Search results for: Joana Gato

Authors: Joana Gato, Ahmed Abotabekh, Panayoti Bachkangi

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Introduction: Oestrogen is an essential gonadal hormone that plays a vital role in the reproductive system of women1. The average age of menopause in the UK is 512. Women who go through premature menopause should be offered Hormone replacement therapy (HRT). Similarly, women who undergo surgical menopause should be offered HRT, unless contraindicated, depending on the indication of their surgery2,3. Aim: To assess if the patients in our department are counselled regarding HRT after surgical treatment and if HRT was prescribed. Methodology: A retrospective audit in a busy district hospital, examining all the patients who had a hysterectomy. The audit examined if HRT was discussed pre-operatively, prescribed on discharge and if a follow up was arranged. For women with contraindication to HRT, the audit assessed if the reasons were discussed pre-operatively and communicated to the Inclusion criteria: woman having a total or subtotal hysterectomy, with or without bilateral salpingo-ophorectomy (BSO), between April and September 2022. Exclusion criteria: woman having a vaginal hysterectomy. Results: 40 patients in total had hysterectomy; 27 (68%) were under the age of 51. 15 out of 27 patients bad BSO. 9 women were prescribed HRT, but 8 were offered HRT immediately, and 1 of them were offered a follow up. Of women who underwent surgical menopause, 7 were not given any HRT. The HRT choice was diverse, however, the majority was prescribed oral HRT. 40% of women undergoing surgical menopause did not have a discussion about HRT prior to their surgery. In postmenopausal women (n=13; 33%), still two were given HRT for preexisting menopausal symptoms. Discussion: Only 59% of the pre-menopausal patients had oophorectomy, therefore undergoing surgical menopause. Of these, 44% were not given any HRT, and 40% had no discussion about HRT prior to surgery. Interestingly, the majority of these women have no obvious contraindication to HRT. The choice of HRT was diverse, but the majority was commenced on oral HRT. Our unit is still working towards meeting all the NICE guidance standards of offering HRT and information prior to surgery to women planning to undergo surgical menopause. Conclusion: Starting HRT at the onset of menopause has been shown to improve quality of life and reduce the risk of cardiovascular disease and osteoporotic fractures4. Our unit still has scope for improvement to comply with the current NICE guidance. All pre-menopausal women undergoing surgical menopause should have a discussion regarding HRT prior to surgery and be offered it if there are no contraindications. This discussion should be clearly documented in the notes. At the time of this report, some of the patients have not yet had a follow up, which we recognize as a limitation to our audit.

Keywords: hormone replacement therapy, menopause, premature ovarian insufficiency, surgical management

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Authors: Seyed Mohsen Samaei, Shirley Gato-Trinidad

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A pre-treatment stage prior to reverse osmosis (RO) is very important to ensure the long-term performance of the RO membranes in any wastewater treatment using RO. This study aims to evaluate the application of the Actiflo^® clarifier as part of a pre-treatment unit in mining operations. It involves performing analytical testing on RO feed water before and after installation of Actiflo^® unit. Water samples prior to RO plant stage were obtained on different dates from Costerfield mining operations in Victoria, Australia. Tests were conducted in an independent laboratory to determine the concentration of various compounds in RO feed water before and after installation of Actiflo^® unit during the entire evaluated period from December 2015 to June 2018. Water quality analysis shows that the quality of RO feed water has remarkably improved since installation of Actiflo^® clarifier. Suspended solids (SS) and turbidity removal efficiencies has been improved by 91 and 85 percent respectively in pre-treatment system since the installation of Actiflo^®. The Actiflo^® clarifier proved to be a valuable part of pre-treatment system prior to RO. It has the potential to conveniently condition the mining wastewater prior to RO unit, and reduce the risk of RO physical failure and irreversible fouling. Consequently, reliable and durable operation of RO unit with minimum requirement for RO membrane replacement is expected with Actiflo^® in use.

Keywords: ACTIFLO ® clarifier, mining wastewater, reverse osmosis, water treatment

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Authors: António Fiúza, Aurora Futuro, Joana Monteiro, Joaquim Góis

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Lepidolite is an important lithium mineral that, to the author’s best knowledge, has not been used to produce lithium hydroxide, which is necessary for energy conversion to electric vehicles. Alkaline leaching of lithium concentrates allows the establishment of a production diagram avoiding most of the environmental drawbacks that are associated with the usage of acid reagents. The tested processes involve a pretreatment by digestion at high temperatures with additives, followed by leaching at hot atmospheric pressure. The solutions obtained must be compatible with solutions from the leaching of spodumene concentrates, allowing the development of a common treatment diagram, an important accomplishment for the feasible exploitation of Portuguese resources. Statistical programming and interpretation techniques minimize the laboratory effort required by conventional approaches and allow phenomenological comprehension.

Keywords: alkaline leaching, lithium, research design, statistical interpretation

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Authors: Monisha Elumalai, Joana Guerreiro, Joana Carvalho, Marta Prado

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DNA biosensors popularity has been increasing over the past few years. Traditional analytical techniques tend to require complex steps and expensive equipment however DNA biosensors have the advantage of getting simple, fast and economic. Additionally, the combination of DNA biosensors with nanomaterials offers the opportunity to improve the selectivity, sensitivity and the overall performance of the devices. DNA biosensors are based on oligonucleotides as sensing elements. These oligonucleotides are highly specific to complementary DNA sequences resulting in the hybridization of the strands. DNA biosensors are not only an advantage in the clinical field but also applicable in numerous research areas such as food analysis or environmental control. Zebra Mussels (ZM), Dreissena polymorpha are invasive species responsible for enormous negative impacts on the environment and ecosystems. Generally, the detection of ZM is made when the observation of adult or macroscopic larvae's is made however at this stage is too late to avoid the harmful effects. Therefore, there is a need to develop an analytical tool for the early detection of ZM. Here, we present a portable plasmonic biosensor for the detection of environmental DNA (eDNA) released to the environment from this invasive species. The plasmonic DNA biosensor combines gold nanoparticles, as transducer elements, due to their great optical properties and high sensitivity. The detection strategy is based on the immobilization of a short base pair DNA sequence on the nanoparticles surface followed by specific hybridization in the presence of a complementary target DNA. The hybridization events are tracked by the optical response provided by the nanospheres and their surrounding environment. The identification of the DNA sequences (synthetic target and probes) to detect Zebra mussel were designed by using Geneious software in order to maximize the specificity. Moreover, to increase the optical response enzyme amplification of DNA might be used. The gold nanospheres were synthesized and characterized by UV-visible spectrophotometry and transmission electron microscopy (TEM). The obtained nanospheres present the maximum localized surface plasmon resonance (LSPR) peak position are found to be around 519 nm and a diameter of 17nm. The DNA probes modified with a sulfur group at one end of the sequence were then loaded on the gold nanospheres at different ionic strengths and DNA probe concentrations. The optimal DNA probe loading will be selected based on the stability of the optical signal followed by the hybridization study. Hybridization process leads to either nanoparticle dispersion or aggregation based on the presence or absence of the target DNA. Finally, this detection system will be integrated into an optical sensing platform. Considering that the developed device will be used in the field, it should fulfill the inexpensive and portability requirements. The sensing devices based on specific DNA detection holds great potential and can be exploited for sensing applications in-loco.

Keywords: ZM DNA, DNA probes, nicking enzyme, gold nanoparticles

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Authors: Joana Portia Sakyi

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The uniqueness of auxiliary verbs and their contribution to grammar as constituents, which act as preverbs to supply additional grammatical or functional meanings to clauses, are well established. Functionally, they relate clauses to tense, aspect, mood, voice, emphasis, and modality, along with the main verbs conveying the appropriate lexical content. There has been an issue in Akan grammar vis-à-vis the status of auxiliary verbs, in terms of whether Akan has auxiliaries or not and even which forms are to be regarded as auxiliaries. We investigate the syntactic, semantic, and pragmatic components of expressions and claim that Akan has auxiliary verbs that contribute the functional or grammatical meaning of modality, tense/aspect, etc., to clauses they occur in. Essentially, we use a self-created corpus data to consider the affix bέ- ‘may’, ‘must’, ‘should’; the form tùmí ‘can’, ‘be able to’; mà ‘to let’, ‘to allow’, ‘to permit’, ‘to make’, or ‘to cause’ someone to do something; the multi-word forms ὲsὲ sέ ‘must’, ‘should’ or ‘have to’ and ètwà sέ ‘must’, ‘should’ or ‘have to’, and assert that they are legitimate modal auxiliaries conveying epistemic, deontic, and dynamic modalities, as well as other meanings in the language.

Keywords: Akan, modality, modal auxiliaries, semantics

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Authors: Carlos H. Ferreira, Joana R. Pereira

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In recent decades, calls for sustainable architecture based on environmental policies have been frequent. Despite a vast number of documents, technical procedures, and publications involving these themes, conceptions, and even architectural practice are often distanced from critical and methodological reflection on the relationship between environment and architecture. Among the various issues that we could consider in this relationship, we highlight in this article the relevance of water in the environment and in the architectural design. From documentary references and works carried out, we seek contributions to a better systematization and framing of water in architectural thinking. We distinguish, on the one hand, more conceptual issues that involve the environmental relationship of water, involving its cycle, relevance in the landscape, and infrastructural commitments. On the other hand, we highlight a more operative component, focusing on the place of water in the design process, from its perception in space-shape dimensions to more specific technical requirements that involve the interdisciplinary boundaries of architecture. In both approaches to water in architectural design, we seek to contribute to greater sensitivity and efficiency in the art of designing a more sustainable future.

Keywords: sustainability, environment, water, resilience design

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Authors: Zoran Visak, Joana Lopes, Vesna Najdanovic-Visak

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Within this study, the separation of nicotine from its aqueous solutions, using inorganic salt sodium chloride or ionic liquid (molten salt) ECOENG212® as salting-out media, was carried out. Thus, liquid-liquid equilibria of the ternary solutions (nicotine+water+NaCl) and (nicotine+water+ECOENG212®) were determined at ambient pressure, 0.1 MPa, at three temperatures. The related phase diagrams were constructed in two manners: by adding the determined cloud-points and by the chemical analysis of phases in equilibrium (tie-line data). The latter were used to calculate two important separation parameters - partition coefficients of nicotine and separation factors. The impacts of the initial compositions of the mother solutions and of temperature on the liquid-liquid phase separation and partition coefficients were analyzed and discussed. The results obtained clearly showed that both investigated salts are good salting-out media for the efficient and sustainable separation of nicotine from its solutions with water. However, when compared, sodium chloride exhibited much better separation performance than the ionic liquid.

Keywords: nicotine, liquid-liquid separation, inorganic salt, ionic liquid

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Authors: Mariana T. Teixeira, Joana P. Luz

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This paper is based on assumptions of psycholinguistics and investigates the processing of ambiguous sentences in Brazilian Portuguese. Specifically, it aims to verify if there is a difference in processing time between sentences with lexical ambiguity and sentences with structural (or syntactic) ambiguity. We hypothesize, based on the Garden Path Theory, that the two types of ambiguity entail different cognitive efforts, since sentences with structural ambiguity require that two structures be processed, whereas ambiguous phrases whose root of ambiguity is in a word require the processing of a single structure, which admits a variation of punctual meaning, within the scope of only one lexical item. In order to test this hypothesis, 25 undergraduate students, whose average age was 27.66 years, native speakers of Brazilian Portuguese, performed a self-monitoring reading task of ambiguous sentences, which had lexical and structural ambiguity. The results suggest that unambiguous sentence processing is faster than ambiguous sentence processing, whether it has lexical or structural ambiguity. In addition, participants presented a mean reading time greater for sentences with syntactic ambiguity than for sentences with lexical ambiguity, evidencing a greater cognitive effort in sentence processing with structural ambiguity.

Keywords: Brazilian portuguese, lexical ambiguity, sentence processing, syntactic ambiguity

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Authors: Marina Sousa, Célia Barreto Carvalho, Carolina da Motta, Joana Cabral, Vera Pereira, Suzana Nunes Caldeira, Ermelindo Peixoto

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Paranoid ideation is a common thought process that constitutes a defense against perceived social threats. The current study aimed at the characterization of paranoid ideation in youths and to explore the possible predictors involved in the development of paranoid ideations. Paranoid ideation, shame, submission, early childhood memories and current depressive, anxious and stress symptomatology was assessed in a sample of 1516 Portuguese youths. Higher frequencies of paranoid ideation were observed, particularly in females and youths from lower socio-economic status. The main predictors identified relates to submissive behaviors and adverse childhood experiences, and especially to shame feelings. The current study emphasizes that the these predictors are similar to findings in adults and clinical populations, and future implications to research and clinical practice aiming at paranoid ideations are discussed, as well as the pertinence of the study of mediating factors that allow a wider understanding of this thought process in younger populations and the prevention of psychopathology in adulthood.

Keywords: adolescence, early memories, paranoid ideation, parenting styles, shame, submissiveness

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Authors: Paulo H. R. G. Reis, Joana P. Maia, Davi Neiva Alves, Mariana R. C. Aquino, Igor B. Guimaraes, Anderson Horta, Thiago Santiago, Mariana Volpini

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Additive manufacturing is a manufacturing technique used in many fields as a tool for the production of complex parts accurately. This technique has a wide possibility of applications in bioengineering, mainly in the manufacture of orthopedic devices, thanks to the versatility of shapes and surface details. The present article aims to evaluate the mechanical viability of a wrist-hand orthosis made using additive manufacturing techniques with Nylon 12 polyamide and compare this device with the wrist-hand orthosis manufactured by the traditional process with thermoplastic Ezeform. The methodology used is based on the application of computational simulations of voltage and temperature, from finite element analysis, in order to evaluate the properties of displacement, mechanical stresses and thermal comfort in the two devices. The execution of this work was carried out through a case study with a 29-year-old male patient. The modeling software involved was Meshmixer from US manufacturer Autodesk and Fusion 360 from the same manufacturer. The results demonstrated that the orthosis developed by 3D printing, from Nylon 12, presents better thermal comfort and response to the mechanical stresses exerted on the orthosis.

Keywords: additive manufacturing, finite elements, hand orthosis, thermal comfort, neurorehabilitation

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Authors: Célia Barreto Carvalho, Carolina da Motta, Marina Sousa, Joana Cabral, Ana Luísa Carvalho, Ermelindo Peixoto

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The aim of the current study was to develop and validate a Response to Stressful Situations Scale (RSSS) for the Portuguese population. This scale assesses the degree of stress experienced in scenarios that can constitute positive, negative and more neutral stressors, and also describes the physiological, emotional and behavioral reactions to those events according to their intensity. These scenario include typical stressor scenarios relevant to patients with schizophrenia, which are currently absent from most scale, assessing specific risks that these stressors may bring on subjects, which may prove useful in non-clinical and clinical populations (i.e. patients with mood or anxiety disorders, schizophrenia). Results from Principal Components Analysis and Confirmatory Factor Analysis of on two adult samples from general population allowed to confirm a three-factor model with good fit indices: χ2 (144)= 370.211, p = 0.000; GFI = 0.928; CFI = 0.927; TLI = 0.914, RMSEA = 0.055, P( rmsea ≤ 0.005) = 0.096; PCFI = 0.781. Further data analysis on the scale revealed that RSSS is an adequate assessment tool of stress response in adults to be used in further research and clinical settings, with good psychometric characteristics, adequate divergent and convergent validity, good temporal stability and high internal consistency.

Keywords: assessment, stress events, stress response, stress vulnerability

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Authors: Narine Ghazaryan, Joana Catarina Macedo, Sara Vaz, Naira Ayvazyan, Elsa Logarinho

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Macrovipera lebetina obtusa (MLO) is a poisonous snake in Armenia. Obtustatin represents the shortest known monomeric disintegrin, isolated from the snake venom of MLO, and is known to specifically inhibit α1β1 integrin. Its oncostatic effect is due to the inhibition of angiogenesis, which likely arises from α1β1 integrin inhibition in the endothelial cells. To explore the therapeutic potential of the MLO snake venom and obtustatin, we studied activity of obtustatin and MLO venom in vitro, by testing their efficacy in human dermal microvascular endothelial cells (HMVEC-D) and in vivo, using chick embryo chorioallantoic membrane assay (CAM assay). Our in vitro results showed that obtustatin in comparison with MLO venom did not exhibit cytotoxic activity in HMVEC-D cells in comparison to MLO venom. But in vivo results have shown that 4µg /embryo (90 µM) of obtustatin inhibited angiogenesis induced by FGF2 by 17% while MLO snake venom induced 22% reduction of the angiogenic index. The concentration of obtustatin in the crude MLO venom was 0.3 nM, which is 300.000 times less than the concentration of the obtustatin itself. Given this enormous difference in concentration, it is likely that some components of the crude venom contribute to the observed anti-angiogenic effect. Hypotheses will be ascertained to justify this action: components in the MLO venom may increase obtustatin efficacy or have independent but synergic anti-angiogenic activities.

Keywords: angiogenesis, alpa1 beta 1 integrin, Macrovipera lebetina obtusa, obtustatin

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Authors: Margarida Maria Cabugueira Csutódio dos Santos, Joana Filipa Pintéus Pereira

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The way children understand the concept of health and illness influences their reaction in contexts where these concepts are present (e.g.,illness; vaccination). The recognition of the importance of children's beliefs/representations about health and disease has led to the development of models that seek to explain the development process of these concepts. In the construction of their representations, children are influenced not only by their cognitive competence but also by their life experiences. In the last 3 years, children have experienced a pandemic health crisis that has exposed them to anomalous and stressful situations. Objective: the aim of this study was (1) to identify children’s representations about disease (including symptoms, causes, control/treatment) and prevention (including health procedures and vaccines) and (2) whether COVID19 is mentioned and influences their representations. Methodology: a qualitative study in which 67 children with 7 to 10 years old (mean 8,8) participated. A semi-structured interview was used following the Bibace and Walsh model, focusing on the representation of the disease and its prevention. Results show a marked influence of the lived experience with regard to causes of the disease, disease control and treatment, and adherence to vaccination. Age-dependent differences were found with older children being able to talk about illness and contamination process and younger displaying more basic, concrete and rigid representations. Conclusions: The results of this study bring clues to the adequacy of communication with the child in the context of health and illness and discriminately in a future health pandemic crisis.

Keywords: childen, health beliefs, pediatrics, covid19, vaccines

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Authors: Marianne Lumacang, Jessarine Dultra, Joana Fenol

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Filipinos are known to be conservative, sex or pornography is not discussed openly in the Philippines, topic of sex, when raised, will most likely elicit snickers, jokes, and blushes in most Filipino or expressions of disgust. However, a lot of Filipinos are still engaging into this kind of activity for some reasons. The study aims to determine young adult’s point of view about cyber pornography viewing, as well as their reasons for engagement, and its effects on them and their relationship with their partner. Interpretative Phenomenological Analysis was used to explore how young adults make sense of cyber pornography viewing. The study focused on Filipino young adults who are in a romantic or married relationship, engage in cyber pornography viewing, and currently residing in Cavite, Philippines. A total of four young adult couples, four females and four males participated in the study as research participants. Data gathered from a total of four young adult couples resulted to a total of nine superordinate themes focusing on (1) exploring young adult couple’s rationales for cyber pornography viewing, (2) experiences of positive effects in engaging to cyber pornography viewing, (3) experiences of negative effects in engaging to cyber pornography viewing, (4) experience of infidelity, (5) experience of necessity, (6) females perception about cyber pornography viewing towards self, (7) males perception about cyber pornography viewing towards self, (8) males perception about cyber pornography viewing towards romantic partner, and (9) males perception about cyber pornography viewing towards others.

Keywords: cyberpornography, Filipino, interpretative phenomenological analysis, making sense of cyberpornography, young adult

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Authors: Joana Carvalho, Margarida Soares, André Ribeiro, Lucas Nascimento, Nádia Valério, Zlatina Genisheva

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Following the exponential growth of human population, a remarkable increase in the amount of fish waste has been produced worldwide. The fish processing industry generates a considerable amount of by-products which represents a considerable environmental problem. Accordingly, the reuse and valorisation of these by-products is a key process for marine resource preservation. The significant volume of fish waste produced worldwide, along with its environmental impact, underscores the urgent need for the adoption of sustainable practices. The transformative potential of utilizing fish processing waste to create industrial value is gaining recognition. The substantial amounts of waste generated by the fish processing industry present both environmental challenges and economic inefficiencies. Different added-value products can be recovered by the valorisation industries, whereas fishing companies can save costs associated with the management of those wastes, with associated advantages, not only in terms of economic income but also considering the environmental impacts. Fish processing by-products have numerous applications; the target portfolio of products will be fish oil, fish protein hydrolysates, bacteriocins, pigments, vitamins, collagen, and calcium-rich powder, targeting food products, additives, supplements, and nutraceuticals. This literature review focuses on the main valorisation ways of fish wastes and different compounds with a high commercial value obtained by fish by-products and their possible applications in different fields. Highlighting its potential in sustainable resource management strategies can play and important role in reshaping the fish processing industry, driving it towards circular economy and consequently more sustainable future.

Keywords: fish process industry, fish wastes, by-products, circular economy, sustainability

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Authors: Nuria Rubio, María Campo, Joana Ruiz, Paola Vecino

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Renewable energies have been proposed for some years as a solution to the ecological crisis caused by traditional fuels. The installation of solar parks for electricity production is therefore necessary for a transition to cleaner energy. Additionally, spaces occupied by solar parks can be ideal places for biodiversity promotion consisting in controlled areas allowing free transit of numerous animal species in absence of phytosanitary products or other substances commonly used in rural areas. The main objective of this project is increasing local biodiversity. Secondary objectives include the installation of beehives with Apis mellifera iberiensis swarms (native honeybee species), the monitoring and periodic evaluation of the state of health and demographic progression of these swarms and study of biodiversity increase in these areas, mainly due to the presence of Apis mellifera iberiensis. Prior to bee-hives installation, a preliminary study of the area is carried out to quantify floral load, biocenosis and geo-climatological characteristics of the area of study for determining the optimal number of hives for the benefit of the local ecosystem. Once beehives set up, the bee-swarms health status is monitored and evaluated quarterly using monitoring systems. Parameters studies are weight, humidity inside the hive, external and internal temperature, and sound inside the hive. Furthermore, a biodiversity study of the area was conducted by direct observation and quantification of species (S) in the area of bee-foraging (1 km around the beehives). A great diversity of species has been detected in the area of study. Therefore, the population of Apis mellifera iberiensis is not displacing other pollinators in the area, on the contrary, results show that it is contributing to the pollination of the different plant species enhancing wild bees’ biodiversity.

Keywords: biodiversity, honeybee, pollination, solar park

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Authors: Joana Margarida Bôto, Belmira Neto, Vera Miguéis, Manuela Meireles, Ada Rocha

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The Mediterranean diet has been recognized as a sustainable model of living with benefits for the environment and human health. However, a complete assessment of its sustainability, encompassing all dimensions and aspects, to our best knowledge, has not yet been realized. This systematic literature review aimed to fill this gap by identifying and describing the indicators used to assess the sustainability of the Mediterranean diet, looking at several dimensions, and presenting the results from their application. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines methodology was used, and searches were conducted in PubMed, Scopus, Web of Science, and GreenFile. There were identified thirty-two articles evaluating the sustainability of the Mediterranean diet. The environmental impact was quantified in twenty-five of these studies, the nutritional quality was evaluated in seven studies, and the daily cost of the diet was assessed in twelve studies. A total of thirty-three indicators were identified and separated by four dimensions of sustainability, specifically, the environmental dimension (ten indicators, namely carbon, water, and ecological footprint), the nutritional dimension (eight indicators, namely Health score and Nutrient Rich Food Index), the economic dimension (one indicator, the dietary cost), the sociocultural dimension (six indicators – with no results). Only eight of the studies used combined indicators. The Mediterranean diet was considered in all articles as a sustainable dietary pattern with a lower impact than Western diets. The carbon footprint ranged between 0.9 and 6.88 kg CO₂/d per capita, the water footprint between 600 and 5280 m³/d per capita, and the ecological footprint between 2.8 and 53.42 m²/d per capita. The nutritional quality was high, obtaining 122 points using the Health score and 12.95 to 90.6 points using the Nutrient Rich Food Index. The cost of the Mediterranean diet did not significantly differ from other diets and varied between 3.33 and 14.42€/d per capita. A diverse approach to evaluating the sustainability of the Mediterranean diet was found.

Keywords: Mediterranean diet, sustainability, environmental indicators, nutritional indicators

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Authors: Diogo Pereira, Maria Moura, Joana Campos, João Nunes

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As the Ukraine war highlights the European Economic Area’s vulnerability and external dependence on feed and food, agriculture gains significant importance. Transformative change is necessary to reach a sustainable and resilient agricultural sector. Agriculture is an important drive for bioeconomy and the equilibrium and survival of society and rural fires resilience. The pressure of (1) water stress, (2) nutrient cycle, and (3) social demographic evolution towards 70% of the population in Urban systems and the aging of the rural population, combined with climate change, exacerbates the problem and paradigm of rural and wildfires, especially in Portugal. The Portuguese territory is characterized by (1) 28% of marginal land, (2) the soil quality of 70% of the territory not being appropriate for agricultural activity, (3) a micro smallholding, with less than 1 ha per proprietor, with mainly familiar and traditional agriculture in the North and Centre regions, and (4) having the most vulnerable areas for rural fires in these same regions. The most important difference between the South, North and Centre of Portugal, referring to rural and wildfires, is the agricultural activity, which has a higher level in the South. In Portugal, rural and wildfires represent an average annual economic loss of around 800 to 1000 million euros. The WinBio model is an agrienvironmental metabolism design, with the capacity to create a new agri-food metabolism through Agricultural Organized Areas, a privatepublic partnership. This partnership seeks to grow agricultural activity in regions with (1) abandoned territory, (2) micro smallholding, (3) water and nutrient management necessities, and (4) low agri-food literacy. It also aims to support planning and monitoring of resource use efficiency and sustainability of territories, using agriculture as a barrier for rural and wildfires in order to protect rural population.

Keywords: agricultural organized areas, residues, climate change, drought, nutrients, rural and wild fires

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Authors: Lourenço Bastos, Filipa Carneiro, Bruno Vale, Rita Marques Joana Silva, Ricardo Freitas, Ângelo Marques, Sara Cortez, Alberta Coelho, Pedro Parreira, Liliana Sousa, Anabela Salgueiro, Bruno Silva

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The process of flushing is considered to be an adequate technique to reduce the risk of infection during the clinical practice of venous catheterization. Nonetheless, there is still a lack of adhesion to this method, in part due to the complexity of this procedure. The project SeringaDuo aimed to develop an innovative double-chamber syringe for intravenous sequential administration of drugs and serums. This device served the purpose of improving the adherence to the practice, through the reduction of manipulations needed, which also improves patient safety, and though the promotion of flushing practice by health professionals, by simplifying this task. To assist on the development of this innovative syringe, a numerical methodology was developed and validated in order to predict the syringe’s mechanical and flow behavior during the fluids’ loading and administration phases, as well as to allow the material behavior evaluation during its production. For this, three commercial numerical simulation software was used, namely ABAQUS, ANSYS/FLUENT, and MOLDFLOW. This methodology aimed to evaluate the concepts feasibility and to optimize the geometries of the syringe’s components, creating this way an iterative process for product development based on numerical simulations, validated by the production of prototypes. Through this methodology, it was possible to achieve a final design that fulfils all the characteristics and specifications defined. This iterative process based on numerical simulations is a powerful tool for product development that allows obtaining fast and accurate results without the strict need for prototypes. An iterative process can be implemented, consisting of consecutive constructions and evaluations of new concepts, to obtain an optimized solution, which fulfils all the predefined specifications and requirements.

Keywords: Venous catheterization, flushing, syringe, numerical simulation

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Authors: Joana Antunes, Thomas Levée, Barbara Radovani, Anu Suonpää, Paulina Saloranta, Liji Sobhana, Petri Ihalainen

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Lignin is an important component in the exploitation of lignocellulosic biomass. It has been shown that within the next years, the yield of added-value lignin-based chemicals and materials will generate renewable alternatives to oil-based products (e.g. polymeric composites, resins and adhesives) and enhance the economic feasibility of biorefineries. In this paper, a novel technology for lignin valorisation (METNIN™) is presented. METNIN™ is based on the oxidative action of an alkaliphilic enzyme in aqueous alkaline conditions (pH 10-11) at mild temperature (40-50 °C) combined with a cascading membrane operation, yielding a collection of lignin fractions (from oligomeric down to mixture of tri-, di- and monomeric units) with distinct molecular weight distribution, low polydispersity and favourable physicochemical properties. The alkaline process conditions ensure the high processibility of crude lignin in an aqueous environment and the efficiency of the enzyme, yielding better compatibility of lignin towards targeted applications. The application of a selected lignin fraction produced by METNIN™ as a suitable lignopolyol to completely replace a commercial polyol in polyurethane rigid foam formulations is presented as a prototype. Liquid lignopolyols with a high lignin content were prepared by oxypropylation and their full utilization in the polyurethane rigid foam formulation was successfully demonstrated. Moreover, selected technical specifications of different foam demonstrators were determined, including closed cell count, water uptake and compression characteristics. These specifications are within industrial standards for rigid foam applications. The lignin loading in the lignopolyol was a major factor determining the properties of the foam. In addition to polyurethane foam demonstrators, other examples of lignin-based products related to resins and sizing applications will be presented.

Keywords: enzyme, lignin valorisation, polyol, polyurethane foam

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Authors: Kamila Troper, Pedro Mestre, Maria Lurdes Menano, Joana Mendonça, Maria João Costa, Sandra Demel

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Introduction: Visual impairment is a problem that has an influence on hundreds of thousands of people all over the world. Although it is possible for a Visually Impaired person to do most jobs, the right training, technological assistance, and emotional support are essential. Ergonomics be able to solve many of the problems/issues with the relative ease of positioning, lighting and design of the workplace. A little forethought can make a tremendous difference to the ease with which a person with an impairment function. Objectives: Review the main ergonomic adaptation measures reported in the literature in order to promote better working conditions and safety measures for the visually impaired. Methodology: This was an exploratory-descriptive, qualitative literature systematic review study. The main databases used were: PubMed, BIREME, LILACS, with articles and studies published between 2000 and 2021. Results: Based on the principles of the theoretical references of ergonomic analysis of work, the main restructuring of the physical space of the workstations were: Accessibility facilities and assistive technologies; A screen reader that captures information from a computer and sends it in real-time to a speech synthesizer or Braille terminal; Installations of software with voice recognition, Monitors with enlarged screens; Magnification software; Adequate lighting, magnifying lenses in addition to recommendations regarding signage and clearance of the places where the visually impaired pass through. Conclusions: Employability rates for people with visual impairments(both those who are blind and those who have low vision)are low and continue to be a concern to the world and for researchers as a topic of international interest. Although numerous authors have identified barriers to employment and proposed strategies to remediate or circumvent those barriers, people with visual impairments continue to experience high rates of unemployment.

Keywords: ergonomic adaptations, visual impairments, ergonomic analysis of work, systematic review

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Authors: Hendri Purwadi, Christine McCloud

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Triage is a complex decision-making process that aims to categorize a victim’s level of acuity and the need for medical assistance. Two common triage systems have been widely used in Mass Casualty Incidents (MCIs) and disaster situation are START (Simple triage algorithm and rapid treatment) and SALT (sort, asses, lifesaving, intervention, and treatment/transport). There is currently controversy regarding the effectiveness of SALT over START triage system. This systematic review aims to investigate and compare the effectiveness between SALT and START triage system in disaster and MCIs setting. Literatures were searched via systematic search strategy from 2009 until 2019 in PubMed, Cochrane Library, CINAHL, Scopus, Science direct, Medlib, ProQuest. This review included simulated-based and medical record -based studies investigating the accuracy and applicability of SALT and START triage systems of adult and children population during MCIs and disaster. All type of studies were included. Joana Briggs institute critical appraisal tools were used to assess the quality of reviewed studies. As a result, 1450 articles identified in the search, 10 articles were included. Four themes were identified by review, they were accuracy, under-triage, over-triage and time to triage per individual victim. The START triage system has a wide range and inconsistent level of accuracy compared to SALT triage system (44% to 94. 2% of START compared to 70% to 83% of SALT). The under-triage error of START triage system ranged from 2.73% to 20%, slightly lower than SALT triage system (7.6 to 23.3%). The over-triage error of START triage system was slightly greater than SALT triage system (START ranged from 2% to 53% compared to 2% to 22% of SALT). The time for applying START triage system was faster than SALT triage system (START was 70-72.18 seconds compared to 78 second of SALT). Consequently; The START triage system has lower level of under-triage error and faster than SALT triage system in classifying victims of MCIs and disaster whereas SALT triage system is known slightly more accurate and lower level of over-triage. However, the magnitude of these differences is relatively small, and therefore the effect on the patient outcomes is not significance. Hence, regardless of the triage error, either START or SALT triage system is equally effective to triage victims of disaster and MCIs.

Keywords: disaster, effectiveness, mass casualty incidents, START triage system, SALT triage system

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Authors: Matthew F. Gibson, Narasimha D. Rao, Raphael B. Slade, Joana Portugal Pereira, Joeri Rogelj

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Globally, India’s population is among the most severely impacted by nutrient deficiency, yet millions of tonnes of food are lost before reaching consumers. Across food groups, grains represent the largest share of daily calories and overall losses by mass in India. If current losses remain unresolved and follow projected population rates, we estimate, by 2030, losses from grains for human consumption could increase by 1.3-1.8 million tonnes (Mt) per year against current levels of ~10 Mt per year. This study quantifies energy input to minimise storage losses across India, responsible for a quarter of grain supply chain losses. In doing so, we identify and explore a Sustainable Development Goal (SDG) triplet between SDG₂, SDG₇, and SDG₁₂ and provide insight for development of joined up agriculture and health policy in the country. Analyzing rice, wheat, maize, bajra, and sorghum, we quantify one route to reduce losses in supply chains, by modelling the energy input to maintain favorable climatic conditions in modern silo storage. We quantify key nutrients (calories, protein, zinc, iron, vitamin A) contained within these losses and calculate roughly how much deficiency in these dietary components could be reduced if grain losses were eliminated. Our modelling indicates, with appropriate uncertainty, maize has the highest energy input intensity for storage, at 110 kWh per tonne of grain (kWh/t), and wheat the lowest (72 kWh/t). This energy trade-off represents 8%-16% of the energy input required in grain production. We estimate if grain losses across the supply chain were saved and targeted to India’s nutritionally deficient population, average protein deficiency could reduce by 46%, calorie by 27%, zinc by 26%, and iron by 11%. This study offers insight for development of Indian agriculture, food, and health policy by first quantifying and then presenting benefits and trade-offs of tackling food grain losses.

Keywords: energy, food loss, grain storage, hunger, India, sustainable development goal, SDG

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Authors: Abigail Kusi Amponsah, Evans Frimpong Kyei, John Bright Agyemang, Hanson Boakye, Joana Kyei-Dompim, Collins Kwadwo Ahoto, Evans Oduro

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Staff shortages, deficient knowledge, inappropriate attitudes, demanding workloads, analgesic shortages, and low prioritization of pain management have been identified in earlier studies as the nursing-related barriers to optimal children’s pain management. These studies have mainly been undertaken in developed countries, which have different healthcare dynamics than those in developing countries. The current study, therefore, sought to identify and understand the nursing-related barriers to children’s pain management in the Ghanaian context. A descriptive qualitative study was conducted among 28 purposively sampled nurses working in the pediatric units of five hospitals in the Ashanti region of Ghana. Over the course of three months, participants were interviewed on the barriers which prevented them from optimally managing children’s pain in practice. Recorded interviews were transcribed verbatim and deductively analysed based on a conceptual interest in pain assessment and management-related barriers. NVivo 12 plus software guided data management and analyses. The mean age of participating nurses was 30 years, with majority being females (n =24). Participants had worked in the nursing profession for an average of five years and in the pediatric care settings for an average of two years. The nursing-related barriers identified in the present study included communication difficulties in assessing and evaluating pain management interventions with children who have nonfunctional speech, insufficient training, misconceptions on the experience of pain in children, lack of assessment tools, and insufficient number of nurses to manage the workload and nurses’ inability to prescribe analgesics. The present study revealed some barriers which prevented Ghanaian nurses from optimally managing children’s pain. Nurses should be educated, empowered, and supported with the requisite material resources to effectively manage children’s pain and improve outcomes for families, healthcare systems, and the nation. Future studies should explore the facilitators and barriers from other stakeholders involved in pediatric pain management

Keywords: Nursing-Related Barriers, Children, Pain Management, Ghana

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Authors: Zachary Huffman, Joana Rocha

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Wall-pressure fluctuations induced by the turbulent boundary layer (TBL) developed over aircraft are a significant source of aircraft cabin noise. Since the power spectral density (PSD) of these pressure fluctuations is directly correlated with the amount of sound radiated into the cabin, the development of accurate empirical models that predict the PSD has been an important ongoing research topic. The sound emitted can be represented from the pressure fluctuations term in the Reynoldsaveraged Navier-Stokes equations (RANS). Therefore, early TBL empirical models (including those from Lowson, Robertson, Chase, and Howe) were primarily derived by simplifying and solving the RANS for pressure fluctuation and adding appropriate scales. Most subsequent models (including Goody, Efimtsov, Laganelli, Smol’yakov, and Rackl and Weston models) were derived by making modifications to these early models or by physical principles. Overall, these models have had varying levels of accuracy, but, in general, they are most accurate under the specific Reynolds and Mach numbers they were developed for, while being less accurate under other flow conditions. Despite this, recent research into the possibility of using alternative methods for deriving the models has been rather limited. More recent studies have demonstrated that an artificial neural network model was more accurate than traditional models and could be applied more generally, but the accuracy of other machine learning techniques has not been explored. In the current study, an original model is derived using a stepwise regression algorithm in the statistical programming language R, and TBL wall-pressure fluctuations PSD data gathered at the Carleton University wind tunnel. The theoretical advantage of a stepwise regression approach is that it will automatically filter out redundant or uncorrelated input variables (through the process of feature selection), and it is computationally faster than machine learning. The main disadvantage is the potential risk of overfitting. The accuracy of the developed model is assessed by comparing it to independently sourced datasets.

Keywords: aircraft noise, machine learning, power spectral density models, regression models, turbulent boundary layer wall-pressure fluctuations

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Authors: Zlatina Genisheva, Pedro Ferreira-Santos, Margarida Soares, Cândida Vilarinho, Joana Carvalho

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The wine industry produces significant quantities of waste, much of which remains underutilized as a potential raw material. Typically, this waste is either discarded in the fields or incinerated, leading to environmental concerns. By-products of wine production, like lees and grape pomace, are readily available at relatively low costs and hold promise as raw materials for biochemical conversion into valuable products. Reusing these waste materials is crucial, not only for reducing environmental impact but also for enhancing profitability. The Vinhos Verdes demarcated region, the largest wine-producing area in Portugal, has remained relatively stagnant over time. This project aims to offer an alternative income source for producers in the region while also expanding the limited existing research on this area. The main objective of this project is the study of the sustainable valorization of grape pomace and lees from the production of DOC Vinho Verde. Extraction tests were performed to obtain high-value compounds, targeting phenolic compounds from grape pomace and protein-rich extracts from lees. An environmentally friendly technique, microwave extraction, was used for this process. This method is not only efficient but also aligns with the principles of green chemistry, reducing the use of harmful solvents and minimizing energy consumption. The findings from this study have the potential to open new revenue streams for the region’s wine producers while promoting environmental sustainability. The optimal conditions for extracting proteins from lees involve the use of NaOH at 150ºC. Regardless of the solvent employed, the ideal temperature for obtaining extracts rich in polyphenol compounds and exhibiting strong antioxidant activity is also 150ºC. For grape pomace, extracts with a high concentration of polyphenols and significant antioxidant properties were obtained at 210ºC. However, the highest total tannin concentrations were achieved at 150ºC, while the maximum total flavonoid content was obtained at 170ºC.

Keywords: antioxidants, circular economy, polyphenol compounds, waste valorization

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Authors: Joana PaScoa Pinheiro, David Goncalves Ferreira, Filipe Ramos, Joaquim Soares Do Brito, Samuel Martins, Marco Sarmento

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Introduction: The SARS-CoV-2 (COVID-19) pandemic was identified in January 2020 in China, in the city of Wuhan. The increase in the number of cases over the following months was responsible for the restructuring of hospitals and departments in order to accommodate admissions related to COVID-19. Essential services, such as trauma, had to readapt to maintain their functionality and thus guarantee quick and safe access in case of an emergency. Objectives: This study describes the impact of COVID-19 on a Level III Trauma Center and particularly on the clinical management of hospitalized patients with spine injuries. Study Design & Methods: This is a retrospective cohort study whose results were obtained through the medical records of patients with spine injuries who underwent surgical intervention in the years 2019 and 2020 (period from March 1st to December 31st). A comparison between the two groups was made. In the study patients with injuries in the context of trauma were included who underwent surgery in the periods previously described. Patients hospitalized with a spine injury in a non-traumatic context and/or were not surgically treated were excluded. Results: In total, 137 patients underwent trauma spine surgery of which 71 in 2019 (51.8%) were without significant differences in intergroup comparisons. The most frequent injury mechanism in 2019 was motor vehicle crash (47.9%) compared to 2020 which was of a person falling from a height between 2-4 meters (37.9%). Cervical trauma was reported to be the most frequent spine injury in both years. There was a significant decrease in the need for intensive care in 2020, 51.4% vs 30.3%, p = .015 and the number of complications was also lower in 2020 (1.35% vs 0.98%), including the number of deaths, being the difference marginally significant. There were no significant differences regarding time for presentation to surgery or in the total days of hospitalization. Conclusions: The restructuring made in the trauma unit at a Level III Trauma Center in the context of the current COVID-19 pandemic was effective, with no significant differences between the years of 2019 vs 2020 when compared with the time for presentation to surgery or the number of days of hospitalization. It was also found that lockdown rules in 2020 were probably responsible for the decrease in the number of road traffic accidents, which justifies a significant decrease in the need for intensive care as well as in the number of complications in patients hospitalized in the context of spine trauma.

Keywords: trauma, spine, impact, covid-19

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Authors: Joana Mourão

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Transition to a low carbon economy requires changes in consumption and production patterns, including the improvement of existing buildings’ environmental performance. Urban rehabilitation is a top policy priority in Europe, creating an opportunity to increase this performance. However, urban rehabilitation comprises different typologies of interventions with distinct levels of consideration for cultural urban heritage values and for environmental values, thus with different impacts. Cities rely on both material and non-material forms of heritage that are deep-rooted and resilient. One of the most relevant parts of that urban heritage is the historical pre-industrial housing stock, with an extensive presence in many European cities, as Lisbon. This stock is rehabilitated and transformed at the framework of urban management and local governance traditions, as well as the framework of the global economy, and in that context, faces opportunities and threats that need evaluation and control. The scope of this article is to define methodological bases and research lines for the assessment of impacts that urban rehabilitation initiatives set on the vulnerable and historical pre-industrial urban housing stock, considering it as an environmental and cultural unreplaceable material value and resource. As a framework, this article reviews the concepts of urban regeneration, urban renewal, current buildings conservation and refurbishment, and energy refurbishment of buildings, seeking to define key typologies of urban rehabilitation that represent different approaches to the urban fabric, in terms of scope, actors, and priorities. Moreover, main types of interventions - basing on a case-study in a XVIII century neighborhood in Lisbon - are defined and analyzed in terms of the elements lost in each type of intervention, and relating those to urbanistic, architectonic and constructive values of urban heritage, as well as to environmental and energy efficiency. Further, the article overviews environmental cultural heritage assessment and life-cycle assessment tools, selecting relevant and feasible impact assessment criteria for urban buildings rehabilitation regulation, focusing on multi-level urban heritage integrity. Urbanistic, architectonic, constructive and energetic integrity are studied as criteria for impact assessment and specific indicators are proposed. The role of these criteria in sustainable urban management is discussed. Throughout this article, the key challenges for urban rehabilitation planning and management, concerning urban built heritage as a resource for sustainability, are discussed and clarified.

Keywords: urban rehabilitation, impact assessment criteria, buildings integrity, embodied energy

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Authors: Susana Gonçalves, Joana Lencart, Anabela Gregório Dias

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Introduction: In combination with chemotherapy, Total Body Irradiation (TBI) is most used as part of the conditioning regimen prior to allogeneic hematopoietic stem cell transplantation. Conventional TBI techniques have a long application time but non-conformality of beam-application with the inability to individually spare organs at risk. Our institution’s intention is to start using Volumetric Modulated Arc Therapy (VMAT) techniques to increase homogeneity of delivered radiation. As a first approach, a dosimetric plan was performed on a computed tomography (CT) scan of a Rando Alderson antropomorfic phantom (head and torso), using a set of six arcs distributed along the phantom. However, a full body anthropomorphic phantom is essential to carry out technique validation and implementation. Our aim is to define the physical and chemical characteristics and the ideal manufacturing procedure of upper and lower limbs to our anthropomorphic phantom, for later validate TBI using VMAT. Materials and Methods: To study the better fit between our phantom and limbs, a CT scan of Rando Alderson anthropomorphic phantom was acquired. CT was performed on GE Healthcare equipment (model Optima CT580 W), with slice thickness of 2.5 mm. This CT was also used to access the electronic density of soft tissue and bone through Hounsfield units (HU) analysis. Results: CT images were analyzed and measures were made for the ideal upper and lower limbs. Upper limbs should be build under the following measures: 43cm length and 7cm diameter (next to the shoulder section). Lower limbs should be build under the following measures: 79cm length and 16.5cm diameter (next to the thigh section). As expected, soft tissue and bone have very different electronic density. This is important to choose and analyze different materials to better represent soft tissue and bone characteristics. The approximate HU values of the soft tissue and for bone shall be 35HU and 250HU, respectively. Conclusion: At the moment, several compounds are being developed based on different types of resins and additives in order to be able to control and mimic the various constituent densities of the tissues. Concurrently, several manufacturing techniques are being explored to make it possible to produce the upper and lower limbs in a simple and non-expensive way, in order to finally carry out a systematic and appropriate study of the total body irradiation. This preliminary study was a good starting point to demonstrate the feasibility of TBI with VMAT.

Keywords: TBI, VMAT, anthropomorphic phantom, tissue equivalent materials

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Authors: Teresa Sarmento de Beires, Sofia Padilha, Pedro Arantes, Joana Ribeiro, Andreia Eiras

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Background: Trichotillomania is a psychiatric condition that is very challenging to treat, with no first-line medications approved by any medical agency. It is defined as a recurrent compulsive habit of pulling out one's own hair, usually from the scalp and eyebrows area, but it can also affect eyelashes or any other hair-bearing area. N-acetylcysteine, a glutamate modulator, has been studied as a possible treatment for several psychiatric and neurological disorders, considering its role in attenuating pathophysiological processes responsible for compulsive behaviors and, therefore, trichotillomania. Objective: This study aims to determine the efficacy of N-acetylcysteine in the treatment of adults with trichotillomania. Methodology: The authors researched guidelines, standards of clinical guidance, systematic reviews, meta-analyses, and randomized clinical trials, published in the last 20 years using the MeSH terms: "Trichotillomania” and “N-acetylcysteine” in the following databases: PubMed, Cochrane library, National Guideline Clearing House, National Institute of Health and Care Excellence (NICE), Canadian Medical Association Practice Guidelines and Database of Abstracts of Reviews of Effectiveness (DARE). The Strength of Recommendation Taxonomy (SORT) Scale, from the American Family Physician, was used to evaluate the level of evidence and assign the strength of recommendation. Results: The research found fifteen articles, among which only three were eligible according to the inclusion criteria: 1. systematic review and 2. meta-analyses. There was evidence of a probable beneficial effect of N-acetylcysteine on treatment response and reduction of trichotillomania symptom severity in adults, with moderate certainty in the effect estimate. There was no evidence of effectiveness with the use of inositol, antioxidants, naltrexone, or selective serotonin reuptake inhibitors (SSRIs) in the treatment of adults with trichotillomania. Clomipramine and Olanzapine showed potential treatment benefits, with low certainty. N-acetylcysteine had the least severe side effect profile in adults compared with the other potentially beneficial pharmacological treatments. Conclusion: Evidence points towards the effectiveness of N-acetylcysteine in the treatment of adults with trichotillomania, which exhibits a good tolerability profile with minimal adverse effects. Therefore, the authors attribute a level of evidence 2, the strength of recommendation B, to the prescription of N-acetylcysteine in the treatment of adults suffering from trichotillomania (SORT analysis). Further investigation is needed in order to extract high-quality conclusions from the meta-analysis.

Keywords: trichotillomania, hair pulling, treatment, n-acetylcysteine

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