Introdução: A síndrome do intestino curto (SIC) representa um estado clínico de má absorção grave, e a gestão dietética de pacientes com SIC é extremamente desafiadora. Uma vez que o grau de desnutrição é frequentemente considerável, a intervenção dietética bem sucedida depende da estimativa mais exata possível das necessidades energéticas para prever as metas da terapia nutricional. Objetivo: Quantificar o gasto energético total (GET) em pacientes com SIC pelo método da água duplamente marcada (ADM). Materiais e Métodos: Neste estudo observacional, o GET foi mensurado pelo método da água duplamente marcada em 22 voluntários, 11 com SIC e 11 controles pareados por sexo, idade e IMC (grupo Controle). O GET foi estimado pela equação de Escott-Stump e a partir de acelerômetro, e foi comparado com o GET determinado pela ADM. O gasto energético em repouso (GER) foi mensurado por calorimetria indireta (CI) e comparado com o GER estimado pela equação de Harris e Benedict. O acelerômetro também foi utilizado para estabelecer o nível de atividade física. Resultados: Os participantes tinham idade (média ± DP) de 53 ± 8 anos. O GET medido por ADM foi significativamente menor no grupo SIC comparado ao grupo Controle (p < 0,01); no entanto, o GET estimado não diferiu significativamente entre os grupos. O GET medido foi significativamente maior do que o GET estimado por fórmula no grupo SIC, (respectivamente 1875 ± 276 e 1517 ± 175 kcal/dia, p < 0,01), assim como para o grupo Controle (2393 ± 445 e 1532 ± 178 kcal/dia, p < 0,01). No entanto, o GET medido foi significativamente menor do que o GET predito a partir do acelerômetro no grupo SIC (2075 ± 298 kcal/dia, p = 0,02), e não diferiu significativamente no grupo Controle (2207 ± 355 kcal/dia, p = 0,21). Não foram verificadas diferenças significantes entre o GER medido e predito para ambos, e entre os grupos. Conclusão: O GET medido em pacientes com SIC foi significativamente maior do que o GET estimado por fórmula, e foi menor quando comparado com os valores dos sujeitos controles. No entanto, o GET estimado a partir do acelerômetro, superestima o GET medido por ADM. As fórmulas atualmente utilizadas na prática clínica parecem subestimar as necessidades de energia de pacientes com SIC. Desta forma, adaptações da estimativa atual, aumentando as prescrições de ingestão energética nestes pacientes parecem ser adequadas para apoiar as necessidades diárias de energia e evitar a subnutrição. / Background: Short bowel syndrome (SBS) is a serious malabsorption disorder, and dietetic management of SBS patients is extremely challenging. Once the degree of undernutrition has been assessed, successful dietary intervention depends on the most accurate estimation and provision of energy needs to provide nutritional therapy goals. Objective: To quantify total energy expenditure (TEE) in SBS patients using the doubly labeled water (DLW) method. Design: In this observational study, TEE was measured by the DLW method in 22 participants, 11 with SBS and 11 gender-age-and BMI-matched controls (Control group). Predicted energy requirements were determined using the Escott-Stump equation and by using and accelerometer, and they were compared with TEE determined with DLW. Resting energy expenditure (REE) was measured using indirect calorimetry and compared with predict REE using the Harris and Benedict equation. The accelerometer was also used to determine physical activity level. Results: Participants were aged (mean ± SD) 53 ± 8 years. Measured TEE was significantly lower in the SBS group compared to the Control group (p < 0.01); however, predicted TEE did not differ significantly between the groups. Measured TEE was significantly higher than predicted TEE for the SBS group, (1875 ± 276 and 1517 ± 175 kcal/d, p < 0.01) and also for the Control group (2393 ± 445 and 1532 ± 178 kcal/d, p < 0.01) when determined by formula. However, measured TEE was significantly lower than predicted TEE (2075 ± 298 kcal/d, p = 0.02) for the SBS group, and did not differ for the Control group (2207 ± 355 kcal/d, p = 0.21) when determined by accelerometer. No significant differences were seen between measured and predicted REE both within and between groups. Conclusion: Measured TEE in SBS patients was significantly higher than predicted using standard equations, but also lower than values for age, BMI and gender-matched non-SBS controls. However, predicted TEE using accelerometer overestimated the measured TEE. Currently-used formulas in clinical practice appear to underestimate energy requirements of SBS patients. Therefore, adjustments to the current estimation, increasing the energy intake requirements in these patients appear to be adequate to support the daily energy requirements and avoid undernutrition.

La croissance de la consommation par les villes de ressources naturelles est un facteur déterminant dans l’altération de la biosphère. Pour comprendre le processus du changement du rapport entre la ville et la biosphère, transition socioécologique dans le cas particulier de la ville, nous avons caractérisé la ville comme étant tributaire de la ressource externe en termes matériel et écologique. On s'intéresse dans ce travail à la relation entre la demande en énergie de la ville, l'évolution du système d'approvisionnement urbain et extra urbain en énergie, et le bassin d'approvisionnement en ressource énergétique avec le cas de l'agglomération parisienne. Pour ce faire, nous avons d'une part tenté d'évaluer la pression environnementale effectuée pour la consommation énergétique urbaine, métabolisme urbain, en utilisant la méthode d'analyse de flux d'énergie et de matière (AFME). L'AFME s'intéresse à mesurer le métabolisme d'une société et inclut par conséquent la consommation énergétique technique (pour le chauffage, le transport, l'industrie) ainsi que l'alimentation humaine et animale consommée dans la ville. La consommation énergétique urbaine est évaluée par la demande énergétique totale (DET), indicateur de pression environnementale, dans le but de mesurer la consommation d'énergie primaire en amont pour l'approvisionnement en énergie finale du territoire. On essaie ensuite de mettre en parallèle l'évolution de la DET pour l'énergie technique et l'évolution du rayon d'approvisionnement de cette dernière au fur et à mesure de la croissance urbaine. / Increasing urban natural resource consumption and particularly fossil energy consumption is one of the important factors of global environment alteration. To understand the socioecological transition process for the city, we characterize it as a natural resource dependent system in material and ecological terms. Cities mobilize a technical system to draw the external natural resource. Therefore, externality is a fundamental character of urban metabolism. We focus in this work on the relationship between the energy demand of the city, the evolution of the urban and extraurban energy supply system, and the energy resource supply area of Paris. We used energy and material flow analysis (MEFA) to evaluate environmental pressure driven by city's energy consumption, urban metabolism. MEFA aims to evaluate social metabolism, therefore energy demand including both the energy for technical system and bioenergy for food and forage provision for a society. Particularly, total energy requirement (TER) refers ta primary energy consumption, an indicator to evaluate the environmental pressure. Furthermore, we try to view the energy demand for the technical energy increase of the city in parallel with its energy supply area tor three dates chosen during the 19th and 21th centuries.

Introdução: A síndrome do intestino curto (SIC) representa um estado clínico de má absorção grave, e a gestão dietética de pacientes com SIC é extremamente desafiadora. Uma vez que o grau de desnutrição é frequentemente considerável, a intervenção dietética bem sucedida depende da estimativa mais exata possível das necessidades energéticas para prever as metas da terapia nutricional. Objetivo: Quantificar o gasto energético total (GET) em pacientes com SIC pelo método da água duplamente marcada (ADM). Materiais e Métodos: Neste estudo observacional, o GET foi mensurado pelo método da água duplamente marcada em 22 voluntários, 11 com SIC e 11 controles pareados por sexo, idade e IMC (grupo Controle). O GET foi estimado pela equação de Escott-Stump e a partir de acelerômetro, e foi comparado com o GET determinado pela ADM. O gasto energético em repouso (GER) foi mensurado por calorimetria indireta (CI) e comparado com o GER estimado pela equação de Harris e Benedict. O acelerômetro também foi utilizado para estabelecer o nível de atividade física. Resultados: Os participantes tinham idade (média ± DP) de 53 ± 8 anos. O GET medido por ADM foi significativamente menor no grupo SIC comparado ao grupo Controle (p < 0,01); no entanto, o GET estimado não diferiu significativamente entre os grupos. O GET medido foi significativamente maior do que o GET estimado por fórmula no grupo SIC, (respectivamente 1875 ± 276 e 1517 ± 175 kcal/dia, p < 0,01), assim como para o grupo Controle (2393 ± 445 e 1532 ± 178 kcal/dia, p < 0,01). No entanto, o GET medido foi significativamente menor do que o GET predito a partir do acelerômetro no grupo SIC (2075 ± 298 kcal/dia, p = 0,02), e não diferiu significativamente no grupo Controle (2207 ± 355 kcal/dia, p = 0,21). Não foram verificadas diferenças significantes entre o GER medido e predito para ambos, e entre os grupos. Conclusão: O GET medido em pacientes com SIC foi significativamente maior do que o GET estimado por fórmula, e foi menor quando comparado com os valores dos sujeitos controles. No entanto, o GET estimado a partir do acelerômetro, superestima o GET medido por ADM. As fórmulas atualmente utilizadas na prática clínica parecem subestimar as necessidades de energia de pacientes com SIC. Desta forma, adaptações da estimativa atual, aumentando as prescrições de ingestão energética nestes pacientes parecem ser adequadas para apoiar as necessidades diárias de energia e evitar a subnutrição. / Background: Short bowel syndrome (SBS) is a serious malabsorption disorder, and dietetic management of SBS patients is extremely challenging. Once the degree of undernutrition has been assessed, successful dietary intervention depends on the most accurate estimation and provision of energy needs to provide nutritional therapy goals. Objective: To quantify total energy expenditure (TEE) in SBS patients using the doubly labeled water (DLW) method. Design: In this observational study, TEE was measured by the DLW method in 22 participants, 11 with SBS and 11 gender-age-and BMI-matched controls (Control group). Predicted energy requirements were determined using the Escott-Stump equation and by using and accelerometer, and they were compared with TEE determined with DLW. Resting energy expenditure (REE) was measured using indirect calorimetry and compared with predict REE using the Harris and Benedict equation. The accelerometer was also used to determine physical activity level. Results: Participants were aged (mean ± SD) 53 ± 8 years. Measured TEE was significantly lower in the SBS group compared to the Control group (p < 0.01); however, predicted TEE did not differ significantly between the groups. Measured TEE was significantly higher than predicted TEE for the SBS group, (1875 ± 276 and 1517 ± 175 kcal/d, p < 0.01) and also for the Control group (2393 ± 445 and 1532 ± 178 kcal/d, p < 0.01) when determined by formula. However, measured TEE was significantly lower than predicted TEE (2075 ± 298 kcal/d, p = 0.02) for the SBS group, and did not differ for the Control group (2207 ± 355 kcal/d, p = 0.21) when determined by accelerometer. No significant differences were seen between measured and predicted REE both within and between groups. Conclusion: Measured TEE in SBS patients was significantly higher than predicted using standard equations, but also lower than values for age, BMI and gender-matched non-SBS controls. However, predicted TEE using accelerometer overestimated the measured TEE. Currently-used formulas in clinical practice appear to underestimate energy requirements of SBS patients. Therefore, adjustments to the current estimation, increasing the energy intake requirements in these patients appear to be adequate to support the daily energy requirements and avoid undernutrition.

The solar industry is one of the fastest-growing energy industries in the global market. The reason is a combination of the falling prices of modules and inverters and increased conversion to fossil-free energy production. When a photovoltaic module reaches the end of its life it needs to be replaced and discarded, which can create a sustainability problem depending on how this is managed. Today, less than 10% of the global photovoltaic waste is recycled. Only the European Union has implemented photovoltaic waste regulations in the form of the WEEE Directive, which requires that 85% of the waste is collected and at least 80% of waste collected must be prepared for reuse or recycling. This master thesis examines the energy technical, economic, and political conditions for a Swedish photovoltaic recycling plant. This is done through a literary study that is enhanced with calculations of future potential waste volumes and their economic value. As an alternative to a Swedish plant, the energy consumption for transporting waste to existing recycling plants in Europe is evaluated. The photovoltaic technologies included in this work are silicon-based mono-and polycrystalline modules, cadmium tellurium (CdTe) and copper indium gallium selenide (CIGS). Based on the calculations and the literature study, the energy technical conditions are good and not a barrier for a potential facility, the political conditions are deficient, and regulations need further development. The economic conditions constitute the largest barrier as waste volumes are not large enough for a Swedish facility to be economically profitable until 2042. The energy consumption for transport to existing recycling plants in Europe was 22 MJ/module for silicon-based mono-and polycrystalline modules and 10 MJ/module for CdTe modules. Which is a good alternative to a Swedish plant as collection processes and recycling processes are already in place.

博士(スポーツ健康科学) / Doctor of Philosophy in Health and Sports Science / 同志社大学 / Doshisha University

Preface - Biotechnology is generally accepted to be the next economical wave of the future. In order to attain the many benefits associated with this growing industry simulation modelling techniques have to be implemented successfully. One of the simulations that ne' ed to be performed is that of the human energy system. Pharmaceutical companies are currently pouring vast amounts of capital into research regarding simulation of bodily processes. Their aim is to develop cures, treatments, medication, etc. for major diseases. These diseases include epidemics like diabetes, cancer, cardiovascular diseases, obesity, stress, hypertension, etc. One of the most important driving forces behind these diseases is poor blood sugar control. The blood glucose system is one of the major subsystems of the complete human energy system. In this study a simulation model and procedure for simulating blood glucose response due to various external influences on the human body is presented. The study is presented in two parts. The first is the development of a novel concept for quantifying glucose energy flow into, within and out of the human energy system. The new quantification unit is called ets (equivalent teaspoons sugar). The second part of the study is the implementation of the ets concept in order to develop the simulation model. Development of the ets concept - In the first part of the study the ets concept, used for predicting glycaemic response, is developed and presented. The two current methods for predicting glycaemic response due to ingestion of food are discussed, namely carbohydrate counting and the glycaemic index. Furthermore, it is shown that it is currently incorrectly assumed that 100% of the chemical energy contained in food is available to the human energy system after consumption. The ets concept is derived to provide a better measure of available energy from food. In order to verify the ets concept, two links with ets are investigated. These are the links with insulin response prediction as well as with endurance energy expenditure. It is shown that with both these links linear relationships provide a good approximation of empirical data. It is also shown that individualised characterisation of different people is only dependent on a single measurable variable for each link. Lastly, two novel applications of the ets concept are considered. The first is a new method to use the ets values associated with food and energy expenditure in order to calculate both short-acting and long-acting insulin dosages for Type 1 diabetics. The second application entails a new quantification method for describing the effects of stress and illness in terms of ets. Development of the blood glucose simulation model - The second part of the study presents a literature study regarding human physiology, the development for the blood glucose simulation model as well as a verification study of the simulation model. Firstly, a brief overview is given for the need and motivation behind simulation is given. A discussion on the implementation of the techniques for construction of the model is also shown. The procedure for solving the model is then outlined. During the literature study regarding human physiology two detailed schematic layouts are presented and discussed. The first layout involves the complex flow pathways of energy through the human energy system. The second layout presents a detailed discussion on the control system involved with the glucose energy pathway. Following the literature review the model for predicting glycaemic response is proposed. The design of the component models used for the simulations of the internal processes are developed in detail as well as the control strategies implemented for the control system of the simulation model. Lastly, the simulation model is applied for glycaemic response prediction of actual test subjects and the quality of the predictions are evaluated. The verification of the model and the procedure is performed by comparing simulated results to measured data. Two evaluations were considered, namely long-term and short-term trials. The quality of both are determined according to certain evaluation criteria and it is found that the model is more than 70% accurate for long-term simulations and more than 80% accurate for short-term simulations. Conclusion - In conclusion, it is shown that simplified simulation of the human energy system is not only possible but also relatively accurate. However, in order to accomplish the simulations a simple quantification method is required and this is provided by the ets concept developed in the first part of this study. Some recommendations are also made for future research regarding both the ets concept and the simulation model. Finally, as an initial endeavour the simulation model and the ets concept proposed in this study may provide the necessary edge for groundbreaking biotechnological discoveries. / PhD (Mechanical Engineering) North-West University, Potchefstroom Campus, 2003

Preface - Biotechnology is generally accepted to be the next economical wave of the future. In order to attain the many benefits associated with this growing industry simulation modelling techniques have to be implemented successfully. One of the simulations that ne' ed to be performed is that of the human energy system. Pharmaceutical companies are currently pouring vast amounts of capital into research regarding simulation of bodily processes. Their aim is to develop cures, treatments, medication, etc. for major diseases. These diseases include epidemics like diabetes, cancer, cardiovascular diseases, obesity, stress, hypertension, etc. One of the most important driving forces behind these diseases is poor blood sugar control. The blood glucose system is one of the major subsystems of the complete human energy system. In this study a simulation model and procedure for simulating blood glucose response due to various external influences on the human body is presented. The study is presented in two parts. The first is the development of a novel concept for quantifying glucose energy flow into, within and out of the human energy system. The new quantification unit is called ets (equivalent teaspoons sugar). The second part of the study is the implementation of the ets concept in order to develop the simulation model. Development of the ets concept - In the first part of the study the ets concept, used for predicting glycaemic response, is developed and presented. The two current methods for predicting glycaemic response due to ingestion of food are discussed, namely carbohydrate counting and the glycaemic index. Furthermore, it is shown that it is currently incorrectly assumed that 100% of the chemical energy contained in food is available to the human energy system after consumption. The ets concept is derived to provide a better measure of available energy from food. In order to verify the ets concept, two links with ets are investigated. These are the links with insulin response prediction as well as with endurance energy expenditure. It is shown that with both these links linear relationships provide a good approximation of empirical data. It is also shown that individualised characterisation of different people is only dependent on a single measurable variable for each link. Lastly, two novel applications of the ets concept are considered. The first is a new method to use the ets values associated with food and energy expenditure in order to calculate both short-acting and long-acting insulin dosages for Type 1 diabetics. The second application entails a new quantification method for describing the effects of stress and illness in terms of ets. Development of the blood glucose simulation model - The second part of the study presents a literature study regarding human physiology, the development for the blood glucose simulation model as well as a verification study of the simulation model. Firstly, a brief overview is given for the need and motivation behind simulation is given. A discussion on the implementation of the techniques for construction of the model is also shown. The procedure for solving the model is then outlined. During the literature study regarding human physiology two detailed schematic layouts are presented and discussed. The first layout involves the complex flow pathways of energy through the human energy system. The second layout presents a detailed discussion on the control system involved with the glucose energy pathway. Following the literature review the model for predicting glycaemic response is proposed. The design of the component models used for the simulations of the internal processes are developed in detail as well as the control strategies implemented for the control system of the simulation model. Lastly, the simulation model is applied for glycaemic response prediction of actual test subjects and the quality of the predictions are evaluated. The verification of the model and the procedure is performed by comparing simulated results to measured data. Two evaluations were considered, namely long-term and short-term trials. The quality of both are determined according to certain evaluation criteria and it is found that the model is more than 70% accurate for long-term simulations and more than 80% accurate for short-term simulations. Conclusion - In conclusion, it is shown that simplified simulation of the human energy system is not only possible but also relatively accurate. However, in order to accomplish the simulations a simple quantification method is required and this is provided by the ets concept developed in the first part of this study. Some recommendations are also made for future research regarding both the ets concept and the simulation model. Finally, as an initial endeavour the simulation model and the ets concept proposed in this study may provide the necessary edge for groundbreaking biotechnological discoveries. / PhD (Mechanical Engineering) North-West University, Potchefstroom Campus, 2003