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A pin-connected joint, which was intended to accommodate a certain in-plane rotation and resist the shear forces, was introduced in this paper. Pinned-connections were applied on Truss-Column joints to support the heavy-loaded floors and roofs in a long-span steel structure. The Pinned-connection was designed in accordance with European code, and compared with other standards such as America standard and Australia standard. To better understand the behavior of materials and structure of this pin-connection structural system, four specimens, including two full-scale pin-connections and two truss connections, were tested to investigate the performance under both monotonic and cyclic loads. The load–displacement curves, hysteretic curve and ultimate loads were obtained, and the failure mode, capacity and ductility were discussed. The experimental and numerical results indicated that the pin-connection behaved good ductility, load transfer ability and capacity.

Higher education courses must be continuously updated to catch up with the ever-changing industrial advancements. An up-to-date course benefits all parties of interest including students, employers and the education institution. This paper discusses the process of identifying industry expectations from graduates and implementing industry inputs based on two engineering courses offered at the Engineering Institute of Technology. A generic, but detailed implementation procedure is developed. The procedure mainly involves an industry panel and a course advisory committee. The purpose of an industry panel is to make recommendations on course content, so that any gap identified between the course learning outcomes and the current industry needs is closed. The objective of a course advisory committee is to assess the industry panel proposals and implement them appropriately. Both engineering courses discussed in the paper are coursework-based master programs. The uniqueness of both courses is analyzed through comparisons. Surveys were conducted amongst the industry panels and the course advisory committees involved in the two courses. The survey results verified the effectiveness of the implementation procedure and provided additional insights. Furthermore, other factors that could affect the efficiency of the procedure are identified.

The learning environment has shifted from the traditional synchronous classroom-based mode to synchronous and asynchronous online mode. However, critical aspects of engineering courses where theories meet applications, such as in the form of practical or laboratory work, are challenging to be conducted effectively online. The rise of industry 4.0 has led to more education institutions adopting remote laboratories as a contemporary alternative to cater for the technical and social competences needed for engineering students and instructors. This paper aims to explore and review the current global landscape of remote or virtual laboratories to better understand its impact on online engineering courses. Furthermore, the Engineering Institute of Technology’s (EIT’s) Remote Laboratory System(RLS) is used as a case study to analyse some critical and specific aspects of remote laboratories. In this case study, using the current data available from EIT’s RLS, quantitative analysis has been conducted and a forecasting model of the RLS activities has been achieved. The benefits derived from utilizing remote laboratories are demonstrated by analyzing engineering students’ academic performance.

ResumoA isquemia mesentérica aguda é uma entidade de elevada mortalidade e constitui frequentemente o culminar de um processo patológico crónico. A revascularização convencional permanece como abordagem de escolha nestes casos. Os autores apresentam 2 casos de isquemia mesentérica crónica agudizada operados na instituição. O primeiro caso refere‐se a um homem de 76 anos submetido a revascularização cirúrgica das artérias hepática comum e mesentérica superior por quadro arrastado de dor abdominal e perda ponderal. O segundo caso refere‐se a uma mulher de 83 anos com quadro de vómitos e diarreia de evolução rápida para abdómen agudo, submetida a bypass aorto‐mesentérico superior com veia grande safena e ressecção ileocecal. Os 2 casos tiveram desfecho favorável graças a um diagnóstico célere, a uma revascularização convencional pronta e à ressecção intestinal concomitante.AbstractAcute mesenteric ischemia is a disease with high mortality and is frequently the end result of a chronic process. Surgical revascularization is still the preferred therapy in these cases. We present two cases of “acute‐on‐chronic” mesenteric ischemia operated in our institution. The first was a 76 year‐old male with a protracted history of abdominal pain and weight loss treated with revascularization of the common hepatic and superior mesenteric arteries. The second was a 83 year‐old female with a history of vomiting and diarrhea that quickly evolved into an acute abdomen and was submitted to aorto‐mesenteric bypass with great saphenous vein and ileo‐cecal resection. The two cases had a favorable outcome due to a timely diagnosis, to a prompt surgical revascularization and to a bowel resection.

Microalgae can provide an untapped number of important bioactive molecules (functional ingredients), and their incorporation in traditional foods (e.g. breakfast cereals, spreads, breads, cookies, brownies, energy bars, mayonnaises, gelled desserts, pastas, emulsions, ice creams, and beverag

Marfan's Syndrome is a rare connective tissue disease whose surgical treatment presents several challenges. The existing criteria and recommendations on how and when to surgically approach this disease is almost exclusively confined to the root and ascending aorta, in contrast to the variability of indications on the involvement of the remaining segments of the thoracic and abdominal aorta, due to the multiplicity, morphology and topography of these involvements. This case report is related to a 39 year old woman with Marfan's syndrome, with a type B chronic dissection and a segmentar aneurysm of the proximal descending thoracic aorta with 6,1cm of maximum diameter. The clinical and imagiologic evaluation pointed out the absence of any disorder of the heart, root or ascending aorta. The patient underwent surgical management of the dissecting aneurysm through a transthoracic approach to the aneurysm, with fenestration of the distal aorta and exclusion of the aneurism and intercostal arteries. The efficacy and result of the procedure in addition to the rarity of the vascular pathology presented by the patient, even in the context of a Marfan, completely justify the presentation and disclosure of this clinical case.

The clinical case of a 72-years old male is reported, admitted into a Medical Department through the Emergency Service, with a clinical picture of heavy lumbar pain, with walking compromise and acute urinary retention, lasting for several hours. Laboratory analysis revealed a marked elevation of acute inflammatory parameters and a renal failure, expressed by 108 mg/dl of urea and 4.4 mg/dl of creatinine. The patient was admitted with the provisional diagnosis of acute prostatitis, pos-renal acute renal insufficiency and dorso-lumbar pathology of unknown etiology. Three consecutive and subsequent hemocultures allowed the isolation of a Streptococcus pneumonae strain and a CT dorso lumbar spine evaluation disclosed a D11 to D12 spondylodiscitis, with a partial destruction of the vertebral bodies and an extensive throracoabdominal aortic aneurysm adjacent to those vertebrae, with some characteristic features of an infectious aneurysm. Simultaneously, an hemothorax on the left chest was noticed, consequence of a chronic contained rupture of the aneurysm. Following an intensive and specific antibiotic therapy and with an almost completed recovery of the renal function, he underwent surgical management, consisting in the evacuation and drainage of the hemothorax, followed by resection of the aneurysm and extensive tissular debridmente, culminating in the vascular reconstruction utilizing the "simplified technique", introduced in 1984 by A. Dinis da Gama for the surgical management of thoracoabdominal aortic aneurysms. The patiente tolerated the procedure well, with no intercorrences or complications and the post operative course was unventfull. One month later, a CT-angio control disclosed the revascularization procedure working in excellent condition. Finally, an orthopedic artrodhesis of the injuried vertebrae was performed, allowing an easy and pain-free walking and he was discharged on day 60, under antibiotic treatment. The main features of this clinical case are emphasized and discussed, namely those aspects related to its pathogenesis, clinical presentation, diagnosis and surgical management.

The objective of this study was to evaluate the results of endovascular treatment of the superficial femoral artery and to identify some possible predictors of poor prognosis.All patients with femoropopliteal artery occlusive disease submitted to endovascular treatment in the internment section of the first author, between July 2007 to September 2010, were reviewed. Intention to treat analysis was performed. Patient's demographics and angiographic anatomic characteristics (results were standardized according to TransAtlantic Inter-Society Consensus II) were analyzed. Kaplan-Meier survival analyses were performed to assess time-dependent outcomes. We performed a univariate and bivariate analysis in order to determine factors temporally associated with a poor prognosis of endoluminal therapy. Results were evaluated in view of absence of re-stenosis, absence of re-intervention, patency and overall limb salvage rate.A total of 34 patients corresponding to 36 lower limbs were treated during this period (mean age 65±12 years; males: 80%). Seventy-five percent of patients presented with chronic lower limb ischemia stage IV according to the Leriche-Fontaine classification, while the remaining 25% presented with chronic lower limb ischemia stage III. The lesions classified according to the TASC II document included 9 lesions TASC II B (25%), 20 lesions TASC II C (55%) and 7 lesions TASC II D (19%). Runoff at the tibial level was 1.8±0.6 patent vessels. The success rate was 94%. Mean follow-up was 13.5 months (varying 1-31 months) from the date of initial intervention. Five lower limbs (14%) presented with re-stenosis. Primary patency rates were 91% at 1 month and 77% at 6 months. Limb salvage rate was 88% at 12 months. Subgroup analysis revealed that primary patency rates were highly dependent on patient gender, lesion type and infra-popliteal runoff patent vessels.Endovascular treatment of femoropopliteal sector is associated with high technical success rate. The best results were obtained in male patients with segmental, stenotic lesions and with a runoff of at least two vessels.

The occurrence of an arteriovenous fistula is a potential complication of cardiac catheterization. Most of these fistulas cause no harm. We report the clinical case of a 70 years old woman with high-output heart failure caused by an arteriovenous fistula (FAV) in the groin. The fistula was successfully closed by surgical repair and the heart failure was resolved. This case confirms the potential harmfulness for the vascular bed of certain surgical/endovascular interventions and intravascular monitoring techniques. When heart failure of uncertain etiology appears in patients previously submitted to one of the above mentioned procedures, a careful clinical examination can lead to a correct diagnosis of iatrogenic FAV, whose surgical correction is usually followed by the restoration of a normal cardiac function.

The authors report the clinical case of a 56 years old man who developed a deep venous thrombosis of the left lower extremity, managed conventionally with subcutaneous heparin. Physical examination revealed a large tumor of the middle third, antero lateral view of the left thigh. CT and NMR studies, disclosed an extensive multilobulated tumor along the femoral vessels, with medial deviation of the superficial femoral artery and a surgical biopsy revealed the diagnosis of leiomyosarcoma of the femoral vein, grade 3 of malignancy. The patient underwent a complete resection of the tumor, followed by chemotherapy. Two months after the operation a staging CT scan disclosed multiple micronodular metastasis in both lungs and six months later he was found asymptomatic and in good condition. A review of the literature concerning primary malignant tumors of the veins of the extremities is made, with emphasis on main features of its biology, clinical presentation, methods of diagnosis, treatment and results.

Fibromuscular dysplasia (FMD) is a noninflammatory, nonatherosclerotic sistemic disease of unknown etiology, primarily affecting muscular arteries of intermediate size. It has been most commonly observed in the renal, carotid, and intracerebral arteries, although it has been reported in other arterial beds. However, being an uncommon disease in general, the manifestation of FMD in the upper extremities is exceedingly rare. The authors report the case of a 69 years old female admitted with ischemia of the right hand, secondary to fibromuscular dysplasia of the midbrachial artery. The patient presented to vascular surgery clinic with a 4 month history of numbness, pain, and coolness of her right hand, with a small necrotic lesion on her right index finger. Peripheral pulses were barely palpable, and doppler-derived brachial and radial systolic pressures suggested midbrachial artery stenosis. Arteriography showed a normal arch and normal innominate, subclavian, and axillary arteries. The midbrachial artery was markedly abnormal and had alternating areas of stenosis and aneurysm formation - "string-of-beads" appearance. The patient underwent surgical excision of the abnormal right brachial artery, and reconstruction was accomplished with a reversed saphenous vein graft. Distal pulses were restored postoperatively. Pathologic examination confirmed the diagnosis of fibromuscular dysplasia. A review of the literature on the topic was made.

Energy crises, global warming, and climatic changes call for technological and commercial advances in manufacturing high-quality transportation fuels from unconventional feedstocks. Microalgae is one of the most promising sources of biofuels due to the high yields attained per unit area and because it does not displace food crops. Neochloris oleabundans (Neo) microalga is an important promising microbial source of single-cell oil (SCO). Different experimental growth and lipid production conditions were evaluated and compared by using optical density (540 nm), dry-weight determination, and flow cytometry (FC). Best Neo average biomass productivity was obtained at 30 degrees C under conditions of nitrogen-sufficiency and CO(2) supplementation (N+/30 degrees C/CO(2)), with an average doubling time of 1.4 days. The second and third highest productivities occurred with N-sufficient cultures without CO(2) supplementation at 26 degrees C (N+/26 degrees C) and at 30 degrees C (N+/30 degrees C), with doubling times of 1.7 and 2.2 days, respectively. Microbial lipid production was monitored by flow cytometry using Nile red (NR), a lipophilic fluorochrome that possesses several advantageous characteristics for in situ screening near real time (at line). Results showed maximum lipid content (56%) after 6 days of nitrogen depletion under nitrogen starvation without CO(2) supplementation (N-/30 degrees C), followed by N-/30 degrees C/CO(2) and N-/26 degrees C conditions with 52% lipid content, after 5 and 6 days of N starvation, respectively. The adequate fatty acid profile and iodine value of Neo lipids reinforced this microalga as a good source of SCO, in particular for use as biodiesel.

Paradoxical embolism (EP) occurs when a venous thrombus passes into the arterial circulation, most commonly through an intracardiac shunt. A patent foramen ovale (FOP) is present in 25-35%of people at all ages. It is now possible to detect FOP by contrast echocardiography and it has been shown that there exists quite frequently a spontaneous transient right-to-left shunt during systole and, moreover, a right-to-left shunt during Valsalva maneuver and coughing. Acute or chronic pulmonary hypertension are also causes of shunt. This phenomenon has been associated with catastrophic outcomes such as stroke, visceral infarction and ischemic limb. We report the case of a 31-year old man with multiple paradoxical thromboemboli into his right kidney, spleen, small bowel and left brachial artery. Paradoxical embolism was suspected and confirmed by transoesophageal contrast echocardiography, disclosing FOP with right-to-left shunt. Successful percutaneous closure of patent foramen ovale with Amplatzer(R) PFO occluder 18 mm allowed subsequent oral antiaggregation with acetilsalicilic acid 150 mg/day and clopidogrel 75 mg/day. A new case gives the opportunity to review mechanisms, diagnosis and therapeutic issues. Treatment strategies for FOP in recurrent PE include antiplatelet agents, anticoagulants, surgical closure, or percutaneous closure devices. The completion of ongoing, randomized clinical trials comparing percutaneous closure devices with medical management is urgently needed to clarify if the risks of invasive endovascular device placement are outweighed by a long-term reduction in recurrent vascular events.

In this paper the clinical condition of two male patients, aged 58 and 65 years are presented, after being admitted as a consequence of a rare complication of an inflammatory aneurysm of the abdominal aorta, which is an ureteral compression, with hydronephrosis, anuria and acute renal failure. After having an urgent haemodialysis session, the etiology of the process was diagnosed by echography and abdominal CT-scans, followed by ureteral catheterization, restoration of diuresis and normalization of renal function. Conventional surgery was performed later, in elective conditions, and the post operative course was normal, without complications. The main features of this clinical entity, its diagnosis and multidisciplinary management are presented and discussed.

The revascularization of the lower limbs through a bypass graft from the descending thoracic aorta is one of the most uncommon surgical procedures within the scope of the so-called "extra-anatomic revascularization". It is an highly selective procedure in terms of indications and is regarded as an effective hemodynamic alternative, with acceptable long-lasting results. Two patients who underwent successfully the operation are reported, followed by a discussion on the technical aspects, indications, complications and early and late results of the procedure.

Introduction The leiomyosarcoma of the inferior vena cava (IVC) is a rare clinical entity, although it represents the most common malignant tumor of the venous system. Level II IVC tumors (supra-renal) are the most frequent and those who have a better prognosis for the development of symptoms earlier. Case report The authors report a case of IVC leiomyosarcoma in a 59-year-old woman, presenting with DVT of the right lower limb, subsequent to prolongued nonspecific abdominal pain. Computed tomography revealed a large retroperitoneal neoformation, centered to IVC, which extended above the renal veins (the left one patent and the right one involved in the mass). The patient underwent en block resection of the tumor and reconstruction of the renal veins: construction of a new IVC bifurcation at the supra-renal level with a bifurcated PTFE graft, followed by graft extension to both renal veins using externally-supported 8 mm PTFE grafts. Histology revealed a high-grade leiomyosarcoma. The postoperative period was complicated by a type 2 MI and retroperitoneal hematoma, with occlusion of the right graft branch and partial infarction of the right kidney. The patient underwent surgery again and proceeded to partial resection of the thrombosed graft branch. The patient was discharged home under anticoagulation and is clinically well without edema of the lower limbs, normal renal function, and has begun adjunctive therapy. Conclusion The prognosis of these tumors is poor, with a high recurrence rate. An aggressive surgical approach combined with adjuvant therapy may not be curative, but is the best strategy to prolong survival.

ResumoO aneurisma da artéria hipogástrica é uma entidade clínica rara, constituindo um desafio diagnóstico e terapêutico associado a mortalidade relevante, sobretudo em contexto de rutura.Os autores divulgam o caso clínico de um homem de 75 anos de idade, com antecedentes de ressecção parcial de aneurisma aorto‐ilíaco infrarrenal através de interposição de prótese aorto‐bifemoral, a quem foi diagnosticado no «follow up» de 9 anos, aneurisma da artéria hipogástrica esquerda (4,5cm). Este foi submetido a tratamento endovascular através de embolização hipogástrica complementada por implantação de endoprótese ilíaca, o que se revelou uma alternativa segura e eficaz, a curto e médio prazo.AbstractThe internal iliac artery aneurysm is a rare clinical entity, which constitutes a diagnostic and therapeutic challenge, manifested by a high percentage of mortality cases when rupture occurs.The authors present a 75 year‐old male previously submitted to infra‐renal aorto‐iliac aneurysm partial resection and interposition of a bifurcated aorto‐bifemoral graft. At 9 years follow‐up a 4,5cm asymptomatic hypogastric aneurysm was diagnosed. Hypogastric embolization complemented with the implantation of an iliac stent‐graft was the treatment of choice, proving to be a safe and effective treatment modality

ResumoIntroduçãoOs sarcomas do membro inferior representam a localização mais comum dos tumores do tecido conjuntivo e nenhum outro tratamento demonstrou ser melhor do que o cirúrgico. O objetivo deste trabalho é apresentar o caso de uma mulher de 59 anos com um leiomiossarcoma localizado na coxa esquerda.Caso clínicoOs autores descrevem o caso de uma doente de 59 anos de idade, assintomática até janeiro de 2013, altura em que identificou uma tumefação na coxa esquerda, indolor e de crescimento progressivo. Sem sinais de compromisso neurovascular. Ao exame objetivo identificou‐se uma massa com cerca de 10cm de diâmetro, aderente aos planos profundos, sem pulsatilidade. Não apresentava adenopatias palpáveis e os pulsos estavam presentes e simétricos. Realizou RMN que revelou uma lesão sólida em plano intermuscular projetada ao longo do pedículo vasculo‐nervoso. A biópsia incisional demonstrou tratar‐se de um leiomiossarcoma. Em articulação com o serviço de cirurgia plástica foi realizada uma ressecção alargada do leiomiossarcoma, seguida de reconstrução da artéria femoral superficial e veia femoral com interposição da veia grande safena contralateral em posição femoro‐femoral. O procedimento decorreu sem intercorrências de relevo.Discussão e conclusãoOs leiomiossarcomas são tumores malignos e localmente agressivos, sendo a ressecção alargada (no touch no see) a melhor possibilidade terapêutica, tornando‐se indispensável uma abordagem multidisciplinar para se alcançar a cura com preservação funcional do membro mesmo com ressecções radicais.AbstractIntroductionThe lower limb sarcomas represent the most common location of tumors of the connective tissue and no other treatment proved to be better than surgery. The objective of this paper is to present a case of leiomyosarcoma located in the left thigh of a 59 year old woman.Case reportThe authors describe the case of a 59 year old woman, asymptomatic until January 2013, when a swelling, painless and progressive growth in the left thigh has been identified. No signs of neuro‐vascular compromise. A mass with 10cm diameter, adhering to the deep planes, without pulsatility, has been identified through physical examination. She had no palpable lymphadenopathy and pulses were present and symmetrical. MRI revealed a solid lesion in intermuscular plane designed along the vascular‐nervous pedicle. The incisional biopsy confirmed a leiomyosarcoma. Together with the Plastic Surgery service a wide resection of leiomyosarcoma was performed followed by reconstruction of the SFA and the FV with interposition of the contralateral great saphenous vein in femoro‐femoral position. The procedure was held without significant complications.Discussion and conclusionLeiomyosarcomas are malignant and locally aggressive, therefore the extended resection (no touch no see) has been proved to be the best therapeutic option, as a multidisciplinary approach in order to achieve the cure with functional preservation of the member even with radical resections becomes indispensable.