bluuebunny/crossref_metadata_2025 huggingface dataset:
Novel active method for the estimation of a building wall thermal resistance
Authors: François Adrien , Ibos Laurent , Feuillet Vincent , Meulemans Johann
Published: June 2020

The thermal resistance of a wall can be readily measured in steady-state. However, such a state is seldomly achieved in a building because of the variation of outdoor conditions as well as the high thermal inertia of building materials. This paper introduces a novel active (dynamic) method to measure the thermal resistance of a building wall. Not only are active approaches less sensitive to external temperature variations, they also enable to perform measurements within only a few hours. In the proposed methodology, an artificial thermal load is applied to a wall (heating of the indoor air) and its thermal response is monitored. Inverse techniques are used with a reduced model to estimate the value of the thermal resistance of a wall from the measured temperatures and heat fluxes. The methodology was validated on a known load-bearing wall built inside a climate chamber. The results were in good agreement with reference values derived from a steady-state characterization of the wall. The method also demonstrated a good reproducibility.
Effect of superabsorbent polymer admixtures on hygric and thermal properties of cement mortar
Authors: Fořt Jan , Hotěk Petr , Mildner Martin , Krejsová Jitka , Černý Robert
Published: June 2020

Materials known as superabsorbent polymers (SAP) or hydrogels are currently used in quite a few applications, ranging from diapers or napkins to nutrient carriers and soil conditioners. The great ability of SAPs to absorb and hold a significant amount of water can be utilized well also in the construction sector. For instance, SAPs can serve as effective admixtures for mitigation of autogenous shrinkage of high-performance concrete, frost protection, or cracks sealing. In this paper, basic physical, hygric and thermal properties of cement mortars containing superabsorbent polymer admixtures are analyzed. Basic physical characteristics are measured using the water vacuum saturation method and helium pycnometry. Moisture diffusivity is determined by utilizing the results of water sorptivity measurements, water vapor diffusion permeability is measured by the cup method. Sorption isotherms are determined by the desiccator method in the range of relative humidity of 11% – 96%. Thermal conductivity and specific heat capacity are measured by pulse method. Experimental results show a very significant dependence of all hygric and thermal parameters on the SAP dosage in the mix.
Climate adaptation of listed buildings: an interaction between design, regulations and energy efficiency
Authors: Karasu Arda , Hantouch Yaser , Steffan Claus
Published: June 2020

Energy retrofitting of listed buildings requires a rethink as it is economically and technically complicated to retrofit. The Technische Universität Berlin has 47 buildings with a total net floor area above 500.000 m2 in its central campus, and 60% of them are listed. In Germany, optimizing the energy efficiency of such buildings has not to fulfill the requirements of the energy efficiency regulations. On the one hand, this situation is not corresponding to the national objectives regarding climate adaptation. On the other hand, they have to be retrofitted because of issues like poor energy efficiency and user comfort, and not privileged with special regulations. However, instead of changing the regulations, it is possible to solve the problem by changing the way of thinking. In this regard, rather than retrofitting such buildings directly, a new approach has been developed where the surrounding climatic conditions are optimized. Hereby, a simulation-based concept has been developed with an external transparent envelope. This “climate envelope” creates an intermediate space between outdoor and indoor, where through controlled air movement and passive solar gains, the balance in seasonal energy efficiency can be kept economically without any implementation on the buildings according to the building thermal and CFD simulations. This overall approach activates the yet not exploited capacity of energy savings by listed buildings using intelligent design and saves up to 30% more of primary energy.
Humidity change rate control in intermittently heated historic buildings
Authors: Wessberg Magnus , Vyhlídal Tomáš , Broström Tor
Published: June 2020

Many massive historic buildings such as stone churches are intermittently heated. The predominant heating strategy is to heat the building with as high heating power as possible to achieve a fast and energy efficient heat-up process. However, the fast change rate of temperature induces a high change rate of relative humidity, which can be dangerous for interiors and objects in churches. It has been suggested that the change rate of relative humidity should be limited with respect to conservation. Desorption from the walls has a significant effect on the change rate of relative humidity. Typically, the absolute humidity can increase by 50% when the church is heated. Based on a hygrothermal model that allows for a prediction of both temperature and absolute humidity as function of time, this paper presents a model-based feed-forward control algorithm that calculates the maximum hourly heating power increase allowed for limit the change rate in relative humidity to a pre-defined value. The control algorithm is validated using simulations.
Study of the conservation and exhibition of burned wall paintings in the main hall of the treasure house at Horyu-ji Temple
Authors: Wada Takuya , Ogura Daisuke , Sano Chie , Hokoi Shuichi , Iba Chiemi
Published: June 2020

Horyu-ji Temple is the main temple and Buddhist monument in the Horyu-ji area designated a UNESCO world heritage site since 1993. In 1949, the main hall in the Horyu-ji Temple, Nara prefecture, Japan, suffered a fire. Paintings on the burned walls are now stored with other cultural property in the treasure house which has no air conditioning, and doors and windows that are always closed. There is a fear of mold and pest generation due to high relative humidity in the room, so the environment must be controlled to protect the wall paintings from biological damage. Furthermore, Horyu-ji is considering an exhibition of the burned wall paintings in the treasure house, and we therefore need to consider the impact of visitors’ heat and moisture on the generation of mold and pests on the wall. I investigated environmental control methods using a blower in the attic space by numerical analysis. The analysis was performed in two case scenarios. One case involved preserving the walls in a closed treasure house and the other supposed an exhibition. As a result of this analysis, the effect of the reduction of relative humidity using a blower was clarified quantitatively.
The trade-off between deep energy retrofit and improving building intelligence in a university building
Authors: Jradi Muhyiddine
Published: June 2020

In the last three decades, deep energy retrofit measures have been the standard option to improve the existing Danish building stock performance, with conventional techniques including envelope constructions insulation, windows change and lights replacement. While such techniques have demonstrated large technical and economic benefits, they may not be the optimal solution for every building retrofit case. With the advancement in the field of smart buildings and building automation systems, new energy performance improvement measures have emerged aiming to enhance the building intelligence quotient. In this paper, a technical evaluation and assessment of the trade-off between implementing deep energy retrofit techniques and improving building intelligence measures is provided. The assessment is driven by energy simulations of a detailed dynamic energy performance model developed in EnergyPlus. A 2500 m2 university building in Denmark is considered as a case study, where a holistic energy model was developed and calibrated using actual data. Different performance improvement measures are implemented and assessed. Standard deep energy retrofit measures are considered, where the building intelligence improvement measures are in compliance with the European Standard EN 15232 recommendations. The overall assessment and evaluation results will serve as recommendations aiding the decision to retrofit the building and improve the performance.
Comparison of an LCA and LCC for façade renovation strategies designed for change
Authors: Van Gulck Lisa , Van de Putte Stijn , Van Den Bossche Nathan , Steeman Marijke
Published: June 2020

This paper examines the environmental and financial impact of façade renovation strategies designed for change and how taking into account each of these aspects will lead to different renovation decisions. In a first part of the paper the optimal construction method for different façade renovation strategies is searched from the environmental point of view. This is done through life cycle analysis (LCA). In a second part of the paper the financial impact of the results obtained with LCA is determined. This is done with life cycle costing (LCC). The results show that although both LCA and LCC are life cycle studies that follow similar principles and boundaries this does not mean that LCA and LCC based decisions will coincide. For the environmental score the operational energy of a building has the largest impact and energy efficiency measures will often be beneficial. For the financial cost the investment cost is the most important impact and energy efficiency measures will only pay off to a certain extent. Decisions that are based solely on the financial cost may thus lead to sub-optimal solutions from an environmental point of view.
Driving decarbonisation of the EU building stock by enhancing a consumer centred and locally based circular renovation process
Authors: Tisov Ana , Kuusk Kalle , Navarro Escudero Miriam , Niki Assimakopoulos Margarita , Papadaki Dimitra , Pihelo Peep , op ‘t Veld Peter , Kalamees Targo
Published: June 2020

H2020 project DRIVE0 (Driving decarbonisation of the EU building stock by enhancing a consumer centred and locally based circular renovation process) aims to come to a decarbonisation of the EU building stock and to accelerate deep renovation processes by enhancing a consumer centred circular renovation process in order to make deep renovation more attractive for consumers and investors, more environmental friendly. Circular renovation concepts and process will specifically be developed and implemented in the seven demonstration cases in seven countries, representing all climatic zones in Europe
Optimization of building form and its fenestration in response to microclimate conditions of an urban area
Authors: Javanroodi Kavan , Nik Vahid M. , Yang Yuchen
Published: June 2020

Designing building form in urban areas is a complicated process that demands considering a high number of influencing parameters. On the other hand, there has been an increasing trend to design highly fenestrated building envelopes for office buildings to induce higher levels of natural lighting into the workspace. This paper presents a novel optimization framework to design high-performance building form and fenestration configuration considering the impacts of urban microclimate in typical and extreme weather conditions during a thirty-year period of climate data (2010-2039). In this regard, based on the introduced technique and algorithm, the annual energy demand and thermal comfort of over 8008 eligible form combinations with eight different fenestration configurations and seven different building orientation angels were analysed in a detailed urban area to find optimal design solutions in response to microclimate conditions. Results showed that adopting the framework, annual heating, and cooling demand can be reduced by 21% and 38% while maintaining thermal comfort by taking design-based decisions at the early stages of design.
Current building strategies in Greenland
Authors: Møller Eva B. , Lading Tove
Published: June 2020

Most buildings in Greenland are built within the last 70 years. Within this relatively short period, the building styles have often changed; from small wooden houses in the 50ties to also encompass more industrialised buildings in the 70ties, and later more diverse technics. This paper describes the major tendencies in building construction of today. Apart from an extreme climate, one of the challenges in Greenland is the lack of building materials; almost everything has to be imported. Greenland is an island-operated community, with no interlinking road grid between towns and settlements. Therefore, everything must be transported by ship or plane. Furthermore, severe mould growth is a big problem. Consequently, three building strategies are currently prevailing. 1) In-situ concrete gables and partitioning walls, and facades with wooden studs. 2) Focus on non-organic material and therefore concrete structures with exterior insulation. 3) Strategies focussing on the process e.g. mainly using prefabricated elements. The paper describes the pro and cons for the different strategies seen in a Greenlandic context. The harsh climate makes Greenland a good test site for assessing new building designs. Furthermore, assessment of sustainability might be very different in Greenland from countries where resources and transportation is very different.
Experiences with external drainage systems from compact roofs in Norwegian climates
Authors: Andenæs Erlend , Skagseth Vegard A. , Bunkholt Nora S. , Kvande Tore , Lohne Jardar
Published: June 2020

To reduce loads on urban drainage systems and facilitate local infiltration of stormwater, it is desired to lead runoff water from roofs through external drains and into the local soil. However, in cold climates, situations often arise where water freezes in external drainpipes, damaging the pipes and preventing drainage. This article investigates the perceived feasibility of external drainage when compared against the risk of freezing damage. A literature study investigates mechanics of ice formation in drains and gutters, and under which conditions ice formation poses a risk to the building. Actors in the Norwegian building sector are interviewed about the challenges related to external drainage from compact roofs in several locations in Norway. Findings suggest that external drainage is considered feasible, but many challenges exist. Suggested solutions may conflict with building regulations, either due to risk of damages or through an unreasonably high energy consumption. Passive solutions without heating elements may, however, be feasible in certain climates in Norway. It is suggested that further research follows up the feasibility of using external drainage in relation to local climate and building concepts.
The development of an RC-network simulation model calibrated with monitoring data for use in the performance guarantee of Net-Zero houses
Authors: Spiekman Marleen , Vijlbrief Olav , Tahir Haseeb , Bulut Yasin , Borsboom Wouter , van Goch T.A.J. , van Ginkel Dick , van Kessel Edwin
Published: June 2020

In order to drive forward the energy transition, construction companies and other suppliers of deep retrofitting solutions have started to give guarantees on the energy performance of very energy efficient houses. With these initiatives, a need has arisen for methods that can assess per household the actual energy performance during the use phase. An RC-network simulation model calibrated with monitoring data has been developed and tested on deep retrofitted Net-Zero houses in Emmen (the Netherlands). The results show that this has been a successful first step in order to arrive at a realistic analysis of the actual energy performance of individual houses. The big challenge will be to determine the parameters in the model with more certainty. This applies especially, but not exclusively, to the behavioural parameters.
Validation of a coupled pressure-equalization-thermal-mechanical model to study double-skin facades
Authors: Van Den Bossche Nathan , Van den Brande Kjartan , De Bleecker Henk , Lori Guido
Published: June 2020

Although double skin façades are a well-known façade system, still few experimental data and numerical approaches exist in literature that couple their thermal behaviour and pressure equalisation with the structural response. The reason is that, differently from insulating glazing units, the extent of the problem is trivial when designing ventilated double skins. Indeed, the leakage of the double skin cavity is large enough to avoid any response of the internal cavity pressure to its temperature variations. However, during the last years Closed Cavity Façades, a new trend of double skins, have been applied in order to achieve high performances in terms of thermal and acoustic insulation and providing at the same time valuable benefit with regards to maintenance cost reduction. The CCF low levels of air permeability are responsible for a strong correlation of pressure and temperature of its cavity and the phenomenon needs an accurate model to support the design. Indeed, an optimal design of the outer and inner skin should consider the skin interactions and their coupling through the cavity, under the dynamic temperature and variable mass within the cavity itself. The mass variation is governed by two counteracting effects: on one side the dry and clean air that is pumped into the cavity in order to avoid the risk of condensation, on the other side the mass flows through the skin openings that connects cavity with external and internal environment. Moreover, the pressure is also affected by the interior and exterior air pressures that induce a deflection of the inner and outer skin. A numerical calculation procedure was developed, integrated with commercial codes commonly used in façade design, in order to provide a unique assessment tool for the coupled thermal-mechanical design of double skin facades. The tool has been validated by means of an extensive experimental campaign and the different relevant effects have been described.
Proposed method for probabilistic risk analysis using building performance simulations and stochastic parameters
Authors: Ekström Tomas , Burke Stephen , Harderup Lars-Erik , Arfvidsson Jesper
Published: June 2020

As parts of the world continue the work of mitigating the impact of climate change, many countries strive for continued reductions in energy demand from buildings by implementing more stringent building regulations. Consequently, the importance of accurate and efficient building performance simulations to predict the energy use of a building design increases. As observed in earlier studies, there are performance gaps between the predicted annual energy demand from building energy performance simulations based on deterministic methods compared to the monitored annual energy use of a building. This paper presents a preliminary method developed using probabilistic methods for risk analysis and building performance simulations to predict the energy performance of buildings using stochastic parameters. The method is used to calculate the probability for the energy performance of a building design to fulfil the energy requirements. The consequences are quantified using an example of energy performance contracting to evaluate the inherent risk of a building’s design. The method was demonstrated in a case study and validated by comparing the results in energy performance and probability of failure against measured data from 26 single-family houses.
Submarine seismic tomography using optical fibres
Authors: Fernández-Ruiz María R. , Martins Hugo F. , Martin-Lopez Sonia , Gonzalez-Herraez Miguel
Published: June 2020

The repurpose of the available telecommunication fibre optical network as a seismic monitoring tool has been recently tested with very promising prospects. Optical fibre networks possess all the ingredients to become the next generation seismic monitoring system, offering high performance at minimum deployment and maintenance cost, especially at hardly accessible regions such as the oceans’ bottom.
Die Fachklinik Bad Bentheim
Authors: Meurer J. , Tsianakas A.
Published: June 2020

Die Fachklinik Bad Bentheim mit ihrer mehr als 300-jährigen Geschichte basierte ursprünglich auf den natürlichen Heilquellen wie dem Schwefelmineralwasser und der Sole. Durch die Entwicklung der Balneofototherapie in den 70er- und 80er-Jahren entwickelte sich die Dermatologie zu einem besonders wichtigen Fachbereich. Heute stellt die Dermatologie mit der Akutklinik, der Klinik für Rehabilitation sowie der Ambulanz und Studienambulanz einen führenden Teilbereich der Klinik dar und bietet ihren Patienten modernste Medizin in historischem Ambiente. Dabei zeigen bspw. der Aufbau einer professionellen Studienambulanz, die Entwicklung eines spezifischen Rehabilitationskonzeptes für chronischen Pruritus sowie der Aufbau der dermato-onkologischen Rehabilitation die Anpassungsfähigkeit an die Erfordernisse der Zeit.
Impfmanagement in der dermatologischen Praxis
Authors: Pierchalla P.
Published: June 2020

Dermatologen, die Systemtherapeutika mit immunsuppressiver Wirkung bei chronisch-entzündlichen Dermatosen (z. B. Biologika) in der Praxis verordnen, sollten ein Impfmanagement einführen, um bei der Durchführung notwendiger Impfungen zeitliche Verzögerungen und Probleme bei der Abstimmung mit anderen Fachgruppen zu vermeiden. Auch bei der Betreuung dermatologischer Patienten ohne Immunsuppression kann das Anbieten von Impfungen in der Praxis aus medizinischen und wirtschaftlichen Gründen sinnvoll sein.
Krebstherapie unter Ausnahmebedingungen
Authors: Kretzschmar Alexander
Published: June 2020

Interview mit Prof. Lorenz Trümper, Göttingen, Geschäftsführender Vorsitzender der Deutschen Gesellschaft für Hämatologie und Medizinische Onkologie e. V. (DGHO).
Adenokarzinom der Lunge
Authors: Krome Susanne
Published: June 2020

Die PD-L1-Expression ist der einzige prädiktive Biomarker bei Patienten mit einem Adenokarzinom der Lunge und Immuncheckpoint-Inhibition. Die Sensitivität ist allerdings mäßig. In der nach Angaben der Autoren bislang größten Studie wurden klinische und molekulare Charakteristika identifiziert, die mit der Expression assoziiert waren und die prognostische Aussagekraft von PD-L1 beeinflussten.
Chemoimmuntherapie des kleinzelligen Bronchialkarzinoms
Authors: Krome Susanne
Published: June 2020

In der IMpower133-Studie verlängerte Atezolizumab das progressionsfreie (PFS) und Gesamtüberleben (OS) unbehandelter Patienten mit ausgedehntem kleinzelligen Bronchialkarzinom und extensiver Ausbreitung (ES-SCLC). Die Sekundäranalyse zeigt, dass die zusätzliche Lebenszeit nicht von einem schlechteren Allgemeinzustand begleitet war. Im Gegenteil: Patienten mit Chemotherapie plus Atezolizumab fühlten sich langfristig besser.
Wundheilungsstörungen am Damm – vermeiden, erkennen, behandeln
Authors: Hildebrandt Sven
Published: June 2020

Verletzungen des Dammes gehören zu den häufigsten geburtshilflichen Komplikationen, sind oft harmlos und heilen meist gut und ohne Folgen für die Frau ab. Dennoch führen sie auch immer wieder zu nachhaltigen Einschränkungen der Funktion und der Wahrnehmung des Beckenbodens. Deshalb sollte selbst jede kleine Verletzung dieser so sensiblen und wichtigen Körperregion der Frau vermieden werden. Das gelingt jedoch auch bei umsichtigster Geburtshilfe nicht immer. Insofern ist es wichtig, Beschädigungen des Dammes gewissenhaft zu versorgen und eine optimale Wundheilung zu unterstützen.
Nichterkennung einer Skabies trotz positiver Familienanamnese
Authors: Elsner P. , Meyer J.
Published: June 2020

Bei einer Patientin wurde von einem Dermatologen trotz mehrfacher Konsultationen eine Skabies nicht diagnostiziert, obgleich die Tochter der Patientin von eben diesem Dermatologen zeitnah unter der Diagnose einer Skabies behandelt worden war. Erst nachdem die Patientin mit verschlechtertem Hautzustand in einer Hautklinik stationär aufgenommen wurde, erfolgte die korrekte Diagnosestellung und Therapie. Die Schlichtungsstelle bewertete die Nichtberücksichtigung der positiven Familienanamnese für Skabies als vorwerfbaren Diagnosefehler.

Bei pruriginösen Erkrankungen unklarer Genese sollte stets auch an eine Skabies gedacht und eine Familienanamnese erhoben werden. Falls diese positiv ist, sind die Familienangehörigen als Kontaktpersonen, d. h. Personen mit längerem Kontakt zu Patienten mit gewöhnlicher Skabies oder Personen auch mit nur kurzem Kontakt zu Patienten mit Scabies crustosa, zu behandeln. Diese erhalten zumindest eine einmalige Sicherheitsbehandlung mit Permethrin, dem aktuellen Behandlungsstandard.
Strahlentherapie
Authors: Kretzschmar Alexander
Published: June 2020

Sollen Tumorpatienten vor einer Bestrahlung einen β-Rezeptor-Blocker, beispielsweise Propranolol, zur Dämpfung der β-adrenergen Stressreaktion erhalten, um die Wirkung der Strahlentherapie zu verbessern? Diesen Schluss legen Daten einer US-Arbeitsgruppe nahe, die jetzt hochkarätig in „Nature Communications“ veröffentlicht wurden. Sie wiesen eine starke Assoziation zwischen der Wirksamkeit der Bestrahlung und dem Ausmaß der Aktivierung der Stresshormone Noradrenalin und Adrenalin nach.
Covid-19: Eine Ad hoc Public-Health-Ethikberatung
Authors: Wild Verina , Buyx Alena , Hurst Samia , Munthe Christian , Rid Annette , Schröder-Bäck Peter , Strech Daniel , Thompson Alison
Published: June 2020

In diesem Dokument beschreiben wir den Prozess und den Inhalt einer ad hoc
Public-Health-Ethikberatung vom 22. März 2020 für eine
regionale Gesundheitsbehörde (Bayerisches Landesamt für
Gesundheit und Lebensmittelsicherheit) zu Entscheidungen im Zusammenhang mit
Covid-19.
Digital Measurement of Individual Motor and Proprioceptive Skills in Patients with Osteoarthritis of the Knee Prior to Total Knee Replacement
Authors: Redelbach Robert , Mahnke Alexander , Anders Jens O.
Published: June 2020

Purpose In spite of consistent improvement in operative methods for total knee arthroplasty, individual motor deficits may lead to a lower outcome. The preoperative classification in individual motoric capacity may get more significance for the future. Complementary to established questionnaires and clinical tests, this pilot study should demonstrate that it is possible to generate a preoperative motor score using a force platform measurement (KMP). Compared to questionnaires the new score represents digital values suitable for everyday clinical use.

Methods In total 63 Patients were randomized selected on the day before a bicondylar total knee replacement. A mobile force platform KMP (Motosana) measured the parameter maximum force, power and balance. Fluctuation area was measured in mm² and fluctuation path in mm. One leg standing without holding, transient help or permanent holding at armrests were registered. The force (Newton) was measured while a modified cross lift exercise and power (Watt) by performing five squads.

Results Based on comprehensive statistical consolidated data of maximum force, power and balance it was possible to create a new motor score “Knie Fit 1.0”. Depending on interindividual performance patients were divided into those with higher or lower results. Regarding to their individual motor proprioceptive capacity we could also graduate patients into 4 different groups for force/power and balance. In total 17 of 63 patients offered a complex motor deficit, but on the other hand 17 different patients showed superior results in all categories.

Conclusion It is possible to measure the motor capacity of patients using the mobile force platform (KMP) in everyday clinical practice. Based on this data a new motor score “KnieFit 1.0” was generated and groups of patients with different insufficiencies were created. Further follow-up studies should proof and compare the pre- and postoperative outcome in this field. With “KnieFit 1.0” it may be possible to create an individual perioperative rehabilitation program for compensation of detected deficits.
COVID-19: Was wir wissen können
Authors: Wildner Manfred
Published: June 2020

Die Ausarbeitung seiner Logik-Vorlesungen hatte Immanuel Kant an Gottlob Benjamin
Jäsche übertragen, welcher im Jahr 1800 ein Handbuch dazu
veröffentlichte. Dieser Niederschrift verdanken wir die einprägsame
Formulierung: „Das Feld der Philosophie […] läßt
sich auf folgende Fragen bringen: 1) Was kann ich wissen? – 2) Was soll
ich tun? 3) Was darf ich hoffen? 4) Was ist der Mensch?“ 1. Diese Frage nach dem berechtigten
Wissen-Können hat nicht nur Immanuel Kant und seine Zeitgenossen
beschäftigt, sondern ist eine Kernfrage von den Anfängen der
Philosophie bis zu modernen heutigen Wissenschaftstheorien 2. Die damit verbundene Skepsis –
exemplifiziert durch den Empirismus David Humes – unterbrach nach eigenen
Angaben Immanuel Kants seinen „dogmatischen Schlummer“ und gab
seinem Denken „eine ganz andere Richtung“ 3.
Koronare CT-Angiografie (CTA): Die anatomische Bildgebung überzeugt
Authors: Schmermund Axel , Eckert Joachim , Schmidt Marco , Magedanz Annett , Voigtländer Thomas
Published: June 2020

Bei stabilen Patienten mit V. a. koronare Herzkrankheit (KHK) können mittels koronarer CT-Angiografie (CTA) mehrere Aspekte der koronaren Atherosklerose untersucht werden. Stenosen werden zuverlässig detektiert, die Plaquebildung kann quantifiziert und in nicht verkalkte und verkalkte Läsionen unterschieden werden und potenzielle Marker einer Instabilität wie Remodeling, gesprenkelte Verkalkungen und ein großes Atherom können detektiert werden. Selbst kleine Plaques werden mit exzellenter Sensitivität dokumentiert. Bei ausgedehnter Plaquebildung wiederum wird manchmal die hämodynamische Auswirkung überschätzt. Dies kann teilweise durch den Einsatz von Computational Fluid Dynamics mit CT-basierter Fractional Flow Reserve, FFRCT, korrigiert werden. Große prospektive Studien haben den diagnostischen Nutzen der CTA insbesondere zum Ausschluss einer stenosierenden KHK etabliert. Durch die Detektion von nicht stenosierenden Plaques werden im Unterschied zur Ischämie-/Funktionsdiagnostik auch Patienten mit subklinischer Atherosklerose identifiziert, die gezielt behandelt werden können. In den aktuellen Europäischen Leitlinien erhält die CTA eine Klasse-I-Empfehlung für die Abklärung chronischer Koronarsyndrome.
Risikostratifizierung des chronischen Koronarsyndroms – Empfehlungen zur
Risikobewertung und Diagnostik im klinischen Alltag gemäß ESC-Leitlinie
2019
Authors: Hielscher Lisa , Noack Frank , Schlitt Axel
Published: June 2020

Die neue Leitlinie der European Society of Cardiology (ESC) von 2019 liefert neue
Empfehlungen zum Umgang mit dem chronischen Koronarsyndrom (CCS, früher stabile
koronare Herzerkrankung = KHK). In diesem Beitrag werden Methoden zur Bestimmung der
Prätestwahrscheinlichkeit eines CCS und die relevanten diagnostischen Mittel
vorgestellt, wie etwa die neuen Empfehlungen für die Stellung des Angio-CT und die
Verwendung der Koronarangiografie. Ein besonderer Schwerpunkt dieses Beitrags liegt
auf denjenigen Patientengruppen, die Ärzte und Pflegekräfte im klinischen Alltag vor
besondere Herausforderungen stellen. Hierzu gehören Patienten mit atypischer oder
fehlender Klinik, Patienten höheren Alters und Patientinnen. Für diese Gruppen werden
gesonderte Empfehlungen formuliert.
Music Therapy for Early Postoperative Pain, Anxiety, and Sleep in Patients after Mitral Valve Replacement
Authors: Zhang Qi-Liang , Xu Ning , Huang Shu-Ting , Lin Ze-Wei , Chen Liang-Wan , Cao Hua , Chen Qiang
Published: June 2020

Background To investigate the effect of music therapy on early postoperative pain, anxiety, and sleep quality in patients after mechanical mitral valve replacement (MVR).

Methods A total of 222 patients undergoing mechanical MVR were divided into two groups: the music group and the control group. The patients in the music group received 30 minutes of music therapy every day, whereas the patients in the control group had 30 minutes of quiet time. The visual analogue scale (VAS) was used to evaluate the degree of pain, and the Self-Rating Anxiety Scale (SAS) was used to evaluate the degree of early postoperative anxiety. We also recorded the sleep duration of the patients and used the Verran and Snyder-Halpern (VSH) Sleep Scale to evaluate the sleep quality of the patients.

Results The VAS scores in the music group were significantly lower than those in the control group, and early postoperative anxiety in the music group was also significantly improved compared with that in the control group. The sleep duration in the music group was significantly greater than that in the control group. In the evaluation of sleep quality using the VSH Sleep Scale, the scores for sleep interruption, sleep length, sleep depth, degree of rest, and subjective sleep quality in the music group were significantly lower than those in the control group.

Conclusions Music therapy can be an effective intervention to reduce early postoperative pain, relieve early postoperative anxiety, prolong sleep time, and improve the sleep quality of patients after mechanical MVR.
Potential for, and drivers of, private voluntary initiatives for the decarbonisation of short sea shipping: evidence from a Swedish ferry line
Authors: Christodoulou Anastasia , Cullinane Kevin
Published: June 2020

The aim of this paper is to analyse shipping firms’ reactions to environmental challenges and identify how significant reductions in energy consumption and air emissions can come about by implementing a variety of voluntary initiatives. The paper focuses on the various sustainability initiatives implemented by the Swedish short sea shipping operator, Stena Line, either on a purely voluntary basis as part of their corporate social responsibility (CSR) strategy or as their chosen route for compliance with regulations. A conceptual model is developed based on stakeholder theory, the theory of planned behaviour and resource dependence theory to understand the main drivers of the firm’s adoption of sustainability initiatives and the factors affecting the integration of CSR in maritime companies. According to our findings, the company operates within a strongly enforced regulatory environmental framework and needs to exceed this framework to differentiate its service and strengthen its relationships with its customers by addressing their social and environmental concerns. As the firm’s competitive strategy focuses on service differentiation, a large pool of complementary resources is available for CSR and the implementation of sustainability practices. The results of this paper bring new insights to the potential of local private voluntary initiatives for the reduction of maritime air emissions. These include the provision of onshore power supply, the conversion of vessels to use methanol, ferry electrification, the construction of larger RoPax vessels and the implementation of an energy-saving program that focuses on crew involvement and continuous training. The environmental outcomes derived from a combination of local operational and technical energy efficiency measures are found to be significant and can contribute to the efforts for the achievement of sustainable maritime transport undertaken by international and regional organisations. The main barriers for the adoption of voluntary sustainability initiatives in the maritime sector are economic and technological. To encourage the wider adoption of these initiatives, the provision of economic incentives at national or regional level is crucial, as such initiatives usually imply high initial installation costs that should be somehow compensated for both vessels and terminals.
Long-term follow up of older people on diabetes medications: observational study using linked health databases
Authors: Wallis Katharine A. , Wells Susan , Selak Vanessa , Poppe Katrina
Published: June 2020

There is uncertainty about the long-term benefits and risks of diabetes medications in older people. We investigated differences in hypoglycaemia, cardiovascular disease (CVD) or mortality in older people according to diabetes medication, using linked national hospitalisation and mortality data from New Zealand. Adults aged ≥65 years dispensed diabetes medication in 2010 with a baseline glycated haemoglobulin (HbA1c) level (n=18099, mean age 73 years, 50% female) were included and stratified into four groups: metformin-only (42%); metformin-plus-other-oral-hypoglycaemic/s (27%); other-oral/s-only (11%); and any-insulin (20%). Time to first event was analysed with Cox models adjusted for sociodemographic factors; clinical history (prior hospitalisation for diabetes or CVD, and comorbidities); glycated haemoglobin; and CVD medications. Over 7-year follow up, 16% of participants experienced hypoglycaemia, 36% a CVD event and 31% died. Compared with metformin-only, insulin and other oral hypoglycaemic/s were associated with five- to 10-fold long-term increased risk of hypoglycaemia, and increased risk of CVD and death although adjusted survival curves showed no important separation between medication groups for CVD and death with the possible exception of insulin. Although confounding by indication is unable to be eliminated, this study raises further questions about the use of second-line diabetes medications in older people.
Characteristics of lipid droplets and the expression of proteins involved in lipolysis in the murine cervix during mid-pregnancy
Authors: Tao Longlong , Zhang Hongyan , Wang Hongmei , Li Liuhui , Huang Libo , Su Feng , Yuan Xuejun , Luo Mingjiu , Ge Lijiang
Published: June 2020

Lipid droplets (LDs) are reservoirs of arachidonoyl lipids for prostaglandin (PG) E2 synthesis, and progesterone can stimulate PGE2 synthesis; however, the relationship between progesterone and LD metabolism in the murine cervix remains unclear. In the present study we examined LD distribution and changes in the expression of proteins involved in lipolysis and autophagy in the murine cervix during pregnancy, and compared the findings with those in dioestrous mice. During mid-pregnancy, LDs were predominantly distributed in the cervical epithelium. Electron microscopy revealed the transfer of numerous LDs from the basal to apical region in the luminal epithelium, marked catabolism of LDs, an elevated number of LDs and autophagosomes and a higher LD:mitochondrion size ratio in murine cervical epithelial cells (P<0.05). In addition, immunohistochemical and western blotting analyses showed significantly higher cAMP-dependent protein kinase, adipose triglyceride lipase and hormone-sensitive lipase expression, and a higher light chain 3 (LC3) II:LC3I ratio in the stroma and smooth muscles and, particularly, in murine cervical epithelial cells, during mid-pregnancy than late dioestrus. In conclusion, these results suggest that the enhanced lipolysis of LDs and autophagy in murine cervical tissues were closely related to pregnancy and were possibly controlled by progesterone because LD catabolism may be necessary for energy provision and PGE2 synthesis to maintain a closed pregnant cervix.
Mechanism of β-arrestin recruitment by the μ-opioid G protein-coupled receptor
Authors: Mafi Amirhossein , Kim Soo-Kyung , Goddard William A.
Published: June 2020

Significance

We report high-resolution structures for the μ-opioid G protein-coupled receptor (μOR) complexed with β-arrestin2 while bound to either strong nonbiased agonists (morphine and DAMGO) or to biased agonist
TRV130
. We used these structures to identify a sequence of events leading to β-arrestin2 recruitment. We discovered that for nonbiased agonists, β-arrestin2 and Gi protein make strong anchors to the same intracellular loops of μOR, even though their recruitment leads to different outcomes. However, we find that for the biased ligand, β-arrestin2 binds much more weakly to μOR, possibly explaining the reduction in side effects. These structures provide the basis for structure-based design of biased drugs to mediate pain more effectively while reducing such side effects as respiratory depression.
Maturation of the functional mouse CRES amyloid from globular form
Authors: Hewetson Aveline , Khan Nazmul H. , Dominguez Matthew J. , Do Hoa Quynh , Kusko R. E. , Borcik Collin G. , Rigden Daniel J. , Keegan Ronan M. , Sutton R. Bryan , Latham Michael P. , Wylie Benjamin J. , Cornwall Gail A.
Published: June 2020

Significance

Some amyloids are functional in the normal physiology of cells. Of these, several have been found in complex amyloid matrices that are composed of multiple amyloidogenic precursors. Here we trace the lifecycle of the mouse CRES (cystatin-related epididymal spermatogenic) protein, a functional amyloidogenic precursor and component of a complex amyloid matrix in the epididymis, as it progresses from monomeric folded protein to an advanced amyloid. We discovered that CRES amyloid formation may involve β-sheet assemblies generated by two distinct mechanisms: those formed by a flexible CRES loop and those formed by domain swapping. These mechanisms would provide multiple contact surfaces for further β-sheet assemblies with neighboring proteins resulting in sophisticated quaternary structures which may be integral for biological function.
Ferromagnetic behavior of native point defects and vacancy-clusters in ZnO studied by first principle calculation
Authors: Luo Cai-Qin , Zhu Si-Cong , Lam Chi-Hang , Ling Francis Chi-Chung
Published: June 2020

The origin of room temperature ferromagnetism in undoped ZnO is still a question of debate. Experimental and theoretical findings are inconclusive as to the predominant contributor for the magnetic behavior of undoped ZnO. First principle calculation pseudopotential method was used to systematically determine the relaxed atomic geometry, the formation energies and the magnetic properties of the native point defects (vacancies, interstitials and antisites), and vacancy clusters (VZnVO, VZn − 2VO and 2VZn − VO) in ZnO. The results show that ZnO cells consisting of the VZn and the Oi have non-zero magnetic moments, energetically favoring ferromagnetic states and close-to-room-temperature Curie temperatures (294 K). VZn and Oi are also characterized by their low formation energies, in particular in the case of n-type (i.e. Fermi level close to the conduction band minimum) and O-rich conditions. The energy differences between the ferromagnetic state and anti-ferromagnetic state for VZn and Oi are larger than kT at room temperature but still relatively small (∼34 meV). Although VZn and Oi would contribute for the room temperature ferromagnetism, the ferromagnetism states would not be robustly stable for thermal excitation to the anti-ferromagnetic states.
NaxWO3 + TiO2 nanocomposites as plasmonic photocatalysts for the degradation of organic dyes
Authors: Tegg Levi , Keast Vicki J
Published: June 2020

The combination of plasmonic metal nanostructures with semiconductor photocatalysts can improve their photocatalytic efficiency by increasing light absorption and aiding in charge separation. Metallic Na
x
WO3 has been shown to be strongly plasmonic and offers a readily synthesized and low-cost replacement for the noble metals which are conventionally used in plasmonic photocatalysts. In this work, a range of Na
x
WO3 + TiO2 nanocomposites were fabricated. Composites containing both semiconducting (x < 0.25) and metallic (x > 0.25) Na
x
WO3 were prepared. The degradation of rhodamine 6G (R6G) under visible and near infrared (NIR) light illumination was observed only when Na
x
WO3 and TiO2 were both present in the composite. Photocatalytic activity was generally higher in metallic samples than in semiconducting ones, but the sample with the highest activity had a mixture of both. This suggests that a combination of interband transitions and plasmonics-enhanced processes can be used together to catalyse reactions.
Cliché
Authors: Grimwood Tom
Published: June 2020

A term deriving from the sound of the mechanical printing process able to provide cheap and fast reproductions of literary works, the cliché is at once both a foundation of modern culture and its constant adversary. Denoting a lack of originality, thought, or effort, clichés appear to be the very opposite of literature’s aspirations, and there is no end to the warnings for writers to avoid them at all costs. However, few theorists have spent sustained time detailing the workings of the cliché outside of criticizing their use. Indeed, the cliché seems to resist being thought about too much. At the same time, this resistance to theory can also obscure a range of issues that the cliché raises as a problem for literature. Unpacking these problems suggests that the cliché is not simply an issue of unoriginal thought, but arises from, and is perpetuated by, a number of tensions within the production and circulation of writing itself. These include tensions between artistic worth and literary ownership; between organic creation and technologies of reproduction; between localized communications and universal truth; and concerning the status of the intellectual in relation to the masses and the place of authenticity in late-modern culture.
Cognitive Poetics
Authors: Spolsky Ellen
Published: June 2020

Northrup Frye expressed a scholarly impatience with what seemed to him the inconsequentiality of literary study, asking if criticism might provide “a coordinating principle, a central hypothesis, which, like the theory of evolution in biology, will see the phenomena it deals with as parts of a whole" (1957). Cognitive literary theory did not actually answer to Frye’s scientism until almost fifty years later, and when it did, it moved quickly in many directions. But it did not (and still has not) coalesced into a unified theory. The vigor and excitement of the field derive from its openness to many different areas of brain science, the wide reach of its attention to so many varieties of works of imagination—their production, their reception, and their history— and its resistance to a centralizing dogma. In her introduction to the Oxford Handbook of Cognitive Literary Studies, Lisa Zunshine, scholar in the field and its best historian, describes cognitive literary critics as working “not toward consilience with science but toward a richer engagement with a variety of theoretical paradigms in literary and cultural studies" (2015). Scholars from most traditional humanities fields: philosophers (both analytical and phenomenological and philosophers of mind and of language), cultural, literary, and art historians, literary critics and linguists, for example, and social scientists as well (anthropologists, archaeologists, and ethologists), have found the various fields of brain science to offer new perspectives on some persistent questions. Studies by developmental psychologists have made major contributions. And as brain imaging has become more powerful and widely used, the hypotheses of neurophysiologists and neurobiologists have come into the picture. Evolutionary biology has made perhaps the largest contribution by providing the overriding argument in the field—namely that human potential, individual behavior, and group dynamics can be studied as emerging phenomena. This begins with bodies that have over the millennia grown into worlds in which competition and cooperation have built and continue to build cultural life.