Energy efficiency in Väätsa retirement home – the role of monitoring in analysis and proposed model for energy optimization

Hoonete energiatõhusus on aktuaalne kogu maailmas. Hoonete monitooring energiatõhustamise meetmena on seejuures taastuvate energiaallikate kõrval kujunemas väga vajalikuks ja oluliseks viisiks optimeeritud tarbimise suunas. Antud töö eesmärgiks oli keskenduda hoonete monitooringu olulisusele ja seeläbi välja selgitada, kuidas hinnata opereeriva hoone toimivust energiatõhususe aspektist lähtuvalt, leida hoone mõõtmisandmete kaudu energiakasutuse kitsaskohad ning pakkuda energiakasutuse optimeerimist teoreetilise mudeli kaudu. Töös on kasutatud hoone mõõtmisandmeid üheaastase perioodi vältel. Andmeanalüüsi on teostatud empiriilise uurimise kaudu ning optimeerimislahenduste osas on kasutatud normaalvõrrandi meetodit ja mitme muutujaga lineaarse regressiooni algoritmi. Magistritöö tulemusena leiti, et hoone järjepidev monitooring on energiakasutuse optimeerimise aluseks juhul kui neid andmeid analüüsitakse, andmete jälgimine ja esitamine peavad olema tehtud võimalikult lihtsaks. Sisekliima parameetrite analüüsist selgus, et hoone sisetemperatuur on keskmiselt 1,5 kraadi kõrgem ning ventilatsioonisüsteemi õhuvahetuskordsus on liiga suur. Tulemusena on hoones 31% kavandatust suurem soojusenergiakulu ja 17% suurem elektrienergiakulu. Päikesenergiaga suudeti katta hoone elektrienergia vajadus 14% ulatuses ning sooja tarbevee energiat 28%. Optimeerimislahendusena välja töötatud mudeliga suudeti hoone koguenergiakulu vähendada 10,2%. Jätku-uuringutena oleks vaja mudelit katsetada energiatõhususe parameetritega koosmõju puhul ning välja töötada toimiv hoonete energiatõhustamise optimeerimismudel.Household energy efficiency is a hot topic worldwide. Building monitoring system as an energy efficiency measure is becoming a necessary addition to the use of renewable energies in the energy optimization. The objective of this work is to focus on the importance of building monitoring system and thereby to identify how to evaluate performance of a building in operation. How to find energy efficiency shortcomings of the recorded data. It also aims to present guidelines based on a theoretical model. The data is collected during a period of one year. The data analysis is performed using an empirical method and the optimization is applied using the linear optimization algorithm. It was concluded that the constant building monitoring is the base of energy use optimization assuming the data is analyzed. The presentation must be made as simple as possible. Indoor climate parameters analysis showed that building's room temperatures were 1,5 degrees higher than planned and too much ventilation takes places, which causes excessively high energy consumption. As a result the building's heating energy consumption was 31% more than designed. The same number for electric energy was 17% higher. 14% of the electric energy and 28% of water heating needs were covered by solar power. The composed model for optimization was able to lower the energy needs by 10,2%. More work should be performed to test the interaction of the influencing parameters in order to develop a working optimization model

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

A Survey of Empirical Results on Program Slicing

International audienceBACKGROUND:Patients with peripheral artery disease have an increased risk of cardiovascular morbidity and mortality. Antiplatelet agents are widely used to reduce these complications.METHODS:This was a multicentre, double-blind, randomised placebo-controlled trial for which patients were recruited at 602 hospitals, clinics, or community practices from 33 countries across six continents. Eligible patients had a history of peripheral artery disease of the lower extremities (previous peripheral bypass surgery or angioplasty, limb or foot amputation, intermittent claudication with objective evidence of peripheral artery disease), of the carotid arteries (previous carotid artery revascularisation or asymptomatic carotid artery stenosis of at least 50%), or coronary artery disease with an ankle-brachial index of less than 0·90. After a 30-day run-in period, patients were randomly assigned (1:1:1) to receive oral rivaroxaban (2·5 mg twice a day) plus aspirin (100 mg once a day), rivaroxaban twice a day (5 mg with aspirin placebo once a day), or to aspirin once a day (100 mg and rivaroxaban placebo twice a day). Randomisation was computer generated. Each treatment group was double dummy, and the patient, investigators, and central study staff were masked to treatment allocation. The primary outcome was cardiovascular death, myocardial infarction or stroke; the primary peripheral artery disease outcome was major adverse limb events including major amputation. This trial is registered with ClinicalTrials.gov, number NCT01776424, and is closed to new participants.FINDINGS:Between March 12, 2013, and May 10, 2016, we enrolled 7470 patients with peripheral artery disease from 558 centres. The combination of rivaroxaban plus aspirin compared with aspirin alone reduced the composite endpoint of cardiovascular death, myocardial infarction, or stroke (126 [5%] of 2492 vs 174 [7%] of 2504; hazard ratio [HR] 0·72, 95% CI 0·57-0·90, p=0·0047), and major adverse limb events including major amputation (32 [1%] vs 60 [2%]; HR 0·54 95% CI 0·35-0·82, p=0·0037). Rivaroxaban 5 mg twice a day compared with aspirin alone did not significantly reduce the composite endpoint (149 [6%] of 2474 vs 174 [7%] of 2504; HR 0·86, 95% CI 0·69-1·08, p=0·19), but reduced major adverse limb events including major amputation (40 [2%] vs 60 [2%]; HR 0·67, 95% CI 0·45-1·00, p=0·05). The median duration of treatment was 21 months. The use of the rivaroxaban plus aspirin combination increased major bleeding compared with the aspirin alone group (77 [3%] of 2492 vs 48 [2%] of 2504; HR 1·61, 95% CI 1·12-2·31, p=0·0089), which was mainly gastrointestinal. Similarly, major bleeding occurred in 79 (3%) of 2474 patients with rivaroxaban 5 mg, and in 48 (2%) of 2504 in the aspirin alone group (HR 1·68, 95% CI 1·17-2·40; p=0·0043).INTERPRETATION:Low-dose rivaroxaban taken twice a day plus aspirin once a day reduced major adverse cardiovascular and limb events when compared with aspirin alone. Although major bleeding was increased, fatal or critical organ bleeding was not. This combination therapy represents an important advance in the management of patients with peripheral artery disease. Rivaroxaban alone did not significantly reduce major adverse cardiovascular events compared with asprin alone, but reduced major adverse limb events and increased major bleeding