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  • 1
    Online Resource
    Online Resource
    Evaluating the Eco-Efficiency of Wastewater Treatment Plants: Comparison of Optimistic and Pessimistic Approaches
    MDPI AG ; 2020
    In:  Sustainability Vol. 12, No. 24 ( 2020-12-17), p. 10580-
    Details
    In: Sustainability, MDPI AG, Vol. 12, No. 24 ( 2020-12-17), p. 10580-
    Abstract: The assessment of wastewater treatment plant (WWTP) performance has gained the interest of water utilities and water regulators. Eco-efficiency has been identified as a powerful indicator, as it integrates economic and environmental variables into a single index. Most previous studies have employed traditional data envelopment analysis (DEA) for the evaluation of WWTP eco-efficiency. However, DEA allows the selection of input and output weights for individual WWTPs for the calculation of eco-efficiency scores. To overcome this limitation, we employed the double-frontier and common set of weights methods to evaluate the eco-efficiency of a sample of 30 WWTPs in Spain. The WWTPs were ranked based on eco-efficiency scores derived under several scenarios including best- and worst-case scenarios; this approach to performance assessment is reliable and robust. Twenty-six of the 30 WWTPs were not classified as eco-efficient, even under the most favorable scenario, indicating that these facilities have substantial room for the reduction of costs and greenhouse gas emissions. The ranking of WWTPs varied according to the scenario used for evaluation, which has notable consequences when eco-efficiency scores are used for regulatory purposes. The findings of this study are relevant for water regulators and water utilities, as they demonstrate the importance of weight allocation for eco-efficiency score estimation.
    Type of Medium: Online Resource
    ISSN: 2071-1050
    URL: Article
    DOI: 10.3390/su122410580
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2518383-7
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  • 2
    Online Resource
    Online Resource
    Kinematic Parameters That Can Discriminate in Levels of Functionality in the Six-Minute Walk Test in Patients with Heart Failure with a Preserved Ejection Fraction
    MDPI AG ; 2022
    In:  Journal of Clinical Medicine Vol. 12, No. 1 ( 2022-12-28), p. 241-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 12, No. 1 ( 2022-12-28), p. 241-
    Abstract: It is a challenge to manage and assess heart failure with preserved left ventricular ejection fraction (HFpEF) patients. Six-Minute Walk Test (6MWT) is used in this clinical population as a functional test. The objective of the study was to assess gait and kinematic parameters in HFpEF patients during the 6MWT with an inertial sensor and to discriminate patients according to their performance in the 6MWT: (1) walk more or less than 300 m, (2) finish or stop the test, (3) women or men and (4) fallen or did not fall in the last year. A cross-sectional study was performed in patients with HFpEF older than 70 years. 6MWT was carried out in a closed corridor larger than 30 m. Two Shimmer3 inertial sensors were used in the chest and lumbar region. Pure kinematic parameters analysed were angular velocity and linear acceleration in the three axes. Using these data, an algorithm calculated gait kinematic parameters: total distance, lap time, gait speed and step and stride variables. Two analyses were done according to the performance. Student’s t-test measured differences between groups and receiver operating characteristic assessed discriminant ability. Seventy patients performed the 6MWT. Step time, step symmetry, stride time and stride symmetry in both analyses showed high AUC values ( 〉 0.75). More significant differences in velocity and acceleration in the maximum Y axis or vertical movements. Three pure kinematic parameters obtained good discriminant capacity (AUC 〉 0.75). The new methodology proved differences in gait and pure kinematic parameters that can distinguish two groups according to the performance in the 6MWT and they had discriminant capacity.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm12010241
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2662592-1
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  • 3
    Online Resource
    Online Resource
    Estimation of Functional Aerobic Capacity Using the Sit-to-Stand Test in Older Adults with Heart Failure with Preserved Ejection Fraction
    MDPI AG ; 2022
    In:  Journal of Clinical Medicine Vol. 11, No. 10 ( 2022-05-10), p. 2692-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 11, No. 10 ( 2022-05-10), p. 2692-
    Abstract: Background: The 6-Min Walking Test (6MWT) has been proposed to assess functional aerobic capacity in patients with heart failure, but many older adults with heart failure cannot complete it. The adequacy of the 5-repetition Sit-To-Stand (5-STS), a simpler test than 6MWT, to assess the functional aerobic capacity in older adults with heart failure has not been evaluated. Objectives: This study aimed to assess the usefulness of 5-STS in estimating maximal oxygen uptake (VO2 peak) in older adults with heart failure with preserved ejection fraction (HFpEF). Methods: A cross-sectional study was carried out. Patients 70 years and older with HFpEF were included. A bivariant Pearson correlation and subsequent multivariate linear regression analysis were used to analyze the correlations between the 5-STS and the estimated VO2 peak. Results: Seventy-six patients (80.74 (5.89) years) were recruited. The 5-STS showed a moderate and inversely correlation with the estimated VO2 peak (r = −0.555, p 〈 0.001). The 5-STS explained 40.4% of the variance in the estimated VO2 peak, adjusted by age, sex, and BMI. When older adults were stratified by BMI, the 5-STS explained 70% and 31.4% of the variance in the estimated VO2 peak in older adults with normal weight and overweight/obesity, respectively. Conclusions: The 5-STS may be an easy tool to assess functional aerobic capacity in older adults with HFpEF, especially for those with normal weight.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm11102692
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2662592-1
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