bluuebunny/crossref_metadata_2025 huggingface dataset:
Methods for creating CLT Construction Guidelines
Authors: Wahlstrøm Simen
Published: June 2020

During the past decade, the use of Cross-Laminated Timber (CLT) elements has become gradually more popular and widespread in building construction in Norway. A study mapping the experience of CLT use in the Norwegian construction industry reveals that existing domestic literature on this topic is outdated and no longer relevant. This paper describes the methods used for preparing updated CLT construction guidelines. Information obtained from expert actors in the construction industry, combined with document studies, has formed the knowledge basis for this study. A total of 19 qualitative in-depth interviews were conducted, and more than 400 documents from 12 CLT projects were received from 11 actors. A CLT construction guide focusing on moisture safety design and rational production was prepared based on the information obtained, and was quality assured by 16 experts from industry and the research community. Guidance on the approach to preparation of the guide, its format and layout, was provided by SINTEF Science Communication. Critical feedback influenced the content of the guide and its design recommendations. The study shows that dialogue with the construction industry and research community is a valuable contribution to the preparation of structured construction solutions. The involvement of the industry has accentuated the importance of the preparation of CLT construction guidelines. It is hoped that the guide will inspire research institutions to prepare and publish updated guidelines.
Achieving airtightness and weather protection of CLT buildings
Authors: Herms Jens-Lüder
Published: June 2020

CLT buildings - a critical view concerning airtightness and weather protection during building time. Wood constructions are gaining a bigger and bigger share in the building industry as well in bigger constructions. Mainly CLT (Cross-Laminated-Timber) elements are due to it’s stability, fast building up time, easy installation and high share of prefabrication a key point for this success. In this presentation I will take a critical view on the building physical properties like diffusion resistance and airtightness. Especially according to the normal building material properties of wood like swelling and dwindling of timber. As well we will take a closer look to different glue technologies which are used on adhesive tapes to seal the CLT elements airtight. There are different technologies available in the market which offer different quality levels. Another point to solve is the temporary weather protection of timber building due to an enlarged building time. Especially when we have visible surface in the walls or in the ceiling they must be protected against rain water – there are new self sticking membranes available in the market which have proven their ability to protect ceilings against rain in a large number of realised constructions. The performance of these products will be presented in some already realised projects and we will take a closer look at the requirements and problems which have been found in these projects.
Pressure distribution around the thermal envelope - a parametric study of the impact from wind and temperature on contaminant transport within a building
Authors: Domhagen Fredrik , Wahlgren Paula , Hagentoft Carl-Eric
Published: June 2020

Several school buildings in Sweden have indoor air quality problems. The contaminant source is often assumed to come from within the construction, for example from the crawl space or attic space. Contaminants, in these cases, are transported by air leaking between compartments in the building. Here, the driving force for the air leakage is difference in pressure and, therefore, determining pressure also determines the direction of contaminant transport. In many cases, measures to improve the air quality are taken without a thorough understanding of how it might affect the pressure distribution in the building. In this paper a numerical model is used to examine how different climate scenarios and different building configurations affect the leakage and contaminant transport in a building with a crawl space. Results show that for leaky buildings the ventilation rate increases with increased wind and therefore the contaminant concentration decreases. The worst scenario in terms of high contaminant concentration is mild days with little wind. Also, when installing an exhaust fan in the crawl space with the purpose to prevent air from leaking from the crawl space to the classroom it is advisable to also consider the airtightness and the climate, not only the pressure difference across the floor.
Preliminary results of indoor moisture excess measurements for residential and office buildings in Latvia
Authors: Zemitis Jurgis , Bogdanovics Raimonds
Published: June 2020

It is vitally important to understand the moisture transfer process in the buildings as this knowledge allows to generate solutions on how to control it. The data about typical indoor air humidity levels and moisture sources are usually taken from the existing standards. However, this information needs to be verified and adapted for the local situation as occupant behaviour varies for each country. Similar studies have been performed in Estonia and Finland and they indicate that the typical data of these northern countries differ from the one provided in the standard. This paper presents the preliminary results of moisture measurements for several residential and office buildings in Latvia. Afterward, the difference between indoor and outdoor air absolute humidity is calculated and the data is analyzed depending on the outside air temperature. The results can be used to provide suggestions on the adaption of EN ISO 13788:2012 Figure A.2 which presents the information on the variation of internal humidity classes with external temperatures. The study is not yet completed as more measurements must be taken since the outside temperatures have dropped under zero degrees only for a few days and the number of the test objects must be increased.
Analysis of monthly and daily profiles of DHW use in apartment blocks in Norway
Authors: Ivanko Dmytro , Taxt Walnum Harald , Lekang Sørensen Åse , Nord Natasa
Published: June 2020

Profiles of domestic hot water (DHW) use give valuable information for achieving energy saving in buildings. In this article, analysis of monthly and hourly profiles in apartment blocks in Norway was performed. The aim was firstly to identify influencing factors on DHW use and afterwards to define typical DHW use profiles. Due to availability, two different data samples were used for monthly and hourly analysis. Monthly data from 49 apartments showed that approximately 30% of DHW was used in kitchens and the rest 70% in bathrooms. The influence of apartment sizes on DHW use was tested based on monthly profiles. Monthly profiles for three categories of apartments with 33 m2, 51-52 m2, and 68-72 m2 floor area were developed. Cluster analysis allowed us to identify profiles for three groups of apartments with a typical number of residents. In addition, for comparison purpose, DHW hourly profiles in two social housings and two housing cooperatives were investigated. These profiles indicated that there was a difference in when DHW was used in these two types of buildings, with a higher daytime DHW use in social housing. Finally, the measured DHW heat use profiles are compared with the profile in the national standard.
The influence of heat loss from pipes in an unheated basement on the heating energy consumption of an entire typical apartment building
Authors: Hamburg Anti , Kalamees Targo
Published: June 2020

The majority of old apartment buildings were designed with an unheated basement. Building service systems such as district heating heat exchangers and pipes for domestic hot water and for space heating are usually located in this unheated basement. In addition, these locations are connected with shafts. All these pipe’s heat losses increase air temperature in the basement. If these losses are included into the building energy balance, then they decrease heat loss through the basement ceiling. The basement’s heat balance is also dependent on heat loss from the basement envelope and outdoor air exchange in the basement. In early stages of design, designers and energy auditors need rough models to make decisions in limited information conditions. Once the effects of heat losses from pipes become apparent, they need to be factored into the buildings energy balance, and their effects on heat loss through the basement ceiling needs to be calculated. In this paper we analyse the effect these heat losses have on the service system’s heat gains and heat loss through an uninsulated basement ceiling at different basement insulation levels and with different thicknesses of pipe insulation. From our study we found that pipe losses in the basement increase the building energy performance value by at least 4 kWh/(m²∙a) and their impact on a renovated apartment building is very important.
Analysis of causes of the end of service life of a spray polyurethane foam and polyurea roof
Authors: Kalamees Targo , Ilomets Simo , Põldaru Mattias , Klõseiko Paul , Kallavus Urve , Rosenberg Margit , Õiger Karl
Published: June 2020

Spray polyurethane foam (SPF) roofs are widely used in North America. Much fewer usage examples and experience can be found in Northern European cold climatic conditions. This study analyses hygrothermal performance and the reasons for the roof’s degradation and end of service life of an SPF and polyurea roof. The service life of the roof is over and major reconstruction is needed eight year after construction. The current study uses field measurements included onsite temperature and humidity measurements and extensive surveying, the roof was opened from several locations and test samples were taken for laboratory tests. The influence of UV radiation on the loss of adhesion was tested. Solar radiation quickly degraded the top surface of the in-situ sprayed polyurethane foam insulation causing a weak connection between the foam layers. Due to mechanically damaged and UV degraded polyurea roofing, water has leaked into the SPF. The water inside or below the foam evaporated during sunny days and broke the adhesion of different foam layers. Larger foam blisters were observed on the upper part of the insulation caused by high water vapour pressure. This is considered the most realistic cause of separation of the SPF layers. The analyse of hygrothermal performance, service life, and durability prediction should be included into the design process, especially for structures with small or without long term performance experience.
Hygrothermal performance of log walls in a building of 18th century and prediction of climate change impact on biological deterioration
Authors: Choidis Petros , Tsikaloudaki Katerina , Kraniotis Dimitrios
Published: June 2020

Several studies underline the dramatic changes that are expected to take place in nature and environment due to climate change. The latter is also expected to affect the built environment. Particular emphasis is currently given to the impact of climate change on historical structures. Within this context, it is important to use simple methods and novel tools in order to investigate specific case studies. In this study, the climate change impact on the hygrothermal performance of the log walls in a historic timber building is presented. The building under investigation is the Fadum storehouse, also known as ‘the coated house’, located in Tønsberg, Norway. The storehouse dates to the late 18thcentury. It has a particular design with the main features of stumps or piles up to which it stands and the ‘coating’ that covers its outer walls. The main damage of the construction is related to the biological degradation of the wood. The hygrothermal performance of the log walls, as well as the exterior and interior climate, have been monitored and the results have been used to validate a Heat, Air and Moisture transport (HAM) model. The validated HAM model is then used to examine the performance of the log walls for both current and potential future climate conditions. The transient hygrothermal boundary conditions serve as the input parameters to a biohygrothermal model that is used to investigate the biological deterioration of the building components. The findings reveal that currently there is no mould risk for the main body of the construction, which is in accordance with the visual inspection. The passive systems of the building are highly conducive to these results, since they protect it from driving rain and other sources of moisture and eliminate the potential impact of future climate change risk scenarios.
Uncertainty and sensitivity analysis applied to a rammed earth wall: evaluation of the discrepancies between experimental and numerical data
Authors: Bui Rudy , Goffart Jeanne , McGregor Fionn , Woloszyn Monika , Fabbri Antonin , Grillet Anne-Cécile
Published: June 2020

Due to the environmental impact of building materials, researches on sustainable materials, such as bio-based and earth materials, are now widespread. These materials offer numerous qualities such as their availability, recyclability and their ability to dampen the indoor relative humidity variations due to their hygroscopicity. As these materials can absorb large amount of humidity, numerical and experimental studies of their hygrothermal behaviour are crucial to assess their durability.

To validate a hygrothermal model, numerical and experimental data have to be confronted. Such confrontation must take into consideration the uncertainties related to the experimental protocol, but also to the model. Statistical tools such as uncertainty and global sensitivity analysis are essential for this task. The uncertainty analysis estimates the robustness of the model, while the global sensitivity analysis identifies the most influential input(s) responsible for this robustness. However, these methods are not commonly used because of the complexity of hygrothermal models, and therefore the prohibitive simulation cost.

This study presents a methodology for comparing the numerical and experimental data of a rammed earth wall subjected to varying temperature and relative humidity conditions. The main objectives are the investigation of the uncertainties impact, the estimation of the model robustness, and finally the identification of the input(s) responsible for the discrepancies between numerical and experimental data. To do so, a recent and low-cost global variance-based sensitivity method, named RBD-FAST, is applied. First, the uncertainty propagation through the model is calculated, then the sensitivity indices are estimated. They represent the part of the output variability related to each input variability. The output of interest is the vapour pressure in the middle of the wall to confront it to the experimental measurement. Good agreement is obtained between the experimental and numerical results. It is also highlighted that the sorption isotherm is the main factor influencing the vapour pressure in the material.
Electroosmosis – a method applied for handling of moisture in foundations
Authors: Björk Folke , Sederholm Bror , Trägårdh Jan , Olofsson Bo
Published: June 2020

Electroosmosis is an electrokinetic phenomena which is applied in some technical fields. It is also applied large scale for transport of moisture out of basements. We see the method of electroosmosis as an opportunity for solving moisture problems in basements. However, there is a need to develop both the technology for the method and the understanding about what to expect out of it. Better methods are needed to predict whether the method will work in a particular case.
Environmental evaluation of pareto optimal renovation strategies: a multidimensional life-cycle analysis
Authors: Decorte Yanaika , Steeman Marijke , Van Den Bossche Nathan , Calle Klaas
Published: June 2020

The substantial contribution of buildings in the energy consumption and emissions renders the existing building stock a key element to tackle the climate crisis. Consequently, defining a deliberate decision-making process gains importance. Decisions are currently often based on building codes, budget, and in the best case Pareto optimality of the energy performance and the net present value of the life-cycle cost. The growing attention to sustainability, however, raises questions about the effect of environmental considerations on the outcome of the Pareto optimal solutions. This study quantifies the effect of including the environmental aspect as a third dimension to the current evaluation approach. Therefore, the most appropriate renovation measures are selected using a multidimensional Pareto optimization. The method is applied to a residential high-rise building in Belgium. Firstly, the Pareto front is constituted based on life-cycle costing and life-cycle assessment separately. Subsequently, the respective results are combined into an integrated life cycle approach by enumerating the LCA results as an external cost to the LCC results. The results show that the Pareto optimal solutions from a financial and environmental perspective do not coincide. Although the financial aspect dominates, adding the environmental cost eliminates low-performant financial optima, leading to optimal solutions with a larger insulation thickness.
Modular statistical system for an integrated environmental control
Authors: Romanska-Zapala Anna , Dudek Piotr , Górny Mariusz , Dudzik Marek
Published: June 2020

In this paper series, we will examine the relation between the smart grid and the next generation of buildings. The new objective is now to design buildings so that the energy exchange takes place in time suitable for both sides. The building takes energy from the grid and give it back at different time because in the next generation of buildings they are equipped in advanced control system that controls energy storage for several hours and the new or retrofitted building can eliminate energy peaks and valleys for itself and assist the smart grid in equalization of the load. The control systems include monitoring and modeling of energy use and indoor environment to arrive to a weather-based prediction, Therefore, in part 1 of the paper series we address collecting, processing and analysis of the measurement data that can be done by the new modular statistical software alone or in conjunction with a dedicated neural network. We want to minimize energy use and maximize the thermal comfort of the occupants. Using the modular structure of the database, data transformation technologies and other existing tools, the modular statistical software (MSS) has been created to process large amounts of data as input to the decision-making algorithm. This is to enable buildings automated control (BAC) to take over the control of heating/cooling, ventilation, illumination and other performance aspects that relate to sustainability of built environment.
Monitored conditions in wooden wall plates in relation to mold and wood decaying fungi
Authors: Kvist Hansen Tessa , Feldt Jensen Nickolaj , Møller Eva , Jan de Place Hansen Ernst , Peuhkuri Ruut
Published: June 2020

In historic masonry buildings, wood can be embedded in the walls as storey partition beams, or as supportive wall plates. Half-timbered masonry constructions, or wooden frames, e.g. combined with internal insulation, are other examples of wooden elements. Wood decaying fungi can cause serious damage to wood, which may lose mass and strength, ultimately yielding the risk of collapse. In addition, some fungal species may even be hazardous for occupants. All wood decaying fungi depend on favorable moisture and temperature conditions, although the threshold conditions may vary with various fungal species and types, and state of the wood. To predict the risk of occurrence of wood rot, several models have been developed, however most of these are based on a limited number of experiments, or very specific cases. For these reasons, the applicability of the models to other scenarios (fungal species, wood species) may not be appropriate. Furthermore, another failure mode for wood and moisture, is mold growth, which is initiated at lower moisture levels. An indication of risk of mold growth would indicate problems or risks before the initiation of wood rot. Mold growth does not deteriorate the wood, but is usually equally undesired due to health concerns of occupants. For this reason, there might be places where some mold growth would be acceptable, e.g. embedded beam ends if there is no transfer of air from the moldy area to the indoor air. Therefore, risk of rot could be important. The paper investigates models for mass loss due to wood decay and mold growth based on exposure time to favorable hygrothermal conditions. The investigation is based on inspection of wood samples (wall plates) from a full-scale experimental setup of masonry with embedded wood and monitored conditions, to which the prediction models will be applied. Monitored hygrothermal conditions were implemented in mold and wood decay models, and samples were removed from the test setup. The implemented models yielded high mold index and mass loss, whereas neither mold nor decay was observed in the physical samples. Results indicate that the implemented models, in these cases appear to overestimate the risks of mold and rot in the supportive lath behind the insulation.
Assessment of interstitial mould growth through impaction: a feasibility study
Authors: Efthymiopoulos Spyridon , Altamirano Hector , Marincioni Valentina
Published: June 2020

The application of insulation to solid walls is one of the measures to help reduce the energy consumption of a building. Where external wall insulation is not feasible (e.g. listed buildings), internal insulation may be the only option to improve the thermal property of external walls. However, such interventions may be followed by unintended consequences [1], such as moisture accumulation and the growth of mould [2]. The study aims to develop a method for the non-disruptive assessment of interstitial mould growth in internally insulated walls. Air sampling through impaction and culture-based analysis was used in the study. Mould species commonly found in buildings were cultivated and used in small-scale experiments, and the effects of several sampling periods and airflow rates assessed. Potential relationships between the sampling variables and the results were determined by means of statistical analysis - a strong correlation between the coverage of mould behind the wall and the sampling periods and airflow rates. The effect of the inertial impaction frequency on the sampling results and the feasibility and applicability of the suggested methodology in real-life scenarios are also discussed.
Study on the temperature dependence of gas permeation and adsorption behavior of the vacuum insulation panel with getter materials
Authors: Yamamoto Hideya , Ogura Daisuke
Published: June 2020

Vacuum insulation panel (VIP) is a high-performance heat insulation material that has contributed to the energy efficiency of refrigerators, vending machines, and cooler boxes. Glass wool or fumed silica covered by a laminated film are the core materials of VIP; by evacuating air inside, it is possible to reduce the gas thermal conductivity to be close to 0 and exhibit high thermal performance. In recent years, the research on long-term performance prediction has been conducted for use in building insulation. Specifically, various getter materials have been developed to improve the long-term performance of glass wool VIP. However, there are no studies that clearly show the adsorption behavior or temperature dependence inside VIP with getter materials. We measured the adsorption temperature dependence of two types of getters using the constant volume method and then observed the adsorption behavior inside VIP using VIP equipped with a micro pressure sensor. Regarding the internal pressure of VIPs equipped with the micro pressure sensor, the pressure fluctuation derived from the adsorbent was confirmed by the temperature change, and it was confirmed that the thermal conductivity changed accordingly. If the internal temperature of VIP increases, gases may be released from the getter. Therefore, in the building environment, it is necessary to select a getter that is suitable for the usage environment and to use an appropriate amount of getter.
Identifying faults in the building system based on model prediction and residuum analysis
Authors: Parzinger Michael , Wellisch Ulrich , Hanfstaengl Lucia , Sigg Ferdinand , Wirnsberger Markus , Spindler Uli
Published: June 2020

The energy efficiency of the building HVAC systems can be improved when faults in the running system are known. To this day, there are no cost-efficient, automatic methods that detect faults of the building HVAC systems to a satisfactory degree. This study induces a new method for fault detection that can replace a graphical, user-subjective evaluation of a building data measured on site with an automatic, data-based approach. This method can be a step towards cost-effective monitoring. For this research, the data from a detailed simulation of a residential case study house was used to compare a faultless operation of a building with a faulty operation. We argue that one can detect faults by analysing the properties of residuals of the prediction to the actual data. A machine learning model and an ARX model predict the building operation, and the method employs various statistical tests such as the Sign Test, the Turning Point Test, the Box-Pierce Test and the Bartels-Rank Test. The results show that the amount of data, the type and density of system faults significantly affect the accuracy of the prediction of faults. It became apparent that the challenge is to find a decision rule for the best combination of statistical tests on residuals to predict a fault.
Estimating thermal transmittance of the aluminium window profiles in practice
Authors: Witek Arkadiusz , Pietruszka Barbara
Published: June 2020

Calculation of the heat flow through the air cavities in the EN ISO 10077-2:2017 standard for the determination of the thermal transmittance of window profiles uses models based on the equivalent thermal conductivity method. The method takes into account the radiative heat exchange in a simplified or accurate manner. In the first case, the heat exchange depends on the average temperature in cavity, in the second case - it is determined accurately by the ray tracing method. It is also of importance to differentiate emissivity of surfaces due to aging or painting what influences calculation time. In this work, the impact of the calculation method and the impact of simplifications in modelling of the untreated surfaces on the value of the thermal transmittance of aluminium profiles was analysed on the example of a real series of products. Comparing the simplified and accurate method of determining the radiation exchange in cavities, the differences in the thermal transmittances of window profiles were up to 22%. The differences between the most simplified and the most accurate modelling of the surfaces emissivity reached 23%.
Colour degradation of façade coatings – the effect of nanopigments incorporation
Authors: Ramos Nuno M. M. , Souza Andrea R. , Maia Joana , Almeida Ricardo M. S. F.
Published: June 2020

The increasing interest in the use of a wide range of colours in buildings, especially dark colours, may lead to the early degradation of the façades, compromising their aesthetic and thermal performance. On the other hand, the incorporation of nanopigments with high reflectance properties can contribute to reducing the absorption of solar radiation. The nanoparticles contribute to increasing the solar reflectance of coatings, decreasing the surface temperature and improving the coating performance. This work evaluates the natural degradation of the colour of finishing coat with nanopigments in ETICS. The colour parameters were evaluated in different ETICS specimens, considering the colour black and red with and without incorporated nanopigments, under natural ageing. The colour measurement was performed according to ISO 1164-4, using a portable spectrophotometer. The results confirmed that the use of nanopigments improved the colour durability, promoting the maintenance of the colours parameters. The total colour difference was lower than the perceptible by the human eyes, even as the lower variation on chroma and hue parameters of the colours with nanopigments. In summary, the incorporation of nanoparticles in finishing coat of ETICS can contribute to increasing their durability and improve their thermal performance without compromising the aesthetic characteristics.
Data driven process for the energy assessment of building envelope retrofits
Authors: Garay-Martinez Roberto , Arregi Beñat , Lumbreras Mikel , Zurro Belén , Gonzalez Jose Manuel , Hernandez Jose Luis
Published: June 2020

In the last decades, a growing industry has been created in relation to building envelope retrofits. Linked to the lack of financial capacity of many building owners, innovative instruments such as energy performance contracts have been promoted by public bodies. This kind of instruments require of detailed energy assessment processes in order to define the expected heat load reduction and the associated economic flows between building owners and Energy Services Companies. When dealing with building envelopes, existing methods for building envelope heat loss characterization require of substantial efforts in terms of equipment and time, which makes them difficult to apply in real practice. In this paper, a novel method is proposed based on whole-building heat load assessment by means of heat meters, and analytical calculations of building envelope transmission heat load coefficients. This method, which requires minimal or no additional equipment, can be used over historical data from District Heating systems. It assigns a specific load fraction to building envelope heat transfer and allows to assess the expected reduction due to the building envelope retrofit. Numerical and experimental data is presented based on an educational building in the city of Burgos, Spain.
Application of occupancy and booking information to optimize space and energy use in higher education institutions
Authors: Azizi Shoaib , Rabiee Ramtin , Nair Gireesh , Olofsson Thomas
Published: June 2020

Building in higher education institutions (HEIs) are characterized as energy intensive Experience from practice showing large discrepancies between predicted and actual energy performance. The deviation can sometimes reach 100%. Explanations often originate from occupant’s behaviour along with building operation. IoT-based smart tools can provide extensive information about building usage to improve the building management, often associates with opportunities, for significant energy saving. The analysis in this study investigate space use based on occupancy and booking information in eight different lecture rooms at Umeå University. The results suggest interventions for significant saving potentials, such as modification of access permission and closing down redundant lecture rooms.
Finite element error analysis of surface Stokes equations in stream function formulation
Authors: Brandner Philip , Reusken Arnold
Published: June 2020

We consider a surface Stokes problem in stream function formulation on a simply connected oriented surface Γ ⊂ ℝ3 without boundary. This formulation leads to a coupled system of two second order scalar surface partial differential equations (for the stream function and an auxiliary variable). To this coupled system a trace finite element discretization method is applied. The main topic of the paper is an error analysis of this discretization method, resulting in optimal order discretization error bounds. The analysis applies to the surface finite element method of Dziuk–Elliott, too. We also investigate methods for reconstructing velocity and pressure from the stream function approximation. Results of numerical experiments are included.
Real-time use of inverse modeling techniques to assess the atmospheric accidental release from a nuclear power plant
Authors: Saunier O. , Korsakissok I. , Didier D. , Doursout T. , Mathieu A.
Published: June 2020

The assessment of the source term including the time evolution of the release rate into the atmosphere and its distribution between radionuclides is one of the key issues in the understanding of the consequences of a nuclear accident. Inverse modeling methods, which combine environmental measurements, and atmospheric dispersion models have been proven to be efficient in assessing the source term due to an accidental situation. We developed our own tool, which has been applied to the Fukushima accident by using dose rate measurements and air concentration measurements. The inverse modeling tool has been implemented and tested during exercises implying fictitious radioactive releases with the aim of testing this method for emergency management. The exercises showed the relevance of the inverse modeling tool and it is a rewarding experience, which helped us to identify the required developments for the purpose of an operational use.
Practical advices for optimal CT scanner dose in children
Authors: Malchair F. , Maccia C.
Published: June 2020

Radiation protection and dose optimisation in computerized tomography (CT) for pediatric patients are of utmost importance because of the potential risk of cancer induction by exposure to ionizing radiation. A review of available technical features in modern CT machines aiming at reducing and/or optimizing patient dose was performed. Practical advices to operators were listed according to dose-related technical solutions studied to decrease the doses and to practically implement dose optimisation.
Les démarches d’implication des parties prenantes dans la gestion des situations post-accidentelles − quels enseignements pour la préparation ?
Authors: Maître Mélanie , Schneider Thierry , Charron Sylvie
Published: June 2020

En situation post-accidentelle, l’implication des parties prenantes contribue à l’amélioration de leurs conditions de vie quotidienne et facilite la reprise des activités socio-économiques du territoire affecté. De ce constat, il en ressort plusieurs enjeux pour la préparation à la gestion post-accidentelle dont notamment l’importance d’engager le plus en amont possible des actions avec les acteurs des territoires potentiellement concernés par un accident nucléaire. Depuis 2013, plusieurs projets de recherche européens ont été menés (e.g., PREPARE, SHAMISEN, CONFIDENCE, TERRITORIES, ENGAGE et SHAMISEN-SINGS) afin d’approfondir les enjeux associés à l’implication des parties prenantes pour une meilleure préparation à la gestion post-accidentelle. L’objectif de cet article est de proposer une synthèse des recommandations issues de ces différents projets européens en mettant en avant les modalités et thématiques de dialogue qui pourraient être mises en œuvre à l’échelle d’un territoire.
Aktuelle Standards in der Diagnostik und Therapie von peripheren T-Zell-Lymphomen
Authors: Staber Philipp , Hopfinger Georg
Published: June 2020

WAS IST NEU?

Neue WHO-Klassifikation 2017 für Lymphome und molekulare Marker Es erfolgte gegenüber der Version von 2008 eine genauere Definition einzelner Entitäten, wie z. B. dem anaplastischen großzelligen Lymphom (ALK). Darüber hinaus wird der Terminus des Enteropathie-assoziierten T-Zell-Lymphoms (EATCL, Typ 1) nunmehr für die mit einer Zöliakie assoziierten Form verwendet. Der Einsatz molekularer Marker mittels Next-Generation-Sequencing (NGS) ermöglicht einerseits eine bessere Differenzialdiagnostik; so ist z. B. das angioimmunoblastische Lymphom (AITL) durch das Vorliegen von TET2-, RHOA-, IDH2- und DNMT3A-Mutationen charakterisiert. Andererseits haben bestimmte Mutationen auch prognostische Bedeutung. Beim ALCL/ALK– ist der Nachweis eines DUSP22/IRF4-Rearrangements mit einer besseren, der Nachweis von TP63 mit einer schlechteren Prognose assoziiert.

Klinisches Bild und Prognose Neben sog. B-Symptomatik und nodaler Manifestation können auch extranodale Manifestationen wie Hautinfiltrate in bis zu 20 % beobachtet werden. Als Zeichen eines dysregulierten Immunsystems können beim AITL eine polyklonale Hypergammaglobulinämie, Coombspositive hämolytische Anämie und Immundefizienz auftreten.

Fortschritte in der Therapie Durch Kombination des Immunkonjugats Brentuximab-Vedotin (BV) mit Chemotherapie konnte erstmals ein positiver Effekt auf krankheitsfreies (PFS) und Gesamtüberleben (OS) bei CD30+-PTCL gezeigt werden.

Ausblick Gegenwärtig werden neue Therapieansätze, z. B. mit der demethylierenden Substanz 5-Azacytidin bei AITL und PTCL mit einem T-Follikel-Helper-Type (TFH), geprüft.
Der kinästhetische Händedruck – eine schonende und effiziente Alternative zur Kristellerhilfe
Authors: Sühling Alina
Published: June 2020

Die Autorin stellt in diesem Beitrag den kinästhetischen Händedruck als Methode zur aktiven Unterstützung des Geburtsverlaufs vor, erklärt die Durchführung und die Vorteile gegenüber Maßnahmen wie Valsalva-Pressmanöver und Kristeller-Handgriff. Die Empfehlungen beruhen auf den subjektiven Erfolgserlebnissen des geburtshilflichen Teams im Diakonissen-Stiftungs-Krankenhaus in Speyer und auf den zugrundeliegenden Theorien der Kinästhetik.
Kommentar
Authors: Kretzschmar Alexander
Published: June 2020

Die Zahl der Projekte zur Entwicklung eines passiven oder aktiven Impfstoffes sowie für die Entwicklung wirksamer therapeutischer Interventionen ist inzwischen auf eine dreistellige Zahl gewachsen. Gleichzeitig wächst auch die Zahl der Registerstudien von Kliniken, Fachgesellschaften und pharmazeutischen Herstellern und vielleicht auch des Deutschen Fußballbundes (cave fake news), und, und…
Cesarean Section Rate Analysis in a Tertiary Hospital in Portugal According to Robson Ten Group Classification System
Authors: Vargas Sara , Rego Susana , Clode Nuno
Published: June 2020

Objective The Robson 10 group classification system (RTGCS) is a reproducible, clinically relevant and prospective classification system proposed by the World Health Organization (WHO) as a global standard for assessing, monitoring and comparing cesarean section (CS) rates. The purpose of the present study is to analyze CS rates according to the RTGCS over a 3-year period and to identify the main contributors to this rate.

Methods We reviewed data regarding deliveries performed from 2014 up to 2016 in a tertiary hospital in Portugal, and classified all women according to the RTGCS. We analyzed the CS rate in each group.

Results We included data from 6,369 deliveries. Groups 1 (n = 1,703), 2 (n = 1,229) and 3 (n = 1,382) represented 67.7% of the obstetric population. The global CS rate was 25% (n = 1,594). Groups 1, 2, 5 and 10 were responsible for 74.2% of global CS deliveries.

Conclusion As expected, Groups 1, 2, 5 and 10 were the greatest contributors to the overall CS rate. An attempt to increase the number of vaginal deliveries in these groups, especially in Groups 2 and 5, might contribute to the reduction of the CS rate.
The Role of Health-related Behaviors in Gestational Weight Gain among Women with Overweight and Obesity: A Cross-sectional Analysis
Authors: Paulino Daiane Sofia Morais , Pinho-Pompeu Maira , Raikov Fernanda , Freitas-Jesus Juliana Vasconcellos , Machado Helymar Costa , Surita Fernanda Garanhani
Published: June 2020

Objective To evaluate the influence of health-related behaviors including food intake, physical activity, sleep time, smoking habits, stress, depression, and optimism on excessive gestational weight gain (GWG) among women with overweight and obesity.

Methods A cross-sectional study was conducted at the Women's Hospital of the Universidade de Campinas, Campinas, state of São Paulo, Brazil, with 386 mediate postpartum women that fit the inclusion criteria of ≥ 19 years old, first prenatal care visit at or before 14 weeks, and single live baby. Dietary habits, physical exercise practice, sleep duration, smoking and alcohol habits were self-reported. Psychosocial history was evaluated using the Edinburgh Postpartum Depression Scale (EPDS), Perceived Stress Scale (PSS), and Life Orientation Test-Revised (LOT-R). Sociodemographic, obstetric, anthropometric, and neonatal data were retrieved from medical records. Descriptive statistics and stepwise logistic regression were performed.

Results The prevalence of overweight and obesity was 29.27% and 24.61%, respectively, according to the body mass index (BMI). Excessive GWG was observed in 47.79% of women with overweight and in 45.26% of women with obesity. Excessive GWG among overweight and obese women was associated with inadequate vegetable and bean consumption (odds ratio [OR] = 2.95, 95% confidence interval [CI]: 1.35–6.46 and OR = 1.91; 95%CI: 1.01–3.63, respectively) and stress (OR = 1.63; 95%CI 1.01–2.64). After adjustment by maternal age, multiparity, sleep duration, smoking, and alcohol intake, we found that stress (PSS ≥ 20) was associated with excessive GWG in women with overweight or obesity (OR: 1.75; 95%CI: 1.03–2.96).

Conclusion Among women with overweight and obesity, stress is the main variable associated with excessive GWG. Inadequate vegetables and beans consumption also showed association with excessive GWG.
Cellular Angiofibroma: A Rare Vulvar Tumor Case Report
Authors: Fachada Ana Helena Barbosa , Pais Cátia Sofia Guilherme Ferreira , Fernandes Marta Andrea Ferreira , Dias Nuno Jorge Lopes , Pipa António Manuel Leitão Loureiro
Published: June 2020

Cellular angiofibroma (CA)is a rare benign mesenchymal tumor. In women, it occurs mainly in the vulvovaginal region, with vulvar location in 70% of the cases. Its clinical presentation is nonspecific and similar to several other vulvar tumors of different cellular origins. Thus, its histological and immunohistochemical features allow distinction from other tumors. Cellular angiofibromas have good prognosis, despite some risk of relapse. The authors present the case of a 49-year-old woman with a bulky right vulvar lesion, for which the preoperative diagnosis was a Bartholin cyst, but the histological and immunohistochemical evaluation yielded a CA.
High-risk Human Papillomavirus Testing for Triage of Women with Previous Cytological Abnormalities from the Vale do Ribeira Region
Authors: Lorente Sandra , Fernandes Natália Coelho Couto de Azevedo , Etlinger-Colonelli Daniela , Réssio Rodrigo Albergaria , Oliveira Sonia Maria Pereira de , Catarino Regina Maria
Published: June 2020

Objective To evaluate the performance of the hybrid capture 2 (HC2) high-risk papillomavirus (hrHPV) assay and cytological test in women with previous abnormalities, to detect cervical intraepithelial neoplasia grade 2 or worse (≥ CIN 2).

Methods A cytological test and HC2 (Qiagen, Gaithersburg, Maryland, EUA) for hrHPV were conducted in 359 liquid-based (Sure Path, Becton Dickinson, TriPath Imaging, Burlington, NC, USA) samples collected from women from the Vale do Ribeira Region, during July 2013 and September 2015 with previous cytology classified as atypical squamous cells of undetermined significance (ASC-US), low-grade squamous intraepithelial lesion (LSIL), atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesions (ASC-H), and atypical glandular cells (AGC). The histopathological examination was conducted in 179 women. The performance evaluations were calculated using the “exact” Clopper-Pearson 95% confidence interval (CI) test by MEDCALC (Medcalc Software Ltd, Ostend, Belgium).

Results The ≥ CIN 2 frequency was 11.7% (21/179). The HC2 for hrHPV and repeat cytology to detect ≥ CIN 2 obtained, respectively, a sensitivity of 90.5% (95%CI = 69.6–98.8) and 90.5%, (95%CI = 69.6–98.8), a specificity of 65.8% (95% CI = 57.9–73.2) and 43.7% (95%CI = 35.8–51.8), a positive predictive value of 26.0% (95% CI = 21.4–31.3) and 17.6%, (95%CI = 14.9–20.6), and a negative predictive value of 98.1% (95%CI = 93.3–99.5) and 97.2% (95% CI = 90.1–99.2).

Conclusion Hybrid capture 2 for hrHPV improves the performance of the detection of ≥ CIN 2, without compromising sensitivity, and provides a greater safety margin to return to the triennial screening of women undergoing follow-up due to previous abnormalities, without underlying ≥ CIN 2.
Rhodium-Catalyzed Ortho-Vinylation of 2-Arylpyridines and Its Application in the Total Synthesis of Palmatine
Authors: Lv Shan , Nie Ruifang , Guo Lingmei , Zheng Yang , Liu Yanzhao , Guo Li , Wu Yong
Published: June 2020

An efficient protocol by Rh-catalyzed direct C–H vinylation of 2-arylpyridines with a commercially available and air-stable potassium vinyl donor has been developed. This method affords the corresponding pyridinyl styrene derivative with moderate to excellent yields under mild conditions, which is extremely beneficial to the total synthesis of the natural product palmatine.
Antenatal Corticosteroids for Pregnant Women at High Risk of Preterm Delivery with COVID-19 Infection: A Decision Analysis
Authors: Packer Claire H. , Zhou Clarice G. , Hersh Alyssa R. , Allen Allison J. , Hermesch Amy C. , Caughey Aaron B.
Published: June 2020

Objective Antenatal corticosteroids given prior to preterm deliveries reduce the risk of adverse neonatal outcomes. However, steroid administration in the setting of a viral respiratory infection can worsen maternal outcomes. Therefore, the decision to administer corticosteroids must balance the neonatal benefits with the potential harm to the mother if she is infected with the novel coronavirus disease 2019 (COVID-19). This study aimed to determine the gestational ages for which administering antenatal corticosteroids to women at high risk of preterm labor with concurrent COVID-19 infection results in improved combined maternal and infant outcomes.

Study Design A decision-analytic model using TreeAge (2020) software was constructed for a theoretical cohort of hospitalized women with COVID-19 in the United States. All model inputs were derived from the literature. Outcomes included maternal intensive care unit (ICU) admission and death, along with infant outcomes of death, respiratory distress syndrome, intraventricular hemorrhage, and neurodevelopmental delay. Quality-adjusted life years (QALYs) were assessed from the maternal and infant perspectives. Sensitivity analyses were performed to determine if the results were robust over a range of assumptions.

Results In our theoretical cohort of 10,000 women delivering between 24 and 33 weeks of gestation with COVID-19, corticosteroid administration resulted in 2,200 women admitted to the ICU and 110 maternal deaths. No antenatal corticosteroid use resulted in 1,500 ICU admissions and 75 maternal deaths. Overall, we found that corticosteroid administration resulted in higher combined QALYs up to 31 weeks of gestation in all hospitalized patients, and up to 29 weeks of gestation in ICU patients.

Conclusion Administration of antenatal corticosteroids at less than 32 weeks of gestation for hospitalized patients and less than 30 weeks of gestation for patients admitted to the ICU resulted in higher combined maternal and infant outcomes compared with expectant management for women at high risk of preterm birth with COVID-19 infection. These results can guide clinicians in their counseling and management of these pregnant women.

Key Points