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Background Acute kidney injury (AKI) is frequent during hospitalization and may contribute to adverse short- and long-term consequences. Acute kidney disease (AKD) reflects the continuing pathological processes and adverse events developing after AKI. We aimed to evaluate the association of AKD, long-term adverse renal function and mortality in a cohort of patients with sepsis. Methods We performed a retrospective analysis of adult patients with septic AKI admitted to the Division of Intensive Medicine of the Centro Hospitalar Lisboa Norte (Lisbon, Portugal) between January 2008 and December 2014. Patients were categorized according to the development of AKI using the Kidney Disease: Improving Global Outcomes (KDIGO) classification. AKI was defined as an increase in absolute serum creatinine (SCr) ≥0.3 mg/dL or by a percentage increase in SCr ≥50% and/or by a decrease in urine output to 6 h. AKD was defined as presenting at least KDIGO Stage 1 criteria for >7 days after an AKI initiating event. Adverse renal outcomes (need for long-term dialysis and/or a 25% decrease in estimated glomerular filtration rate after hospital discharge) and mortality after discharge were evaluated. Results From 256 selected patients with septic AKI, 53.9% developed AKD. The 30-day mortality rate was 24.5% (n = 55). The mean long-term follow-up was 45.9 ± 43.3 months. The majority of patients experience an adverse renal outcome [n = 158 (61.7%)] and 44.1% (n = 113) of patients died during follow-up. Adverse renal outcomes, 30-day mortality and long-term mortality after hospital discharge were more frequent among AKD patients [77.5 versus 43.2% (P Conclusions AKD after septic AKI was independently associated with the risk of long-term need for dialysis and/or renal function decline and with the risk of death after hospital discharge.

Background: AKI is frequent in critically ill patients, in whom the leading cause of AKI is sepsis. The role of intrarenal and systemic inflammation appears to be significant in the pathophysiology of septic-AKI. The neutrophils to lymphocytes and platelets (N/LP) ratio is an indirect marker of inflammation. The aim of this study was to evaluate the prognostic ability of N/LP ratio at admission in septic-AKI patients admitted to an intensive care unit (ICU). Methods: This is a retrospective analysis of 399 septic-AKI patients admitted to the Division of Intensive Medicine of the Centro Hospitalar Universitário Lisboa Norte between January 2008 and December 2014. The Kidney Disease Improving Global Outcomes (KDIGO) classification was used to define AKI. N/LP ratio was calculated as: (Neutrophil count × 100)/(Lymphocyte count × Platelet count). Results: Fifty-two percent of patients were KDIGO stage 3, 25.8% KDIGO stage 2 and 22.3% KDIGO stage 1. A higher N/LP ratio was an independent predictor of increased risk of in-hospital mortality in septic-AKI patients regardless of KDIGO stage (31.59 ± 126.8 vs 13.66 ± 22.64, p = 0.028; unadjusted OR 1.01 (95% CI 1.00–1.02), p = 0.027; adjusted OR 1.01 (95% CI 1.00–1.02), p = 0.015). The AUC for mortality prediction in septic-AKI was of 0.565 (95% CI (0.515–0.615), p = 0.034). Conclusions: The N/LP ratio at ICU admission was independently associated with in-hospital mortality in septic-AKI patients. Resumen: Antecedentes: La LRA es frecuente en pacientes críticos, en quienes la causa principal de LRA es la sepsis. El papel de la inflamación intrarrenal y sistémica parece ser significativo en la fisiopatología de la LRA por sepsis. La relación entre neutrófilos y linfocitos y plaquetas (N/LP) es un marcador indirecto de inflamación. El objetivo de este estudio fue evaluar la capacidad pronóstica de N/LP en el momento del ingreso en pacientes con LRA por sepsis ingresados en una unidad de cuidados intensivos. Métodos: Se trata de un análisis retrospectivo de 399 pacientes con LRA por sepsis ingresados en la Unidad de Medicina Intensiva del Centro Hospitalario Universitario Lisboa Norte, entre enero de 2008 y diciembre de 2014. Se usó la clasificación del Kidney Disease Improving Global Outcomes (KDIGO) para definir la LRA. La relación N/LP se calculó como: (recuento de neutrófilos × 100)/(recuento de linfocitos × recuento de plaquetas). Resultados: El 52% de los pacientes presentaba KDIGO estadio 3, el 25,8% KDIGO estadio 2 y el 22,3% KDIGO estadio 1. Un valor más elevado de N/LP fue un factor pronóstico independiente de mayor riesgo de mortalidad intrahospitalaria en pacientes con LRA por sepsis, independientemente del estadio KDIGO (31,59 ± 126,8 frente a 13,66 ± 22,64, p = 0,028); OR sin ajustar 1,01 (IC del 95%: 1,00-1,02, p = 0,027), OR ajustada 1,01 (IC del 95%: 1,00-1,02, p = 0,015). El AUC para la predicción de mortalidad en la LRA por sepsis fue de 0,565 (IC del 95%: 0,515-0,615, p = 0,034). Conclusiones: La relación N/LP en el momento del ingreso en la unidad de cuidados intensivos se asoció de forma independiente con la mortalidad intrahospitalaria en pacientes con LRA por sepsis.

Objetivo O objetivo do estudo é contribuir para a validação do Questionário de Avaliação dos Fatores Associados ao Aconselhamento na Diabetes do Tipo 2 (CSRBQ), que avalia os fatores psicossociais envolvidos na prestação de aconselhamento nutricional, de atividade física e de educação continuada (e.g., autoeficácia). Método Foi utilizada uma metodologia mista, com recurso a questionário e entrevistas individuais com profissionais de saúde. Primeiro foram feitas análises à sensibilidade e fiabilidade do instrumento numa amostra de 74 profissionais de saúde envolvidos diretamente na consulta de Diabetes do Tipo 2 (médicos e enfermeiros); posteriormente, foi feita uma análise facial do instrumento através da análise de conteúdo de 17 entrevistas individuais. Resultados A versão portuguesa do CSRBQ apresenta medidas descritivas e consistência interna aceitáveis para quase todas as escalas e, de um modo geral, foi bem aceite e interpretada pelos profissionais de saúde. A análise das entrevistas sugere a necessidade de ajustamento do questionário ao nível da sua organização e clarificação. Conclusão O CSRBQ pode oferecer informação relevante acerca das barreiras e facilitadores à prestação de aconselhamento pelos profissionais de saúde na diabetes do tipo 2.

Current COVID-19 epidemics was declared on December 31, 2019 at the Wuhan city seafood market, rapidly spreading throughout China, and later reaching several countries (mainly South Korea, Japan, Italy and Iran) and, since March 1, reaching Portugal. Most of the infected patients present with mild symptoms, not requiring hospitalization. Among those admitted to the hospital, 6% to 10% require admission to the intensive care unit. These recommendations are aimed to support the organization of intensive care services to respond COVID-19, providing optimized care to the patient and protection for healthcare professionals.

According to the World Health Organization, cancer is one of the leading causes of morbidity and mortality worldwide. The previously estimated 14 million new cases in the year of 2012 are expected to rise, yearly, over the following 2 decades. Among women, breast cancer is the most common one. In 2012, almost 1.7 million people were diagnosed worldwide and half a million died from the disease. Despite having several treatments available, from surgery to chemotherapy, most of these treatments have severe adverse effects. Chemotherapy has a narrow therapeutic window and requires high dosage treatment in patients with advanced-stage cancers and further need innovative treatment strategies. Although methotrexate (MTX) is not a first line drug used against breast cancer, however, it might be valuable to fight the disease. MTX is an effective and cheap drug that might impair malignant growth without irreversible damage to normal tissues. Nevertheless, while MTX does present some disadvantages including poor solubility and low permeability, several strategies are being used to discover and provide novel and effective targeted treatment against breast cancer. In this review, we analyze the chemotherapy of breast cancer and its relationship with drug MTX.

While HCI remains vastly abundant in human- and land- centric applications, in this work we focus on exploring further the Human Computer Biosphere Interaction (HCBI) concept in aquatic settings. Based on the existing techniques for prototyping the geodesic domes, we design them as five marine megafauna species, for the on- and off- shore locations. We describe novel interaction concepts with and within such structures: (i) Turtle AR nesting, (ii) Bird XR watching, (iii) Dolphin acoustic swimming, (iv) Seal night scuba-diving, and (v) Whale projection mapping. We report the design of such interaquatic environments, focused at depicting the ongoing concerns with such marina megafauna species, discussing their feasibility, suggesting research, implementation and validation for all interaquatic domes, planned in our future work.

Background: Infections classified as group 1 biological carcinogens include the helminthiases caused by Schistosoma haematobium and Opisthorchis viverrini. The molecular mediators underlying the infection with these parasites and cancer remain unclear. Although carcinogenesis is a multistep process, we have postulated that these parasites release metabolites including oxysterols and estrogen-like metabolites that interact with host cell DNA. How and why the parasite produce/excrete these metabolites remain unclear. A gene encoding a CYP enzyme was identified in schistosomes and opisthorchiids. Therefore, it is reasonable hypothesized that CYP 450 might play a role in generation of pro-inflammatory and potentially carcinogenic compounds produced by helminth parasites such as oxysterols and catechol estrogens. Here, we performed enzymatic assays using several isoforms of CYP 450 as CYP1A1, 2E1 and 3A4 which are involved in the metabolism of chemical carcinogens that have been associated with several cancer. The main aim was the analysis of the role of these enzymes in production of helminth-associated metabolites and DNA-adducts. Method: The effect of cytochrome P450 enzymes CYP 1A1, 2E1 and 3A4 during the interaction between DNA, glycocholic acid and taurochenodeoxycholate sodium on the formation of DNA-adducts and metabolites associated with urogenital schistosomiasis (UGS) and opisthorchiasis was investigated in vitro. Liquid chromatography/mass spectrometry was used to detect and identify metabolites. Main findings: Through the enzymatic assays we provide a deeper understanding of how metabolites derived from helminths are formed and the influence of CYP 450. The assays using compounds similar to those previously observed in helminths as glycocholic acid and taurochenodeoxycholate sodium, allowed the detection of metabolites in their oxidized form and their with DNA. Remarkably, these metabolites were previously associated with schistosomiaisis and opisthorchiasis. Thus, in the future, it may be possible to synthesize this type of metabolites through this methodology and use them in cell lines to clarify the carcinogenesis process associated with these diseases. Principal conclusions: Metabolites similar to those detected in helminths are able to interact with DNA in vitro leading to the formation of DNA adducts. These evidences supported the previous postulate that imply helminth-like metabolites as initiators of helminthiases-associated carcinogenesis. Nonetheless, studies including these kinds of metabolites and cell lines in order to evaluate its potential carcinogenic are required. This work was financed by FEDER - Fundo Europeu de Desenvolvimento Regional funds through the COMPETE 2020 - Operacional Programme for Competitiveness and Internationalisation (POCI), Portugal 2020, and by Portuguese funds through FCT - Fundação para a Ciência e a Tecnologia, in the framework of the project, Institute for Research and Innovation in Health Sciences” (POCI-01-0145-FEDER-007274). The FCT and FEDER (European Union) also supported these studies through project number IF/00092/2014/CP1255/CT0004 info:eu-repo/semantics/publishedVersion

The deep decarbonisation of the power sector coupled with electrification of end-use sectors will be crucial towards a carbon neutral economy, as required to achieve the Paris Agreement's goal. Several studies have highlighted the relevance of electrification under deep decarbonisation. However, previous work does not explore what would be the major shifts towards electrification, i.e., in what economic activities it will likely occur and when up to 2050 considering gradually stricter GHG emissions constraints. This is of upmost relevance since relatively small variations in emission caps may trigger substantial modifications in specific components of the energy system, namely the shift for the electrification of a particular energy end-use, with impacts on the power sector’s portfolio. In this paper, we analyse the extension of the electrification of the energy system as a cost-effective strategy for deep decarbonisation. We set a large number of increasingly stringent mitigation caps to assess: (i) the degree of electrification of different energy end-uses across all economic activities, (ii) the impact in power sector portfolio and costs and (iii) investment needs. The novelty of this paper relies on the anticipation of electrification of activities traditionally supplied by non-electricity energy carriers, by exploring when and how such transformation may occur in the future, and how much it would cost. We assess the case of Portugal till 2050 by using the TIMES_PT model to generate 50 increasingly stricter decarbonisation scenarios. In the long term, incremental changes (+1%) in more aggressive decarbonisation targets (beyond −70% reduction) induce substantial increase in the share of electrification growth rates. Electric private vehicles, electricity-based steam and heat production in ceramic industrial sector and heat pumps in buildings are the most cost-effective electric technologies. We found that a decarbonisation up to near −80% of 1990′s levels of the Portuguese energy system does not have a significant impact on the power sector unit costs, and does not surpass historic values for some years. However, it should be noted that incremental changes (+1%) in more aggressive decarbonisation targets may increase sharply electricity costs in 2050 (+9%). Thus, focusing in only few scenarios may narrow the role of electrification (or other mitigation options) and its associated costs for deep decarbonisation. This paper allows researchers, planners and decision makers to enhance awareness regarding the relevance and cost-effectiveness of electrification under decarbonisation, namely its feasibility and affordability, providing fruitful insights.

The Positive Energy District (PED) concept has been pointed out as key for cities' energy system transformation toward carbon neutrality. The PED may be defined as an energy-efficient and flexible urban area with net-zero energy import and greenhouse gas emissions, aiming toward annual local surplus of renewable energy. Most of the studies and practical experiences about PEDs are based on newly built districts, where the planning and integration of innovative solutions are less complex and more cost-effective. However, to achieve Europe Union's 2050 carbon-neutral ambition, we argue that the transformation of the settled districts is essential, including historic districts, which present common challenges across European cities, such as degraded dwellings, low-income families, and gentrification processes due to massive tourism flows. This paper aims to discuss how the PED model can be an opportunity for historic districts to reduce their emissions and mitigate energy poverty. The historic district of Alfama, in the city of Lisbon (Portugal), is used as a case study to show the potential of energy renovation measures and solar PV production in households, cornerstones of a PED. The annual energy needs potential reduction due to building retrofit is 84 and 19% for space heating and cooling, respectively, while the integration of building-integrated PV technologies in rooftops and windows potentially generates up to 60 GWh/year. At the district scale, these two components of the PED concept could require an investment of 60M€ to 81M€ depending on the PV technologies in the rooftops, a sensitive aspect in historical districts. Unlike other mechanisms to tackle energy poverty, like the social tariffs, the adoption of structural measures like building energy efficiency retrofit and renewable energy integration will contribute to solve the energy poverty problem, which is significant in Alfama, in both the winter and summer. The highlighted investments require an innovative financial scheme to support not only buildings' owners but also tenants, as these are among the most vulnerable to energy poverty. However, the social benefits of that investment, on the health system, air quality, climate resilience, labor productivity, and social integration, would be invaluable.

Helminthiases are extremely prevalent in the developing world. In addition, the chronic infection with some parasitic worms are classified as carcinogenic. Therefore, it is utmost importance to understand the parasite-host interactions, the mechanisms underlay carcinogenesis and how they could be counteracted. This knowledge may ultimately guide novel control strategies that include chemotherapy-based approaches targeting these pathogens and associated pathologies caused by their infections. Little is known on how some helminthiases are associated with cancer; however, it has been hypothesized that chemical carcinogenesis may be involved in the process. Here, we summarize the current knowledge on chemical carcinogenesis associated with helminthiases, along with available therapeutic options and potential therapeutic alternatives including chemotherapy and/or immunotherapy. Ideally, the treatment of the carcinogenic helminthiases should target both the parasite and associated pathologies. The success of any chemotherapeutic regimen often depends on the host immune response during the infection and nutritional status among other factors. The close association between chemotherapy and cell-mediated immunity suggests that a dual therapeutic approach would be advantageous. In addition, there is a pressing need for complementary drugs that antagonize the carcinogenesis process associated with the helminth infections.

Cancer is the second leading cause of death in the world and its treatment is extremely challenging, mainly due to its complexity. Cell-Penetrating Peptides (CPPs) are peptides that can transport into the cell a wide variety of biologically active conjugates (or cargoes), and are, therefore, promising in the treatment and in the diagnosis of several types of cancer. Some notable examples are TAT and Penetratin, capable of penetrating the central nervous system (CNS) and, therefore, acting in cancers of this system, such as Glioblastoma Multiforme (GBM). These above-mentioned peptides, conjugated with traditional chemotherapeutic such as Doxorubicin (DOX) and Paclitaxel (PTX), have also been shown to induce apoptosis of breast and liver cancer cells, as well as in lung cancer cells, respectively. In other cancers, such as esophageal cancer, the attachment of Magainin 2 (MG2) to Bombesin (MG2B), another CPP, led to pronounced anticancer effects. Other examples are CopA3, that selectively decreased the viability of gastric cancer cells, and the CPP p28. Furthermore, in preclinical tests, the anti-tumor efficacy of this peptide was evaluated on human breast cancer, prostate cancer, ovarian cancer, and melanoma cells in vitro, leading to high expression of p53 and promoting cell cycle arrest. Despite the numerous in vitro and in vivo studies with promising results, and the increasing number of clinical trials using CPPs, few treatments reach the expected clinical efficacy. Usually, their clinical application is limited by its poor aqueous solubility, immunogenicity issues and dose-limiting toxicity. This review describes the most recent advances and innovations in the use of CPPs in several types of cancer, highlighting their crucial importance for various purposes, from therapeutic to diagnosis. Further clinical trials with these peptides are warranted to examine its effects on various types of cancer.

Although the prognostic effect of obesity has been studied in critically ill patients its impact on outcomes of septic patients and its role as a risk factor for acute kidney injury (AKI) is not consensual. We aimed to analyze the impact of obesity on the occurrence of AKI and on in-hospital mortality in a cohort of critically ill septic patients. This study is retrospective including 456 adult patients with sepsis admitted to the Division of Intensive Medicine of the Centro Hospitalar Lisboa Norte (Lisbon, Portugal) between January 2008 and December 2014. Obesity was defined as a body mass index of 30 kg/m2 or higher. The Kidney Disease Improving Global Outcomes classification was used to diagnose and classify patients developing AKI. AKI occurred in 87.5% of patients (19.5% with stage 1, 22.6% with stage 2 and 45.4% with stage 3). Obese patients developed AKI more frequently than non-obese patients (92.8% versus 85.5%, p = .035; unadjusted OR 2.2 (95% CI: 1.04-4.6), p = .039; adjusted OR 2.31 (95% CI: 1.07-5.02), p = .034). The percentage of obese patients, however, did not differ between AKI stages (stage 1, 25.1%; stage 2, 28.6%; stage 3, 15.4%; p = .145). There was no association between obesity and mortality (p = .739). Of note, when comparing AKI patients with or without obesity in terms of in-hospital mortality there were also no significant differences between those groups (38.4% versus 38.4%, p = .998). Obesity was associated with the occurrence of AKI in critically ill patients with sepsis; however, it was not associated with in-hospital mortality. info:eu-repo/semantics/publishedVersion

Urban areas have a pivotal role to play in climate change mitigation, as they are responsible for a high share of energy consumption and provide many opportunities for more efficient supply & use of energy. This makes the case for energy system modelling at city level, as done within the INSMART EU project, which identified the optimum mix of measures for a sustainable energy future for four European cities in a holistic manner. The approach combined quantitative modelling with Multi-Criteria Decision Analysis. Sector specific data and models (buildings and transport) were articulated into one integrated energy system model based on the TIMES model generator. It was found that urban level energy modelling brings with it a new set of challenges, since for a well-known territory, transparency and effective communication with local decision-makers are even more important than at national or transnational level. Special efforts should be paid to making model results geographically explicit, and urban modelling results should expect scrutiny by local agents. It was found that there is a gap between the scope for action of local energy planners and the most energy intensive urban sectors, which highlighted new priorities instead of those traditionally taken under municipal management. Keywords: Integrated energy planning, Low carbon urban energy plans, TIMES energy system model, Sustainable energy action plans

Fuel poverty is a recognized and increasing problem in several European countries. A growing body of literature covers this topic, but dedicated analysis for Portugal are scarce despite the high perception of this condition. This paper contributes to fill this knowledge gap focusing on a European southern city while bringing new datasets and analysis to the assessment of this topic; consumer groups identification and to policy discussion. Daily electricity smart meters' registries were combined with socio-economic data, collected from door-to-door surveys, to understand the extent and the determinants of energy consumption for two contrasting consumer groups (herein called fuel poverty and fuel obesity groups). The analysis is based on the amount and annual profile of electricity consumption and was complemented with building energy simulations for relevant building typologies in those groups, to identify heating and cooling thermal performance gaps. The existence of these gaps allowed confirming and/or discarding the initial hypothesis of the poverty or obesity conditions. Results disclose socio-economic variables, as income, and consumers' behavior as key determinants of electricity consumption. It was identified a severe lack of thermal comfort levels inside households of both groups, either in cooling (98% for fuel poverty and 87% for fuel obesity) and heating seasons (98% for fuel poverty and 94% for fuel obesity). Major conclusion refers that electricity consumption cannot be used alone to segment consumer groups. This assessment may serve to support energy policy measures and instruments targeted to different consumers' groups. For example, distinct campaigns and differentiated incentives may apply to achieve energy efficiency and reduction while keep or improve indoor comfort levels.

Daily electricity consumption profiles from smart meters are explored as proxies of active behavior regarding space heating and cooling. The influence of the environment air temperature (multiple maximum and minimum daily thresholds) on electricity consumption was explored for a final sample of 19 households located in southwestern Europe (characterized by hot, dry summers and cool, wet winters), taking the full year of 2014. Statistical analysis of the deviations from hourly average electricity consumptions for each temperature thresholds was performed for each household. Firstly, these deviations could act as proxies highlighting possible lack of thermal comfort on space cooling, and partially on space heating, supported by door-to-door survey data, on socio-economic details of occupants, buildings bearing structure and equipment's ownership and use. Secondly, meaningful differences of consumers' behavior on electricity consumption pattern were identified as a response for space heating and cooling to the environment air temperatures thresholds. Additionally, statistical clusters of active and non-active behavior groups of households were assessed, showing the electricity use for space heating. This paper illustrates the importance of the widespread use of smart-meters data on the increasingly electrified buildings sector, to understand whether and how thermal comfort could be achieved through active climatization behavior of its occupants. This is particularly important in regions where automatic HVAC systems are almost absent.

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Operating isolated power systems with increasing shares of renewable energy sources requires the integration of battery energy storage systems in order to assure enhanced frequency regulation capabilities. The control mode of power converters interfacing battery energy storage systems to the grid can be based on grid-forming type structures given its superior performance with respect to the mitigation of network frequency disturbances. Nevertheless, in case of network faults, the interactions between existing synchronous units and the grid-forming type converters may adversely affect the global system behavior. Therefore, this paper addresses the study-case of a MW-scale isolated power system with large shares of converter-interfaced renewable generation, operating with both synchronous machines and a grid-forming type power converter. An optimal grid-forming control parameter tuning procedure considering different disturbances is presented, aiming to reduce the associated battery energy storage system power regulating effort following the disturbances. Moreover, it is proposed and discussed the need of a novel rule-based adaptive control solution to switch between different sets of control parameters used in grid-forming type converters depending on the network status following a fault-type disturbance. Extensive numerical simulations performed over different operating scenarios illustrate the performance of the proposed solution.

The European Commission has acknowledged the significance of local and regional communities in its effort to tackle climate change. In this respect a number of initiatives and programmes (e.g. Covenant of Mayors, Covenant of Mayors for Climate and Energy, CONCERTO, CIVITAS, etc.) have been set up in order to engage European cities in the effort towards a low carbon future and an improved quality of life through sustainable economic development. These initiatives have been generally successful and have resulted in the commitment of an increasing number of European cities towards sustainable development goals. At the same time, however, it has been revealed that there is a critical need for improved comprehensive city planning driven by an integrated and strategic approach, focused on cost benefit assessment towards sustainable energy use. This paper presents an innovative city planning approach developed within the EU FP7 project InSMART. It brings together four European municipalities – Evora (Portugal), Nottingham (UK), Trikala (Greece) and Cesena (Italy) –, academics, industries and technical consultants in order to establish a common methodology for enhancing sustainable planning for both the current and future city needs through an integrative and multidisciplinary approach. The methodology develops and employs a number of tools to assess the optimum mix of medium term measures (up to 2030) for a sustainable energy future, addressing the efficiency of energy flows across various city sectors with regards to economic, environmental and social criteria and paving the way towards actual implementation of priority actions. This paper presents the key concepts around this methodology and some selected results of the project (still ongoing). The results refer to the four city partners, all actively involved in developing a more sustainable energy system. Further on, the proposed approach may be replicable to other cities.

Selective laser melting, which is based on the principle of material incremental manufacturing, has been recognised as a promising additive manufacturing technology. The principle of additive manufacturing lies in fabricating a part or an assembly of parts, layer by layer through a bottom to top approach. The technology is suited for creating geometrically complex components that can not possibly or feasibly be made by any other means. This technique has a weak point related to the surface finishing. Therefore, during the construction of layer by layer, there is a need to use techniques such as milling to remove material. This hybrid approach allows the fabrication of parts with internal complex structures and very good surface finishing. To plan and optimize the successive additive and subtractive phases, we need a quick tool to determine when the geometry of a piece is suitable for surface finishing by a 3 axes milling machine. This problem can be reduced to a layer by layer subproblem of approximately covering a slice of the object by circles of the diameter of the smallest drill available that can reach its depth. This reduction to the plane allows us to use a medial axis approach. The medial axis of a planar domain, defined as the set of centers of maximal circles contained in the domain, relates very closely to the notion of generalized Voronoi diagram, and has been proposed in several milling applications that involve motion planning. We propose to use it, and certain extensions of it, as a practical way of determining the best possible finishing quality at a slice. To that end we have to find which of the available construction strategies best suits our needs to determine exactly or approximately the medial axis of a polygon and its extensions.

Urban areas constitute over three-fourths of the current global economy, house more than half of the global population and consume more than two thirds of final global energy consumption with the consequential greenhouse gas emissions. New dynamics are occurring with cities becoming vectors of sustainable development, through initiatives like the Covenant of Mayors. Innovative approaches and tools are required to support city development planning in compliance with climate change mitigation goals. City planning and management are typically addressed through a fragmented and silo approach, failing to capture the dynamics and complexity of a city energy system. Integrated energy system modelling tools are progressively incorporating increasing realism to enhance results quality and confidence. This paper demonstrates the effects of including household budget constraints in integrated energy system optimisation modelling on low carbon city pathways. The TIMES_EVORA model was used to characterize current and future city energy system, covering all its chain, from energy supply sectors (e.g. electricity production) to end use sectors (e.g. residential and transport). Optimal solutions for meeting Évora municipality (Portugal) 2030 greenhouse gases emissions targets were assessed, combining household budget constraints for the acquisition of more efficient technologies – from appliances to private vehicles. The results showed a decrease of hybrid vehicles ownership in 2030 and a consequent increase of diesel vehicles. The optimal model solution shows a persistence in the acquisition of highly efficient households' appliances and the deployment of additional PV systems to facilitate a reduction of the electricity generation CO2 footprint. This allows to offset the transport CO2 emission increase and provide benefits across all energy system. Improving the integration of behavioural or real-life aspects in energy system optimisation models allows further understanding of city energy systems dynamics and provide robust city decarbonization strategies design. Cities sustainable energy system and urban planning should include different agent's investment constraints in order to avoid technology deployment locking that can compromise cities sustainable pathways. Keywords: City energy system, Scenarios analysis, Integrated energy model, Household budget constraints, Portugal

Schistosomiasis is a major neglected tropical disease. Treatment for schistosomiasis with praziquantel (PZQ), which is effective against the parasite, by itself is not capable to counteract infection-associated disease lesions including hepatic fibrosis. There is a pressing need for novel therapies. Due to their biological properties, antioxidant biomolecules might be useful in treating and reverting associated pathological sequelae. Here, we investigated a novel therapy approach based on a combination of anthelmintic drugs with antioxidant biomolecules. We used a host-parasite model involving Bioamphalaria glabrata and newly transformed schistosomula (NTS) of Schistosoma mansoni. For in vitro drug screening assays, was selected several antioxidants and evaluated not only antischistosomal activity but also ability to enhance activity of the anthelmintic drugs praziquantel (PZQ) and artesunate (AS). The morphological alterations induced by compounds alone/combined were assessed on daily basis using an inverted and automated microscope to quantify NTS viability by a fluorometric-based method. The findings indicated that not only do some antioxidants improve antischistosomal activity of the two anthelmintics, but they exhibit activity per se, leading to high mortality of NTS post-exposure. The combination index (CI) of PZQ + Mel (CI = 0.80), PZQ + Resv (CI = 0.74), AS + Resv (CI = 0.34), AS + NAC (CI = 0.89), VDT + Flav (CI = 1.03) and VDT + Resv (CI = 1.06) reveal that they display moderate to strong synergism. The combination of compounds with discrete mechanisms of action might provide a valuable adjunct to contribution for treatment of schistosomiasis-associated disease. This work was financed by FEDER - Fundo Europeu de Desenvolvimento Regional funds through the COMPETE 2020 - Operational Programme for Competitiveness and Internationalisation (POCI), Portugal 2020, and by Portuguese funds through FCT - Fundação para a Ciência e a Tecnologia, in the framework of the projects "Institute for Research and Innovation in Health Sciences" (POCI-01-0145-FEDER-007274). NV also acknowledges support from FCT and FEDER (European Union), award number IF/00092/2014/CP1255/CT0004. Acknowledgments: We express our deepest appreciation to Mrs. Maria Lurdes Delgado for expert maintenance of the schistosome life cycle and her technical support. NV thanks FCT by IF position, Fundação Manuel António da Mota (FMAM, Portugal) and Pfizer Portugal by support Nuno Vale Lab. JMCC thanks FCT for Pest-OE/AGR/UI0211/2011 and Strategic Project UI211. PJB acknowledges support from award CA164719 from the National Cancer Institute (NCI), National Institutes of Health (NIH), USA. The contents of this report are solely the responsibility of the authors and do not necessarily represent the official views of the FCT, FMAM, Pfizer Portugal or the NIH.

The work supporting this paper was partly funded by the European project InSMART - Integrative Smart City Planning (EU FP7 Grant agreement no: 314164). The authors would like to thank Evora municipality, namely its InSMART project team members, for providing essential information. The authors would also like to thank Katherine Mahoney for her English revisions at the final stage. Finally, the authors acknowledge and appreciate the support given to CENSE by the Portuguese Foundation for Science and Technology through the strategic project UID/AMB/04085/2013. The recent decrease in solar photovoltaic (PV) investment cost has transformed the attractiveness of the technology. Southern Europe has one of the highest levels of solar radiation in the world, and policy makers are very keen to take full advantage of this resource for electricity and heat production. However, physiographic characteristics and specific land uses (e.g. agro-forestry and nature conservation) present important spatial constraints. This paper proposes a methodology for the evaluation of utility-scale solar PV projects’ (>1 MW) technical potential. The municipality of Évora (Portugal) was used as a case study, considering topographical features and spatial planning regulations. Three compatible scenarios for solar PV farms and other competing land uses were studied. The assessment was carried out using a geographic information system and statistical tools. It was conducted for four sizes of PV project (1, 10, 20 and 30 MW) consisting of two different technology types: concentrated PV and crystalline-silicon tracking PV. Concentrated PV 1 MW projects were found to have greater adaptability for use in available areas dispersed throughout the territory, while preserving land for agriculture and nature conservation. The scenario with land primacy for agricultural purposes reduced PV technical potential by more than half (from 2494 to 1116 MW). Nevertheless, the remaining potential was sufficient to cover substantial shares of local annual electricity consumption. The results provided support for future spatial planning regulations and local sustainable energy action plans. authorsversion published

The decarbonization of cities’ energy systems requires multiple data sources, increasingly available at different temporal and spatial resolutions, as well as integrated energy planning tools to identify smart and sustainable solutions. This chapter presents the case of Evora Municipality, in Portugal, which launched several initiatives toward a smart city, namely, the rollout of more than 34,000 smart meters from 2010. An integrated analytical framework, supported by multiple data sources, models and tools over the city, is presented to illustrate how decarbonized pathways up to 2030 can be generated throughout an energy planning process. A codesign practice with the stakeholders’ participation along this process was taken as a crucial step to consider aspects other than technological options and its cost-effectiveness. Evora city’s energy system includes residential buildings, transport and mobility, other energy demand sectors (i.e., waste water and sewage systems, industries, public lighting, public buildings, services, and agriculture), and the energy supply system, including local renewable energy sources. Multiple cost-effective measures were assessed through a multicriteria tool, and its costs were estimated to feed a mid-term sustainable energy plan. Evora is presented as an example of a smart city regarding its energy system, with implemented and planned smart solutions to be adopted for a sustainable and local empowered city.

Energy Poverty (EP) is the inability to attain a socially and materially necessitated level of domestic energy services. In the EU this occurs primarily due to low incomes, poor energy performance of buildings and high energy costs. The impacts of EP range from impaired social lives to unhealthy living conditions, with further consequences in the physical and mental health of energy poor individuals. Member states have been assigned by the EU with the responsibility of dealing with EP within their own territories. This is attainable mainly by creating effective policies, while also encouraging synergies among policies of different fields. However, scientific knowledge is gathered and action is taken on a national level only in a limited number of EU countries. For this reason, this paper aims to fill in the gap and capture snapshots from five EU countries (Cyprus, Spain, Portugal, Bulgaria and Lithuania) where EP has not been exhaustively examined. The study provides an overview of selected policies and measures directly or indirectly targeting EP alleviation and analyses their history and evolution at an EU level as well as at national level. It considers the different geographical dimensions, conditions and aspects (e.g. national or regional) where EP is encountered, in an attempt to identify any variances or similarities in the approaches adopted. Through this comparative study, strengths and weaknesses of national strategies are identified and analysed. Conclusively, based on this analysis, recommendations are made on how to utilise policy tools and provide the most efficient support to energy poor households in the corresponding countries.

In the Mediterranean area most of the public authorities need to enhance their institutional capacity in the field of Energy Efficiency (EE) and use of Renewable Energy Sources (RES) in order to contribute to the Energy Performance of Buildings and the Energy Efficiency Directives, developing solutions suited to various regional contexts. The PrioritEE project, funded by the Interreg MED programme, aims at reinforcing the capacities of public administrations in selecting and implementing eco-friendly and cost-effective energy planning measures. This paper aims to describe the main efforts carried out by local public authorities and professional institutions from five MED countries (Italy, Portugal, Spain, Greece and Croatia) in order to reduce energy consumption and prioritize EE investments in Municipal Public Buildings (MPBs). In particular, it focuses on the methodological framework describing the main components of the proposed toolbox, the main objectives and expected outcomes but also the current achievements and the way forward.

The discovery of novel antiparasitic drugs for neglected tropical diseases (NTDs) constitutes a global urgency and requires a range of innovative strategies to ensure a sustainable pipeline of lead compounds. Thus far, primaquine (PQ) is the only transmission-blocking antimalarial that is clinically available, displaying marked activity against gametocytes of all causative species of human malaria (Plasmodium spp.). Chagas disease, caused by Trypanosoma cruzi, is another PQ-sensitive illness besides malaria. One of the major drawbacks of PQ is its metabolism into carboxyprimaquine (CPQ), which is less active than the parent drug. In this study, we developed different synthetic pathways to confer N-protection to PQ through introduction of thioxo-imidazolidin-4-one. The introduction of this group prevents the formation of CPQ, counteracting one major drawback of the parent drug. After that, we evaluated the potential biological activity of the novel 2-thioxo-imidazolidin-4-one derivative of PQ, which showed relevant in vitro activity against Trypanosoma cruzi (IC50 1.4 μM) compared to PQ (IC50 1.7 μM) and the reference drug benznidazole (IC50 1.6 μM). Noting its acceptable pharmacokinetic profile, this PQ conjugate may be a potential scaffold for novel drug exploration against Chagas disease.

Schistosomiasis is the most important helminthiasis worldwide in terms of morbidity and mortality. Most of the infections occurs in Africa, which about two thirds are caused by Schistosoma haematobium. The infection with S. haematobium is considered carcinogenic leading to squamous cell carcinoma (SCC) and urothelial carcinoma of the urinary bladder. Additionally, it is responsible for female genital schistosomiasis leading to infertility and higher risk of human immunodeficiency virus (HIV) transmission. Remarkably, a recent outbreak in Corsica (France) drew attention to its potential re-mergence in Southern Europe. Thus far, little is known related to host-parasite interactions that trigger carcinogenesis. However, recent studies have opened new avenues to understand mechanisms on how the parasite infection can lead cancer and other associated pathologies. Here, we present a historical perspective of schistosomiasis, and review the infection-associated pathologies and studies on host–parasite interactions that unveil tentative mechanisms underlying schistosomiasis-associated carcinogenesis.

Making public buildings smarter and more energy efficient requires tailored solutions to overcome the barriers in implementing suitable technology options in a large variety of building types. The PrioritEE project aimed to strengthen the policy-making and strategic planning competencies of local and regional public authorities in the energy management of Municipal Public Buildings, gaining experience in five local pilots in the Mediterranean area. This paper focuses on the PrioritEE toolbox, describing both the “soft components” and the technical components. These components are widely applicable and replicable in all European cities for supporting local administrations in improving energy efficiency and the use of renewable energy sources in municipal public buildings. The Energy Technologies and Building Retrofit Database is a technology repository of energy efficiency measures and renewable energy technologies, providing the main reference data on costs, technical performance and lifetime. With the Decision Support Tool users can assess current building stock energy performance, evaluate different efficiency and renewable interventions, and compare, rank, and prioritize technical options through a set of key performance indicators. A sample of the results to date in the five partner regions are also presented, comparing the main individual characteristics in order to derive replicable solutions for local authorities. This project also highlighted how crucial stakeholder involvement is for tool improvement, capacity building and enabling knowledge transfer. info:eu-repo/semantics/publishedVersion

The integration of distributed Battery Energy Storage Systems (BESS) at the Medium Voltage (MV) and Low Voltage (LV) networks increases the distribution grid flexibility to deal with high penetration of Renewable Energy Sources (RES). In addition, it also enables the deployment of key self-healing functionalities, which allow the islanded operation of small sections of the distribution network. However, new planning and real-time operation strategies are required to allow the BESS coordinated control, as well as a cost-effective and stable operation. This paper presents new tools developed for the planning and real-time operation of distribution networks integrating BESS, particularly when operating islanding. For real-time operation, a short-term emergency operation-planning tool assesses the feasibility of islanded operation of a small section of the distribution network. The long-term impact of a BESS control strategy for islanded operation is assessed through a Life Cycle Analysis (LCA) tool. The results and implementation experience in real distribution network are also discussed.

In this paper, we study the problem of establishing a dynamic charging schedule of electric vehicles (EVs) at a charging station, assuming that limited power implies that only a limited number of EVs can charge simultaneously. The only control we assume to be available to the charging station is the ability to (at any given time) turn on or off the power supply to any EV, with this tool we want to develop a charging schedule that will satisfy the energy demands of the EVs in their intended deadlines. We propose two distinct approaches to this problem: a discretized time version, based on a greedy-like algorithm, and a continuous time version, based on linear programming. We compare these two approaches and numerically study the improvement they yield in the efficiency of the charging procedure, when applied to simulated data based on real parking data. Finally, we illustrate the flexibility of the models by sketching several possible extensions.

Improvements of energy efficiency and reduction of Electricity Consumption (EC) could be pushed by increased knowledge on consumption profiles. This paper contributes to a comprehensive understanding of the EC profiles in a Southwest European city through the combination of high-resolution data from smart meters (daily electricity consumption) with door-to-door 110-question surveys for a sample of 265 households in the city of Evora, in Portugal. This analysis allowed to define ten power consumption clusters using Ward's method hierarchical clustering, corresponding to four distinct types of annual consumption profiles: U shape (sharp and soft), W shape and Flat. U shape pattern is the most common one, covering 77% of the sampled households. The results show that three major groups of determinants characterize the electricity consumption segmentation: physical characteristics of a dwelling, especially year of construction and floor area; HVAC equipment and fireplaces ownership and use; and occupants’ profiles (mainly number and monthly income). The combination of the daily EC data with qualitative door-to-door survey-based data proved to be a powerful data nutshell to distinguish groups of power consumers, allowing to derive insights to support DSOs, ESCOs, and retailers to design measures and instruments targeted to effective energy reduction (e.g. peak shaving, energy efficiency).

With the increasing amount of big data available from high temporal resolution from smart meters and with the increasing digitalisation of the customer expectation of digital service brings forward new business models, which might request significant improvement information and communications technology (ICT) capabilities for the distribution systems operator (DSO), as well as new decision support tools and new challenges to procure flexibility services from distributed generation, electric vehicle charging network, demand response or storage. Active network management and distributed generation along with the changing market structures are drivers for change towards the future cities. This study will provide a better understanding on the actual state of the art for utilities and DSOs seeking their new role as market facilitator and data manager with additional insights from market segmentation as well as the potential role of the DSO in the integrated framework for smart cities. The INSMART project developed a mix of sustainable energy measures to improve the energy efficiency of each partner city, identified with specialised tools and models.

Estrogen-like metabolites have been identified in S. haematobium, the helminth parasite that causes urogenital schistosomiasis (UGS) and in patients´ blood and urine during UGS. Estrogen receptor (ER) activation is enriched in the luminal molecular subtype bladder cancer (BlaCa). To date, the significance of ER to these diseases remains elusive. We evaluated ERα and ERβ expression in UGS-related BlaCa (n = 27), UGS-related non-malignant lesions (n = 35), and noninfected BlaCa (n = 80). We investigated the potential of ERα to recognize S. haematobium-derived metabolites by docking and molecular dynamics simulations and studied ERα modulation in vitro using 3 BlaCa cell lines, T24, 5637 and HT1376. ERα was expressed in tumor and stromal cells in approximately 20% noninfected cases and in 30% of UGS-related BlaCa, predominantly in the epithelial cells. Overall, ERα expression was associated with features of tumor aggressiveness such as high proliferation and p53 positive expression. ERα expression correlated with presence of schistosome eggs. ERβ was widely expressed in both cohorts but weaker in UGS-related cases. molecular dynamics simulations of the 4 most abundant S. haematobium-derived metabolites revealed that smaller metabolites have comparable affinity for the ERα active state than 17β-estradiol, while the larger metabolites present higher affinity. Our in vitro findings suggested that ERα activation promotes proliferation in ERα expressing BlaCa cells and that this can be reverted with anti-estrogenic therapy. In summary, we report differential ER expression between UGS-related BlaCa and noninfected BlaCa and provide evidence supporting a role of active ERα during UGS and UGS-induced carcinogenesis. Highlights: Estrogen receptor (ERs) are expressed in both urogenital schistosomiasis and bladder cancer; ERα was associated with aggressive tumor features and presence of schistosome eggs; In silico analysis shows an agonistic putative action of S. haematobium-derived metabolites for ERα; ERα induced proliferation in bladder cancer cells can be reverted by anti-estrogens; Evidence suggests that activation of ERα could play a role in urogenital schistosomiasis and urogenital schistosomiasis-induced carcinogenesis. PJB acknowledges support from award R01CA164719 from the National Cancer Institute (NCI), National Institutes of Health (NIH), USA. info:eu-repo/semantics/publishedVersion

Infections caused by Schistosoma haematobium and Opisthorchis viverrini are classified as Group 1 biological carcinogen and it has been postulated that parasites produce oxysterol and estrogen-like metabolites that might be considered as initiators of infection-associated carcinogenesis. Chemotherapy for these helminthic infections relies on a single drug, praziquantel, (PZQ) that mainly targets the parasite. Additionally, PZQ has some major drawbacks as inefficacy against juvenile form and alone it is not capable to counteract pathologies associated to infections or prevent carcinogenesis. There is an urgent need to develop novel therapeutic approaches that not only target the parasite but also improve the pathologies associated to infection, and ultimately, counteract or/and prevent the carcinogenesis processes. Repurposing the drug in combination of compounds with different modes of action is a promising strategy to find novel therapeutics approaches against these helminthic infections and its pathologies. Here, we emphasized that using antioxidants either alone or combined with anthelmintic drugs could ameliorate tissue damage, infection-associated complications, moreover, could prevent the development of cancer associated to infections. Hence, antioxidants represent a potential adjuvant approach during treatment to reduce morbidity and mortality. Despite the success of some strategies, there is a long way to go to implement novel therapies for schistosomiasis.

© Associação de Medicina Intensiva Brasileira - AMIB. This is an open access article under the CC BY, license https://creativecommons.org/licenses/by/4.0/)., Critically ill patients are at risk of developing stress ulcers in the upper digestive tract. Agents that suppress gastric acid are commonly prescribed to reduce the incidence of clinically important stress ulcer-related gastrointestinal bleeding. However, the indiscriminate use of stress ulcer prophylaxis in all patients admitted to the intensive care unit is not warranted and can have potential adverse clinical effects and cost implications. The present guidelines from the Sociedade Portuguesa de Cuidados Intensivos summarizes the current evidence and gives six clinical statements and an algorithm aiming to provide a standardized prescribing policy for the use of stress ulcer prophylaxis in the intensive care unit., O paciente crítico corre risco de desenvolver úlceras de estresse do trato gastrintestinal. Antiácidos e antiulcerosos de diferentes classes são frequentemente prescritos para reduzir a incidência de hemorragia gastrintestinal clinicamente significativa associada à úlcera de estresse. No entanto, o uso indiscriminado deste tipo de profilaxia em todos os pacientes admitidos a unidades de terapia intensiva não só não se justifica, como tem potenciais efeitos adversos e implicações de custo. As presentes diretrizes da Sociedade Portuguesa de Cuidados Intensivos resume a evidência atual e fornece seis afirmações clínicas e um algoritmo com o objetivo de fornecer uma política padronizada para prescrição de profilaxia da úlcera estresse em unidades de terapia intensiva.

Schistosomiasis is a major neglected tropical disease. Control of schistosomiasis currently relies on a single drug, praziquantel, and despite its efficacy against the all schistosome species that parasitize humans, it displays some problematic drawbacks and alone is ineffective in counteracting adverse pathologies associated with infection. Moreover, due to the development of the potential emergence of PZQ-resistant strains, the search for additional or alternative antischistosomal drugs have become a public health priority. The current drug discovery for schistosomiasis has been slow and uninspiring. By contrast, repurposing of existing approved drugs may offer a safe, rapid and cost-effective alternative. Combined treatment with PZQ and other drugs with different mode of action, i.e., antimalarials, shows promise results. In addition, a combination of anthelminthic drugs with antioxidant might be advantageous for modulating oxidative processes associated with schistosomiasis. Herein, we review studies dealing with combination therapies that involve PZQ and other anthelminthic drugs and/or antioxidant agents in treatment of schistosomiasis. Whereas PZQ combined with antioxidant agents might or might not interfere with anthelminthic efficacy, combinations may nonetheless ameliorate tissue damage and infection-associated complications. In fact, alone or combine with other drugs, antioxidants might be a valuable adjuvant to reduce morbidity and mortality of schistosomiasis. Therefore, attempting new combinations of anthelmintic drugs with other biomolecules such as antioxidants provides new avenues for discovery of alternatives to PZQ. NV acknowledges support from Fundação para a Ciência e Tecnologia (FCT, Lisbon, Portugal) and FEDER (European Union), award numbers UID/Multi/04378/2013 and IF/00092/2014. NV also thanks FCT for the IF position and Fundação Manuel António da Mota (FMAM, Porto, Portugal) and Pfizer, Portugal for support for the Nuno Vale Research Group. JMCC thanks FCT for Pest-OE/AGR/UI0211/2011 and Strategic Project UI211. PJB acknowledges support from award CA164719 from the National Cancer Institute (NCI, Rockville, MD, USA), National Institutes of Health (NIH, Bethesda, MD, USA). The contents of this report are solely the responsibility of the authors and do not necessarily represent the official views of the FCT, FMAM, the NCI, or the NIH.

In order to achieve the goal of the Paris Agreement on Climate Change to limit average global temperature rise to well under 2 °C, concerted action will be needed in cities to manage energy consumption and reduce greenhouse gas emissions. But, what can be done at city level to move towards such a global ambitious target? The project InSMART (Integrative Smart City Planning) brought together four EU cities: Evora (Portugal), Cesena (Italy), Nottingham (UK) and Trikala (Greece), and scientific organizations in these countries in order to try and provide some answers to this question. A methodology was established for enhancing sustainable energy planning for future city needs through an integrative and multidisciplinary approach, including City Energy System Models (ESM), development of different scenarios with a participatory workshop approach, and a multi-criteria assessment for the final ranking of measures and the development of a Sustainable Energy Action Plan. It is important not to overestimate the contribution and the area of influence of city-agents to the global GHG target; but it is undoubted that municipalities are extremely well positioned for actions related to households, and their consumption in buildings and transport, for bridging locally the gap between what is perceived/known and what would be economically and technically feasible and for urban planning with a focus on significant benefits for GHG emissions reduction.

This chapter explores the impacts on energy systems of deep decarbonization in Portugal up to 2050. The technological bottom-up model TIMES_PT is used to generate three families of scenarios; a reference case, three deep decarbonization scenarios and three electrification scenarios. Results show that the electrification of the final energy consumption of the Portuguese economy contributes significantly towards decarbonization, but that this is not a linear relationship. Electrification is not always the synonym of renewable power, although it is cost-effective to deploy renewable power plants up to the maximum endogenous potentials of onshore wind and hydro. Electrification is achieved by significant deployment of renewable electricity generation, mainly solar photovoltaic and offshore wind, as well as concentrated solar power (to a lesser extent). The end use technologies that contribute the most to the electrification of the Portuguese economy are electric vehicles, heat pumps (both in residential and commercial buildings) and dryers and kilns in some industrial sectors. Investment costs will be the cost component with the highest growth in share of total costs over the modelled period, from around 36% of total costs in 2015 up to almost 60% in 2050 for the most stringent greenhouse gas mitigation scenario, while fuel costs substantially decline. The current energy and climate national policies do not consider any of these specific low carbon energy technologies, nor the major investments that will be required. Such aspects need to be specifically addressed in the Portugal Carbon Neutrality Roadmap studies that have recently started.

This paper provides a method to identify drivers, barriers and synergies (DBS) related to the deployment of a CO2 pipeline network. The method was demonstrated for the West Mediterranean region (WMR) (i.e. Spain, Portugal and Morocco). The method comprises a literature review, analysis of embedded pipeline trajectories, interviews with experts, and workshops with stakeholders. Subsequently, the collected information was used to identify route specific DBS in several CO2 pipeline network deployment scenarios that were modeled for the WMR. Most identified DBS apply to CO2 pipeline transport in general. The barriers (e.g. technical knowledge gaps, outstanding legislative issues, lack of financial incentive) can in principle be tackled to make the design, construction and operation of a CO2 pipeline network possible, but could sometimes lead to somewhat higher costs. Furthermore, there are also facilitating processes (e.g. experience with CO2 pipeline transport for EOR). Cost benefits due to pipeline oversizing were identified as a route specific driver, whereas crossings of mountains, water and nature areas are route specific barriers. Installing CO2 pipelines along natural gas pipelines could be either a route specific synergy or barrier, depending on site conditions. Finally, several key measures were proposed to enable CO2 pipeline networks in the future.

In this paper we propose an improved mathematical model for locating EV charging stations. We consider the successive activities of the travelers, i.e., a person with two main stops during the day should charge the vehicle in just one of the parking spots, hence avoiding double counting the demand. The model is tested for the city of Coimbra (Portugal), where there is a network of nine stations. We conclude that our solution is better than the one that was implemented in reality, moreover we are able to conclude that demand transference has a rather significant impact on the solutions.

Schistosomiasis, a major neglected tropical disease, affects more than 250 million people worldwide. Treatment of schistosomiasis has relied on the anthelmintic drug praziquantel (PZQ) for more than a generation. PZQ is the drug of choice for the treatment of schistosomiasis; it is effective against all major forms of schistosomiasis, although it is less active against juvenile than mature parasites. A pyrazino-isoquinoline derivative, PZQ is not considered to be toxic and generally causes few or transient, mild side effects. Increasingly, mass drug administration targeting populations in sub-Saharan Africa where schistosomiasis is endemic has led to the appearance of reduced efficacy of PZQ, which portends the selection of drug-resistant forms of these pathogens. The synthesis of improved derivatives of PZQ is attracting attention, e.g., in the (i) synthesis of drug analogues, (ii) rational design of pharmacophores, and (iii) discovery of new compounds from large-scale screening programs. This article reviews reports from the 1970s to the present on the metabolism and mechanism of action of PZQ and its derivatives against schistosomes. We acknowledge support from the Fundação para a Ciência e Tecnologia (FCT, Portugal) and FEDER (European Union) through UID/MULTI/04378/2013 and project Minireview Antimicrobial Agents and Chemotherapy May 2017 Volume 61 Issue 5 e02582-16 aac.asm.org 12 Downloaded from http://aac.asm.org/ on March 12, 2018 by B-ON FCCN TRIAL grant IF/00092/2014 and from award R01CA164719 from the National Cancer Institute (NCI), National Institutes of Health (NIH). We thank FCT for the IF2014 position (N.V.) and Pest-OE/AGR/UI0211/2011 and Strategic Project UI211 (J.M.C.C). info:eu-repo/semantics/publishedVersion

Anxiety and depression in the elderly individuals have been studied around the world, and some authors consider them among the most serious problems faced by modern societies. With recent economic crisis-very important in Southern European countries-isolation, loneliness, and exclusion of the active society, mental problems are probably raising and associated with distinct factors. In this cross-sectional analysis, nested in a longitudinal population-based cohort study, we analyze anxiety and depression prevalence, and their related factors, in a representative cohort of Portuguese seniors. We used data retrieved from second wave of follow-up of EpiDoC Cohort-EpiDoC 2 study, which is composed by 10,661 adults, representative of adult Portuguese population. This study included all ≥65 years old EpiDoC 2 study participants, who responded to Hospital Anxiety and Depression Scale (HADS), n = 1,680. Sociodemographic, lifestyles, self-reported non-communicable diseases, health-related quality of life (EQ-5D-3D), physical function (HAQ), and health resources consumption data were collected. Anxiety and depression were assessed with HADS. Anxiety and depression prevalence were estimated. Multivariable logistic regression was used to assess anxiety and depression score determinants. The estimated prevalence of anxiety among Portuguese elderly is 9.6% and depression is 11.8%. Seniors with anxiety and seniors with depression have a higher probability to self-report higher levels of physical disability (OR = 3.10; 96% CI 2.12-4.52; OR = 3.08, 95% CI 2.29-4.14, respectively) and lower levels of quality of life (OR = 0.03, 95% CI 0.01-0.09; OR = 0.03, 95% CI 0.01-0.06, respectively). Female gender (OR = 2.77, 95% CI 1.53-5.00), low educational level (OR = 2.30, 95% CI 1.22-4.36), allergic (OR = 2.02, 95% CI 1.14-3.55), and rheumatic disease (OR = 2.92, 95% CI 1.74-4.90) were significantly and independently associated with the presence of anxiety symptoms. Physical inactivity (OR = 1.64, 95% CI 1.11-2.42) and low educational level (OR = 2.40, 95% CI 1.41-4.09) were significantly and independently associated with depression symptoms. Subjects that reported to drink alcohol daily or occasionally were negatively associated with depression symptoms. Anxiety and depression are frequent among Portuguese elderly. These prevalence rates suggest that preventing mental illness in senior population is a crucial need. A well-designed prevention strategy might have an effective action in raising the well-being of elderly. info:eu-repo/semantics/publishedVersion

A distinctive characteristic of a Microgrid (MG) system is related to the ability of operating autonomously. However, the stability of the system relies in storage and generation availability, providing frequency and voltage regulation. Considering the deployment of distributed storage units in the Low Voltage network and of smart metering infrastructures, this paper presents an online tool for promoting an effective coordination of MG flexible resources in order ensure a secure autonomous operation and maximize the time that the MG is able to operate islanded from the main grid. The tool determines a priori an emergency operation plan for the next hours, based on load and microgeneration forecasting. The limited energy capacity of the distributed storage units participating in MG control is also considered.

The increase of renewables in power sector, together with the increase of their electricity share in final energy consumption, is changing our perception about energy security with diverse and contradictory statements. The Portuguese security of electricity supply is analyzed in this study by comparing selected indicators for 2 years before and after the high increase of onshore wind since 2005. Our goal is to find how the security of electricity supply was impacted by the penetration of renewables, taking a supply chain approach. Our analysis highlights that the penetration of renewables has decreased the energy dependence of the power sector by more than 20% between 2004 and 2011, while risks related to the concentration of natural gas suppliers and to the still-high share of fossil fuels suffering from price volatility are discussed. We observed a significant improvement in power interconnections with Spain, as well as an increase of the de-rated generation capacity margin, allowing proper management of renewable power intermittency if necessary, thereby improving power security. Although the share of intermittent renewables almost quadrupled in total installed capacity between those years, the indicators reveal an improvement in the quality of transport and distribution when delivering electricity to end-users. Although electricity prices increased, mainly due to taxes, the lack of energy efficiency is an aspect deserving improvement to alleviate the pressure on electricity security, mainly at high peak demands.

The reduction of energy consumption and the increase in energy efficiency is currently an important cornerstone of EU policy. Energy performance certificates (EPCs) were implemented as one of the tools to promote this agenda, and are used for the energy performance assessment of buildings. In this study, the characteristics of the Portuguese dwelling stock are regionally analysed using data from approximately 523,000 Portuguese residential EPCs. Furthermore, a bottom-up building typology approach is used to assess the regional energy needs impact of retrofitting actions and to estimate the heating and cooling energy performance gaps of the whole dwelling stock, as well as the potential CO2 emissions resulting from the gaps’ potential offset due to increase thermal comfort. The results show that Portuguese residential buildings have very low energy performance, with windows and roofs being identified as the most energy inefficient elements. Roof retrofitting has the highest potential for the reduction of energy needs. The estimated heating and cooling energy performance gap amount to very significant percentages, due to the poor performing building stock but also very low energy consumption levels, with probable consequences for the thermal comfort of occupants. Assuming the current energy mix, carbon emissions would be 9.8 and 20.2 times higher associated with heating and cooling, respectively, if the actual final energy consumption were to match the estimated theoretical values derived from building regulation. This study demonstrates several application cases and leverages the potential of the individual EPC, increasing the detail in the dwelling stock characterization and energy performance estimation, revealing its value for energy retrofit and climate change mitigation assessments, as well as establishing the ground for future work related to building retrofits, energy efficiency measure implementation, climate change mitigation, thermal comfort, and energy poverty studies.

Carbon capture and storage (CCS) has been identified by several studies as a promising option in the greenhouse gas mitigation portfolio of different countries. Since the Iberian Peninsula is a region with a large availability of renewable energy sources (RES), the role of CCS deserves deeper analysis. Using the TIMES_IBERIA optimization model, this paper investigates the contribution of several factors (i.e. climate policy, RES and CCS cost curves, and gas prices) that might promote or constrain the adoption of CCS technologies as part of a portfolio for reducing CO 2 emissions from the power generation and industrial sector, in the medium–long term (2020–2050), within the Iberian Peninsula energy system. CCS becomes cost effective only after mature renewables, namely wind onshore and hydropower, are fully exploited up to their technical-economic potential. An ambitious long term climate target (−50% reduction in 2050 over 1990) contributes to an early penetration of CCS (in 2025). It penetrates more in the power sector (60% of captured emissions) than in industry (40%), and most of it is implemented in Spain (95%), not in Portugal. CCS penetration appears very sensitive to the costs of CCS technologies, while much less sensitive to the costs of renewable technologies.

PURPOSE Using the Risk, Injury, Failure, Loss of kidney function, End-stage kidney disease (RIFLE), Acute Kidney Injury Network (AKIN) and Kidney Disease: Improving Global Outcomes (KDIGO) systems, the incidence of acute kidney injury (AKI) and their ability to predict in-hospital mortality in severe sepsis or septic shock was compared. MATERIALS AND METHODS We performed a retrospective analysis of 457 critically ill patients with severe sepsis or septic shock hospitalized between January 2008 and December 2014. Multivariate logistic regression was employed to evaluate the association between the RIFLE, AKIN and KDIGO systems with in-hospital mortality. Model fit was assessed by the goodness-of-fit test and discrimination by the area under the receiver operating characteristic (AUROC) curve. Statistical significance was defined as P < 0.05. RESULTS RIFLE (84.2%) and KDIGO (87.5%) identified more patients with AKI than AKIN (72.8%) (P < 0.001). AKI defined by AKIN and KDIGO was associated with in-hospital mortality {AKIN: adjusted odds ratio [OR] 2.3[95% confidence interval (CI) 1.3-4], P = 0.006; KDIGO: adjusted OR 2.7[95% CI 1.2-6.2], P = 0.021} while AKI defined by RIFLE was not [adjusted OR 2.0 (95% CI 1-4), P = 0.063]. The AUROC curve for in-hospital mortality was similar between the three classifications (RIFLE 0.652, P < 0.001; AKIN 0.686, P < 0.001; KDIGO 0.658, P < 0.001). CONCLUSIONS RIFLE and KDIGO diagnosed more patients with AKI than AKIN, but the prediction ability for in-hospital mortality was similar between the three systems.

Muitos estudos têm mostrado que as crianças e adolescentes com obesidade apresentam pior qualidade de vida (QdV) e maior insatisfação com a imagem corporal, comparativamente a crianças e adolescentes de peso saudável. Contudo, até ao momento, não é conhecido o papel da imagem corporal no ajustamento psicossocial destes jovens, nem são bem compreendidas as especificidades desenvolvimentais e de género. Deste modo, o presente estudo pretende comparar a QdV e a insatisfação com a imagem corporal de rapazes e raparigas, crianças e adolescentes, com peso saudável e com obesidade. Adicionalmente, pretende analisar se a relação entre o peso e a QdV é mediada pela insatisfação com a imagem corporal e moderada pelo género das crianças e adolescentes. A amostra contém 155 crianças e adolescentes com peso saudável e 207 crianças e adolescentes com obesidade, entre os 8 e os 18 anos de idade. Os participantes preencheram o KIDSCREEN-10 e a Escala de Silhuetas de Collins. As crianças e adolescentes com obesidade apresentaram pior QdV e maior insatisfação com a imagem corporal, comparativamente a crianças e adolescentes de peso saudável. Adicionalmente, observou-se que as raparigas reportam pior QdV e estão mais insatisfeitas com o seu corpo do que os rapazes. Verificou-se também que a insatisfação com a imagem corporal mediou a relação entre o peso e a QdV, mas apenas no grupo de adolescentes. As crianças e adolescentes com obesidade tendem a apresentar pior QdV e a estarem mais insatisfeitas com a sua imagem corporal. A satisfação com a imagem corporal demonstrou ser um importante mecanismo explicativo da relação entre o peso e a QdV, tornando-se um alvo de intervenção relevante, especialmente em adolescentes. Importância deve ser dada à prevenção e intervenção psicológica precoce em equipas multidisciplinares capazes de detetar e intervir eficazmente nos problemas psicossociais das crianças e adolescentes com obesidade.

Projections of energy demand are important for energy security supply and low carbon futures, and usually rely on final energy consumption trends methods, limiting the opportunity for future options. Methods supported by energy services are much preferred to estimate future energy demand, since they are better suited to accomplish end-users needs. Final energy can then be assessed through complementary tools, as technological models, resulting in deeper knowledge on the relation between energy services and technology options. This paper presents a bottom-up methodology to project detailed energy end-uses demand in the Portuguese residential buildings until 2050, aiming to identify the parameters governing energy services demand uncertainty, through a sensitivity analysis. The partial equilibrium TIMES (The Integrated MARKAL-EFOM System) model was used to assess technology options and final energy needs for the range of parameters variations for each end-use, allowing to conclude on the impact of uncertainty of energy services demand in final energy. Main results show that technology can overweight behavioral practices and lifestyle changes for some end-uses as in space heating and lighting. Nevertheless, important focus should be given to uncertain parameters related with consumer behavior, especially those on heating and other electric end-uses, as thermal comfort and equipment's use.