Negative energy impacts in the absence of proper baseline studies - a South African case study

Abstract: Energy Conservation projects have become a focus area throughout the world in an attempt to reduce greenhouse gasses. These projects encompass various energy efficient technologies of which the retrofit of old technologies with new technology has become a common phenomenon. Energy savings are usually quantified by comparing actual post-retrofit energy consumption levels with baseline levels representative of the preretrofit status quo, adjusted for changes in energy drivers (e.g. weather). Baseline adjustments during energy conservation projects are of the utmost importance if operating conditions, occupancies, ambient temperatures, production levels and other factors have changed between the baseline period and the postretrofit period. During a recent case study in South Africa, an HVAC retrofit was done on a multistorey building where old technology air-conditioners were replaced with heat pump based units with inverters. To the disappointment of the landlord, the post energy measurements exceeded the baseline energy consumption by approximately 12% without any changes in operating conditions. This paper illustrates the catastrophic effects when an energy efficiency project is accelerated to the implementation stage without due consideration of operating conditions during the pre-implementation stage. A qualitative analysis prior to baseline establishment is proposed

Best Pratice Guide to Manage Vegetation and Promote Biodiversity in Linear Infrastructures

The present guide is based on the experience acquired in the framework of the LIFE LINES project (LIFE14 NAT/PT/001081) and intends to compile and disseminate the recommendable procedures for the management of biodiversity, particularly of plant diversity, in the marginal areas of linear infrastructures, primarily focusing on the national roads, decommissioned railways now used for recreation purposes (ecotrails) and power lines of very high voltage. The guide includes technical information for those in charge of the management of roads, trails and power lines (concession holders, municipalities), for environmental consultancy (Agência Portuguesa do Ambiente, Instituto de Conservação da Natureza e Florestas), and for landscape and agroforestry technicians, as well as for the general public

Evaluation of savings from an underground fan replacement project

Abstract: The savings calculation methodology from a fan replacement project is presented in this paper. The fans replaced are part of the underground ventilation system in a platinum mine. Initially, 290 axial flow fans rated at 45kW were to be replaced with carbon fibre composite fans. According to the manufacturer, the carbon fibre construction allowed for an optimum blade shape which results in the carbon fibre fan being more energy efficient. However, after the first few fans were replaced, it was discovered that the mine’s blasting activities caused the carbon fibre fans to crack and eventually fail. Fortunately, the manufacturer was able to produce a steel fan with similar performance to that of the carbon composite fans and continue replacing old fans in the mine. The savings were independently verified according to the International Performance Measurement & Verification Protocol (IPMVP). This involved testing old and new fans in a BS848 test duct and comparing the old and new fans at various operating points on their fan curves and making adjustments for operating conditions such as air density underground vs at the test duct. It was found that the new fans saved 5kW on average, across a range of operating points

Innocent heart murmurs

Innocent heart murmur is a frequent auscultatory finding in children. The diagnosis is essentially clinical, without need for further investigation. However, excluding heart disease can be a difficult task. This review article describes some features of medical history and physical examination that help in this differentiation. The role of diagnostic tests is also examined

Paraquat Intoxication – experience of an Internal Medicine ward for 18 years

Introduction: Paraquat is a contact herbicide commercially available since 1962. Paraquat intoxication (PI) is usually voluntary and highly lethal, since there is no effective antidote. Toxicity occurs through cyclic redox reactions, damaging mainly the kidneys and lungs. Aim, material and methods: featuring the clinical presentation, management and outcome of patients with PI over an 18 years period (from the 01st January 1993 to the 31st December 2010) through the retrospective analysis of clinical files and comparing the survivors and the deceased. Results: Thirty-one cases of Paraquat intoxication were included, with a male: female ratio 1:1. Age range from 13 to 80 years, mean age 42.4years (±18.7).All intoxications were voluntary and by oral route. There was statistical difference in the amount ingested (22.1 mL vs. 72.7 mL, p<0.0005). A non-significant trend to a longer delay until getting medical attention in the deceased group (1.6 h vs. 3.2 h, p=0.091). Statistical significance was found between mortality and leukocytosis, hypocapnea, hypoxemia, LDH, alkaline phosphatase and AST. There was no difference between groups according to treatment options, although hemocarboperfusion was used more often in the deceased group (53.9% vs. 66.7%, p=0.471) and corticosteroids in the survivor group (61.5% vs. 44.4%, p=0.350). Mortality rate was 58.1% (66.7% in the first 72 hours), due to respiratory insufficiency and multiple organ failure. Variable levels of pulmonary fibrosis occurred in 38.5% of the survivors. Discussion & Conclusion: Paraquat intoxication has a poor prognosis with limited efficiency of treatment approaches. The relation between Paraquat in the urine and the time elapsed after ingestion is the main determinant factor in the prognosis. In this study the presence of dyspnea, hypocapnea and hypoxemia was linked to a bad prognosis. There was no statistical difference between the available treatment options

Guião de Boas Práticas de Gestão da Vegetação para a Promoção e Biodiversidade em Infraestruturas Lineares

O presente guião de boas práticas tem por base a experiência adquirida ao longo do projeto LIFE LINES (LIFE14 NAT/PT/001081), pretendendo reunir e divulgar procedimentos recomendáveis para a gestão da biodiversidade, com ênfase na diversidade vegetal das zo nas marginais associadas às infraestruturas lineares, e focando-se, so bretudo, em estradas nacionais, ferrovias desativadas com uso recrea tivo (ecopistas) e linhas elétricas de muito alta tensão. O guião inclui informação técnica dirigida às entidades gestoras de estradas, caminhos pedestres e de linhas de muito alta tensão (con cessionárias, autarquias), a responsáveis pela Avaliação de Impacte Ambiental de infraestruturas lineares (Agência Portuguesa do Ambien te, Instituto de Conservação da Natureza e Florestas), a técnicos da área do paisagismo e operações agroflorestais, bem como informação dirigida ao público em geral

Beta Cell Function as a Baseline Predictor of Weight Loss After Bariatric Surgery

Background: Obesity is a multifactorial disease, which is strongly associated to other metabolic disorders. Bariatric surgery is the most effective treatment of morbid obesity. The role of beta cell function in weight loss after bariatric surgery is uncertain. Aim: To evaluate the association between beta cell function and percentage of total body weight loss (TBWL%) 1, 2, 3, and 4 years after bariatric surgery in patients with morbid obesity. Methods: Retrospective longitudinal study in patients with morbid obesity followed in our center between January 2010 and July 2018. Patients were excluded if they had diabetes at baseline or missing data on the needed parameters. We evaluated baseline Homeostatic Model Assessment of IR, Homeostatic Model Assessment of ß-cell function (HOMA-beta), Quantitative Insulin Sensitivity Check Index, and Matsuda and DeFronzo index, and TBWL% at years 1 to 4. Linear regression models were used to evaluate the association of indexes of insulin resistance with TBWL% (unadjusted and adjusted for age, sex, BMI, and type of surgery). Results: There were 1,561 patients included in this analysis. HOMA-beta was negatively associated with TBWL% at second, third, and fourth years post-surgery (ß = -1.04 [-1.82 to -0.26], p<0.01; ß = -1.16 [-2.13 to -0.19], p=0.02; ß = -1.29 [-2.64 to 0.06], p=0.061, respectively). This was not observed in the first year post-surgery nor for the other indexes. Glycemia at baseline was positively associated to EWL% at second and third years post-surgery. Conclusion: ß-cell function at baseline seems to be associated to long-term weight loss, explicitly after the first year post bariatric surgery. This might be a helpful predictor of weight loss in clinical practice.The authors would like to thank all the CRIO group members for following these patients: John Rodrigues Preto; Eduardo Jorge Lima da Costa; Hugo Miguel Santos Sousa; André Manuel Costa Pinho; Carla Cristina Oliveira Rodrigues Teixeira Galego; Maria Flora Ferreira Sampaio Carvalho Correia; Cidália Fátima Castro Carção Gil; Diva Bizarro Figueiredo Melim; Eduardo Gil Ferreira Rodrigues Pinto; Marco António Costa Silva; Cristina Sarmento Pontes Martins; Luis Miguel Gonçalves Pereira; Inês Vasconcelos Sousa Magalhães; Isabel Maria Boavista Vieira Marques Brandão; Sertório Manuel Freitas Andrade, and Patrícia Maria Lopes Nunes. The authors would also like to thank the patients and the hospital for their support. The authors would like to thank to Associação dos Amigos do Serviço de Endocrinologia do Hospital de S. João

Oral glucose tolerance testing at 1 h and 2 h: relationship with glucose and cardiometabolic parameters and agreement for pre-diabetes diagnosis in patients with morbid obesity

Background: One hour plasma glucose concentration (1hPG) during an oral glucose tolerance test (OGTT) may be an alternative to 2-h plasma glucose concentration (2hPG) in the identification of individuals at increased risk of hyperglycaemia, although its role is not fully understood. Aim: We aim to investigate the relationship of these measures with other glucose parameters, as well as their relationship with cardiometabolic risk markers and the level of agreement for prediabetes mellitus diagnosis, in a sample of patients with morbid obesity. Methods: We retrospectively evaluated 656 patients with morbid obesity without diagnosed diabetes. To define prediabetes with 2hPG, 2022 American Diabetes Association guidelines criteria were used, while for 1hPG, glucose ≥ 155 mg/dL was considered. Cohen’s Kappa coefficient was used to assess the agreement between both measures of prediabetes mellitus diagnosis. Results: A Cohen’s Kappa coefficient of 0.405 (p < 0.001) was obtained. The 1hPG were positively correlated with homeostatic model assessment for insulin resistance (HOMA-IR) (ρ = 0.281, p < 0.001), fasting plasma glucose (FPG) (ρ = 0.581, p < 0.001), glycated haemoglobin (Hb1AC) (ρ = 0.347, p < 0.001) and were negatively correlated with homeostatic model assessment for cell-β function (HOMA-β) (ρ = −0.092, p = 0.018). 2hPG were also correlated with the same parameters, except for HOMA-β. Conclusion: A fair agreement between 1 and 2hPG was verified. 1hPG criteria may be a useful indicator of β-cell dysfunction and insulin resistance in patients with morbid obesity without diabetes diagnosis. © 2022, The Author(s).Funding text 1: We would like to acknowledge the support of all the endocrinologists, surgeons and nutritionists of the Multidisciplinary Group for Surgical Management of Obesity.; Funding text 2: Isabel Maia holds a PhD Grant (ref: SFRH/BD/117371/2016) co-funded by the Foundation for Science and Technology—FCT (The Portuguese Ministry of Science, Technology and Higher Education) and the POCH/FSE programme

Thyroid Function and the Risk of Non-Alcoholic Fatty Liver Disease in Morbid Obesity

Background: An association between hypothyroidism and the risk of Non-alcoholic Fatty Liver Disease (NAFLD) has been suggested. This association remains to be elucidated in patients with morbid obesity. Aim: To evaluate the association between thyroid function and parameters of liver function and hepatic scores in patients with morbid obesity. Methods: Patients with morbid obesity followed in our center between January 2010 and July 2018 were included. The ones without evaluation of liver and thyroid functions were excluded. Fatty Liver Index (FLI) and BARD scores were used as predictors of hepatic steatosis and fibrosis, respectively. Results: We observed a positive association between TSH and both BARD (OR 1.14; p = 0.035) and FLI (OR 1.19; p = 0.010) in the unadjusted analysis. We found a negative association between free triiodothyronine levels and BARD (OR 0.70; p<0.01) and a positive association between free triiodothyronine levels and FLI (OR 1.48; p = 0.022). Concerning liver function, we found a positive association between total bilirubin and free thyroxine levels (ß = 0.18 [0.02 to 0.35]; p = 0.033) and a negative association between total bilirubin and free triiodothyronine levels (ß = -0.07 [-0.14 to -0.002]; p = 0.042). Conclusion: Higher levels of TSH and free triiodothyronine may be associated with a higher risk of NAFLD, particularly steatosis, in patients with morbid obesity