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A newly published article in Lancet Gastroenterology & Hepatology entitled "Optimal dilation time for combined small endoscopic sphincterotomy and balloon dilation for common bile duct stones: a multicentre, single-blinded, randomised controlled trial" assessed the optimal duration of dilation for combined EST and EPBD for the removal of common bile duct stones (7).
The procedures for papilla included EST in 58 patients, EPBD in 9, and EPLBD in 8 in the removal group and EST in 11 in the drainage group.
Assessment was performed in terms of primary energy (as required by EPBD), assuming that heat is produced from natural gas and electricity from non-renewable energy sources.
However, comparing the different methods to assess the effectiveness of energy efficiency solutions, only two objective functions are usually used, such as: primary energy consumption and life-cycle cost, according to the EPBD recast-2010 methodology; energy consumption and thermal comfort; single-score metric of environmental impact (e.g.
[2.] EPBD recast: EU-Directive 2010/31/EU of the European Parliament and of the Council of 19 May 2010 on the energy performance of buildings.
The recast of Energy Performance of Buildings Directive (EPBD recast 2010) has established several newer strengthened requirements such as the obligation that all new buildings should reach nearly zero-energy levels by the end of 2020.
It is obtained based on the Energy Performance of the Building Directive (EPBD) provided by EU as a building energy performance standard, the Commercial Buildings Energy Consumption Survey (CBECS) provided by the U.S.
Directive 2010/31/EU, EPBD recast  stipulates that Member States (MS) shall ensure that minimum energy performance requirements of buildings are set with a view of achieving cost optimal levels for buildings, building units and building elements using a comparative methodology framework established by the Commission, completed with relevant national parameters.
One of the main drivers of the market for glazing sealants is new European regulations on creating energy efficiency in buildings (EU Energy Performance of Buildings Directive (EPBD)).
For a retail store builder and operator, the ENERGY STAR program in the U.S., EPBD in the EU, LEED, BREEAM and Green Star programs offer clear opportunities for objective evaluations of achievements in store design and operations.
These advisers will need to be active members of an accredited Energy Performance of Buildings Directive (EPBD) Accreditation Scheme for either domestic energy assessors (DEAs) or non-domestic energy assessors (NDEAs) as appropriate.
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