Structuring the Digital Energy Platform Jungle: Development of a Multi-Layer Taxonomy and Implications for Practice

Rising and volatile energy prices are forcing production companies to optimize their consumption patterns and reduce carbon emissions to remain competitive. Demand-side management (DSM) or energy flexibility (EF) is a promising option for the active management of electricity demand. With DSM, energy procurement costs can be effectively reduced, for example, by reducing peak loads and taking advantage of volatile energy prices. In addition, renewable energies can be better integrated to reduce carbon emissions while stabilizing the power grid. Although the benefits of DSM for production companies are well known, implementation is not yet widespread. A key barrier is the high requirements of IT systems and the associated effort and complexity involved in setting them up. Companies often lack appropriate IT systems or have historically grown systems that do not allow continuous communication from the machine to the energy market. A variety of different platforms promise solutions to address these challenges. However, when selecting platforms, it is often unclear which aspects and functionalities of a platform are relevant for a company’s specific application. To address this gap, we developed a multi-layer taxonomy of digital platforms for energy-related applications in the industry that includes a general, as well as a more specific data-centric and transaction-centric perspective. We develop, revise, and evaluate our taxonomy using insights from literature and analysis of 46 commercially available platforms or platforms developed through research projects. Based on our taxonomy, we derive implications for research and practice. Our results contribute to the descriptive knowledge of digital platforms in energy-related applications. Our taxonomy enables researchers and practitioners to classify such platforms and make informed decisions about their deployment

Speech Comprehension Difficulties in Chronic Tinnitus and Its Relation to Hyperacusis

Objective: Many tinnitus patients complain about difficulties regarding speech comprehension. In spite of the high clinical relevance little is known about underlying mechanisms and predisposing factors. Here, we performed an exploratory investigation in a large sample of tinnitus patients to (1) estimate the prevalence of speech comprehension difficulties among tinnitus patients, to (2) compare subjective reports of speech comprehension difficulties with behavioral measurements in a standardized speech comprehension test and to (3) explore underlying mechanisms by analyzing the relationship between speech comprehension difficulties and peripheral hearing function (pure tone audiogram), as well as with co-morbid hyperacusis as a central auditory processing disorder. Subjects and Methods: Speech comprehension was assessed in 361 tinnitus patients presenting between 07/2012 and 08/2014 at the Interdisciplinary Tinnitus Clinic at the University of Regensburg. The assessment included standard audiological assessments (pure tone audiometry, tinnitus pitch, and loudness matching), the Goettingen sentence test (in quiet) for speech audiometric evaluation, two questions about hyperacusis, and two questions about speech comprehension in quiet and noisy environments ("How would you rate your ability to understand speech?"; "How would you rate your ability to follow a conversation when multiple people are speaking simultaneously?"). Results: Subjectively-reported speech comprehension deficits are frequent among tinnitus patients, especially in noisy environments (cocktail party situation). 74.2% of all investigated patients showed disturbed speech comprehension (indicated by values above 21.5 dB SPL in the Goettingen sentence test). Subjective speech comprehension complaints (both for general and in noisy environment) were correlated with hearing level and with audiologically-assessed speech comprehension ability. In contrast, co-morbid hyperacusis was only correlated with speech comprehension difficulties in noisy environments, but not with speech comprehension difficulties in general. Conclusion: Speech comprehension deficits are frequent among tinnitus patients. Whereas speech comprehension deficits in quiet environments are primarily due to peripheral hearing loss, speech comprehension deficits in noisy environments are related to both peripheral hearing loss and dysfunctional central auditory processing. Disturbed speech comprehension in noisy environments might be modulated by a central inhibitory deficit. In addition, attentional and cognitive aspects may play a role

Expression of pH-Sensitive TRPC4 in Common Skin Tumors

TRPCs (transient receptor potential classical or cation channels) play a crucial role in tumor biology, especially in the Ca2+ homeostasis in cancer cells. TRPC4 is a pH-sensitive member of this family of proteins. As solid tumors exhibit an inversed pH-gradient with lowered extracellular and increased intracellular pH, both contributing to tumor progression, TRPC4 might be a signaling molecule in the altered tumor microenvironment. This is the first study to investigate the expression profiles of TRPC4 in common skin cancers such as basal cell carcinoma (BCC), squamous cell carcinoma (SCC), malignant melanoma (MM) and nevus cell nevi (NCN). We found that all SCCs, NCNs, and MMs show positive TRPC4-expression, while BCCs do only in about half of the analyzed samples. These data render TRPC4 an immunohistochemical marker to distinguish SCC and BCC, and this also gives rise to future studies investigating the role of TRPC4 in tumor progression, and especially metastasis as BCCs very rarely spread and are mostly negative for TRPC4

Occurence of a round window membrane rupture in patients with sudden sensorineural hearing loss

BACKGROUND: Aim of the present study was to evaluate the occurence of a round window membrane rupture and the effects of hearing restoration after exploratory tympanotomy and sealing of the round window (niche) in patients with unilateral sudden deafness. METHODS: Retrospective analysis of patients' charts in a tertiary referral center. Charts of 69 patients with sudden deafness followed by exploratory tympanotomy were retrospectively analyzed. Pure-tone audiometry data before and after tympanotomy were compared to determine the outcome of hearing recovery. The postoperative hearing test values were documented 3 weeks after tympanotomy. All surgical reports were reviewed with regard to the surgical technique performed and the intraoperative findings. RESULTS: 18.8% of the patients revealed a visible perilymphatic fistula in the round window niche. 89.8% of the patients reported no typical history for a round window membrane rupture. All patients were treated with an exploratory tympanotomy under local anesthesia and an intravenous corticosteroid treatment regimen. The majority of the surgeons used a fat plomb to cover the round window. Postoperative hearing was significantly improved compared to the preoperative hearing test data. No patient showed a worsened hearing curve after the treatment. CONCLUSION: Most patients suffering from unilateral sudden deafness had no visible perilymphatic fistula. In our study population, the majority of patients reported no typical history of a pressure elevation in the inner ear. Exploratory tympanotomy is a safe procedure that may support hearing recovery in patients with sudden deafness in addition to the established treatment regimen including high-dose steroids

A comparison of cell survival and heat shock protein expression after radiation in normal dermal fibroblasts, microvascular endothelial cells, and different head and neck squamous carcinoma cell lines

Head and neck squamous cell carcinoma (HNSCC) shows increased radioresistance due to the manipulation of homeostatic mechanisms like the heat shock response. This study intended to comparatively analyze effects of ionizing radiation on different HNSCC cell lines (PCI) and normal human dermal fibroblasts (NHFs) and human dermal microvascular endothelial cells (HDMECs) to uncover differences in radiation coping strategies. Proliferation (BrdU assay), apoptosis (caspase 3/7) and intracellular protein expression of heat shock protein (HSP)-70, and phosphorylated and total HSP27, determined by enzyme-linked immunosorbent assay (ELISA), were analyzed after exposure to increasing doses of ionizing radiation (2, 6, and 12 Gray, Gy). Cell count decreased dose-dependently, but PCI cell lines consistently showed higher numbers compared to NHF and HDMEC. Likewise, high doses reduced cell proliferation, but low-dose radiation (2 Gy) instead increased proliferation in PCI 9 and 52. Apoptosis was not detectable in PCI cell lines. Basic HSP70 expression was high in PCI cells with little additional increase by irradiation. PCI cells yielded high basic total HSP27 concentrations but irradiation dose-dependently increased HSP27 in HDMEC, NHF, and PCI cells. Phosphorylated HSP27 concentrations were highest in NHF. PCI cell lines showed higher resistance to dose-dependent reduction in cell number, proliferation, and protection from apoptosis compared to NHF and HDMEC. In parallel, we observed a high basic and radiation-induced expression of intracellular HSP70 leading to the assumption that the radioresistance of PCI cells is conferred by HSP70. HNSCC use HSP to escape radiation-induced apoptosis and certain subtypes might increase proliferation after low-dose irradiation

The role of soluble adhesion molecules and cytokines in sudden sensorineural hearing loss

OBJECTIVE: The underlying pathology of sudden sensorineural hearing loss (SSNHL) is still not completely understood. Inflammatory and vascular factors are part of the present discussion. The aim of this study was to learn more about the possible role of adhesion molecules and cytokines in patients with SSNHL. These molecules are thought to contribute to endothelial dysfunction. STUDY DESIGN: Case-control study with planned data collection. SETTING: Tertiary referral center. SUBJECTS AND METHODS: Blood samples of 35 patients presenting with SSNHL of more than 30 dB in at least 3 contiguous frequencies were compared to a gender- and age-matched control group of normal-hearing subjects. Levels of the soluble adhesion molecules intercellular adhesion molecule (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1), endothelial selectin (E-selectin), and concentration of interleukin 6 (IL-6), interleukin 8 (IL-8), and monocyte chemoattractant protein 1 (MCP-1) were measured using established enzyme-linked immunosorbent assays. These parameters as well as fibrinogen and lipid values were statistically analyzed. RESULTS: Levels of soluble ICAM-1, VCAM-1, E-selectin, IL-6, IL-8, and MCP-1 were not significantly elevated in patients with SSNHL. The clinical chemistry and hematologic determinations showed no significant differences between patients and control subjects. CONCLUSION: This study revealed no association concerning SSNHL and typical vascular risk factors such as lipids and fibrinogen. Soluble adhesion molecules were not elevated in the SSNHL group. The role of endothelial dysfunction represented by increased levels of soluble adhesion molecules in the pathogenesis of SSNHL remains unclear. Further studies are necessary to elucidate the vascular etiology of SSNHL

Subgroups in the treatment of nasal polyposis with dupilumab A retrospective study

Dupilumab has been shown to be safe and effective in treating chronic rhinosinusitis with polyposis (CRSwNP). There is to this date no published data whether subgroups like patients with aspirin exacerbated respiratory disease (AERD), increased histologic eosinophilia or elevated blood eosinophil or IgE-levels benefit greater from dupilumab therapy. Moreover, there is no data comparing the efficacy of functional endoscopic sinus surgery (FESS) with dupilumab therapy. We conducted a retrospective chart review of all patients that were treated at a tertiary referral center for CRswNP with dupilumab. We also contacted the patients with a questionnaire to evaluate the efficacy of previous surgeries and dupilumab therapy by visual analogue scale (VAS) and the glasgow benefit inventory (GBI) as well as report on side effects. Overall, 75 patients were included in the study at hand that reported back 138 times. While dupilumab treatment was efficient, we found no systematic evidence of greater efficacy of dupilumab in patients with AERD, histologic eosinophilia or increased blood eosinophil or IgE-levels. All patients showed a considerable decrease in subjective burden of disease, objective smell tests and endoscopic findings. From the patients point of view, dupilumab therapy showed greater efficacy both in the VAS and the GBI overall and all subcategories but social support. Dupilumab is efficient in treating CRSwNP;this effect is independent from disease characteristics like AERD, histologic eosinophilia, serum IgE-levels or eosinophil counts. There seems to be a group of patients that benefit greater from dupilumab therapy compared to FESS

Biological predictors of radiosensitivity in head and neck squamous cell carcinoma

The aim of this study is to investigate the influence of prognostic biomarkers on radiosensitivity and survival of advanced head and neck squamous cell carcinomas treated by primary (chemo)radiation. The clinicopathological data and immunohistochemical staining of p16, c-Met, survivin, PD-1, and PD-L1 of 82 primarily (chemo)irradiated patients with head and neck squamous cell carcinoma were analyzed. Associations with local and locoregional radiation response, overall survival (OS), disease-free (DFS), and disease-specific survival (DSS) were assessed. Complete tumor response was associated with increased patient age (p = 0.007), N0-status (p = 0.022), M0-status (p = 0.007), and p16-positivity (p = 0.022). High PD-L1 was associated with M0-status (p = 0.026) and indicated tumor response to irradiation (p = 0.057); survivin expression showed higher rates of response failure (p = 0.073). Low PD-1 was associated with increased T-stage (p = 0.029) and local recurrence (p = 0.014). High PD-1 was strongly correlated with PD-L1-positive tumor infiltrating lymphocytes (p < 0.001). Low PD-L1 showed a significant correlation with high c-Met expression (p = 0.01). Significant predictors for unfavorable univariate survival were incomplete tumor response (DSS, p < 0.001), single radiotherapy (DSS, p = 0.002), M1-status (DSS, p < 0.001), decreased radiation dose (DSS, p = 0.014), high survivin (DSS, p = 0.045), and high c-Met (OS, p < 0.05). Survivin and c-Met also showed prognostic significance in multivariate survival analysis. P16 and PD-L1 indicate radiosensitivity, whereas survivin and c-Met implicate radioresistance in primarily (chemo)irradiated head and neck squamous cell carcinomas. The role of the PD-1/PD-L1 immune checkpoints in radiation response and survival merits further investigation. The findings may improve patient-specific therapy according to individual tumor characteristics

NHE1 expression at wound margins increases time-dependently during physiological healing

Wound repair is an orchestrated process, encompassing the phases of inflammation, proliferation and tissue remodeling. In this context, sodium hydrogen exchanger 1 (NHE1) is crucial to epidermal barrier integrity and acidification. Recently, we found that extracellular pH (pHe) on wound surfaces is dramatically increased initially after barrier disruption, and that pHe decreases gradually during physiological healing. Additionally, we have shown that spatial NHE1-patterns account for pHe-gradients on surfaces of chronic wounds. Here, we show that NHE1-expression is very low at margins initially after wounding and that it increases massively during the time-course of physiolgical healing. This finding is in accordance with the decrease of pHe on wound surfaces, which we reported on in previous works. Thus, we show that NHE1 is an interesting target when it comes to modification of surface pHe on wounds, both acute and chronic, and that NHE1 is time-dependently regulated in physiological healing