End-use efficiency, demand response and coupling of different energy vectors are important aspects of future renewable energy systems. Growth in the number of data centres is leading to an increase ...in electricity demand and the emergence of a new electricity-intensive industry. Studies on data centres and energy use have so far focused mainly on energy efficiency. This paper contributes with an assessment of the potential for energy system integration of data centres via demand response and waste heat utilization, and with a review of EU policies relevant to this. Waste heat utilization is mainly an option for data centres that are close to district heating systems. Flexible electricity demand can be achieved through temporal and spatial scheduling of data centre operations. This could provide more than 10 GW of demand response in the European electricity system in 2030. Most data centres also have auxiliary power systems employing batteries and stand-by diesel generators, which could potentially be used in power system balancing. These potentials have received little attention so far and have not yet been considered in policies concerning energy or data centres. Policies are needed to capture the potential societal benefits of energy system integration of data centres. In the EU, such policies are in their nascent phase and mainly focused on energy efficiency through the voluntary Code of Conduct and criteria under the EU Ecodesign Directive. Some research and development in the field of energy efficiency and integration is also supported through the EU Horizon 2020 programme. Our analysis shows that there is considerable potential for demand response and energy system integration. This motivates greater efforts in developing future policies, policy coordination, and changes in regulation, taxation and electricity market design.
More focus is increasingly being put on implementation of the free trade agreements (FTAs) the European Commission has negotiated on behalf of the European Union (EU). Based on data gathered by EU ...Delegations from competent authorities in partner countries, this article is the first of its kind to analyse the uptake of preferences by EU exports in these markets. Overall, the preference utilization rate (PUR) stood at about 75% in 2013, up from 63% in 2009, albeit with a changing country coverage over the years. The PURs vary significantly by originating EU Member State (MS) and by broad product group. EU export flows of low values make relatively good use of preferences as opposed to low value exports from developing countries to developed countries, which is something the literature has pointed to. Similarly, the figures challenge a commonly held view that the preferential margin needs to be in the range of 3%-6% for preferences to be used. The empirical analysis examines the extent to which the PUR is influenced by the preferential margin, the value of exports and potential duty savings.
This paper investigates the moisture dependency of ion diffusion in binary cementitious binders with Portland cement (OPC) in combination with slag or silica fume. Resistivity measurements and ...calculations with a thermodynamic model, GEMS, were used to assess the unsaturated chloride diffusion coefficient. The results show that the relation between the relative diffusion coefficient and the degree of saturation is not significantly affected by w/b (in the investigated range of w/b from 0.38 to 0.53), while the investigated binder compositions seem to affect the relation. These results are of value for service-life models, where they potentially represent important input data. The results also highlight the need for considering the pore solution conductivity when using resistivity measurements for evaluation of ion transport properties.
Objective:
Both methadone and buprenorphine are effective therapy for heroin dependence. Efficacy is best documented for methadone maintenance therapy, but safety concerns limit its use. ...Buprenorphine offers lower overdose risk and improved access, but efficacy may be lower. The authors compared adaptive, buprenorphine-based stepped care to optimal methadone maintenance treatment.
Method:
This randomized controlled trial was undertaken 2004-2006. It consisted of a 24-day uniform double-blind induction phase followed by single-blind flexible dosing based on structured clinical criteria, for a total of 6 months. Ninety-six self-referred subjects with heroin dependence were randomly assigned to methadone or to stepped treatment initiated with buprenorphine naloxone and escalated to methadone if needed. All subjects received intensive behavioral treatment. Primary outcome was retention in treatment. Secondary outcomes were completer analyses of problem severity (Addiction Severity Index) and proportion of urine samples free of illicit drugs.
Results:
Overall, 6-month retention was 78%. Stepped treatment and methadone maintenance therapy outcomes were virtually identical. Among completers of stepped therapy, 46% remained on buprenorphine naloxone. Proportion of urine samples free of illicit opiates increased over time and ultimately reached approximately 80% in both arms. Problem severity decreased significantly and uniformly in both arms.
Conclusions:
A stepped treatment of heroin dependence as described here appears equally efficacious compared to optimally delivered methadone maintenance therapy. Together with prior data on the advantageous safety of buprenorphine, this suggests that broad implementation of strategies using buprenorphine as first-line treatment should be considered.
Aquaporin-4 (AQP4) is the predominant water channel in brain and is selectively expressed in astrocytes. Astrocytic endfoot membranes exhibit tenfold higher densities of AQP4 than non-endfoot ...membranes, making AQP4 an excellent marker of astrocyte polarization. Loss of astrocyte polarization is known to compromise astrocytic function and to be associated with impaired water and K+ homeostasis. Here we investigate by a combination of light and electron microscopic immunocytochemistry whether amyloid deposition is associated with a loss of astrocyte polarization, using AQP4 as a marker. We used the tg-ArcSwe mouse model of Alzheimer's disease, as this model displays perivascular plaques as well as plaques confined to the neuropil. 3D reconstructions were done to establish the spatial relation between plaques and astrocytic endfeet, the latter known to contain the perivascular pool of AQP4. Changes in AQP4 expression emerge just after the appearance of the first plaques. Typically, there is a loss of AQP4 from endfoot membranes at sites of perivascular amyloid deposits, combined with an upregulation of AQP4 in the neuropil surrounding plaques. By electron microscopy it could be verified that the upregulation reflects an increased concentration of AQP4 in those delicate astrocytic processes that abound in synaptic regions. Thus, astrocytes exhibit a redistribution of AQP4 from endfoot membranes to non-endfoot membrane domains. The present data suggest that the development of amyloid deposits is associated with a loss of astrocyte polarization. The possible perturbation of water and K+ homeostasis could contribute to cognitive decline and seizure propensity in patients with Alzheimer's disease.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Background
Automated peritoneal dialysis (APD) is a growing PD modality but as with other home dialysis methods, the lack of monitoring of patients’ adherence to prescriptions is a limitation with ...potential negative impact on clinical outcome parameters. Remote patient monitoring (RPM) allowing the clinical team to have access to dialysis data and adjust the treatment may overcome this limitation. The present study sought to determine clinical outcomes associated with RPM use in incident patients on APD therapy.
Methods
A retrospective cohort study included 360 patients with a mean age of 57 years (diabetes 42.5%) initiating APD between 1 October 2016 and 30 June 2017 in 28 Baxter Renal Care Services (BRCS) units in Colombia. An RPM program was used in 65 (18%) of the patients (APD-RPM cohort), and 295 (82%) were treated with APD without RPM. Hospitalizations and hospital days were recorded over 1 year. Propensity score matching 1:1, yielding 63 individuals in each group, was used to evaluate the association of RPM exposure with numbers of hospitalizations and hospital days.
Results
After propensity score matching, APD therapy with RPM (n = 63) compared with APD-without RPM (n = 63) was associated with significant reductions in hospitalization rate (0.36 fewer hospitalizations per patient-year; incidence rate ratio IRR of 0.61 95% confidence interval (CI) 0.39 – 0.95; p = 0.029) and hospitalization days (6.57 fewer days per patient-year; IRR 0.46 95% CI 0.23 – 0.92; p = 0.028).
Conclusions
The use of RPM in APD patients is associated with lower hospitalization rates and fewer hospitalization days; RPM could constitute a tool for improvement of APD therapy.
Several studies have linked the KIBRA rs17070145 T polymorphism to superior episodic memory in healthy humans. One study investigated the effect of KIBRA on brain activation patterns ...(Papassotiropoulos et al., 2006) and observed increased hippocampal activation in noncarriers of the T allele during retrieval. Noncarriers were interpreted to need more hippocampal activation to reach the same performance level as T carriers. Using large behavioral (N = 2230) and fMRI (N = 83) samples, we replicated the KIBRA effect on episodic memory performance, but found increased hippocampal activation in T carriers during episodic retrieval. There was no evidence of compensatory brain activation in noncarriers within the hippocampal region. In the main fMRI sample, T carriers performed better than noncarriers during scanning but, importantly, the difference in hippocampus activation remained after post hoc matching according to performance, sex, and age (N = 64). These findings link enhanced memory performance in KIBRA T allele carriers to elevated hippocampal functioning, rather than to neural compensation in noncarriers.
Cerebral white matter lesions are frequently observed on magnetic resonance imaging (MRI) scans in elderly people and are associated with stroke and dementia. Elevated blood pressure is presumed one ...of the main risk factors, although data are almost exclusively derived from cross-sectional studies. We assessed in 10 European cohorts the relation between concurrently and previously measured blood pressure levels, hypertension, its treatment, and severe cerebral white matter lesions. In total, 1805 nondemented subjects aged 65 to 75 years were sampled from ongoing community-based studies that were initiated 5 to 20 years before the MRI. White matter lesions in the periventricular and subcortical region were rated separately using semiquantitative measures. We performed logistic regression analyses adjusted for potential confounders in 1625 people with complete data. Concurrently and formerly assessed diastolic and systolic blood pressure levels were positively associated with severe white matter lesions. Both increases and decreases in diastolic blood pressure were associated with more severe periventricular white matter lesions. Increase in systolic blood pressure levels was associated with more severe periventricular and subcortical white matter lesions. People with poorly controlled hypertension had a higher risk of severe white matter lesions than those without hypertension, or those with controlled or untreated hypertension. Higher blood pressure was associated with an increased risk of severe white matter lesions. Successful treatment of hypertension may reduce this risk; however, a potential negative effect of decreasing diastolic blood pressure level on the occurrence of severe periventricular white matter lesions should be taken into account.
Livebirth after uterus transplantation Brännström, Mats, Prof; Johannesson, Liza, MD; Bokström, Hans, MD ...
The Lancet (British edition),
02/2015, Letnik:
385, Številka:
9968
Journal Article
Recenzirano
Odprti dostop
Summary Background Uterus transplantation is the first available treatment for absolute uterine infertility, which is caused by absence of the uterus or the presence of a non-functional uterus. ...Eleven human uterus transplantation attempts have been done worldwide but no livebirth has yet been reported. Methods In 2013, a 35-year-old woman with congenital absence of the uterus (Rokitansky syndrome) underwent transplantation of the uterus in Sahlgrenska University Hospital, Gothenburg, Sweden. The uterus was donated from a living, 61-year-old, two-parous woman. In-vitro fertilisation treatment of the recipient and her partner had been done before transplantation, from which 11 embryos were cryopreserved. Findings The recipient and the donor had essentially uneventful postoperative recoveries. The recipient's first menstruation occurred 43 days after transplantation and she continued to menstruate at regular intervals of between 26 and 36 days (median 32 days). 1 year after transplantation, the recipient underwent her first single embryo transfer, which resulted in pregnancy. She was then given triple immunosuppression (tacrolimus, azathioprine, and corticosteroids), which was continued throughout pregnancy. She had three episodes of mild rejection, one of which occurred during pregnancy. These episodes were all reversed by corticosteroid treatment. Fetal growth parameters and blood flows of the uterine arteries and umbilical cord were normal throughout pregnancy. The patient was admitted with pre-eclampsia at 31 full weeks and 5 days, and 16 h later a caesarean section was done because of abnormal cardiotocography. A male baby with a normal birthweight for gestational age (1775 g) and with APGAR scores 9, 9, 10 was born. Interpretation We describe the first livebirth after uterus transplantation. This report is a proof-of-concept for uterus transplantation as a treatment for uterine factor infertility. Furthermore, the results show the feasibility of live uterus donation, even from a postmenopausal donor. Funding Jane and Dan Olsson Foundation for Science.
In a future fossil-free circular economy, the petroleum-based plastics industry must be converted to non-fossil feedstock. A known alternative is bio-based plastics, but a relatively unexplored ...option is deriving the key plastic building blocks, hydrogen and carbon, from electricity through electrolytic processes combined with carbon capture and utilization technology. In this paper the future demand for electricity and carbon dioxide is calculated under the assumption that all plastic production is electricity-based in the EU by 2050. The two most important input chemicals are ethylene and propylene and the key finding of this paper is that the electricity demand to produce these are estimated to 20 MWh/ton ethylene and 38 MWh/ton propylene, and that they both could require about 3 tons of carbon dioxide/ton product. With constant production levels, this implies an annual demand of about 800 TWh of electricity and 90 Mton of carbon dioxide by 2050 in the EU. If scaled to the total production of plastics, including all input hydrocarbons in the EU, the annual demand is estimated to 1600 TWh of electricity and 180 Mton of carbon dioxide. This suggests that a complete shift to electricity-based plastics is possible from a resource and technology point of view, but production costs may be 2 to 3 times higher than today. However, the long time frame of this paper creates uncertainties regarding the results and how technical, economic and social development may influence them. The conclusion of this paper is that electricity-based plastics, integrated with bio-based production, can be an important option in 2050 since biomass resources are scarce, but electricity from renewable sources is abundant.
•Scenarios were set up to explore electricity and carbon dioxide based plastics.•Potential demands were calculated and extrapolated for all plastics in the EU.•The electricity need for the plastic production was estimated to 1600 TWh.•The carbon dioxide need for the plastic production was estimated to 180 Mton.
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