Search results for: Joana Kyei-Dompim

Authors: Daniela Magalhaes, Jorge Pedro, Pedro Souteiro, Joao S. Neves, Sofia Castro-Oliveira, Vanessa Guerreiro, Rita Bettencourt- Silva, Maria M. Costa, Ana Varela, Joana Queiros, Paula Freitas, Davide Carvalho

Abstract:

Introduction: Obesity is an independent risk factor for renal dysfunction. Our aims were: (1) evaluate the impact of bariatric surgery (BS) on renal function; (2) clarify the factors determining the postoperative evolution of the glomerular filtration rate (GFR); (3) access the occurrence of oxalate-mediated renal complications. Methods: We investigated a cohort of 1448 obese patients who underwent bariatric surgery. Those with basal GFR (GFR0) < 30mL/min or without information about the GFR 2-year post-surgery (GFR2) were excluded. Results: We included 725 patients, of whom 647 (89.2%) women, with 41 (IQR 34-51) years, a median weight of 112.4 (IQR 103.0-125.0) kg and a median BMI of 43.4 (IQR 40.6-46.9) kg/m2. Of these, 459 (63.3%) performed gastric bypass (RYGB), 144 (19.9%) placed an adjustable gastric band (AGB) and 122 (16.8%) underwent vertical gastrectomy (VG). At 2-year post-surgery, excess weight loss (EWL) was 60.1 (IQR 43.7-72.4) %. There was a significant improve of metabolic and inflammatory status, as well as a significant decrease in the proportion of patients with diabetes, arterial hypertension and dyslipidemia (p < 0.0001). At baseline, 38 (5.2%) of subjects had hyperfiltration with a GFR0 ≥ 125mL/min/1.73m2, 492 (67.9%) had a GFR0 90-124 mL/min/1.73m2, 178 (24.6%) had a GFR0 60-89 mL/min/1.73m2, and 17 (2.3%) had a GFR0 < 60 mL/min/1.73m2. GFR decreased in 63.2% of patients with hyperfiltration (ΔGFR=-2.5±7.6), and increased in 96.6% (ΔGFR=22.2±12.0) and 82.4% (ΔGFR=24.3±30.0) of the subjects with GFR0 60-89 and < 60 mL/min/1.73m2, respectively ( p < 0.0001). This trend was maintained when adjustment was made for the type of surgery performed. Of 321 patients, 10 (3.3%) had a urinary albumin excretion (UAE) > 300 mg/dL (A3), 44 (14.6%) had a UAE 30-300 mg/dL (A2) and 247 (82.1%) has a UAE < 30 mg/dL (A1). Albuminuria decreased after surgery and at 2-year follow-up only 1 (0.3%) patient had A3, 17 (5.6%) had A2 and 283 (94%) had A1 (p < 0,0001). In multivariate analysis, the variables independently associated with ΔGFR were BMI (positively) and fasting plasma glucose (negatively). During the 2-year follow-up, only 57 of the 725 patients had transient urinary excretion of calcium oxalate crystals. None has records of oxalate-mediated renal complications at our center. Conclusions: The evolution of GFR after BS seems to depend on the initial renal function, as it decreases in subjects with hyperfiltration, but tends to increase in those with renal dysfunction. Our results suggest that BS is associated with improvement of renal outcomes, without significant increase of renal complications. So, apart the clear benefits in metabolic and inflammatory status, maybe obese adults with nondialysis-dependent CKD should be referred for bariatric surgery evaluation.

Keywords: albuminuria, bariatric surgery, glomerular filtration rate, renal function

Procedia PDF Downloads 359

Authors: Mariana Branco, Nahida Sobrino, Cristina Neves, Márcia Santos, Afonso Granja, João Rosa Oliveira, Joana Costa, Luísa Castro Leite

Abstract:

This case reports a COVID-19 infection in an unvaccinated adult man with no history of COVID-19 and no relevant clinical history besides anabolic steroid use, undergoing weaning with tamoxifen after a bodybuilding competition. The patient presented a 4cm cervical mass 3 weeks after COVID-19 infection in his cohabitants. He was otherwise asymptomatic and tested negative to multiple RT-PCR tests. Nevertheless, the IgG COVID-19 antibody was positive, suggesting the previous infection. This report raises a potential link between anabolic steroid use and atypical COVID-19 onset. Objectives: The goals of this paper are to raise a potential link between anabolic steroid use and atypical COVID-19 onset but also to report an uncommon case of COVID-19 infection with consecutive negative gold standard tests. Methodology: The authors used CARE guidelines for case report writing. Introduction: This case reports a COVID-19 infection case in an unvaccinated adult man, with multiple serial negative reverse transcription polymerase chain reaction (RT-PCR) test results, presenting with single cervical lymphadenopathy. Although the association between COVID-19 and lymphadenopathy is well established, there are no cases with this presentation, and consistently negative RT-PCR tests have been reported. Methodologies: The authors used CARE guidelines for case report writing. Case presentation: This case reports a 28-year-old Caucasian man with no previous history of COVID-19 infection or vaccination and no relevant clinical history besides anabolic steroid use undergoing weaning with tamoxifendue to participation in a bodybuilding competition. He visits his primary care physician because of a large (4 cm) cervical lump, present for 3 days prior to the consultation. There was a positive family history for COVID-19 infection 3 weeks prior to the visit, during which the patient cohabited with the infected family members. The patient never had any previous clinical manifestation of COVID-19 infection and, despite multiple consecutive RT-PCR testing, never tested positive. The patient was treated with an NSAID and a broad-spectrum antibiotic, with little to no effect. Imagiological testing was performed via a cervical ultrasound, followed by a needle biopsy for histologic analysis. Serologic testing for COVID-19 immunity was conducted, revealing a positive Anti-SARS-CoV-2 IgG (Spike S1) antibody, suggesting the previous infection, given the unvaccinated status of our patient Conclusion: In patients with a positive epidemiologic context and cervical lymphadenopathy, physicians should still consider COVID-19 infection as a differential diagnosis, despite negative PCR testing. This case also raises a potential link between anabolic steroid use and atypical COVID-19 onset, never before reported in scientific literature.

Keywords: COVID-19, cervical lymphadenopathy, anabolic steroids, primary care

Procedia PDF Downloads 116

Authors: Joana Almeida, Kendall Reid, Jonas Bengtsson

Abstract:

Pallets are devices that are used for moving and storing freight and are nearly omnipresent in supply chains. The market is dominated by timber pallets, with plastic being a common alternative. Either option underpins the use of important resources (oil, land, timber), the emission of greenhouse gases and additional waste generation in most supply chains. This study uses a dynamic approach to the life cycle assessment (LCA) of pallets. It demonstrates that what ultimately defines the environmental burden of pallets in the supply chain is how often the length of its lifespan, which depends on the durability of the material and on how pallets are utilized. This study proposes a life cycle assessment (LCA) of pallets in supply chains supported by an algorithm that estimates pallet durability in function of material resilience and of logistics. The LCA runs from cradle-to-grave, including raw material provision, manufacture, transport and end of life. The scope is representative of timber and plastic pallets in the Australian and South-East Asia markets. The materials included in this analysis are: -tropical mixed hardwood, unsustainably harvested in SE Asia; -certified softwood, sustainably harvested; -conventional plastic, a mix of virgin and scrap plastic; -recycled plastic pallets, 100% mixed plastic scrap, which are being pioneered by Re > Pal. The logistical model purports that more complex supply chains and rougher handling subject pallets to higher stress loads. More stress shortens the lifespan of pallets in function of their composition. Timber pallets can be repaired, extending their lifespan, while plastic pallets cannot. At the factory gate, softwood pallets have the lowest carbon footprint. Re > pal follows closely due to its burden-free feedstock. Tropical mixed hardwood and plastic pallets have the highest footprints. Harvesting tropical mixed hardwood in SE Asia often leads to deforestation, leading to emissions from land use change. The higher footprint of plastic pallets is due to the production of virgin plastic. Our findings show that manufacture alone does not determine the sustainability of pallets. Even though certified softwood pallets have lower carbon footprint and their lifespan can be extended by repair, the need for re-supply of materials and disposal of waste timber offsets this advantage. It also leads to most waste being generated among all pallets. In a supply chain context, Re > Pal pallets have the lowest footprint due to lower replacement and disposal needs. In addition, Re > Pal are nearly ‘waste neutral’, because the waste that is generated throughout their life cycle is almost totally offset by the scrap uptake for production. The absolute results of this study can be confirmed by progressing the logistics model, improving data quality, expanding the range of materials and utilization practices. Still, this LCA demonstrates that considering logistics, raw materials and material durability is central for sustainable decision-making on pallet purchasing, management and disposal.

Keywords: carbon footprint, life cycle assessment, recycled plastic, waste

Procedia PDF Downloads 221

Authors: Lucas Nascimento, Ana Rita, Margarida Soares, André Ribeiro, Zlatina Genisheva, Hugo Silva, Joana Carvalho

Abstract:

The footwear industry is an essential fashion industry, focusing on producing various types of footwear, such as shoes, boots, sandals, sneakers, and slippers. Global footwear consumption has doubled every 20 years since the 1950s. It is estimated that in 1950, each person consumed one new pair of shoes yearly; by 2005, over 20 billion pairs of shoes were consumed. To meet global footwear demand, production reached $24.2 billion, equivalent to about $74 per person in the United States. This means three new pairs of shoes per person worldwide. The issue of footwear waste is related to the fact that shoe production can generate a large amount of waste, much of which is difficult to recycle or reuse. This waste includes scraps of leather, fabric, rubber, plastics, toxic chemicals, and other materials. The search for alternative solutions for waste treatment and valorization is increasingly relevant in the current context, mainly when focused on utilizing waste as a source of substitute materials. From the perspective of the new circular economy paradigm, this approach is of utmost importance as it aims to preserve natural resources and minimize the environmental impact associated with sending waste to landfills. In this sense, the incorporation of waste into industrial sectors that allow for the recovery of large volumes, such as road construction, becomes an urgent and necessary solution from an environmental standpoint. This study explores the use of plastic waste from the footwear industry as a substitute for virgin polymers in bitumen modification, a solution that presents a more sustainable future. Replacing conventional polymers with plastic waste in asphalt composition reduces the amount of waste sent to landfills and offers an opportunity to extend the lifespan of road infrastructures. By incorporating waste into construction materials, reducing the consumption of natural resources and the emission of pollutants is possible, promoting a more circular and efficient economy. In the initial phase of this study, waste materials from end-of-life footwear were selected, and plastic waste with the highest potential for application was separated. Based on a literature review, EVA (ethylene vinyl acetate) and PU (polyurethane) were identified as the polymers suitable for modifying 50/70 classification bitumen. Each polymer was analysed at concentrations of 3% and 5%. The production process involved the polymer's fragmentation to a size of 4 millimetres after heating the materials to 180 ºC and mixing for 10 minutes at low speed. After was mixed for 30 minutes in a high-speed mixer. The tests included penetration, softening point, viscosity, and rheological assessments. With the results obtained from the tests, the mixtures with EVA demonstrated better results than those with PU, as EVA had more resistance to temperature, a better viscosity curve and a greater elastic recovery in rheology.

Keywords: footwear waste, hot asphalt pavement, modified bitumen, polymers

Procedia PDF Downloads 15

Authors: Joana Pimenta, Lorena Coelho, José Silva, Vanessa Miranda, Jorge Laranjeira, Rui Soares

Abstract:

In this paper, the results of R&D on an innovative food package for increased shelf-life are presented. SAP4MA aims at the development of a printed active device that enables smart packaging solutions for food preservation, targeting the extension of the shelf-life of the packed food through the controlled release of active natural antioxidant agents at the onset of the food degradation process. To do so, SAP4MA focuses on the development of active devices such as printed heaters and batteries/supercapacitors in a label format to be integrated on packaging lids during its injection molding process, promoting the passive release of natural antioxidants after the product is packed, during transportation and in the shelves, and actively when the end-user activates the package, just prior to consuming the product at home. When the active device present on the lid is activated, the release of the natural antioxidants embedded in the inner layer of the packaging lid in direct contact with the headspace atmosphere of the food package starts. This approach is based on the use of active functional coatings composed of nano encapsulated active agents (natural antioxidants species) in the prevention of the oxidation of lipid compounds in food by agents such as oxygen. Thus keeping the product quality during the shelf-life, not only when the user opens the packaging, but also during the period from food packaging up until the purchase by the consumer. The active systems that make up the printed smart label, heating circuit, and battery were developed using screen-printing technology. These systems must operate under the working conditions associated with this application. The printed heating circuit was studied using three different substrates and two different conductive inks. Inks were selected, taking into consideration that the printed circuits will be subjected to high pressures and temperatures during the injection molding process. The circuit must reach a homogeneous temperature of 40ºC in the entire area of the lid of the food tub, promoting a gradual and controlled release of the antioxidant agents. In addition, the circuit design involves a high level of study in order to guarantee maximum performance after the injection process and meet the specifications required by the control electronics component. Furthermore, to characterize the different heating circuits, the electrical resistance promoted by the conductive ink and the circuit design, as well as the thermal behavior of printed circuits on different substrates, were evaluated. In the injection molding process, the serpentine-shaped design developed for the heating circuit was able to resolve the issues connected to the injection point; in addition, the materials used in the support and printing had high mechanical resistance against the pressure and temperature inherent to the injection process. Acknowledgment: This research has been carried out within the Project “Smart and Active Packing for Margarine Product” (SAP4MA) running under the EURIPIDES Program being co-financed by COMPETE 2020 – the Operational Programme for Competitiveness and Internationalization and under Portugal 2020 through the European Regional Development Fund (ERDF).

Keywords: smart package, printed heat circuits, printed batteries, flexible and printed electronic

Procedia PDF Downloads 109

Authors: Margarida Soares, Zlatina Genisheva, Lucas Nascimento, André Ribeiro, Tiago Miranda, Eduardo Pereira, Joana Carvalho

Abstract:

In the current global context, we face a significant challenge: the rapid population increase combined with the pressing need for sustainable management of agro-industrial waste. Beyond understanding how population growth impacts waste generation, it is essential to first identify the primary types of waste produced and the countries responsible to guide targeted actions. This study presents key statistical data on waste production from the agriculture, forestry, and fishing sectors across the European Union, alongside information on the agricultural areas dedicated to crop production in each European Union country. These insights will form the basis for future research into waste production by crop type and country to improve waste management practices and promote recovery methods that are vital for environmental sustainability. The agricultural sector must stay at the forefront of scientific and technological advancements to meet climate change challenges, protect the environment, and ensure food and health security. The study's findings indicate that population growth significantly increases pressure on natural resources, leading to a rise in agro-industrial waste production. EUROSTAT data shows that, in 2020, the agriculture, forestry, and fishing sectors produced over 21 million tons of waste. Spain emerged as the largest producer, contributing nearly 30% of the EU's total waste in these sectors. Furthermore, five countries—Spain, the Netherlands, France, Sweden, and Germany—were responsible for producing more than two-thirds of the waste from these sectors. Regarding agricultural land use, the data for 2020 revealed that around two-thirds of the total agricultural area was concentrated in six countries: France, Spain, Germany, Poland, Romania, and Italy. Regarding waste production per capita, the Netherlands had the highest figures in the EU for 2020. The data presented in this study highlights the urgent need for action in managing agricultural waste in the EU. As population growth continues to drive up demand for agricultural products, waste generation will inevitably rise unless significant changes are made in managing of agro-industrial waste. The countries must lead the way in adopting technological waste management strategies that focus on reducing, reusing, and recycling waste to benefit both the environment and society. Equally important is the need to promote collaborative efforts between governments, industries, and research institutions to develop and implement technologies that transform waste into valuable resources. The insights from this study are critical for informing future strategies to improve the management and valorization of waste from the agro-industrial sector. One of the most promising approaches is adopting circular economy principles to create closed-loop systems that minimize environmental impacts. By rethinking waste as a valuable resource rather than a by-product, agricultural industries can contribute to more sustainable practices that support both environmental health and economic growth.

Keywords: agricultural area, agricultural waste, circular economy, environmental challenges, population growth

Procedia PDF Downloads 13