, dies jedoch lediglich auf Kosten der Versorgungsqualität geschieht.

Die Ergebnisse liefern diverse Denkanstöße und tragen damit gleichermaßen zur aktuellen Diskussion sowie zur künftigen Weiterentwicklung der Gesundheitsökonomie
in Deutschland bei. Um die Relevanz der Gesundheitsökonomie für alle im Gesundheitswesen involvierten Akteure zu steigern, muss zukünftig insbesondere die
Ärzteschaft mit den Vorteilen gesundheitsökonomischer Evaluationen konfrontiert werden. Dies kann z. B. durch eine verstärkte Präsenz gesundheitsökonomischer
Themen in der Öffentlichkeit geschehen. Im Rahmen solcher Maßnahmen könnte gezeigt werden, dass sich die Gesundheitsökonomie nicht, wie im Rahmen des Surveys
häufig kritisiert, auf Kosteneinsparungen im Gesundheitswesen reduzieren lässt, sondern dass die erfolgreiche Versorgung der Patienten unter optimalem
Ressourceneinsatz in den Vordergrund gestellt wird und somit Vorteile für alle Beteiligten mit sich bringen kann.
Arbeitshilfen Bessere Kommunikation – Die unterschätzte Gelegenheit
Authors: Holtel Markus
Published: June 2018

Schon der Eintrag in Wikipedia spricht Bände: Zur ärztlichen Visite wird dort nicht in erster Linie aufgezählt, was sie leisten kann und soll. Stattdessen
eine Vielzahl von Kommunikationsmängeln. Die Zeit sei zu kurz, die Kommunikation asymmetrisch. Beschwerden und Fragen des Patienten erhielten nicht
ausreichend Raum.
Demenz – Die Auswirkungen der Demenz auf die Gesellschaft
Authors: Thiem Helena
Published: June 2018

Michalowsky B et al. Healthcare utilization and costs in primary care patients with dementia: baseline results of the DelpHi-trial. Eur J Health Econ 2018; 19:
87–102

Aufgrund der immer älter werdenden Gesellschaft ist zu erwarten, dass die Zahl an Patienten mit Demenz stetig steigen wird. Untersuchungen gehen sogar von
einer Verdoppelung der Patientenzahl in den kommenden zwanzig Jahren aus. Die Demenz kann somit aus gesellschaftlicher wie aus finanzieller Sicht als eine
der bedeutendsten Erkrankungen des Alters gesehen werden. Die Autoren untersuchen, welche ökonomischen Konsequenzen diese Erkrankung mit sich
bringt.
Qualitätsorientierte Vergütung – Pay-for-Performance (P4P) in der zahnärztlichen Versorgung
Authors: Potempa Christoph
Published: June 2018

Chenot R. Wirkungen von Pay-for-Performance (P4P) in der zahnärztlichen Versorgung. Ein systematischer narrativer Review. Z Evid Fortbild Qual Gesundh wesen;
2017; 127–128: 42–55

In den USA, England und Skandinavien werden derzeit die ersten P4P-Modelle im Rahmen der zahnärztlichen Versorgung erprobt. Auf Basis eines systematischen
Reviews beschreibt die Autorin Chenot ihre Erkenntnisse über den Einsatz und die potenziellen Auswirkungen von P4P-Versorgungsmodellen für den Bereich der
zahnärztlichen Versorgung.
Unerwünschte Arzneimittelereignisse (UAW) – Jede Methode liefert ein anderes Ergebnis bezüglich der Kostenentstehung
Authors: Fietz Cornelia
Published: June 2018

Gyllensten H et al. Comparing Methods for Estimating Direct Costs of Adverse Drug Events. Value Health 2017; 20: 1299–1310

Unumstritten ist, dass unerwünschte Arzneimittelereignisse einen erheblichen Ressourcenverbrauch im Gesundheitssystem verursachen. Wann hängt jedoch ein
unerwünschtes Ereignis kausal mit dem Arzneimittel zusammen, wie gravierend sind die Effekte für den Ressourcenverbrauch und welche Kosten für das
Gesundheitssystem sind damit verbunden? Die Autoren zeigen, wie methodologische Entscheidungen die Kostenkalkulation beeinflussen.
40 Jahre Gesundheitsökonomie in Deutschland – Festvortrag von J.-Matthias Graf von der Schulenburg anlässlich der 10. Jahrestagung der dggö am 5.3.2018 in Hamburg
Authors: von der Schulenburg J.-Matthias Graf
Published: June 2018

Mein Festvortrag beginnt mit einer schlechten und einer guten Nachricht: Die schlechte Nachricht ist, dass mein Vortrag nicht das gemeinsame Lesen von PPT-Folien ist, sondern Sie sich allein auf das gesprochene Wort konzentrieren müssen. Die gute Nachricht ist, dass der Vortrag nur 15 Minuten lang ist und nur drei Teile hat: I. Prolog; II. Oper in 4 Akten (besser ist Operette in 4 Akten, da es kein tragisches sondern fröhliches Ereignis ist); III. Epilog.
Osteoporose bei Typ-1- und Typ-2-Diabetes
Authors: Scharla Stephan
Published: June 2018

Diabetes mellitus und Osteoporose sind häufige Erkrankungen. Deshalb gibt es viele Patienten, die an beiden Krankheiten gleichzeitig leiden. Darüber hinaus sind jedoch sowohl der Typ-1- als auch der Typ-2-Diabetes jeweils prädisponierende Erkrankungen, die das Risiko für Osteoporose und Frakturen erhöhen. Dabei ist das Risiko bei einem Diabetes mellitus Typ 1 stärker ausgeprägt, während bei Diabetes mellitus Typ 2 vor allem Patienten mit längerer Krankheitsdauer, schlechter Stoffwechsellage, Insulinpflichtigkeit und vaskulären Folgeschäden frakturgefährdet sind. Die Knochendichte ist bei Menschen mit Typ-1-Diabetes erniedrigt, während insbesondere adipöse Typ-2-Diabetespatienten auch höhere Knochendichtewerte aufweisen können. Das Frakturrisiko wird jedoch nicht nur durch Veränderungen der Knochendichte und der Knochenarchitektur erhöht, sondern auch durch veränderte Knochenmaterialeigenschaften (veränderte Kollagen-Quervernetzung). Pathogenetische Faktoren sind Hyperglykämie, hormonelle Veränderungen und der Einfluss von oralen Antidiabetika. Während Inkretine und DPP-4-Hemmer das Frakturrisiko zu senken scheinen, sind Glitazone mit höherem Risiko assoziiert. Auch SGLT-2-Hemmer könnten bei eingeschränkter Nierenfunktion mit einem höheren Frakturrisiko behaftet sein. Die Therapie der Osteoporose bei Menschen mit Diabetes mellitus unterscheidet sich nicht vom Vorgehen bei primärer Osteoporose. Die Effizienz von antiresorptiven Medikamenten wird durch den Diabetes mellitus nicht beeinflusst.
Nicht schon wieder ein Reise-Faltblatt!
Authors: Polok Adrian
Published: June 2018

Pünktlich zum Beginn der diesjährigen Hauptreisesaison gibt es Neuigkeiten aus dem Ratgebersortiment der Deutschen Diabetes Stiftung (DDS). Mit der jüngst erschienenen Broschüre „Unterwegs mit Diabetes“ beantwortet die DDS auf umfangreichen 30 Seiten medizinische, logistische und bürokratische Fragen rund um das Reisen mit Diabetes.
Pharmacological Control of Complications Following to Third Molar Removal: Evidence Based on A Meta-Analysis
Authors: Isiordia-Espinoza Mario , Bologna-Molina Ronell , Hernández-Miramontes Ycenna , Zapata-Morales Juan , Alonso-Castro Angel , Martínez-Morales Flavio , Sánchez-Enriquez Sergio , Serafín-Higuera Nicolás , Pérez-Cortez Guillermo , Franco-de la Torre Lorenzo
Published: June 2018

Aims The purpose of this meta-analysis was to evaluate the clinical efficacy of non-steroidal anti-inflammatory drugs and dexamethasone on the trismus, postsurgical pain, facial swelling, as well as the analgesic consumption after third molar surgery.

Material and Methods The reports were identified in the most important medical databases. Those studies that met the requirements were fully assessed according to the inclusion and exclusion criteria. The quality of each report was evaluated with the Oxford Quality Scale and using the Cochrane Collaboration’s risk of bias tool. Each meta-analysis was done using the technique of mean difference and 95% confidence intervals employing a random effects model with the Review Manager 5.3., from the Cochrane Library. Significant statistical difference was accepted when the p value was less than 0.05 on the test of overall effect (Z value).

Results Qualitative evaluation was done using the data of 330 patients extracted from seven articles and the quantitative assessment with data of 200 patients from three reports. It was not observed difference among non-steroidal anti-inflammatory drugs and dexamethasone in any of the clinical effectiveness indicators.

Conclusion The outcomes of our meta-analysis indicate that non-steroidal anti-inflammatory drugs and dexamethasone have good therapeutic effect for the management of inflammatory complications following to third molar surgery.
Pre-Treatment with Curcumin Ameliorates Cisplatin-Induced Kidney Damage by Suppressing Kidney Inflammation and Apoptosis in Rats
Authors: Soetikno Vivian , Sari Shinta , Ul Maknun Lulu , Sumbung Nielda , Rahmi Deliana , Pandhita Bashar , Louisa Melva , Estuningtyas Ari
Published: June 2018

Objective In addition to oxidative stress, inflammation and apoptosis have an important role in the pathogenesis of cisplatin-induced kidney damage. This study aimed to investigate the molecular mechanisms of protective effects of curcumin against cisplatin-induced kidney inflammation and apoptosis in rats.

Materials and Methods Eighteen rats were equally divided into three groups; normal (0.5% CMC-Na), cisplatin (CDPP) (7 mg/kg i.p.), and cisplatin+curcumin (CMN100) groups. Curcumin was given at a dose of 100 mg/kg orally for nine days, starts one week before giving a single dose of cisplatin. Kidney and plasma were taken for analysis.

Results Cisplatin challenged rats demonstrated kidney injury as shown by reduced creatinine clearance, increased of plasma BUN, plasma creatinine, and kidney MDA, decreased of kidney GSH levels, and kidney histopathology alterations. Also, cisplatin increased ERK1/2 phosphorylation and NF-κB expression, which subsequently increased mRNA expression of TNF-α, IL-6, KIM-1, NGAL, and Bax/Bcl-2 ratio as well as decreased mRNA expression of IL-10 in kidney tissues. Pre-treatment with curcumin significantly ameliorated inflammation and apoptosis induced by cisplatin. In addition, curcumin downregulated Ctr1 and OCT2 drug transporters as compared to cisplatin group. Histopathological examination furthers confirmed the kidney damage protection effect of curcumin.

Conclusions These data indicate that curcumin has nephroprotective properties against cisplatin-induced kidney damage in rats and this effect is associated with its anti-inflammatory and anti-apoptosis profiles, in addition to its antioxidant. Hence, curcumin may be useful for preventing kidney damage against cisplatin administration.
Rapid Determination of Profibrinolysin (Plasminogen) in Plasma
Authors: Nanninga L. B
Published: June 2018

A determination of Profibrinolysin in plasma is described, based on activation of euglobulin precipitate with urokinase and estimation of the obtained fibrinolytic activity by means of the initial lysis of fibrinogen. This was measured by means of the rapid decrease of turbidity in 25% saturated ammonium sulfate in diluted samples taken each minute for the first 6 min of the reaction. The results indicate a large excess of antifibrinolysin over Profibrinolysin in normal plasma.