Life cycle assessment of a renewable energy generation system with a vanadium redox flow battery in a NZEB household

6th International Conference on Energy and Environment ResearchBuildings are responsible for a significant part of the global energy consumption. Besides the need to improve their energy efficiency, new buildings also need to generate their own energy, preferably from renewable sources, to become more sustainable. As renewable energy generation is strongly dependent on the climatic conditions, energy storage must be considered when designing such a system. In this study, a cradle-to-grave life cycle assessment (LCA) study of a renewable energy generation system with a prototype Vanadium flow battery integrated in a Near Zero Energy Building (NZEB) is performed. A combined grid-connected PV and a solar thermal system generates the energy, and it was dimensioned to supply the annual energy needs of a household in Porto, Portugal considering the local climatic conditions. As an end of life scenario, it is assumed that the battery is dismantled and most of the materials are recycled. A functional unit of 1 kWh of supplied energy to the system was considered, and study results show that environmental impacts are reduced when the energy is produced onsite and the battery components are recycled or reused. A sensitivity analysis was conducted changing the household’s geographic location.Authors thank the financial support of projects “SunStorage - Harvesting and storage of solar energy”, with reference POCI-01-0145-FEDER-016387, funded by European Regional Development Fund (ERDF), through COMPETE 2020 - Operational Programme for Competitiveness and Internationalization (OPCI), and to FCT - Fundação para a Ciência e a Tecnologia I.P., for funding project IF/01093/2014/CP1249/CT0003, research grants IF/01093/2014 and SFRH/BPD/112003/2015, and financial support of POCI-01-0145-FEDER-006939 (Laboratory for Process Engineering, Environment, Biotechnology and Energy - LEPABE, UID/EQU/00511/2019) funded by FEDER through COMPETE2020-POCI and by national funds through FCT/MCTES (PIDDAC). Authors would also like to thank Dr. Ricardo André Ribeiro Monteiro for the valuable information regarding the vanadium battery prototype obtained within the Sunstorage project.info:eu-repo/semantics/publishedVersio

Portal Vein Embolization With N-Butyl-Cyanoacrylate Through an Ipsilateral Approach Before Major Hepatectomy: Single Center Analysis of 50 Consecutive Patients

PURPOSE: To evaluate the efficacy of portal vein embolization (PVE) with n-Butyl-cyanoacrylate (NBCA) through an ipsilateral approach before major hepatectomy. Secondary end-points were PVE safety, liver resection and patient outcome. METHODS: Over a 5-year period 50 non-cirrhotic consecutive patients were included with primary or secondary liver cancer treatable by hepatectomy with a liver remnant (FLR) volume less than 25% or less than 40% in diseased livers. RESULTS: There were 37 men and 13 women with a mean age of 57 years. Colorectal liver metastases were the most frequent tumor and patients were previously exposed to chemotherapy. FLR increased from 422 ml to 629 ml (P < 0.001) after PVE, corresponding to anincrease of 52%. The FLR ratio increased from 29.6% to 42.3% (P < 0.001). Kinetic growth rate was 2.98%/week. A negative association was observed between increase in the FLR and FLR ratio and FLR volume before PVE (P = 0.002). In 31 patients hepatectomy was accomplished and only one patient presented with liver insufficiency within 30 days after surgery. CONCLUSIONS: PVE with NBCA through an ipsilateral puncture is effective before major hepatectomy. Meticulous attention is needed especially near the end of the embolization procedure to avoid complications.info:eu-repo/semantics/publishedVersio

INFEÇÕES VASCULARES PROTÉSICAS — UMA REVISÃO NARRATIVA

As infeções vasculares protésicas continuam a ser um desafio médico complexo. A evolução da flora hospitalar e o desenvol- vimento da cirurgia vascular têm contribuído para uma mudança na realidade das infeções protésicas, tornando imperativo conhecer o contexto microbiológico atual destas infeções para o seu adequado tratamento. Estas infeções dependem de fatores endógenos e exógenos e variam consoante o tempo de apresentação, localização da prótese vascular e ambiente microbiológico do doente. A morbimortalidade associada a este diagnóstico é elevada e o tratamento deve ser adaptado ao doente em questão, sendo necessário conhecer o microrganismo e as várias possibilidades de tratamento existentes. O conhecimento dos fatores predisponentes da infeção protésica vascular, o seu reconhecimento precoce e prevenção deve ser realizada em todos os doentes e num contexto de cuidados de saúde multidisciplinares.

Prevalence of asymptomatic visceral occlusive disease in patients admitted for chronic lower limb ischemia: A cross-sectional study.

INTRODUCTION: Occlusive disease of the visceral vessels, when complicated, may lead to a high mortality rate. Current data regarding the co-prevalence of atherosclerotic disease of the lower limbs and visceral vessels is scarce. The aim of this study was to analyze the prevalence of splanchnic and renal visceral occlusive disease in patients admitted for chronic lower limb ischemia (CLLI). METHODS: A cross-sectional study was performed including 100 aleatory patients admitted for CLLI between 2015 and 2020, without previous or current history of mesenteric ischemia, and who were submitted to an abdominal computer tomography angiography (CTA) as part of the pre-operative work-up. The presence of splanchnic (celiac artery, superior and inferior mesenteric arteries) and renal atheromatous disease was defined as mild (30- 50% stenosis), moderate (50-70%) and severe (>70% or occlusion), measured by CTA. Outcomes analyzed included prevalence of splanchnic and renal visceral occlusive disease, evaluation of predictive factors for visceral occlusive disease and its relationship with the pattern of lower limb atherosclerotic disease. RESULTS: Mean age was 68.5 years old (SD: 9.7) and 77% were men. Admission diagnosis was incapacitating claudication (Rutherford stage 3) in 19%, and chronic lower limb threating ischemia (CLTI) in 81% (21% with stage 4 Rutherford and 60% with stage 5/6). Seventy-five percent presented aorto-iliac disease (AOID) and 97% presented infra-inguinal disease. Overall prevalence of visceral disease (mild, moderate or severe) was 65%. Severe disease was seen in at least one vessel in 60%. 34% of patients presented severe disease in only one visceral artery, 26% presented in ≥2 visceral vessels and 22% presented severe disease in all three splanchnic arteries. Regarding renal disease, 33% presented severe disease in at least one renal artery and 20% presented with bilateral disease. CLTI was significantly associated with a higher prevalence of severe stenosis in ≥2 splanchnic vessels, p=0.004. After logistic regression, we observed as predictive factor associated with severe disease in ≥2 splanchnic vessels the age, with an OR of 2.01 for every 10-year difference, p= 0.039; and AOID, OR: 14.6 (p=0.011). When analyzed the presence of at least one severe splanchnic vessel stenosis, AOID (OR 5.4, p=0.008) and coronary disease (OR:3.9, p=0.035) were predictive factors. Regarding renal disease, and association was found with age (OR of 3.90 for every 10-year difference, p<0.001); AOID (OR of 25.6, p=0.004) and carotid artery disease (OR: 9.24, p=0.005). CONCLUSION: Our study showed a high prevalence of multi-visceral and renal occlusive disease in patients admitted for chronic lower limb ischemia. We found an association between coronary and carotid disease with splanchnic and renal disease, respectively. Age was also associated with more severe stages of visceral and renal artery disease. More studies are needed to analyze the clinical impact of our findings regarding planning and follow-up for these patients.

Time goals in ruptured abdominal aortic aneurysm – the experience of a tertiary centre

INTRODUCTION: Guidelines state that ruptured abdominal aortic aneurysms should be treated shortly after the diagnosis and ideally within 90 minutes. The main aim of this study is to assess the referral pattern of our centre regarding the intervals between the diagnosis of ruptured AAA and the surgical repair, considering the geographical referral areas of our hospital. METHODS: We conducted an observational, retrospective cohort study from a single centre. The study population included all patients with the diagnosis of symptomatic or ruptured abdominal aortic aneurysm referred to Centro Hospitalar e Universitário Lisboa Norte (CHULN) between 2012 and 2021. The moment of diagnosis was assumed to be the time of the CT angiography and the moment of treatment was assumed as the time of entering the operating room (OR). RESULTS: During the study period a total of 150 patients (90.7% men, mean age 78.3, SD 8.7) were treated. Of these, 86% presented as ruptured aneurysms while 14% presented as symptomatic aneurysms. The median time between the diagnosis and the initiation of surgical treatment was 150 (+/- 132) minutes. Only 22% of patients were treated within 90 minutes of diagnosis and this remained unchanged throughout the study period. No statistically significant difference was observed between the median time intervals registered for survivors and deceased patients at 24 hours (p = 0.907), 48 hours (p = 0.743) and 30 days (p = 0.605) post-surgery. CONCLUSION: In our study, only 22% of patients with ruptured or symptomatic abdominal aortic aneurysms are treated within the recommended time frame. Although there is no significant impact on mortality, the authors recognize unavailability of information regarding patients that died before arrival to our hospital as a relevant limitation

IMPLANTAÇÃO DA ENDOPRÓTESE RAMIFICADA OFF-THE-SHELF COOK® T-BRANCH®: ASPECTOS TÉCNICOS E TIPS AND TRICKS

Introdução: As próteses ramificadas off-the-shelf, como a Cook t-Branch®, surgiram como uma alternativa de rápido acesso no tratamento de aneurismas tóraco-abdominais (ATA). Objetivo/Técnica: Na nossa instituição a utilização da endoprótese Cook T-Branch® tem sido efetuada em casos urgentes e em alguns casos eletivos com anatomia favorável e em que é desaconselhável esperar pela confeção de um custom-made device (CMD). A experiência acumulada justifica o propósito deste artigo de revisão que pretende descrever a forma de implantação, algumas técnicas adjuvantes e algumas tips and tricks que poderão facilitar a curva de aprendizagem em centros com menor contacto com esta plataforma. Conclusão: A utilização de próteses ramificadas off-the-shelf, como a Cook T-Branch®, é uma alternativa segura e viável para o tratamento de ATA cuja principal vantagem é a rápida acessibilidade. Conforme avançamos na curva de aprendizagem e novas técnicas adjuvantes são adquiridas, a sua aplicabilidade aumentada de forma significativa, tanto no contexto urgente como eletivo

TREATMENT OF AORTIC DISSECTIONS USING A COMBINATION OF THE STABILISE AND CERAB TECHNIQUES — TECHNICAL NOTE

Introduction: Endovascular treatment of type B aortic dissection has focused on the covering of the proximal entry tear. However, recently, concern has emerged regarding the distal aortic remodeling and new techniques such as the Stent-Assisted Balloon-Induced Intimal Disruption and Relamination (STABILISE) technique have gained more acceptance. We describe a technical note regarding the combination of the STABILISE technique in addition to the Covered Reconstruction of the Aortic Bifurcation (CERAB) technique to achieve complete aortic remodeling. Methods: The authors describe a stepwise approach regarding the endovascular repair of type B aortic dissections. A simple TEVAR is performed first. If the patient still shows signs of true lumen compression, a STABILISE technique is performed in order to achieve true lumen expansion and complete aortic remodeling. However, in some patients, false lumen perfusion and true lumen compression at the very distal aorta is maintained due to distal comunicating tears. In these patients, if there are still signs of infra-renal aortic or iliac compression/occlusion or distal thrombosis of the false lumen, a simultaneous CERAB is performed. Conclusion: By combining these techniques, we aim to cover both the proximal tear and the distal comunicating tears resulting in a complete flap apposition, false lumen obliteration, re-expansion of the true lumen and achieve optimal remodeling

National survey to Portuguese Angiology and Vascular Surgery residents – Insights into the satisfaction and limitations of the residency program

INTRODUCTION: Vascular Surgery is a demanding specialty with vast technological and research advances in the last decades. This has led to an increasing complexity of providing adequate training programs for the modern Vascular Surgeon. Our aim was to understand the current satisfaction rates and perceived limitations of the Vascular Surgery residency program in Portugal by performing an online survey to residents. METHODS: A survey study was conducted between April and June 2021 targeting Angiology and Vascular Surgery Residents in Portugal. Residents were contacted by e-mail from the National Portuguese Society of Angiology and Vascular Surgery to answer the survey. The survey was anonymized, and all residents from the 1st to 6th year were invited to participate. The survey was carried out using the Google® Forms platform and using Portuguese language. Questions were developed with two main objectives, the first being to analyze the satisfaction rates with the current residency program and the second to understand current limitations and possible areas of improvement. RESULTS: Overall, 33 (65%) out of 51 invited residents participated in the survey, with equally distributions regarding the year of residency. Nineteen residents were male (57.6%). Most residents considered that the current one-year General Surgery rotation should be reduced and replaced by other specialties such as Radiology. Main surgical limitations were found with open aortic surgery. However, when compared to other European countries, residents considered that the main current limitation was scientific/academic training. Most residents were satisfied with their residency and felt professional fulfillment, however, most also reported having an unhealthy work-life balance and lack of time for academic and scientific research. When comparing the survey answers between younger and older residents, older residents reported more often having considered quitting and having experienced bullying or harassment. CONCLUSION: The findings from this study provide insight into the perceptions of the trainees regarding current training limitations and satisfaction rates with the residency program and may provide a base for improvement and development strategies in the residency programs in Portuga

Physical and pulmonary capacities of individuals with severe coronavirus disease after hospital discharge: A preliminary cross-sectional study based on cluster analysis

OBJECTIVE: This study aimed to analyze the physical and pulmonary capacities of hospitalized patients with severe coronavirus disease and its correlation with the time of hospitalization and complications involved. METHODS: A total of 54 patients, aged ≥18 years of both sexes, were evaluated 2-4 months after hospital discharge in São Paulo, Brazil. The physical characteristics analyzed were muscle strength, balance, flexibility, and pulmonary function. The K-means cluster algorithm was used to identify patients with similar physical and pulmonary capacities, related to the time of hospitalization. RESULTS: Two clusters were derived using the K-means algorithm. Patients allocated in cluster 1 had fewer days of hospitalization, intensive care, and intubation than those in cluster 2, which reflected a better physical performance, strength, balance, and pulmonary condition, even 2-4 months after discharge. Days of hospitalization were inversely related to muscle strength, physical performance, and lung function: hand grip D (r=−0.28,&nbsp;p=0.04), Short Physical Performance Battery score (r=−0.28,&nbsp;p=0.03), and forced vital capacity (r=−0.29,&nbsp;p=0.03). CONCLUSION: Patients with a longer hospitalization time and complications progressed with greater loss of physical and pulmonary capacities