Water use and its perception in the hotel industry in the Iberian Peninsula

Trabalho apresentado em International Conference on Water Energy Food and Sustainability (ICoWEFS 2021), 10-12 maio 2021, Leiria, PortugalTourism industry is one of the fastest growing in recent years, before the pandemic, and is a well-known industry with excessive consumption of water. Climate change together with the abusive use of water resources change the hydrological cycle, thus causing water supply problems. Consequently, tourism companies must undertake actions to change the direction based on a more structured knowledge and vision. This work is based on the study of water consumption in the various activities of tourist accommodations in the Iberian Peninsula. It aims to compare the perception of their consumption against the published reference values, as well as to apply measures to reduce water consumption. The applied methodology is based on an initial bibliographic research of the state of the art, reference values for consumption, and the influencing factors in tourist accommodation. Following, the perception of consumption is assessed through an online survey targeting Portuguese and Spanish hoteliers. The survey was conducted in the first months of 2020 and 174 responses were obtained, 101 from Spain and 73 from Portugal. The results show that the surveyed hoteliers do not have the perception of water consumption, since in general they do not make measurements, are unaware of the consumption of each sector within the hotel and mostly refer to consumption below the reference values. Regarding the measures that have already been implemented to reduce water consumption, they represent measures of lower cost and easier application and that do not require major changes.N/

Estudo do consumo de água e sua perceção na indústria hoteleira da Península Ibérica

A indústria hoteleira é uma das que mais tem evoluído nos últimos anos. Com a elevada procura turística surge a necessidade de satisfazer as necessidades de cada hóspede, trazendo consigo agregadamente um problema: o uso excessivo de água. As alterações climáticas juntamente com o uso excessivo dos recursos hídricos fazem alterar o ciclo hidrológico provocando problemas de abastecimento de água. A metodologia aplicada baseia-se numa pesquisa bibliográfica, obtendo assim a informação necessária para levar a cabo o objetivo. Com ajuda dos casos publicados obteve-se os valores de referência, para assim puder comparar o consumo de água nas várias zonas de um alojamento turístico. Para contribuir para a redução do consumo de água, passa por levar a cabo umas medidas tais como: redução do caudal do sistema de abastecimento, promover o uso adequado pelos utilizadores, utilização de água de menor calibre para tarefas que não requerem o uso de água potável, e ações de formação para sensibilizar e formar sobre este tema. A perceção do consumo de água e das medidas para a redução do consumo de água vai ser através do envio de um inquérito e do respetivo tratamento e análise dos dados. Foram enviados 850 inquéritos e obtidas 174 respostas, em que 101 foram por parte de empreendimentos turísticos espanhóis e 73 portugueses, tendo uma taxa de resposta global aproximadamente de 21%. Os empreendimentos turísticos que mais participaram foram hotéis de 3 e 4 Estrelas que representam cerca de 48%, a maioria (68%) com menos de 50 quartos e grande parte (60%) funciona com uma taxa de ocupação superior a 50%. Cerca 50% dos empreendimentos turísticos que participaram no inquérito possui espaços verdes, 47% recorre à água da rede pública para a rega e 28% poço/furo, ainda relativamente ao consumo de água para dar suporte a todas as atividades do empreendimento turístico cerca de 59% consome relativamente pouca água, ou seja, inferior ao valor de referência escolhido, 439 litros/hóspede/noite e cerca de 23% não sabe estimar o consumo de água. Os resultados mostram que os empreendimentos turísticos não têm a perceção do consumo de água e que as medidas que já têm implementadas para reduzir o consumo de água são as de mais baixo custo e de mais fácil aplicação. No que concerne às medidas que futuramente pretendem implementar para preservar os recursos hídricos verifica-se que não têm muita intenção, contudo as medidas escolhidas uma vez mais são as de menor custo e que não requerem grandes modificações nos empreendimentos turísticos.The applied methodology is based on a bibliographic search, thus obtaining the necessary information to carry out the objective. With the help of published cases, reference values were obtained, so that water consumption can be compared in the various areas of a tourist accommodation. To contribute to the reduction of water consumption, involves carrying out a measures such as reducing the flow rate of the supply system, promote proper use by users use water of lesser gauge for tasks that do not require the use of water drinking water, and training actions to raise awareness and train on this topic. The perception of water consumption and measures to reduce water consumption will be through the sending of a survey and the respective treatment and analysis of the data. 850 inquiries were sent and 174 responses were obtained, 101 of which were from Spanish tourist developments and 73 from Portugal, with an overall response rate of approximately 21%. The tourist developments that most participated were 3 and 4 Star hotels, which represent around 48%, the majority (68%) with less than 50 rooms and a large part (60%) operates with an occupancy rate above 50%. Approximately 50% of the tourist developments that participated in the survey have green spaces, 47% use public water for irrigation and 28% well/borehole, still in relation to water consumption to support all activities of the tourist development. 59% consumes relatively little water, that is, less than the chosen reference value, 439 liters /guest/ night and about 23% does not know how to estimate water consumption. The results show that tourism enterprises do not have the perception of water consumption and that the measures they already have in place to reduce water consumption are the lowest cost and easiest to apply. As regards the future measures intended to implement to preserve water resources there that do not have much intention, however the measures chosen once again are less expensive and do not require major changes in tourism enterprises

Mejora de la gestion de los residuos industriales a través de la filosofía lean y industria 4.0

Objetivos: Ante la creciente importancia de la sostenibilidad, se propone un modelo eficiente que permite a identificación y cuantificación de los residuos industriales. Metodología: Primero se realizó una revisión bibliográfica de los modelos existentes de aplicación conjunta: Sostenibilidad, Filosofía Lean e Industria 4.0. Análisis crítico de los modelos existentes de aplicación conjunta de estos conceptos. Elaboración de la propuesta del modelo y análisis de los resultados. Conclusiones: El modelo propuesto, además de contribuir para el cumplimiento de las leyes vigentes, permite una mejor percepción de los residuos producidos, incluyendo su caracterización. Esto promueve al encaminamiento de los residuos a las entidades responsables y competentes para su recogida y reciclaje, mostrando un cambio en la empresa en las políticas de gestión ambiental. Limitación / implicación de la investigación: El coste inherente a la reorganización del diseño del layout puede ser limitante, ya que depende del tipo, tamaño, características de la empresa y la flexibilidad de su sistema de producción existente. Originalidad / Valor del papel: Es un modelo nuevo de aplicación conjunta de los tres conceptos y colmata el vacío de los modelos ya existentes. Esto permite a las organizaciones tener un mayor conocimiento sobre los residuos producidos

Characterization of Optical Coherence Tomography Images for Colon Lesion Differentiation under Deep Learning

(1) Background: Clinicians demand new tools for early diagnosis and improved detection of colon lesions that are vital for patient prognosis. Optical coherence tomography (OCT) allows microscopical inspection of tissue and might serve as an optical biopsy method that could lead to in-situ diagnosis and treatment decisions; (2) Methods: A database of murine (rat) healthy, hyperplastic and neoplastic colonic samples with more than 94,000 images was acquired. A methodology that includes a data augmentation processing strategy and a deep learning model for automatic classification (benign vs. malignant) of OCT images is presented and validated over this dataset. Comparative evaluation is performed both over individual B-scan images and C-scan volumes; (3) Results: A model was trained and evaluated with the proposed methodology using six different data splits to present statistically significant results. Considering this, 0.9695 (_0.0141) sensitivity and 0.8094 (_0.1524) specificity were obtained when diagnosis was performed over B-scan images. On the other hand, 0.9821 (_0.0197) sensitivity and 0.7865 (_0.205) specificity were achieved when diagnosis was made considering all the images in the whole C-scan volume; (4) Conclusions: The proposed methodology based on deep learning showed great potential for the automatic characterization of colon polyps and future development of the optical biopsy paradigm.This work was partially supported by PICCOLO project. This project has received funding from the European Union’s Horizon2020 Research and Innovation Programme under grant agreement No. 732111. This research has also received funding from the Basque Government’s Industry Department under the ELKARTEK program’s project ONKOTOOLS under agreement KK-2020/00069 and the industrial doctorate program UC- DI14 of the University of Cantabria

Nasal atypical carcinoid tumor. A case report

Introduction: Carcinoid tumors are neuroendocrine tumors that are usually located on the gastrointestinal system, but infrequent in the sinus area. Description: The case of a 55-year-old woman with a unilateral nasal mass is described. The pathological analysis shows histological and immunohistochemical characteristics compatible with atypical carcinoid tumor. Discussion: carcinoid tumors may be typical or atypical according to their degree of differentiation. Although rare, they should be considered in differential diagnosis of unilateral polyposis. Treatment is essentially surgical. Conclusions: This case highlights the importance of histopathological analysis of all unilateral nasal lesions.Introducción: Los tumores carcinoides son tumores neuroendocrinos que en su mayoría asientan sobre el sistema gastrointestinal, siendo su localización en el área nasosinusal muy infrecuente. Descripción: Se presenta el caso de una mujer de 55 años de edad con una lesión nasal unilateral. El análisis anatomopatológico evidencia características histológicas e inmunohistoquímicas compatibles con tumor carcinoide atípico. Discusión: los tumores carcinoides pueden ser típicos o atípicos según su grado de diferenciación. Aunque infrecuentes, deben considerarse diagnóstico diferencial en poliposis unilaterales. Su tratamiento es esencialmente quirúrgico. Conclusiones: Este caso clínico destaca la importancia del análisis anatomopatológico de todas las lesiones nasales unilaterales

Novel Pixelwise Co-Registered Hematoxylin-Eosin and Multiphoton Microscopy Image Dataset for Human Colon Lesion Diagnosis

Colorectal cancer presents one of the most elevated incidences of cancer worldwide. Colonoscopy relies on histopathology analysis of hematoxylin-eosin (H&E) images of the removed tissue. Novel techniques such as multi-photon microscopy (MPM) show promising results for performing real-time optical biopsies. However, clinicians are not used to this imaging modality and correlation between MPM and H&E information is not clear. The objective of this paper is to describe and make publicly available an extensive dataset of fully co-registered H&E and MPM images that allows the research community to analyze the relationship between MPM and H&E histopathological images and the effect of the semantic gap that prevents clinicians from correctly diagnosing MPM images. The dataset provides a fully scanned tissue images at 10x optical resolution (0.5 µm/px) from 50 samples of lesions obtained by colonoscopies and colectomies. Diagnostics capabilities of TPF and H&E images were compared. Additionally, TPF tiles were virtually stained into H&E images by means of a deep-learning model. A panel of 5 expert pathologists evaluated the different modalities into three classes (healthy, adenoma/hyperplastic, and adenocarcinoma). Results showed that the performance of the pathologists over MPM images was 65% of the H&E performance while the virtual staining method achieved 90%. MPM imaging can provide appropriate information for diagnosing colorectal cancer without the need for H&E staining. However, the existing semantic gap among modalities needs to be corrected.This work was supported by the PICCOLO project. This project has received funding from the European Union's Horizon 2020 Research and Innovation Programme under grant agreement No. 732111. The sole responsibility of this publication lies with the authors. The European Union is not responsible for any use that may be made of the information contained therein. This research has also been supported by the project ONKOTOOLS (KK2020/00069) funded by the Basque Government Industry Department under the ELKARTEK program

Dehiscent semicircular canal syndrome. Report of two cases

[ES] Introducción y objetivos: En el síndrome de dehiscencia de canales semicirculares (CS) se produce vértigo y nistagmus inducido por presión y se objetiva un adelgazamiento de la pared del canal semicircular afecto mediante TC. El tratamiento es quirúrgico en casos muy sintomáticos. Debemos tener en cuenta esta sintomatología porque es un tipo de vértigo tratable. El objetivo de esta revisión es realizar una revisión bibliográfica sobre el estado del tema. El segundo objetivo es remarcar que la TC de cortes finos y los VEMP con umbral disminuido. Material y métodos: Presentamos dos casos clínicos de pacientes jóvenes con dehiscencia de canales semicirculares, vestibulopatía recurrente muy sintomática; Uno presentaba dehiscencia de CS superior y otro posterior. Resultados: El estudio de imagen mediante TC se realizó en ambos pacientes ante la sospecha clínica de fístula de canal semicircular. En ambos se confirma radiológicamente el hallazgo clínico, pero no siempre es así. Con el diagnóstico de fístula de canales y control de síntomas con tratamiento médico ninguno de los pacientes ha tenido que ser intervenido para sellado-taponamiento de la fístula ó laberintectomía. Discusión: La presencia de dehiscencia del CSS no necesariamente significa que elpaciente padezca un "fenómeno de Tullio". El diagnóstico es cada vez más frecuente gracias a la generalización e importantes importantes avances radiológicos en TC. Debemos solicitar al radiólogo específicamente la sospecha diagnóstica, que obligue a buscar específicamente esta alteración. Existen hallazgos incidentales de fístulas radiológicas que no cursan con la clínica florida de estos pacientes porque podrían presentar indemnidad de la parte membranosa del canal con erosión de la ósea. El diagnóstico es importante para explicar la clínica del paciente y para decidir el tratamiento a efectuar. En pacientes con bulbo de la yugular prominente y una hipoacusia NS mayor de la esperada debe descartarse fístula del CS posterior. Presentan un umbral menor para los VEMP que la población. Conclusión: No en todos los pacientes con vértigo se debe realizar en primer lugar una RMN. El uso de VEMP pueden ser un complemento para confirmar el diagnóstico. [EN] Introduction and objectives: Dehiscent semicircular canal syndrome leads to dizziness and nystagmus induced by pressure. In the tomography scan a week wall of affected semicircular canal is observed. In the most symptomatic patients a chirurgical approach is needed. Is important to consider these syndrome because we can threat these kind of dizziness. The object of these revision is do a bibliographic review. The second objective is remark that a multislice CT is necessary to diagnose the syndrome. Material and methods: We present two clinical issues of young patients with dehiscent semicircular canal and recurrent vestibulopaty and flowery symptoms. One of them present a superior canal dehiscent and the other one was on posterior canal. Results: A multislice CT was done in both cases when we suspect the fistula, and both images confirm the problem. No one of them required a chirurgical approach (laberintectomy or blockage of fistula). Discussion: Dehiscent canal in CT not always course with Tullio phenomenon. The syndrome is more frequent nowadays because of new CT techniques. We should ask for our radiologist especially if we suspect a fistula in anamnesis. Incidental radiologic fistula don’t lead always to diagnose the syndrome, because if membranous part of canal is unaltered there is not clinical alteration. Diagnosis is important to explain the symptoms and take the best decision to treat our patients. In jugular prominent bulb and sensorineural hearing loss we had to confirm that there is not a fistula in posterior semicircular canal. An inferior threshold of VEMP is detected respect to general population. Conclusion: No all of patients showing dizziness must have a nuclear resonance at fist time. VEMP can confirm the clinical suspect

Hyoid bone traumatic fracture

[ES] Introducción y objetivos: La fractura de hiodes es una entidad rara. El tratamiento suele ser conservador salvo que asocie complicaciones. El objetivo de este poster es poner de manifiesto que los traumatismos cervicales son entidades que, por sus potenciales consecuencias, han de ser cuidadosamente valorados por el ORL si presentan disfonía, disfagia o disnea. Material y método: Presentamos el caso de una paciente que tras sufrir una caída con la bicicleta fue remitido a nuestro centro para valoración por intenso dolor medio cervical y disfonía leve. A la exploración se descarta un enfisema subcutáneo y se evidencia una leve disfonía antiálgica sin falsas vías y sin disnea. La fibroscopia descartó obstrucción de las vías altas por edema. Se realiza radiografía simple y se evidencia una línea de fractura a nivel medio del hioides. Resultados: El TC descarta enfisema subcutáneo, neumomediastino o enfisema mediastínico y confirma la existencia de una fractura de hioides. Se mantuvo actitud expectante y tratamiento corticoideo sin evidenciarse complicaciones. Discusión: Está descrita la fractura de hiodes en traumatismos de alta energía como accidentes de tráfico, ahorcamientos, y heridas por arma blanca. También se describen en hiperextensión cervical violenta, degluciones bruscas del bolo alimentico o incluso vómitos incoercibles, maniobras intempestivas de intubación orotraqueal o reanimación cardiopulmonar. La radiografía simple mostrará una elevación del hiodes como signo de disrupción cricotraqueal. La porción afectada más frecuentemente es el cuerpo del hiodes. Se han descrito laceraciones faríngeas o incluso avulsión epiglótica, o luxación aritenoidea que hay que descartar con una fibroscopia. La disfagia puede ser motivada por una afectación del glosofaríngeo y la disnea si se produce hematoma retrofaríngeo o laringoceles. El diagnóstico precoz (radiología simple, TC y endoscopia) nos da idea de su magnitud. Si existen signos de alarma precisan reparación inmediata (cervicotomía suprasternal, traqueotomía en las obstrucciones altas de la vía aérea, toracotomía urgente en casos de rotura traqueobronquial), condicionará el pronóstico inmediato. Conclusión: La mayoría evolucionan bien con actitud expectante como en nuestro caso pero puede ser necesaria una traqueostomía. El pronóstico lo determina la coexistencia de lesiones del SNC y pulmones y las aspiraciones, la presencia de parálisis recurrenciales y la rotura de vía aérea.[EN]Introduction and objectives: Hyoid bone fracture is a rare entity. A conservative treatment is usually the correct one, and only if there are complications we must operate on the patient. The objective is to show that cervical traumatism is an entity that must be analyzed by head and neck surgeon if dysphonia, dysphagia or dyspnea. Material and methods: We introduce a female patient who suffered a cycle drop. She explained that just before the drop, she had an intense cervical pain and dysphonia. We confirmed that there was not any subcutaneous emphysema and that she didn’t had dyspnea or any other complication. Nasofibroscopy confirmed integrity of upper airways. A radiography was made and it confirmed the fracture bone tract on hyoid bone. Results: CT excluded subcutaneous or mediastinum emphysema and confirmed the hyoid bone fracture. Corticoid treatment was started and no complications were observed. Discussion: In high energy trauma like traffic, cold steel injury, or violent cervical hyperextension, sudden deglution movements or vomiting or cardiac pulmonary recovery, a fracture of the hyoid bone may happen. In radiological exam an elevation of hyoid bone is showed as a disruption of cricotracheal membrane. Usually, hyoid bone body is affected and may associate pharyngeal lacerations, epiglotic avulsion or arytenoid luxation. Dysphagia should lead to glossopharyngeal or retropharyngeal hematoma. Early diagnosis may be an alarm symptom of the need of a chirurgical approach (suprasternal cervicotomy or tracheostomy, thoracotomy…). Conclusion: Frequently, waiting is the best attitude. Prognosis is marked by central nervous and pulmonary damage, acute recurrence palsy and airway rupture

Endovascular treatment of parotid arteriovenous fistula

[ES] Introducción y objetivos: Las fístulas arteriovenosas suelen tener un origen traumático, tras traumatismos faciales o heridas en la región parotídea. Existe poca casuística y el objetivo de esta presentación es remarcar la utilidad del eco-doppler como primer método diagnóstico en todo acufeno pulsátil. Material y métodos: Paciente de 40 años que acude a nuestra consulta para valorar acufeno derecho pulsátil de años de evolución, tras accidente de tráfico. La palpación parotídea revela una formación nodular intraparotídea, blanda depresible, rodadera y bien limitada. Tras la otoscopia sin hallazgos valorables, comprobamos una normoacusia y curvas impedanciométricas tipo A. Ante la sospecha de alteración vascular solicitamos Eco-Doppler, que confirma una fístula arteriovenosa y el mismo radiólogo sugiere realizar una angio-resonancia magnética confirma una masa que capta intensamente gadolíneo y la existencia de un vaso aferente. Resultados: Con el estudio de imagen se llega al diagnóstico de Fístula Arteriovenosa de localización parotídea derecha dependiente de la arteria carótida externa. Dada la edad de paciente y la escasa sintomatología que la fístula A-V produce, se decidió realizar un seguimiento evolutivo. Al año se incrementa la sintomatología y la paciente se deriva a radiología intervencionista, que proceden a embolizar el vaso causante y cesa la sintomatología. Discusión: Las fístulas arteriovenosas y los aneurismas traumáticos falsos son complicaciones de traumatismos vasculares.Su principal etiología se debe a heridas de armas y también cirugía vascular reciente. La sospecha diagnóstica es clínica. El diagnóstico diferencial incluye angiomas, tumores vasculares parotídeos o de origen neural y aneurismas vasculares. Conclusión: La confirmación diagnóstica y posible tratamiento endovascular se realiza por arteriografía en casos muy sintomáticos o gran tamaño de la lesión. Tambíen podría plantearse el tratamiento quirúrgico con la división de la fístula y la reconstrucción de la arteria y la vena, con ligadura de la vena.[EN] Introduction and objetives: Most of the arteriovenous fistulas have a traumatic origin: Facial injuries of parotid region. There are described a few series and the objetive is remarck the eco-doppler utitlity as the first diagnosic metod in all throbbing tinnitus. Material and metods: We present a 40 years old woman wo consult for a trhobbing tinnitus for years of evolution beforea a traffic accident. Parotid palpation show an intraparotid nodular formation, depressive and delimitated. Before an anodine otoscopy, a normal audition and impedanciometric A tipe curves. We suspect a vascular alteration and an eco-doppler was done; these confirm the aerteriovenous fistula and a magnetic resonance confirms a mass with an afferent artery and collets a lot of gadolineum. Results: We diagnosed an arteriovenous fistula in the parotid region dependant on exteranal carotid artery. The patient tolerated very good the problem and do an annual control. As the tinnitus was worse tolerated, we propossed embolism the aferal vase. Discussion: Arteriovenous fistula and traumatic aneurism are traumatic vassels injuries, caused by white arms, or chirurgical vascular antecedent. Differential diagnosys include angioma, vascular tumors or aneurism. Conclussion: The endovascular approach requieres a previus arteriography and if the lession is very big or very syntomatic coud been opperated on dividing the fistula and reconstruction of artery and venous vassel is doned

Miller Fisher Syndrom diagnosis after ENT manifestations

[EN] Introduction and objectives: Miller-Fisher Syndrome is most frequent form of Gillain Barré syndrome. It has a characteristic tirade: Oftalmoplexia, ataxia and arreflexia. Material and metods: We present a 19 years old man who consults by an irritative pharyngitis , and develops in hours instability, and an important dysphagia, ataxia and hiporreflexia. Explorating the presence of nystagmus we diagnosed a complete oftalmoplexia. 3 hours after a velopalatine palsy was objetivated and a vocal palsy leads to intubate the patient and ingrese at intensive care unit. Results: Antibody of antiglangliosidine antiGQ1b, showed by ELISA, confirm the diagnosys and leads to iniciate inmunoglobuline treatment. Patient recovers all motor funtions but during 3 months there was an intense dysphagia and diplopia. Discussion: These is an inflamatorial polirradiculopaty with an acute desmielinization. It has an immunological injury that generate antibody for mieline and leads to muscular fulminant palsy. Conclussion: A centripetal and axial-coronal evolution is the most frecuent comportation. In the acute period can compromise life if we don’t iniciate trheatment. A good large prognosis is the norme.[ES] Introducción y objetivos: El Síndrome de Miller-Fisher (SMF) es la forma más frecuente entre las formas no clásicas (variantes) del síndrome de Guillain Barré. Se caracteriza por la tríada clásica de oftalmoplejía, ataxia y arreflexia. Material y métodos: Presentamos el caso de un paciente de 19 años que consulta porque tras una faringitis irritativa vírica, desarrolla una inestablidad importante y aparece una disfagia importante incluso para secreciones basales. Se evidencia una marcha atáxica e hiporreflexia con paresia de pares craneales altos (Inicialmente el IX y el X PC derechos). Al explorar el nistagmus se evidencia la oftalmoplejia tanto externa como interna. La analítica y el TC cerebral no muestran hallazgos de interés. El paciente ingresa para estudio , y a las 3 horas empeora drásticamente su disfagia y se constata una parálisis velopalatina bilateral y una paresia de la cuerda vocal izquierda y tiene que ser intubado y trasladado a UVI. Resultados: La existencia en suero de títulos elevados de anticuerpos antigangliósidos antiGQ1b, analizados mediante ELISA, confirma el SMF y hace iniciar el tratamiento con inmunoglobulinas. A largo plazo el paciente recuperó todas sus funciones motoras pero la disfagia y la diplopía persistieron durante 3 meses. Discusión: El SMF se trata de una polirradiculoneuropatía inflamatoria desmielinizante aguda cuya etiología es aún incierta y en la que están involucrados mecanismos inmunológicos; se generan anticuerpos para la mielina y conlleva a una parálisis muscular que puede ser muy grave y de evolución fulminante. Conclusión: Suele tener un avance centrípeto y axial-coronal, desde la periferia a la columna vertebral. En el período agudo puede poner en riesgo la vida de un paciente sin tratamiento y tiene un muy buen pronóstico a largo plazo