Environmental pressures and impacts of public sector organizations: the case of the Portuguese Military

Progress in Industrial Ecology, An International Journal, nº 4(5), p. 363-381Public institutions are beginning to realise that they must shift their management towards sustainability. Thus, public sector, including defence services, environmental performance evaluation is a growing reality. The main objective of this research was to assess the environmental pressures and impacts profile of the Portuguese defence sector. A questionnaire survey was conducted involving all Portuguese military units that have a person in charge of environmental issues. Respondents generally reported that the majority of their activities have few serious environmental problems. These results could show the respondents’ general perception of the increasing implementation of environmental management practices in military units and probably some lack of knowledge, but also a standard based on compliance with regulations. Many environmental pressures in the Portuguese military are related to primary environmental problems, such as water supply, wastewater and solid waste, showing that the integration of environmental awareness and practices into the Portuguese military is quite new

The state of environmental performance evaluation in the public sector: the case of the Portuguese defence sector

Journal of Cleaner Production, nº 17, p. 36-52The environmental performance evaluation (EPE) of organizations is becoming an autonomous management tool. The main goal of this research was to assess the state of EPE practice in the Portuguese defence sector, as a particular part of public services. A questionnaire survey was conducted involving all Portuguese military units that have a person in charge of environmental issues. The questionnaire was designed to assess: (i) the importance and drivers of EPE; (ii) the ISO 14031 knowledge and implementation; (iii) the knowledge and use of environmental indicators; (iv) the optimal format for indicators; and (v) the advantages and drawbacks of using environmental indicators. Despite various initiatives driving environmental practices in public organizations, most of that experience is only centred on an environmental management system, and EPE is quite a new issue. Nevertheless, general environmental performance evaluation is a growing reality and one in which Portuguese military units are taking an increasing interest. Overall respondents agree on the importance of measuring and communicating environmental performance related to their main missions and activities. The main drivers for EPE in military units are the prevention of health risks and compliance with regulations. However, to date, ISO 14031 and environmental performance indicators are almost unknown in the respondent military units. Among the three military branches, the Navy revealed the worst environmental performance evaluation knowledge, awareness and practice

Primary cutaneous aggressive epidermotropic cytotoxic T-cell lymphomas: reappraisal of a provisional entity in the 2016 WHO classification of cutaneous lymphomas.

Primary cutaneous CD8-positive aggressive epidermotropic T-cell lymphoma is a rare and poorly characterized variant of cutaneous lymphoma still considered a provisional entity in the latest 2016 World Health Organization Classification of Cutaneous lymphomas. We sought to better characterize and provide diagnostic and therapeutic guidance of this rare cutaneous lymphoma. Thirty-four patients with a median age of 77 years (range 19-89 years) presented primarily with extensive annular necrotic plaques or tumor lesions with frequent mucous membrane involvement. The 5-year survival was 32% with a median survival of 12 months. A subset of 17 patients had a prodrome of chronic patches prior to the development of aggressive ulcerative lesions. We identified cases with lack of CD8 or αβ T-cell receptor expression yet with similar clinical and pathological presentation. Allogeneic stem cell transplantation provided partial or complete remissions in 5/6 patients. We recommend the term primary cutaneous aggressive epidermotropic cytotoxic T-cell lymphoma as this more broad designation better describes this clinical-pathologic presentation, which allows the inclusion of cases with CD8 negative and/or αβ/γδ T-cell receptor chain double-positive or double-negative expression. We have identified early skin signs of chronic patch/plaque lesions that are often misdiagnosed as eczema, psoriasis, or mycosis fungoides. Our experience confirms the poor prognosis of this entity and highlights the inefficacy of our standard therapies with the exception of allogeneic stem cell transplantation in selected cases

Endoscopic ultrasound-guided transvascular needle biopsy of thoracic and abdominal lesions: a multicenter experience

Background and study aims Traditionally in the case of a vascular interposition, endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has been contraindicated. A transvascular route (TV) is feasible and probably a safe alternative approach in selected patients, but data are scarce. The primary aim of this study was to analyze the diagnostic yield and safety of EUS-TV-FNA in thoracic and abdominal lesions. Secondary aims included evaluation of the clinical impact and technical aspects. Patients and methods A retrospective multicenter study was conducted with inclusion of all consecutive patients that underwent EUS-TV-FNA from July 2007 to January 2020. Feasibility, cytopathology, procedure details, and safety were evaluated. Univariate analysis was performed to identify variables associated with incidents, cytopathological diagnosis, and clinical impact. Results Data were collected from a total of 49 cases and 50 EUS-TV-FNAs. The aorta (n = 19) and portal system (n = 17) were the most frequently punctured. The most frequent lesions were mediastinal lymph nodes (n = 13) and pancreatic tumors (n = 11). The diagnostic yield was 86 %, and there were nondiagnostic samples in seven cases. Overall sensitivity, specificity, and accuracy were 88% (95 % CI, 0.74-0.96), 100% (95 % CI, 0.59-1), and 90% (95 % CI, 0.78-0.96), respectively. Only three incidents were detected: two mural hematomas and a self-limited bleeding of gastroduodenal artery. In most patients, there was a significant impact on clinical management (88%). Arterial vessel and ASA-III had a trend with incidents (both, P < 0.08). Rapid on-site evlauation was found to be an independent predictor for obtaining a conclusive sample (OR 6.2; 95%CI, 1.06-36.73, P < 0.04). Conclusions EUS-TV-FNA is feasible, seems to be safe, and can be recommended when no other targets are available, and the information obtained would impact on the clinical plan

Desenvolvimento de um pão à base de farinha de castanha, com adição de alfarroba ou chícharo: Viabilidade nutricional

O Consumidor é cada vez mais exigente e procura novas formulações alimentares em busca de sabores diferentes aos habituais, para “fugir” à rotina do dia-a-dia. O pão é um produto alimentar muito bem aceite pelo consumidor, mas nem sempre satisfaz em termos nutricionais as necessidades de uma dieta saudável. Neste projeto, desenvolveram-se várias formulações de pão em que os ingredientes base foram a farinha de trigo e a de castanha. No sentido de enriquecer os produtos finais, adicionou-se ainda alfarroba ou chícharo, para conferir novas propriedades nutricionais e também novos sabores. Para a quantificação dos minerais recorreuse a técnica de Energy Dispersive X-Ray Fluorescence (ED-XRF) (em atmosfera de hélio). Os resultados são discutidos em função dos perfis mineralógicos das diferentes formulações bem como dos valores resultantes de uma análise sensorial hedónica de aceitação.info:eu-repo/semantics/publishedVersio

The impact of chorionicity on pregnancy outcome and neurodevelopment at 2 years old among twins born preterm: the EPIPAGE-2 cohort study

OBJECTIVE To compare the short‐ and mid‐term outcomes of preterm twins by chorionicity of pregnancy. DESIGN Prospective nationwide population‐based EPIPAGE‐2 cohort study. SETTING 546 maternity units in France, between March and December 2011. POPULATION A total of 1700 twin neonates born between 24 and 34 weeks of gestation. METHODS The association of chorionicity with outcomes was analysed using multivariate regression models. MAIN OUTCOME MEASURES First, survival at 2‐year corrected age with or without neurosensory impairment, and second, perinatal, short‐, and mid‐term outcomes (survival at discharge, survival at discharge without severe morbidity) were described and compared by chorionicity. RESULTS In the EPIPAGE 2 cohort, 1700 preterm births were included (850 twin pregnancies). In all, 1220 (71.8%) were from dichorionic (DC) pregnancies and 480 from monochorionic (MC) pregnancies. MC pregnancies had three times more medical terminations than DC pregnancies (1.67 versus 0.51%, P < 0.001), whereas there were three times more stillbirths in MC than in DC pregnancies (10.09 versus 3.78%, P < 0.001). Both twins were alive at birth in 86.6% of DC pregnancies compared with 80.0% among MC pregnancies (P = 0.008). No significant difference according to chorionicity was found regarding neonatal deaths and morbidities. Likewise, for children born earlier than 32 weeks, the 2‐year follow‐up neurodevelopmental results were not significantly different between DC and MC twins. CONCLUSIONS This study confirms that MC pregnancies have a higher risk of adverse outcomes. However, the outcomes among preterm twins admitted to neonatal intensive care units are similar irrespective of chorionicity

Environmental performance policy indicators for the public sector: The case of the defence sector

The development of environmental performance policy indicators for public services, and in particular for the defence sector, is an emerging issue. Despite a number of recent initiatives there has been little work done in this area, since the other sectors usually focused on are agriculture, transport, industry, tourism and energy. This type of tool can be an important component for environmental performance evaluation at policy level, when integrated in the general performance assessment system of public missions and activities. The main objective of this research was to develop environmental performance policy indicators for the public sector, specifically applied to the defence sector. Previous research included an assessment of the environmental profile, through the evaluation of how environmental management practices have been adopted in this sector and an assessment of environmental aspects and impacts. This paper builds upon that previous research, developing an indicator framework-SEPI-supported by the selection and construction of environmental performance indicators. Another aim is to discuss how the current environmental indicator framework can be integrated into overall performance management. The Portuguese defence sector is presented and the usefulness of this methodology demonstrated. Feasibility and relevancy criteria are applied to evaluate the set of indicators proposed, allowing indicators to be scored and indicators for the policy level to be obtained. (c) 2006 Elsevier Ltd. All rights reserved

Gastroduodenal injury after radioembolization of hepatic tumors

Radioembolization is a new tool for the treatment of hepatic tumors that consists in the injection of biocompatible microspheres carrying radioisotopes into the hepatic artery or its branches. METHODS: We have performed radioembolization in 78 patients with hepatic tumors using resin-based microspheres loaded with yttrium-90. All patients were previously evaluated to minimize the risk of hazardous irradiation to nontarget organs and to obtain the data needed for dose calculation. RESULTS: We report a complication found in three cases (3.8%) that consists of abdominal pain resulting from gastroduodenal lesions and that had a chronic, insidious course. Microscopically, microspheres were detected in the specimens obtained from all affected gastric areas. Since these gastroduodenal lesions do not appear when nonradiating microspheres are injected in animals, lesions are likely to be due to radiation and not to an ischemic effect of vascular occlusion by spheres. CONCLUSIONS: We believe that a pretreatment evaluation that includes a more thorough scrutiny of the hepatic vascularization in search of small collaterals connecting to the gastroduodenal tract can help prevent this awkward complicatio