Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Avaliação da produção e qualidade do gás de aterro para energia no aterro sanitário dos Bandeirantes - SP Evaluation of the production and quality of the landfill gas to energy at Bandeirantes landfill - SP

O presente trabalho apresenta os primeiros resultados da avaliação da produção e qualidade do gás para a geração de energia em um aterro sanitário. Foram monitorados parâmetros de qualidade do biogás, pressão exercida pelo sistema e volume de gás extraído. A partir do acompanhamento desses parâmetros, foram feitas três análises em diferentes situações que pudessem explicar o comportamento dos parâmetros: uma análise com poços em diferentes profundidades e duas análises a caráter de comparação: (a) poços conectados ao sistema de captação por extração ativa; e (b) poços não conectados ao sistema de captação, com extração passiva. Os resultados demonstraram que poços em profundidade intermediária apresentam as maiores produções e qualidade do gás e poços com extração passiva em relação à ativa tiveram diferenças significativas dos parâmetros acompanhados.<br>The present work shows the initial results of the evaluation of production and quality of the landfill gas to energy. Parameters of quality, pressure exerted by the system and volume of extracted landfill gas had been monitored. From the accompaniment of these parameters, three different analyses in different situations could explain the behavior of the wells: one analysis of wells in different depths, and two comparison analyses: (a) wells hardwired to the system of collection for active extraction; and (b) wells not hardwired to the collection system, with passive extraction. The results demonstrated that wells at intermediate deep have the highest yields and quality of gas and wells with passive extraction in relation to the active ones had significant differences of the monitored parameters

Product diversification in the sugarcane biorefinery through algae growth and supercritical CO 2 extraction: Thermal and economic analysis

The sugarcane sector in Brazil has undergone a major modernization in the last thirty years. Embracing the biorefinery concept, this sector is investigating bioproduct diversification and mostly putting a lot of effort and investment on second generation ethanol production. In this context, the investigation of the integration of a third generation biofuel production using microalgae to the sugarcane biorefinery seems an important starting point. This study evaluates the integration of microalgae growth and processing to a sugarcane biorefinery producing first and second generation ethanol using process simulation tools. Microalgae are cultivated using CO2 produced during fermentation of ethanol and it is processed using supercritical fluid extraction technology in order to obtain lipids rich in high added-value compounds, carotenoids. The results showed that the integration of microalgae biomass processing without previously drying with the sugarcane biorefinery is not attractive from the thermo-economic point. When considering the extraction of dried microalgae the extraction process could be thermal integrated to the sugarcane biorefinery producing ethanol without the need of buying external fuel. The amount of CO2 used as solvent to the supercritical fluid extraction was the main factor that influenced the economic viability of the process. When microalgae pretreatment by cell disruption or co-solvent extraction was considered, it was possible to decrease the amount of CO2 used in the process and an increase in process yields was consequently achieved. The use of a co-solvent in the extraction increased in 1.4 and 2.4 times lipids and carotenoids extraction, respectively, and presented a lower investment when comparing with microalgae extraction without cell disruption

Comparison of extraction techniques for product diversification in a supercritical water gasification-based sugarcane-wet microalgae biorefinery: Thermoeconomic and environmental analysis

This study presents a thermoeconomic and environmental assessment of the extraction of lipids and proteins from wet microalgal biomass in a 3G biorefinery by two different technologies: supercritical fluid extraction (SFE) and low-pressure solvent extraction (LPSE). Simulation tools were used to study a sugarcane biorefinery producing ethanol from sugarcane juice (1G) and bagasse (2G); the microalgal growth in an open pond; and the processing of microalgal biomass into lipids, proteins and synthetic natural gas (SNG). Supercritical water gasification (SONG) of microalgal biomass enables an increase in biofuel production of 10.2% MJ when no extraction process is considered and of 1.9% MJ when LPSE is considered. The heat demand of the proposed biorefinery with LPSE was increased by 87.8% compared with the demand of the sugarcane biorefinery without microalgal growth and processing. When the SFE process is considered, the heat demand of the overall process increased 3.2 times. SFE for wet microalgae processing is not economically attractive, as it increases the total investment by 71%. The CO2 flow used in the SFE process demonstrated to be a key factor in the thermoeconomic viability of the process. Regarding the wet processing of microalgae prior to SCWG, the best alternative studied was the use of LPSE technology. (C) 2018 Elsevier Ltd. All rights reserved

Thermo-economic and environmental comparison of supercritical water and enzymatic hydrolysis of sugarcane bagasse in a biorefinery concept

In this study, we discuss the difference regarding thermo-economic and environmental (water intake) aspects between two methods of biomass hydrolysis. A thermo-economic model was developed using Aspen Plus® and MATLAB software in order to analyze the energy efficiency, as well as, the economic impact of the hydrolysis process integrated into a traditional ethanol production process from sugarcane. The study aimed at comparing the enzymatic route for sugarcane bagasse ethanol production with the supercritical water-based one. The use of supercritical water hydrolysis (SCWH) process showed promising results, being the process energetically self-sufficient when considering pumping of liquid streams with biomass content of 20% and the decompression of the steam separated after SCWH with a turbine, in order to produce electricity. In terms of economics, the biorefinery concept using enzymatic route presented the highest production costs due to the higher total investment cost and the cost for the raw materials, which is 14% higher than the biorefinery with SCWH, giving a payback time for the investments of 7.5 years, meanwhile 6.2 for the SCWH route. Also better results were obtained for water intake for the SCWH option, being lower than the maximum permitted for a new investment on the Brazilian sugarcane sector