Integration of social aspects in decision support, based on life cycle thinking

Recently increasing attention has been paid to complementing environmental Life Cycle Assessment (LCA) with social aspects. The paper discusses the selection of social impacts and indicators from existing frameworks like Social Life Cycle Assessment (SLCA) and Social Impact Assessment (SIA). Two ongoing case studies, addressing sustainability assessment within decision support, were considered: (1) Integrated Water Resources Management (IWRM) in Indonesia; and (2) Integrated Packaging Waste Management in Spain and Portugal (FENIX). The focus was put on social impacts occurring due to decisions within these systems, such as choice of technologies, practices or suppliers. Thus, decision makers—here understood as intended users of the studies’ results—are not consumers that buy (or do not buy) a product, such as in recent SLCA case-studies, but mainly institutions that decide about the design of the water or packaging waste management system. Therefore, in the FENIX project, a list of social impacts identified from literature was sent to the intended users to be ranked according to their priorities. Finally, the paper discusses to what extent the entire life cycle is reflected in SLCA impact categories and indicators, and explains how both life-cycle and on-site-related social impacts were chosen to be assessed. However, not all indicators in the two projects will assess all stages of the life cycle, because of their varying relevance in the different stages, data availability and practical interest of decision makers

Air Quality and Comfort Characterisation within an Electric Vehicle Cabin in Heating and Cooling Operations†

This work is aimed at the experimental characterisation of air quality and thermal profile within an electric vehicle cabin, measuring at the same time the HVAC system energy consumption. Pollutant concentrations in the vehicle cabin are measured by means of a low-cost system of sensors. The effects of the HVAC system configuration, such as fresh-air and recirculation mode, on cabin air quality, are discussed. It is shown that the PM concentrations observed in recirculation mode are lower than those in fresh-air mode, while VOC concentrations are generally higher in recirculation than in fresh-air mode. The energy consumption is compared in different configurations of the HVAC system. The novelty of this work is the combined measurement of important comfort parameters such as air temperature distribution and air quality within the vehicle, together with the real time energy consumption of the HVAC system. A wider concept of comfort is enabled, based on the use of low-cost sensors in the automotive field

The postpneumonectomy syndrome: clinical presentation and treatment

Background: Postpneumonectomy syndrome (PPS) is a rare complication after pneumonectomy. It consists of an excessive mediastinal shift resulting in compression and stretching of the tracheobronchial tree and the esophagus. The aim of this study was to give a comprehensive overview of diagnosis, variety of symptoms and evaluation of surgical treatment of PPS. Methods: We retrospectively reviewed the charts of all our patients with PPS since 1994 with respect to symptomatology, treatment and outcome. Our results were compared with case reports and case series in the literature. Results: Six women with a median age of 56.5 years (range 49-65) developed PPS after pneumonectomy for the treatment of lung cancer. Four presented with a right PPS and two with a left PPS, respectively. Symptoms consisted of shortness of breath in all patients and dysphagia as well as heartburn in two patients. Correction of PPS required re-exploration of the pneumonectomy space, reposition of the mediastinum followed by the insertion of single silicone prosthesis in five patients or fixation of the mediastinum with a xenopericardial graft in one patient. We could observe an improvement of the FEV(1)/FVC ratio in all our patients and the clinical improvement of shortness of breath was better than we expected by changes of lung function. Four patients returned to their regular activities with a follow-up of four years. We found 73 cases of PPS in the literature, on the right side in 50 patients (68%) and on the left side in 23 patients (32%). Fifty-nine patients (81%) were treated surgically. Symptoms can be suspicious for cardiogenic origin and vary from heartburn to recurrent syncopes. Conclusion: PPS is rare and not predictable. It can occur after right or left pneumonectomy. Symptoms are manifold and result from a shift, leading to compression and stretching of the two conduits located within the mediastinum, the tracheobronchial tree and the esophagus and consists of shortness of breath, stridor and heartburn. Diagnosis must be made by exclusion. Implantation of prosthesis is the most commonly used and effective treatmen

Lipoprotein glomerulopathy treated with LDL-apheresis (Heparin-induced Extracorporeal Lipoprotein Precipitation system): a case report.

INTRODUCTION: Lipoprotein glomerulopathy is a glomerulonephritis which was described for the first time by Saito in 1989 and is currently acknowledged as a separate nosological entity. It is histologically characterized by a marked dilatation of the glomerular capillaries and the presence of lipoprotein thrombi in the glomerular lumens. The dyslipidemic profile is similar to that of type III dyslipoproteinemia with Apolipoprotein E values that are often high; proteinuria and renal dysfunction are present. Proteinuria often does not respond to steroid and cytostatic treatments. The phenotypic expression of lipoprotein glomerulopathy is most probably correlated to a genetic alteration of the lipoprotein metabolism (mutation of the Apolipoprotein E coding gene). In literature, lipoprotein glomerulopathies have mainly been reported in Japanese and Chinese subjects, except for three cases in the Caucasian race, reported in France and the USA.CASE PRESENTATION: We describe the case of a 60-year-old female, Caucasian patient suffering from lipoprotein glomerulopathy, carrier of a new mutation on the Apolipoprotein E gene (Apolipoprotein E(MODENA)), and treated successfully with low density lipoprotein-apheresis with the Heparin induced extracorporeal lipoprotein precipitation system. After a first phase of therapeutic protocol with statins, the patient was admitted for nephrotic syndrome, renal failure and hypertension. Since conventional treatment alone was not able to control dyslipidemia, aphaeretic treatment with heparin-induced Extracorporeal Lipoprotein Precipitation - apheresis (HELP-apheresis) was started to maintain angiotensin converting enzyme inhibitor therapy for the treatment of hypertension. Treatment with HELP-apheresis led to a complete remission of the proteinuria in a very short time (four months), as well as control of hypercholesterolemia and renal function recovery.CONCLUSION: According to this case of lipoprotein glomerulopathy, we believe that renal damage expressed by proteinuria correlates to the levels of lipids and, furthermore, the treatment with HELP-apheresis, by lowering low-density lipoprotein cholesterol and triglycerides, may be considered as a therapeutic option in synergy with pharmacological treatment in the treatment of lipoprotein glomerulopathy