Presentasjon av casestudier i REBO

Copyright SINTEF akademisk forlag 201

Iodine-123 metaiodobenzylguanidine scintigraphic assessment of the transplanted human heart: Evidence for late reinnervation

Objectives.This study attempted to determine whether cardiac sympathetic reinnervation occurs late after orthotopic heart transplantation.Background.Metaiodobenzylguanidine (MIBG) is taken up by myocardial sympathetic nerves. Iodine-123 (I-123) MIBG cardiac uptake reflects intact myocardial sympathetic innervation of the heart. Cardiac transplant recipients do not demonstrate I-123 MIBG cardiac uptake when studied <6 months from transplantation. However, physiologic and biochemical studies suggest that sympathetic reinnervation of the heart can occur >1 year after transplantation.Methods.We performed serial cardiac I-123 MIBG imaging in 23 cardiac transplant recipients early (<-1 year) and late (>1 year) after operation. In 16 subjects transmyocardial norepinephrine release was measured late after transplantation.Results.No subject had visible I-123 MIBG uptake on imaging <1 year after transplantation. However, 11 (48%) of 23 subjects developed visible cardiac I-123 MIBG uptake 1 to 2 years after transplantation. Only 3 (25%) of 12 subjects with a pretransplantation diagnosis of idiopathic cardiomyopathy demonstrated I-123 MIBG uptake compared with 8 (73%) of 11 with a pretransplantation diagnosis of ischemic or rheumatic heart disease (p = 0.04). All 10 subjects with a net myocardial release of norepinephrine had cardiac I-123 MIBG uptake; all 6 subjects without a net release of norepinephrine had no cardiac I-123 MIBG uptake.Conclusions.Sympathetic reinnervation of the transplanted human heart can occur >1 year after operation, as assessed by I-123 MIBG imaging and the transmyocardial release of norepinephrine. Reinnervation is less likely to occur in patients with a pretransplantation diagnosis of idiopathic cardiomyopathy than in those with other etiologies of congestive heart failure

Strategies for a nearly Zero-Energy Building market transition in the European Union

European legislation makes nearly Zero-Energy Buildings (nZEBs) a standard by 2020. The technology is available and proven; however, the large-scale uptake of nZEB construction and renovation remains a challenge. ZEBRA2020 monitored the market uptake of nZEBs across Europe and provided data and knowledge on how to reach the nZEB standard. This information was structured and analysed to derive recommendations. ZEBRA2020 covers 17 European countries and almost 90% of the EU/EEA building stock and population. The online data tools provide unique information regarding nZEB market development and nZEB characteristics. New approaches have been developed in order to allow for a better comparability of national data. However, the absence or difficult accessibility to key data and in particular for non-residential and existing buildings as well as for renovations remains an important obstacle. The online nZEB tracker, based on a set of criteria, assesses the nZEB market maturity. On EU-level, the tracker shows a substantial gap of market maturity that still has to be closed by 2019/2021. A set of barriers and related recommendations have been identified both at national and EU level: The implementation of a common, shared long-term vision for the building stock is crucial. A quantitative comparison of national nZEB definitions is complex due to different system boundaries, calculation methodologies, applied factors etc. However, our analysis indicates that a significant share of nZEB definitions does not meet the intention of the EU directive on energy efficient buildings (EPBD) that the energy consumption should be “nearly zero or very low amount” and the remaining part “should be covered to a very significant extent by energy from renewable sources”. Thus, the new EPBD requires clear definitions of these terms and thresholds. Further, it is important to distinguish between new buildings and renovations – despite of a common nZEB definition for both cases. The nZEB compliance monitoring and sanctions regimes need improvement. Only about half of the covered Member States monitor the compliance of new buildings with energy performance requirements. The lack of professional skills continues to be an important barrier and should remain a focus, especially in case of new built. In many Member States, the reliability and credibility of Energy Performance Certificates (EPC) is often questioned by actors on the real estate market. Transforming EPCs into Building Certificates (“Passes”) for the whole lifetime of a building may increase credibility and serve as a key measure to foster building renovation towards an nZEB standard. Storage of building data in an electronically accessible national database may contribute to better data availability. Energy poverty and vulnerable consumers are a European-wide issue and need further attention. Shifting from fuel subsidy to energy efficiency support is required. Future-proof buildings will be highly-efficient micro energy-hubs consuming, producing, storing and supplying energy. A revised nZEB definition should be future-proofed to be a smart building and district-ready.publishedVersio

Good details for concrete constructions in Passive Houses : FA 1.2 Insulating and energy preserving concrete : SP 1.2.2 Atlas of good construction details for concrete structures to be used in the passive house concept

The present report is mainly a reference source covering details in concrete constructions with low thermal bridge values, in many cases also showing specific air tightness measures. Chapter 2 describes the Passive House concept, including definitions, criteria and main principles, and also methods to achieve low thermal bridge values and sufficient air tightness. In this context, the term thermal bridge free design and calculation methods are discussed. Chapter 0 and 4 give a survey of existing guidelines and recent research results, on which the comprehensive list of details in chapter 0 is based. The details are arranged according to their position related to the building envelope. Every detail contains a description of the construction (in most cases including related U-values), a drawing and corresponding thermal bridge values. In addition, some overviews of foundation and support solutions as well as thermal separation products and U-values for fixing devices are compiled in the annex. This topic requires divulgation at a national level. For that reason, the report has been written in Norwegian and the translation is limited to this summary.publishedVersion3D00624

Energisparekontrakter ved oppgradering av boligblokker. Hva kunne vært oppnådd i Myhrerengaprosjektet – casestudie

Rapporten drøfter i hvilken grad energisparekontrakter (EPC) kan bidra til energivennlige boligbygninger ved rehabilitering, sett opp mot andre gjennomføringsmodeller for ambisiøs oppgradering. Case er Myhrerenga borettslag, som gjennomgikk Norges første passivhusrehabilitering i 2006 til 2011. I fire scenarier diskuteres muligheter og begrensninger ved EPC i en slik boligrehabilitering, til nytte blant annet for rådgivere og styrer som skal ta beslutning om oppgradering og organisering av arbeidene

Good details for concrete constructions in Passive Houses : FA 1.2 Insulating and energy preserving concrete : SP 1.2.2 Atlas of good construction details for concrete structures to be used in the passive house concept

The present report is mainly a reference source covering details in concrete constructions with low thermal bridge values, in many cases also showing specific air tightness measures. Chapter 2 describes the Passive House concept, including definitions, criteria and main principles, and also methods to achieve low thermal bridge values and sufficient air tightness. In this context, the term thermal bridge free design and calculation methods are discussed. Chapter 0 and 4 give a survey of existing guidelines and recent research results, on which the comprehensive list of details in chapter 0 is based. The details are arranged according to their position related to the building envelope. Every detail contains a description of the construction (in most cases including related U-values), a drawing and corresponding thermal bridge values. In addition, some overviews of foundation and support solutions as well as thermal separation products and U-values for fixing devices are compiled in the annex. This topic requires divulgation at a national level. For that reason, the report has been written in Norwegian and the translation is limited to this summary

Ambisiøs energioppgradering med etterisolert fasade. Fuktsikre løsninger for yttervegger og overganger i mur- og betongbygg

Det er viktig å samordne energieffektivisering med øvrig fasaderehabilitering ut fra et helthetlig konsept for bygningen.Denne rapporten viser gode, fuktsikre løsninger som gir grunnlag for energiambisiøs oppgradering når det er behov for rehabilitering. Rapporten – som er et resultat av prosjektet Upgrade Solutions – tar utgangspunkt i yrkesbygg, men løsninger og prinsipper kan også være aktuelle i boligbygg med liknende konstruksjoner

Energisparekontrakter ved oppgradering av boligblokker. Hva kunne vært oppnådd i Myhrerengaprosjektet – casestudie

Rapporten drøfter i hvilken grad energisparekontrakter (EPC) kan bidra til energivennlige boligbygninger ved rehabilitering, sett opp mot andre gjennomføringsmodeller for ambisiøs oppgradering. Case er Myhrerenga borettslag, som gjennomgikk Norges første passivhusrehabilitering i 2006 til 2011. I fire scenarier diskuteres muligheter og begrensninger ved EPC i en slik boligrehabilitering, til nytte blant annet for rådgivere og styrer som skal ta beslutning om oppgradering og organisering av arbeidene