Zero energy consumption.The goal sounds simple and is presented excessively in variations all over the world.Energy and environmental politics demand zero consumption as a long-term goal,marketing has discovered the c...Zero energy consumption.The goal sounds simple and is presented excessively in variations all over the world.Energy and environmental politics demand zero consumption as a long-term goal,marketing has discovered the concept and fi rst buildings and settlements aiming at balanced energy or emission budgets have been constructed.As an example,the German Federal Government specifi es in its fi fth energy research programme(2005):For new buildings,the goal is to reduce the primary energy demand,i.e.the energy demand for heating,domestic hot water,ventilation,air-conditioning,lighting and auxiliary energy,again by half compared to the current state of the art.The long-term goal is zero-emission buildings.England and the USA aim for zero carbon developments and net-zero energy buildings(DOE,2009)in political programmes.The Vatican accepted the offer of climatic“indulgence”—and thus became the fi rst country in the world to completely compensate its carbon emission(Spiegel online,2007).Megaprojects in the growth regions of the Arabian Gulf and China advertise with a CO2-neutral balance.A Zero Carbon Community is to be created in Masdar,Abu Dhabi(Foster,2007),and the fi rst Chinese carbon-neutral ecocity was planned for Dongtan,Shanghai(Pearce,2009).Not only to aid international communication,but also to further the processes required to solve energy-related problems,it is essential that key words,central concepts,their usage and their relationships be clarifi ed.This article intends to contribute to this clarifi cation based on the monitored example of a solar estate.Net zero energy building,equilibrium building,carbon neutral city—the accounting method varies,depending on motivation and point of view.If the focus is on fi nite and scarce resources,energy is the currency;CO2-equivalent emissions are considered if global warming and public health is the issue;the cost of energy is what concerns a tenant paying for heating and electricity.A balance in one set of units can be converted to another,but the conversion factors often also shift the balance point.Energy will be used as the reference quantity in the following article,which prevents confusion with non-energy measures(e.g.carbon credits for forestry)and avoids the nuclear power debate,in which nuclear power is partly calculated as being CO2 neutral.The diversity of concepts is an indicator that a scientifi cally based methodology is still lacking,though initial publications focus hereon(Pless et al.2009).Since October 2008,a group of experts in the International Energy Agency has been addressing this issue under the heading,Towards Net Zero Energy Solar Buildings(Riley et al.2008).The goal is to document and analyse outstanding examples that are close to being net zero-energy buildings,and while doing so,to develop the methodology and tools for working with such buildings.The Chair of Technical Building Services,University of Wuppertal,is co-ordinating the methodological work.The zero-energy approach—still under construction—will here be presented using a solar estate as an illustration.展开更多
Patient prognosis after transjugular intrahepatic portosystemic shunt(TIPS)placement is relatively poor and highly heterogeneous;therefore,a prognostic scoring system is essential for survival prediction and risk stra...Patient prognosis after transjugular intrahepatic portosystemic shunt(TIPS)placement is relatively poor and highly heterogeneous;therefore,a prognostic scoring system is essential for survival prediction and risk stratification.Conventional scores include the Child–Turcotte–Pugh(CTP)and model for end‐stage liver disease(MELD)scores.The CTP score was created empirically and displayed a high correlation with post‐TIPS survival.However,the inclusion of subjective parameters and the use of discrete cut‐offs limit its utility.The advantages of the MELD score include its statistical validation and objective and readily available predictors that contribute to its broad application in clinical practice to predict post‐TIPS outcomes.In addition,multiple modifications of the MELD score,by incorporating additional predictors(e.g.,MELD‐Sodium and MELD‐Sarcopenia scores),adjusting coefficients(recalibrated MELD score),or combined(MELD 3.0),have been proposed to improve the prognostic ability of the standard MELD score.Despite several updates to conventional scores,a prognostic score has been proposed(based on contemporary data)specifically for outcome prediction after TIPS placement.However,this novel score(the Freiburg index of post‐TIPS survival,FIPS)exhibited inconsistent discrimination in external validation studies,and its superiority over conventional scores remains undetermined.Additionally,several tools display potential for application in specific TIPS indications(e.g.,bilirubin‐platelet grade for refractory ascites),and biomarkers of systemic inflammation,nutritional status,liver disease progression,and cardiac decompensation may provide additional value,but require further validation.Future studies should consider the effect of TIPS placement when exploring predictors,as TIPS is a pathophysiological approach that substantially alters systemic hemodynamics and ameliorates bacterial translocation and malnutrition.展开更多
文摘Zero energy consumption.The goal sounds simple and is presented excessively in variations all over the world.Energy and environmental politics demand zero consumption as a long-term goal,marketing has discovered the concept and fi rst buildings and settlements aiming at balanced energy or emission budgets have been constructed.As an example,the German Federal Government specifi es in its fi fth energy research programme(2005):For new buildings,the goal is to reduce the primary energy demand,i.e.the energy demand for heating,domestic hot water,ventilation,air-conditioning,lighting and auxiliary energy,again by half compared to the current state of the art.The long-term goal is zero-emission buildings.England and the USA aim for zero carbon developments and net-zero energy buildings(DOE,2009)in political programmes.The Vatican accepted the offer of climatic“indulgence”—and thus became the fi rst country in the world to completely compensate its carbon emission(Spiegel online,2007).Megaprojects in the growth regions of the Arabian Gulf and China advertise with a CO2-neutral balance.A Zero Carbon Community is to be created in Masdar,Abu Dhabi(Foster,2007),and the fi rst Chinese carbon-neutral ecocity was planned for Dongtan,Shanghai(Pearce,2009).Not only to aid international communication,but also to further the processes required to solve energy-related problems,it is essential that key words,central concepts,their usage and their relationships be clarifi ed.This article intends to contribute to this clarifi cation based on the monitored example of a solar estate.Net zero energy building,equilibrium building,carbon neutral city—the accounting method varies,depending on motivation and point of view.If the focus is on fi nite and scarce resources,energy is the currency;CO2-equivalent emissions are considered if global warming and public health is the issue;the cost of energy is what concerns a tenant paying for heating and electricity.A balance in one set of units can be converted to another,but the conversion factors often also shift the balance point.Energy will be used as the reference quantity in the following article,which prevents confusion with non-energy measures(e.g.carbon credits for forestry)and avoids the nuclear power debate,in which nuclear power is partly calculated as being CO2 neutral.The diversity of concepts is an indicator that a scientifi cally based methodology is still lacking,though initial publications focus hereon(Pless et al.2009).Since October 2008,a group of experts in the International Energy Agency has been addressing this issue under the heading,Towards Net Zero Energy Solar Buildings(Riley et al.2008).The goal is to document and analyse outstanding examples that are close to being net zero-energy buildings,and while doing so,to develop the methodology and tools for working with such buildings.The Chair of Technical Building Services,University of Wuppertal,is co-ordinating the methodological work.The zero-energy approach—still under construction—will here be presented using a solar estate as an illustration.
基金National Natural Science Foundation of China,Grant/Award Number:81873917。
文摘Patient prognosis after transjugular intrahepatic portosystemic shunt(TIPS)placement is relatively poor and highly heterogeneous;therefore,a prognostic scoring system is essential for survival prediction and risk stratification.Conventional scores include the Child–Turcotte–Pugh(CTP)and model for end‐stage liver disease(MELD)scores.The CTP score was created empirically and displayed a high correlation with post‐TIPS survival.However,the inclusion of subjective parameters and the use of discrete cut‐offs limit its utility.The advantages of the MELD score include its statistical validation and objective and readily available predictors that contribute to its broad application in clinical practice to predict post‐TIPS outcomes.In addition,multiple modifications of the MELD score,by incorporating additional predictors(e.g.,MELD‐Sodium and MELD‐Sarcopenia scores),adjusting coefficients(recalibrated MELD score),or combined(MELD 3.0),have been proposed to improve the prognostic ability of the standard MELD score.Despite several updates to conventional scores,a prognostic score has been proposed(based on contemporary data)specifically for outcome prediction after TIPS placement.However,this novel score(the Freiburg index of post‐TIPS survival,FIPS)exhibited inconsistent discrimination in external validation studies,and its superiority over conventional scores remains undetermined.Additionally,several tools display potential for application in specific TIPS indications(e.g.,bilirubin‐platelet grade for refractory ascites),and biomarkers of systemic inflammation,nutritional status,liver disease progression,and cardiac decompensation may provide additional value,but require further validation.Future studies should consider the effect of TIPS placement when exploring predictors,as TIPS is a pathophysiological approach that substantially alters systemic hemodynamics and ameliorates bacterial translocation and malnutrition.
