Influence of hydraulics and control of thermal storage in solar assisted heat pump combisystems

This paper studies the influence of hydraulics and control of thermal storage in systems combined with solar thermal and heat pump for the production of warm water and space heating in dwellings. A reference air source heat pump system with flat plate collectors connected to a combistore was defined and modeled together with the IEA SHC Task 44 / HPP Annex 38 (T44A38) “Solar and Heat Pump Systems” boundary conditions of Strasbourg climate and SFH45 building. Three and four pipe connections as well as use of internal and external heat exchangers for DHW preparation were investigated as well as sensor height for charging of the DHW zone in the store. The temperature in this zone was varied to ensure the same DHW comfort was achieved in all cases. The results show that the four pipe connection results in 9% improvement in SPF compared to three pipe and that the external heat exchanger for DHW preparation leads to a 2% improvement compared to the reference case. Additionally the sensor height for charging the DHW zone of the store should not be too low, otherwise system performance is adversely affected

The kidney in different stages of the cardiovascular continuum

Patients with chronic kidney disease are at higher risk of developing cardiovascular disease. The complex, interaction between the kidney and the cardiovascular system is incompletely understood, particularly at the early stages of the cardiovascular continuum. The overall aim of this thesis was to clarify novel aspects of the interplay between the kidney and the cardiovascular system at different stages of the cardiovascular continuum; from risk factors such as insulin resistance, inflammation and oxidative stress, via sub-clinical cardiovascular damage such as endothelial dysfunction and left ventricular dysfunction, to overt cardiovascular death. This thesis is based on two community-based cohorts of elderly, Uppsala Longitudinal Study of Adult Men (ULSAM) and Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS). The first study, show that higher insulin sensitivity, measured with euglycemic-hyperinsulinemic clamp technique was associated to improve estimated glomerular filtration rate (eGFR) in participants with normal fasting plasma glucose, normal glucose tolerance and normal eGFR. In longitudinal analyses, higher insulin sensitivity at baseline was associated with lower risk of impaired renal function during follow-up. In the second study, eGFR was inversely associated with different inflammatory markers (C-reactive protein, interleukin-6, serum amyloid A) and positively associated with a marker of oxidative stress (urinary F2-isoprostanes). In line with this, the urinary albumin/creatinine ratio was positively associated with these inflammatory markers, and negatively associated with oxidative stress. In study three, higher eGFR was associated with better endothelial function as assessed by the invasive forearm model. Further, in study four, higher eGFR was significantly associated with higher left ventricular systolic function (ejection fraction). The 5th study of the thesis shows that higher urinary albumin excretion rate (UAER) and lower eGFR was independently associated with an increased risk for cardiovascular mortality. Analyses of global model fit, discrimination, calibration, and reclassification suggest that UAER and eGFR add relevant prognostic information beyond established cardiovascular risk factors in participants without prevalent cardiovascular disease. Conclusion: this thesis show that the interaction between the kidney and the cardiovascular system plays an important role in the development of cardiovascular disease and that this interplay begins at an early asymptomatic stage of the disease process.