bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of energy signatures and planning of heating and domestic hot water energy use in buildings in Norway
Authors: Tereshchenko, Tymofii , Ivanko Dmytro , Nord Natasa , Sartori Igor
Published: August 2019

Widespread introduction of low energy buildings (LEBs), passive houses, and zero emission buildings (ZEBs) are national target in Norway. In order to achieve better energy performance in these types of buildings and successfully integrate them in energy system, reliable planning and prediction techniques for heat energy use are required. However, the issue of energy planning in LEBs currently remains challenging for district heating companies. This article proposed an improved methodology for planning and analysis of domestic hot water and heating energy use in LEBs based on energy signature method. The methodology was tested on a passive school in Oslo, Norway. In order to divide energy signature curve on temperature dependent and independent parts, it was proposed to use piecewise regression. Each of these parts were analyzed separately. The problem of dealing with outliers and selection of the factors that had impact of energy was considered. For temperature dependent part, the different methods of modelling were compared by statistical criteria. The investigation showed that linear multiple regression model resulted in better accuracy in the prediction than SVM, PLS, and LASSO models. In order to explain temperature independent part of energy signature the hourly profiles of energy use were developed.
A multipurpose test rig for district heating substations: domestic hot water preparation and keep-warm function comparison
Authors: Al Koussa Jad , Baeten Rutger , Robeyn Nico , Salenbien Robbe
Published: August 2019

A well performing District Heating Substation (DHS) is crucial for the efficiency of the District Heating (DH), especially with the shift towards low temperature 4th generation DH systems. For this reason, testing and characterization of commercially available DHSs becomes important to estimate their effect on the DH network. Within the thermo-technical laboratory of EnergyVille, a multipurpose test rig has been built for testing DHSs. In this setup, different DH conditions and heat demand profiles for space heating and for Domestic Hot Water (DHW) can be emulated. Independent tests have been performed on 4 DHSs from three different manufacturers, focused on the DHW preparation for low DH supply temperature and on the stand-by/keep-warm operation of the substations. The latter maintains a certain temperature within the heat exchanger to avoid delays in the delivery of DHW. The results showed that improvements are needed on DHW production for lower DH supply temperatures. Also, enhancements are needed to reduce losses from the keep-warm function. Given that DH systems can have thousands of substations, this will reduce the overall losses and improve the performance of the DH network.
Energy, economic and environmental analysis of opened natural healing water source
Authors: Miček Denis , Hirš Jiří
Published: August 2019

European´s low carbon economy is the main target in the way of the reducing greenhouse gases at the Earth´s atmosphere. The most promising way is in maximal usage of renewable sources of energy such as geothermal energy, which was in the year 2010 only 1 GWh at the Slovak republic. The paper refers to the detailed analyzation of the opened natural healing water system in the historical spa town Piešťany as one of the most perspective sources of the renewable energy in the Slovak republic primary used for healing procedures. Analysis is based on experimental measurement and numerical simulation of graphite block heat exchanger Korobon which was constructed in the year 1965 and resists highly mineralized water. The main function of this heat exchanger is to cool down the hot natural healing water with average temperature 60 °C to the 37 °C. The biggest impact is in the designing of new heat exchanger with the same quality properties as current one in accordance with the innovation of obsolete energy management at historical spa town. Such as solution allows us to save 5578 cubic meters of ground gas daily, necessary to be used for the same heat generation.
Exergy: Game Changer or Game Maker
Authors: Kilkis Birol
Published: August 2019

Many standard practices of today in the High Performance and Sustainably Green Buildings simply rely on the First-Law of Thermodynamics and economic feasibility in their evaluation and ratings. Although these practices seem to be quite `efficient` and green, new metrics, which are based on the Second-Law, namely exergy rationality metrics show that these practices are not feasible and environmentally advantageous, unless they are redesigned accordingly. For example, a simple ORC system using low-enthalpy geothermal source is not feasible, which means that such a system may save money and apparently energy but definitely destroys exergy compared to direct use of the thermal power from the geothermal well. This poster emphasizes the urgency of switching to exergy-based designs and practices.
Impact of urban textures on residential building performances in terms of energy and cost efficiency
Authors: Mangan Suzi Dilara , Koclar Oral Gul , Erdemir Kocagil Idil
Published: August 2019

Rapid urbanization, responsible for considerable global energy consumption, emphasizes sustainability challenges, in particular that of climate change. In order to tackle with climatic and environmental problems, the first step is to achieve energy efficiency in urban textures, are the main source of emissions, the major part of which is due to the energy consumption of buildings. Therefore, this study aims to develop and suggest a model which allows the evaluation of the level of effects of the design parameters which should be considered at the scale of urban textures, on the energy and economic performance of buildings to design sustainable, energy efficient built environments. Energy and economic performances of a reference building modeled in different urban texture alternatives were evaluated. In the first stage, the evaluations regarding energy consumption were performed through DesignBuilder simulation program. In the second stage, for the assessment of economic performance of the alternatives life cycle cost (LCC) analyses were performed integrated to the energy performance analyses. Consequently, the urban texture alternative which achieved the optimum result in terms of energy and cost efficiency was determined for Istanbul representing temperate-humid climatic region where an ongoing mass urban renewal has already been changing the existing urban textures.
Settlement scale analysis approach to reach nearly zero energy communities
Authors: Kalaycıoğlu Ece , Yılmaz Ayşe Zerrin
Published: August 2019

Looking at the recent developments, the European Union (EU) aims to become a zero carbon community. For the building sector, Energy Performance of Buildings Directive (EPBD) was recast in 2010 introducing the definition of the nearly zero energy building (NZEB) levels to construct all new buildings at this level by the end of 2020. The last revision of the directive in 2018 also promotes the renovation of the building stock to the NZEB levels. In the paper, it was proposed to define the nearly zero energy levels for settlements. This way, it was aimed to discuss the advantages and disadvantages of reaching the nearly zero energy levels at larger scales than single buildings. Settlement level studies, including the district energy systems, intended to reveal the energy efficiency measures which lead to optimal cost levels for more than one building. Key parameters were examined for a new settlement design which may be beneficial for the large-scale renewable energy system implementation and district energy system (DES) usage with high energy performance buildings.
Building stock simulation to support the development of a district multi-energy grid
Authors: Causone Francesco , Pelle Martina
Published: August 2019

The urbanization process is constantly increasing worldwide. Today over 50 % of the population resides in urban areas and this value is expected to grow up to 68 % by 2050. In this scenario, the development of district scale energy grids and management systems has become crucial to optimize energy use and to balance energy flows within the cities, encouraging the use of renewable sources and self-consumption. This study focusses on a district under development in the city of Milan, involving an urban area of about 920 000 m2, which, once completed, will count for about 4 500 apartments, a school and a few other commercial uses. The existing energy systems consist of an electric grid, including a small photovoltaic field, a district heating system and a local district cooling system exploiting groundwater via heat pumps. They serve, at present, seven residential tower buildings (400 apartments). The overarching aim of the research is to evolve the existing grid into a smart energy grid able to guarantee an intelligent management of the district, empowering eventually people to apply for demand-response schemes, electric mobility and other innovative services. In order to perform such an improvement and extension of the exiting grid, it is necessary to evaluate and simulate the profiles and dynamics of the final energy uses for the residential buildings, that will represent the major load on site. Since monitoring data are not yet available for the district, the evaluation of the energy performance of the existing buildings has been developed through dynamic energy simulations via the definition of profile loads of the most frequent apartment typologies, that allow, moreover, to simulate further developments in the districts. Besides, a monitoring plan for the existing systems has been developed and implemented. Monitoring data will be used at first for validating the developed load profiles; then, they will be analysed to develop optimisation algorithms for the management of the upgraded energy grid. In this paper, the case study is presented and the results of the analysis, via energy simulation, on the existing building stock are reported.
Sensitivity analysys and potential evaluation using building thermal mass combined with DSM strategies
Authors: Pavón MCarmen , Sánchez José , Guerrero MCarmen , Molina JLuis , Álvarez Servando
Published: August 2019

The objective of the work is to develop an algorithm that automatically manages the activation of the heat pump in response to the most appropriate strategies according to the pricing and operating conditions. It is interesting to see if a balance can be reached between the cost savings, the increase in energy consumed, the thermal comfort of the occupants and the contribution to the reduction of the peak loads. The study shows different results and conclusions, highlighting the important influence of various factors on the results obtained, such as user behavior, constructive quality of the building and electric pricing. Connection with a future renewable production can maximize the economic savings; it is interesting the use of buildings as thermal storage of unused photovoltaic surplus. Finally, the possibility of combining these measures with electrical storage and with the possible arbitration linked to renewable production.
Effect of highly reflective building envelopes on outdoor environment temperature and indoor thermal loads using CFD and numerical analysis
Authors: Yuan Jihui , Yamanaka Toshio , Kobayashi Tomohiro , Kitakaze Haruto , Emura Kazuo
Published: August 2019

In recent years, the climate change (CC) and urban heat island (UHI) effects are becoming serious problems, affecting people’s life and health, especially in hot summer. For large cities such as Tokyo and Osaka in Japan, the UHI effect is particularly intense. It is known that about 40% of urban anthropogenic heat comes from buildings in large cities. To reduce the anthropogenic heat of buildings is an important countermeasure to this problem. Strategies for UHI mitigation include urban ventilation, urban greening, green roof, highly reflective (HR) roads, and HR building envelopes, etc. Among these mitigation strategies, the research on HR building envelopes has been carried out globally. However, it is not clear that how the HR building envelopes affect the urban outdoor environment temperature and indoor thermal loads of urban buildings which is directly related to the selection of heating, ventilation and air conditioning (HVAC) system. Thus, this study aims to evaluate the effect of solar reflectivity of building envelopes varied from 0.1 to 0.9, on the outdoor environment temperature and indoor thermal loads of buildings located on Osaka University Suita Campus, Japan, using Computational Fluid Dynamics (CFD) and numerical analysis.
Analysis of different building exterior walls insulations using eQUEST
Authors: Zerroug Abdellah , Dzelzitis Egils
Published: August 2019

In this paper, eQUEST simulation tool is used to study of the effect of varying the insulation type (polysterene, polyurethane, and polyisocyanurate) and thickness on heat space energy consumption. Different thicknesses have been used in three scenarios for each type of insulation material, small, medium and large. The simulation was performed by using the eQUEST software, this software which has been proved by previous researchers to be the closest to the real recorded values for energy consumption. A comparison between the thicknesses variation with the same insulation and the heat space energy consumed, as well as the comparison between different types of insulation with the same thickness, and heating energy are investigated. Results of the simulation show that when increasing the thickness of insulation gradually results in a decrease of energy consumed, but after a certain thickness the percentage of energy saved will increase very slowly until saturation.
An Adaptive Architecture for Long Term Energy Programme Management
Authors: Noran Ovidiu
Published: August 2019

Climate change, population growth, changing energy consumption patterns and the advent of feasible renewable energy sources has prompted governments worldwide to set targets for carbon emission reductions. The transition to a ‘near zero emissions’ industry and energy production presents significant opportunities but also caveats in relation to maintaining the balance of the ‘energy triangle’ aspects, namely economic, security and environmental. Various regions and countries find themselves in different economic, cultural and geopolitical situations which require customised approaches. Moreover, the transition is likely to take significant time, with disruptive technologies emerging in the meantime; therefore, a purely technical solution is unlikely to be viable in the long run. Hence, it would be helpful to complement the supportive, albeit high-level artefacts developed by various global organisations with strategic plans satisfying and abiding by principles that maximise the chances of success. Importantly, such strategic planning must follow a method that is transferable between geographical regions and their local maturity levels in respect to energy triangle viewpoints. This paper describes challenges and highlights of planning such a strategy, including guiding principles for the solution architecture and dynamic business models describing the possible structure and relations between an energy transition programme and its projects.
Heating Water and Tap Water Production with an Air-to-Water Heat Pump by Using the Waste Heat of an Oil-Free Air Compressor
Authors: Gulseven Cem , Yilmazoglu M. Zeki
Published: August 2019

Existing buildings require optimization of the individual heating systems to decrease the energy consumption or energy use intensity (EUI) with heat recovery systems to maintain the sustainability. In terms of energy use intensity, hospitals are considered as the second highest EUI among diverse types of buildings. Therefore, to decrease energy use intensity in hospitals heat recovery options have to be analysed. In this application, oil-free air compressors’ waste heat is recovered by using air-to-water heat pumps for providing hot tap water (around 10% of total) during summer mode and heating water for radiators placed in an emergency waiting room (42 m2 area) during winter mode at Gazi University Hospital, in Turkey. The results showed that previously the unserviceable area get in use with a PMV value of +1. The payback period for the implemented system is found to be 2-4 years depending on heat load variations.
Applicability of the whole-house air conditioning system in cold climate district
Authors: LEE Sihwan , KISHI Takuya , ASANO Yoshiharu
Published: August 2019

The number of sudden deaths while bathing related to heat shock in Japan is approximately 17,000 people for a year. This number is over 30% of elderly people dying in the residential buildings. To solve this problem, it is effective to introduce a whole-house air conditioning system in the residential buildings. The purpose of this study is to evaluate the applicability of the whole-house air conditioning system in cold climate district in Japan. To achieve this goal, this study is evaluated the thermal environment by using the whole-house air conditioning system and compared with individual air conditioning system. The results show that the maximum room temperature difference is measured approximately 6.8 ºC. As the reverse simulation in the study, this temperature difference can be decreased to approximately 4 ºC by adjusting the supply airflow rate. When the individual air conditioning is used, the room temperature difference is 7.5 ºC. It means that using the whole-house air conditioning system decreases the room temperature difference and reduces heat shock risk. It is also possible to raise the surface temperature of the wall by 20 to 30 % than in case of using individual air conditioning, thus it is effective in preventing dew condensation on the wall surface.
Implementation of an algorithm for determining the effectiveness of ventilation and energy efficiency in industrial ventilation systems
Authors: Adam Marius , Bancea Olga , Aschilean Ioan
Published: August 2019

The requirements for good indoor air quality and energy efficiency have often been considered to conflict with each other, however, buildings with low energy consumption in Europe seem to have also a lower rate of building related health symptoms. The paper aims to develop a succession of necessary operations, an algorithm, for the determination of ventilation efficiency and energy efficiency in industrial ventilation systems, starting from a general model that will be developed according to the particularities of the industrial ventilation system. These systems are important as they are related both to energy cost and indoor climate management as well as to the health of the occupants. The stages of algorithm development will include: source control and efficient removal of contaminants, proper location of fresh air intakes, cleaning of intake air, efficient air distribution in rooms with improved ventilation efficiency, heat recovery from exhaust air, night time ventilation cooling, ventilation rates control by air quality, correct balancing of air flows and controlling the indoor climate locally.
A convenient method to assess air infiltration rate using particle mass balance principle
Authors: Shi Yuchen , Li Xiaofeng
Published: August 2019

Uncontrolled air leakage across a building exterior (i.e., air infiltration) is a primary reason for excessive energy consumption of air conditioning systems and indoor particle pollution, because infiltration brings outdoor high dew point air and particulate pollutants indoors. Therefore, assessing air infiltration rate is very necessary for improving building energy performance and indoor air quality. However, the commonly used method to assess infiltration rate is very complex to implement. In this paper, we propose a convenient method to assess the infiltration rate based on the mass balance of particulate matters. Given the ubiquity of particulate matters in the outdoor environment and being cost-free, this method is able to avoid the disadvantages of traditional methods. PM2.5 is chosen to establish the mass balance. The method was used in an office room to measure the infiltration rate. Simultaneously, the carbon dioxide tracer gas method was used to verify our method. The relative error between the results calculated by our method and the verifying method is within 10%, which indicates that the proposed method would be feasible in practical applications.
Prediction model for day-ahead solar insolation using meteorological data for smart grid
Authors: Chung Min Hee
Published: August 2019

In the overseas market, power generation and energy service companies have been engaged in the business of providing personalized trading services for the production of electric power through the Internet platform. This is, so that the electric power sharing system between individuals is being developed through the Internet platform. The prediction of insolation is essential for the prediction of power generation for photovoltaic systems. In this study, we present a prediction model for insolation from data observed at the Meteorological Administration. We also present basic data for the development of the insolation prediction model through meteorological parameters provided in future weather forecasts. The prediction model presented is for five years of observation of weather data in the Seoul area. The proposed model was trained by using the feed-forward neural networks, taking into account the daily climatic elements. To validate the reliability of the model, the root mean square error (RMSE), mean bias error (MBE), and mean absolute error (MAE) were used for estimation. The results of this study can be used to predict the solar power generation system and to provide basic information for trading generated output by photovoltaic systems.
Perceived Air Quality of different sources of smell evaluated by primary school children
Authors: Moya Tatiana Armijos , Zhang Dadi , Bluyssen Philomena M.
Published: August 2019

Our sensory system (nose) could predict the perceived odour intensity of various materials relatively well and in many cases the nose seems to be a better receptor of pollutants than some equipment. To test this ability with children, odour tests were performed as part of a study performed with 335 primary school children in the air quality test chamber of the SenseLab. Two similar experiments were conducted to assess the identification of potentially recognizable odours for children. The different sources of odour were placed in different containers and the children were asked how they feel about the smell and to identify the source of smell. There were statistically significant differences among children’s evaluations of different smells and it was difficult for them to identify certain sources of smell.
A study on the actual conditions associated with the presence of Acinetobacter sp. in a hospital waiting room
Authors: Odagiri Akane , Yanagi U , Endo Miyoko , Oda Hisato
Published: August 2019

In recent years, nosocomial infection, including that by multiple-drug-resistant Acinetobacter (MDRA), has become an increasing concern in Japan. Typically, Acinetobacter inhabits soil and river water and is usually harmless to humans. However, bacteria of this genus can become pathogens in inpatients with weakened immune systems, resulting in opportunistic infection. Currently, hospital infection by MDRA is spreading not only in Japan, but also worldwide. This is a very serious problem, and little is known about effective countermeasures. The present study sought to examine the microbiome status in a hospital visitor waiting room as a first step in establishing countermeasures for use against Acinetobacter. Specifically, we performed a so-called metagenomic analysis to directly analyze DNA collected from the environment, without an intervening cultivation step. Indoor airborne bacteria and surface bacteria were sampled and analyzed. The results show that in a visitor waiting room, the top-ten most-abundant genera included (in decreasing order) Acinetobacter, Streptococcus, Prevotella, Pseudomonas, Bifidobacterium, Fusobacterium, Neisseia, Porphyromonas, Leptotrichia, and Haemophilus. Thus, Acinetobacter constituted the mostdetected genus and was present in all collected samples. Furthermore, we assessed the bactericidal effect of ultraviolet C (UVC) against Acinetobacter sp. 7206, a hospital isolate. A UVC dose of 4.0 sec•mW/cm2 was required to kill the 99.9% Acinetobacter sp. 7206 on solid culture medium.
Geothermal System Study Case near Bucharest
Authors: Prică Galina , Onuțu Lohengrin , Țârlea Grațiela
Published: August 2019

The article shows a study case of a geothermal system near Bucharest. In the paper it is shown that for a good efficiency of a geothermal system for heating and air conditioning, it is important to follow a few steps. One step is a very accurate calculation of the heat and cold load. In the next step it is important to use a specific equipment to obtain the Thermal Response Test (TRT) of geological formations crossed by the borehole. TRT is helpful in providing information related to the evolution of the soil temperature while introducing a thermal load. All information that can be obtained or calculated from the TRT will provide how the climate system will function in time and its efficiency. Furthermore, the effective thermal conductivity and thermal resistance of the well will be determined, extremely important parameters in designing the correct length of the geoheat exchanger. The article used specific software to simulate the evolution of parameters in time, for soil and heat pump. Earth Energy Design offer information for the number of needed boreholes, the depth and the yearly evolution of the soil’s temperature in time for the system etc. Following all these main steps, finally a very efficient system can be designed, that can ensure the heating and produce hot water for the consumption of a house, office building or of other destination buildings.
Comparison of performance of heat recovery ventilator and air purifier in reducing indoor PM10 concentrations in a classroom
Authors: Hatta Muhammad , Han Hwataik
Published: August 2019

Recently, outdoor particulate matters have become a serious problem in Korea. Pollutants exhausted from industrial plants and dust transported from adjacent regions contribute to the peaks in fine particle concentration. Indoor air quality is affected by ambient air pollution. Common methods for maintaining good IAQ from harmful outdoor particles are either through the usage of an air purifier (AP) or to install a filter in the heat recovery ventilator (HRV) system. It is important to evaluate the PM10 concentrations in a room using APs and HRVs depending on various system parameters, such as building air-tightness, indoor generation characteristics, and system filter efficiency. The purpose of this study is to compare the performance of AP with that of HRV in reducing PM10 levels in a classroom based on computer simulation. Results show that the filter efficiency of HRV should be increased to over 0.8 under the reference condition in order for the HRV to be compatible with the AP. Increasing the airflow rate of HRV is not an effective way of increasing its filter performance to outperform an AP. We found that HRV performs better as compared to AP in an indoor environment under dusty conditions with the generation rate of over seven times compared to the reference condition.
Internal insulation retrofit with ventilated wall and circulation of dry air – focus on airflow distribution and mitigation of noise
Authors: Hviid Christian A. , Harjani Dessy Wina , Lucchesi Fabricio
Published: August 2019

External façade retrofit changes the look, feel and aesthetics of the building and internal façade retrofit changes the heat and moisture conditions of the existing façade. The ventilated internal insulation wall is an existing solution for internal retrofit applications that promises to be an efficient and moisture resilient retrofit solution. It has a ventilated cavity and the moisture content in the cavity is actively controlled by a small dehumidifier unit mounted in the wall. The dehumidifier circulates air inside the air cavity and any excessive moisture is ejected into the room air. The focus of the paper is on mitigating noise from the dehumidifer by analyzing the required airflow rate, the air distribution inside the air cavity as well as optimizing the dehumidifier. CFD simulations were carried out to analyze airflow velocities and distribution and the final results show a possible 30% reduction in the airflow rate without compromising the drying performance. In addition, experimental studies in noise mitigation were performed. Different dehumidifier designs with different fan configurations were tested. A significant noise reduction was obtained from 39 dB(A) to a noise level of approx. 26 dB(A).
Enhancement of ventilation efficiency in residential buildings by pulsating air-flow
Authors: Mai Ronny , Krause Ralph , Friebe Christian
Published: August 2019

Contrary to conventional air-conditioning systems in non-residential buildings, the air-flow conditions are almost never considered in ventilation systems for residential buildings. Both the air inlets and the outlets are usually located at unfavourable places. This situation culminates in large buildings with many flats, where simplest supply-air apertures are installed with respect to cost restrictions. With small air flow rates, the ventilation efficiency is very poor due to a lack of air mixture. In order to improve the situation, a new supply air aperture has been developed recently. The air flow rate is designed to vary with time, with a low auxiliary energy requirement, with clear maxima and otherwise reduced flow rate. Hence, the corresponding momentum was expected to improve the air mixture in the room. First measurements confirm that the transient flow conditions allow high intrusion depths and a good mixing of the air. The pulsating airflow reduces the risk of draughts and increases both ventilation efficiency and thermal comfort in the living area. Moreover, the energy efficiency is improved as the average air-flow rate can be reduced.
EPL in an eventful environment
Authors: van Tiggelen Bart
Published: August 2019

Europhysics Letters was cofounded in 1986 by 17 European learned societies, and merged the two existing Letter journals Lettere al Nuovo Cimento – published by the Società Italiana di Fisica (SIF) – and the Journal de Physique Lettres, from the Société Françcaise de Physique (SFP). The original idea was to create a real European Letter journal competitive with Physical Review Letters of the American Physical Society. The major scientific force behind EPL is the European Physical Society (EPS) that celebrated its 50th anniversary only last year in Geneva. The publication of Europhysics Letters, re-baptized EPL in 2007 to emphasize its global impact, is a joint venture of the publishing houses of three physical societies: the Institute of Physics (IOP), the SIF, and the SFP.
Moiré with flat bands is different
Authors: Heikkilä Tero T. , Hyart Timo
Published: August 2019

Recent experimental discoveries of superconductivity and other exotic electronic states in twisted bilayer graphene (TBG) call for a reconsideration of our traditional theories of these states, usually based on the assumption of the presence of a Fermi surface. Here we show how such developments may even help us finding mechanisms of increasing the critical temperature of superconductivity towards the room temperature.
Inclusion cleanliness in metallic alloys
Authors: Bellot Jean-Pierre , Gardin Pascal , Gruy Frédéric
Published: August 2019

The inclusion cleanliness remains an issue of great concern in liquid metal processing which has been addressed in a full session of the last Matériaux Conference held in November 2018 in Strasbourg, France. A special issue of the Metallurgical Research & Technology journal gathers most of the papers of this session which are divided into two sub-sections: on the one hand the analysis and characterization techniques of the inclusions are addressed and on the other hand the modelling methods to simulate the behavior of single particle or a population of inclusions are discussed.
Qualität und Struktur der ambulanten Versorgung von erwachsenen Patienten mit ADHS (Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung)
Authors: Thome Johannes , Behnke Kerstin , Gleitz Markus , Steer Lydia , Weiher Martina , Hasford Joerg
Published: August 2019

Ziel der Studie Darstellung der Versorgungsrealität erwachsener ADHS-Patienten in der ambulanten Versorgung.

Methode Vollerhebung aller ambulanten GKV-Patienten ≥ 18 Jahre mit ICD-Code F90.0 für das Jahr 2012 im Freistaat Bayern.

Ergebnisse Die Diagnoseprävalenz betrug 0,1 %. Circa 30 % der Patienten erhielten nach Diagnosestellung ein für die Behandlung der ADHS im Erwachsenenalter zugelassenes Arzneimittel. Drei Viertel der medikamentös versorgten Patienten bekam die Verordnung von einem Facharzt für ZNS-Erkrankungen. Rund 50 % der Patienten erhielten auch psychotherapeutische Versorgung.

Schlussfolgerungen Da auch Hausärzte eine Rolle in der Versorgung von erwachsenen ADHS-Patienten spielen, sollte die Zusammenarbeit zwischen Fach- und Hausärzten sowie das Fortbildungsangebot verstärkt werden.
Update Therapie der ANCA-assoziierten Vaskulitiden
Authors: Holle Julia U. , Moosig Frank
Published: August 2019

Dieser Artikel gibt eine Übersicht über die aktuellen deutschen und europäischen Therapieempfehlungen zu den ANCA-assoziierten Vaskulitiden (AAV) sowie ein Update zu seither publizierten wichtigen Therapiestudien. Nach den deutschen und europäischen Empfehlungen erfolgt die Remissionsinduktion bei GPA/MPA mit organbedrohender Erkrankung mit Glucocorticoiden und Cycloposphamid oder Rituximab, bei nicht organbedrohender Erkrankung mit Glucocorticoiden und Methotrexat (MTX) oder Mycophenolat-Mofetil (MMF). Die kürzlich publizierte MYCYC-Studie unterstützt die Empfehlungen; sie zeigte eine Nicht-Unterlegenheit gegenüber i. v. Cyclosphamid bei GPA/MPA-Patienten mit nicht-organbedrohender und organbedrohender Erkrankung auf. Die remissionserhaltende Therapie soll mit niedrig-dosierten Glucocorticoiden sowie Azathioprin, MTX und Rituximab durchgeführt werden. Rituximab wurde Ende 2018 auf der Basis der MAINRITSAN-Studie als remissionserhaltende Therapie zugelassen und ist damit nun die formal einzige zur Remissionserhaltung zugelassene Therapie. Mehrere Studien zur untersuchten zudem die kurze Anwendung von Glucocorticoiden (z. B. durch additive Therapie mit Avacopan) in der Remissionsinduktion und das komplette Ausschleichen von Glucocorticoiden in der Remissionserhaltung. Die ersten Ergebnisse hierzu sind vielversprechend; Langzeitdaten stehen allerdings aus. Für die sehr viel seltenere EGPA liegen insgesamt deutlich weniger Studiendaten vor. Die Therapie wird jedoch im Wesentlichen nach den gleichen Prinzipien wie bei den anderen AAV durchgeführt. Neuerdings steht, in Deutschland für diese Indikation aber noch nicht zugelassen, eine Biologikatherapie mit dem Anti-IL-5-Antikörper Mepolizumab zur Verfügung.
Long-term Results of Conservative Therapy of Adolescent Idiopathic Scoliosis Using the Cheneau Brace
Authors: Weniger Carmen Dorothea , Fujak Albert , Hofner Benjamin , Fuchs Markus , Forst Raimund , Richter Richard Heinrich
Published: August 2019

Adolescent idiopathic scoliosis is a disease of the growing skeleton. The goal in therapy is to decelerate or to prevent progression of the spinal curve. As part of a retrospective study the patient group of the scoliosis surgery from 1995–2016 was analysed according to the inclusion criteria of the Scoliosis research Society (SRS). 159 of 643 of the patients fullfilled the specific criteria. The assessment of effectiveness was based on the progression of the angle of curvature. If it was ≤5° it was judged positively. The therapy in accordance to Cheneau is a full-time bracing orthosis. Data from 159 patients – 136 fem. (85.5%), 23 male (14.5%) was analysed. The average age at the beginning of treatment was 13.3±1.7 years. The average duration was 3.47±1.2 years. The average Cobb-angle before treatment was 28.39°±9.44°. At the completion is was 27.7°±12.34°. Stabilisation of scoliosis (≤5°) was achieved for 136 of the patients (85.5%). The final follow-up showed a progression of the Cobb angel>5° in 23 cases, of which 19 had to undergo secondary surgery. The length of therapy had a positive influence (p=0.057) on the result. Brace treatment constitutes an effective method of therapy at curvatures between 20–40°. Short duration of therapy correlates with a expressively increased risk towards progression (p=0.057). The Cheneau brace treatment constitutes an effective treatment at curvature angles between 20–40°. The risk of progression can be reduced by a timely and correct identification.
Schwangerschaft bei chronisch-entzündlichen Darmerkrankungen
Authors: Roeb Elke
Published: August 2019

Die höchsten gemeldeten Prävalenzraten für die chronisch-entzündlichen Darmerkrankungen (CED) Morbus Crohn und Colitis ulcerosa liegen aktuell in Europa. Etwa die Hälfte der Patienten sind Frauen und die meisten davon sind im reproduktionsfähigen Alter. Die Betreuung von schwangeren Patientinnen mit CED ist eine Herausforderung für interdisziplinäre Behandlungsteams. Die Auswirkungen der CED und ihrer Therapien auf Schwangerschaft, Neugeborene und Stillzeit sowie die Auswirkungen einer Schwangerschaft auf die CED und die Gesundheit der Mütter werden häufig mit Angst und Sorge betrachtet. Oft wird die Therapie bei Schwangerschaft und Stillzeit abgebrochen, ein signifikantes Risiko für eine Verschlechterung der Krankheitsaktivität und somit das größte bekannte Risiko für Schwangerschaft und Geburt. Frauen und Schwangere mit CED optimal zu betreuen erfordert eine interdisziplinäre Zusammenarbeit bei Diagnostik, Therapie und Prävention.
Mikrobiom und chronisch-entzündliche Darmerkrankungen
Authors: Klag Thomas , Wehkamp Jan
Published: August 2019

Die Pathogenese chronisch-entzündlicher Darmerkrankungen ist durch genetische und Umweltfaktoren beeinflusst. Das Mikrobiom als Umweltfaktor der Darmbarriere steht zunehmend im Interesse der Forschung. Dieses Mikrobiom kann dabei nicht als eigenes Organsystem betrachtet werden, sondern wird durch die unspezifische Immunantwort des Darmepithels moduliert und gesteuert. Primäre und sekundäre Änderungen des Mikrobioms gehen fließend ineinander über und haben mögliche pathophysiologische und therapeutische Implikationen.
Atemwegsmanagement in Schwerelosigkeit
Authors: Hinkelbein Jochen , Schmitz Jan , Kerkhoff Steffen , Tochtermann Felix , Komorowski Matthieu , Neuhaus Christopher , Warnecke Tobias
Published: August 2019

Das Ziel der vorliegenden Arbeit ist es, einen Überblick über den aktuellen Stand der Forschung zum Atemwegsmanagement in Schwerelosigkeit zu geben. Dafür wurde ein narratives Review von bisher publizierter Literatur über Atemwegsmanagement in (simulierter) Schwerelosigkeit erstellt. Mittels einer Suche in PubMed wurden 3 Originalarbeiten identifiziert, die das Atemwegsmanagement in Schwerelosigkeit untersucht haben. Alle 3 Studien wurden an menschlichen Modellen durchgeführt, 2 davon während Parabelflügen und eine Unterwasserstudie. Unter „Free-floating-Bedingungen“ war die Erfolgsrate zur Insertion eines supraglottischen Atemwegshilfsmittels (SGA) hervorragend (91–97 %). Die Erfolgsrate einer konventionellen Laryngoskopie war unter „Free-floating-Bedingungen” wesentlich schlechter und betrug 15–86 %. Die Sicherung des Atemwegs in Schwerelosigkeit scheint prinzipiell für eine Allgemeinanästhesie machbar. Hierbei ist es allerdings essenziell, dass der Anwender ausreichend gut trainiert ist und der Patient im Optimalfall fixiert ist. Die Verwendung eines SGA scheint in Schwerelosigkeit wesentlich einfacher zu sein.
Was hat die Ernährung mit der Wundheilung zu tun?
Authors: Renner R. , Erfurt-Berge C.
Published: August 2019

Bei einer Störung im Ablauf der Wundheilung kann es zu einem verzögerten oder fehlenden Wundverschluss kommen. Als ein möglicher Störfaktor gilt die Ernährung. Man muss zwischen quantitativer und qualitativer Mangelernährung unterscheiden. Gerade übergewichtige Patienten leiden oft an einer qualitativen Mangelernährung und Sarkopenie.

Spezifische Erkrankungen machen eine entsprechende diätetische Nahrungsempfehlung notwendig. So findet man bei dialysepflichtigen Patienten, Dekubitus-Patienten und Ulcus cruris-Patienten oft einen Eiweißmangel. Auch niedrige Level an Vitamin C, Zink, Folsäure, Vitamin D oder Spurenelementen können die Wundheilung negativ beeinflussen.

Größere prospektive Studien sollten klären, ob eine Substitution dieser Mangelzustände den gewünschten positiven Effekt auf die Wundheilung hat. Es erscheint aber sinnvoll, eine ausgewogene Ernährung und an die individuellen Ernährungsgewohnheiten angepasste Verbesserung der Aufnahme von Vitaminen, Spurenelementen und Eiweißen anzustreben.
Influence of Silybum Marianum on Morphine Addicted Rats, Biochemical Parameters and Molecular Simulation Studies on µ-Opioid Receptor
Authors: Malekshah Rahime Eshaghi , Khaleghian Ali
Published: August 2019

The present study aimed to investigate effects of medicinal plant (Silybum marianum) on the animals with treatment of morphine addiction compared to chemical drug (Naloxane). Also, this study was conducted to evaluate the role of Silybum marianum on factors of serum ALT, AST activities and activity of the antioxidant enzyme:superoxide dismutase (SOD) as well as the extent of lipid peroxidation of Morphine addicted rats.High performance liquid chromatography (HPLC) has been used to measure Morphine in the serum, enzymes functions well as lipid peroxidation of Morphine addicted animals. Results demonstrate treatment with S. Marianum for opium rats at dose 400 mg/kg led to a major reduction in serum morphine compared to Naloxane (400 mg/kg>200 mg/kg>100 mg/kg>Naloxane. The positive effect of dose-dependence on liver enzymes function (ALT and AST) in order of 400 mg/kg>Naloxane>200 mg/kg>100 mg/kg. Furthermore, the findings show that the malondialdehyde levels are increased in opium-treated animals. However, the extracts also demonstrate a significant reduction in the MDA levels compared to the control, 400 mg/kg>200 mg/kg>Naloxane>100 mg/kg. Increase of Silybum marianum extract in rats pretreated significantly elevated the activities of superoxide dismutase (SOD).At last, our data suggest that Silibinin as the main component found in Milk thistle is more selective toward µ-Opioid Receptor than Morphine and Naloxane as a narcotic receptor antagonist.
Bahnbrechende Operationen
Authors: Hardinghaus Christian
Published: August 2019

2017 wurden in deutschen Krankenhäusern oder Praxen etwa 17 Millionen Operationen durchgeführt. Am häufigsten am Darm, gefolgt von weiblichen Geschlechtsorganen und der Lendenwirbelsäule. Die weltweit häufigste Operation bleibt aber die Beschneidung der männlichen Vorhaut. Diese Beispiele zeigen, dass nicht nur Chirurgen operieren, auch wenn dies umgangssprachlich immer wieder zu hören ist. Neben der Chirurgie zählen etwa auch Gynäkologie, Urologie, Hals-Nasen-Ohren-Heilkunde oder Augenheilkunde zu den operativen Disziplinen der Medizin. Der Oberbegriff für durchführende Ärzte ist also Operateur. Unter diesen Helden des Alltags befinden sich wahre Genies, denn neben den vorherrschenden Routine-Operationen müssen sie immer wieder auch Pionierarbeit leisten, dafür Risiken in Kauf nehmen, mutige Entscheidungen treffen. Weil irgendwann mal OP-Pioniere ein besonderes Wagnis eingegangen sind oder Tabus gebrochen haben, profitiert davon heute die gesamte Menschheit. Millionen Leben können heute gerettet werden, die vor 100 Jahren noch den sicheren Tod bedeutet hätten. Diese Vordenker und Vorkämpfer sind heute Vorbilder der modernen Operateure. Einige davon samt ihren bahnbrechenden Erfindungen möchte ich heute ins Gedächtnis rufen.
Behçet-Syndrom
Authors: Xenitidis Theodoros , Henes Joerg Christoph
Published: August 2019

Das Behçet-Syndrom gehört zu den Vasculitiden variabler Gefäßgröße. Das klinische Bild ist sehr vielfältig und erfordert in der Regel eine interdisziplinäre Zusammenarbeit. Pathogenetisch scheint es eine Mittelstellung zwischen einer polygenetischen Autoinflammationserkrankung und einer autoimmunen Erkrankung einzunehmen. 2018 wurden neue EULAR-Empfehlungen herausgegeben. Die Therapie richtet sich nach der führenden Beteiligung der einzelnen Organe. Seit 2016 ist Adalimumab zugelassen für die Behandlung der hinteren Augenbeteiligung. Infliximab, Interferon a2a, Interleukin-1-Antagonisten und Apremilast können Therapiealternativen darstellen.
A Simple Retractor for Anterior Cervical Diskectomy
Authors: Eftekhar Behzad
Published: August 2019

Background The insertion of available cervical retractor systems is relatively complex for the limited exposure required for single-level anterior cervical diskectomy.

Objective To introduce a novel cervical retractor system and report the initial experience of its application.

Methods A simple retractor system was designed that is fixed to the vertebral body through Caspar pins. The design allows the retractor to move with the vertebrae during distraction via the traditional Caspar distractor system. The advantages and limitations of the device based on the initial experience are discussed.

Results The author has used the current version of the retractor on 32 single-level anterior cervical diskectomies. The insertion of the retractor is easy, and its application provides safe and satisfactory anterior cervical exposure. There have not been related complications, although transient dysphagia has not been prevented.

Conclusion This newly designed retractor system is simple and efficient for a single-level anterior cervical diskectomy, and its insertion is relatively easy.
Making a Good Hire
Authors: Gregory Laurel , Clark Deborah
Published: August 2019

Hiring the right employee is paramount to the success of any business. In 2019, with unemployment rates low and job openings high, hiring anyone might sound good. However, taking the time to find the right employee far outweighs the cost of replacing a bad or desperate hire. This article discusses the interviewing and onboarding process to shift the odds positively in the direction of making a lasting, good hire.
Digital Marketing for Private Practice: How to Attract New Patients
Authors: StClergy Kevin D.
Published: August 2019

Digital marketing in the hearing profession can be confusing, difficult, and make any private practice owner or manager frustrated with the results they are or are not getting. This article provides a digital marketing plan for getting new patients to contact your office for hearing healthcare services. Patients are confused when researching hearing aids, audiologists, and hearing tests. Some Web sites advertise bypassing licensed professionals, recommending only an online hearing test or an audiogram faxed into their office for the purpose of fitting hearing aids or other technology. We know this system does not take the place of a licensed professional but, Web sites that provide this information are very believable. Practitioners and managers are frustrated and confused by what they should be doing online. Patients continue to find other sources of misinformation before locating an established practice that can help them hear better and get much more out of their hearing healthcare. This article will give each reader a plan for getting results online and attracting new patients to their practice for less money than any other marketing medium available today.