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Jakob Pericak,1,2 Eric K Chin,3,4 David RP Almeida2 1State University of New York at Geneseo, Geneseo, NY, USA; 2Erie Retina Research & Center for Advanced Surgical Exploration, Erie, PA, USA; 3Retina Consultants of Southern California, Redlands, CA, USA; 4Loma Linda Eye Institute; Veterans Affair Hospital, Loma Linda, CA, USACorrespondence: David RP Almeida, Erie Retina Research & Center for Advanced Surgical Exploration, 300 State Street, Suite 302, Erie, PA, 16507, USA, Tel +1 814.476.6227, Fax +1 888.422.5096, Email drpa@pm.mePurpose: The current standard of care for neovascular age-related macular degeneration is serial vascular endothelial growth factor (VEGF) inhibitor intravitreal injections at varying treatment intervals. SUSVIMO is a port-delivery system of ranibizumab that serves as an alternative, lower-maintenance treatment.Methods: A case report from a retinal surgery clinic describing the ocular findings, diagnostic workup, and alternative treatment for an 80-year-old man presenting with new-onset neovascular age-related macular degeneration.Results: Resolved foveal thickness, macular volume, and subretinal fluid after SUSVIMO implantation OD. The patient showed a better response to SUSVIMO than to previous anti-VEGF injections. Before the first refill, the patient began to experience subretinal fluid; however, it was resolved after the refill.Conclusion: Although effective, real-world management of neovascular age-related macular degeneration is associated with an extensive treatment burden that can compromise treatment adherence. Herein, we describe how the port delivery system (PDS; SUSVIMO) - a refillable ocular implant that can continuously deliver a novel formulation of ranibizumab with refills possible at six months or longer - is a viable early therapy that mitigates the treatment burden of intravitreal injections.Keywords: neovascular age-related macular degeneration, SUSVIMO, port delivery system

Jakob M Pericak,1,2 Eric K Chin,3,4 David RP Almeida2 1State University of New York at Geneseo, Geneseo, NY, USA; 2Erie Retina Research & Center for Advanced Surgical Exploration, Erie, PA, USA; 3Retina Consultants of Southern California, Redlands, CA, USA; 4Loma Linda Eye Institute; Veterans Affair Hospital, Loma Linda, CA, USACorrespondence: David RP Almeida, Erie Retina Research & Center for Advanced Surgical Exploration, 300 State Street, Suite 302, Erie, PA, 16507, USA, Tel +1 814 476 6227, Fax +1 888 422 5096, Email drpa@pm.meAbstract: The presentation of vitamin A deficiency (VAD)-induced ocular complications can be challenging to diagnose in elderly patients, particularly due to the overlap with age-related macular degeneration (AMD) symptoms. This case report details the presentation, diagnosis, and management of an 88-year-old female with vision loss, highlighting the ocular manifestations of presumed VAD. Despite vitamin A levels being at the lower end of the normal range, the patient’s symptoms and spectral domain optical coherence tomography (SD-OCT) findings suggested insufficient levels, leading to thinning of the outer nuclear layer. This case underscores the necessity of considering VAD in differential diagnoses of unexplained vision impairment, particularly in individuals with a history of intestinal malabsorption, while also emphasizing the importance of distinguishing VAD from AMD in elderly patients.Keywords: vitamin A deficiency, malabsorption syndrome, age-related macular degeneration

Abstract Background Crowding has been a longstanding issue in emergency departments. To address this, a fast-track system for avoidable patients is being implemented in the Paediatric Emergency Department where our study is conducted. Our goal is to develop an optimized Decision Support System that helps in directing patients to this fast track. We evaluated various Machine Learning models, focusing on a balance between complexity, predictive performance, and interpretability. Methods This is a retrospective study considering all visits to a university-affiliated metropolitan hospital’s PED between 2014 and 2019. Using information available at the time of triage, we trained several models to predict whether a visit is avoidable and should be directed to a fast-track area. Results A total of 507,708 visits to the PED were used in the training and testing of the models. Regarding the outcome, 41.6% of the visits were considered avoidable. Except for the classification made by triage rules, i.e. considering levels 1,2, and 3 as non-avoidable and 4 and 5 as avoidable, all models had similar results in model’s evaluation metrics, e.g. Area Under the Curve ranging from 74% to 80%. Conclusions Regarding predictive performance, the pruned decision tree had evaluation metrics results that were comparable to the other ML models. Furthermore, it offers a low complexity and easy to implement solution. When considering interpretability, a paramount requisite in healthcare since it relates to the trustworthiness and transparency of the system, the pruned decision tree excels. Overall, this paper contributes to the growing body of research on the use of machine learning in healthcare. It highlights practical benefits for patients and healthcare systems of the use ML-based DSS in emergency medicine. Moreover, the obtained results can potentially help to design patients’ flow management strategies in PED settings, which has been sought as a solution for addressing the long-standing problem of overcrowding.

A hipertensão neonatal é um problema clínico raro. A principal causa é renovascular. Os autores apresentam uma causa rara de hiperaldosteronismo transitório secundário a infeção renal. Um recém-nascido (RN) de termo de 22 dias, sem antecedentes de relevo, é enviado ao serviço de urgência por má evolução ponderal. Após análises de sangue e urina é diagnosticado com uma infeção do trato urinário (ITU) e iniciada terapêutica com ampicilina e cefotaxima. Durante a hospitalização, foram observados níveis persistentes de pressão arterial (PA) >P97, tendo sido realizado ecografia renal e eco-Doppler que não mostraram alterações, assim como o estudo hormonal e a função renal analítica normais, excluindo hiperplasia adrenal congénita. Em D9 de internamento, apresentou normalização dos valores de PA. As análises laboratoriais revelaram níveis de aldosterona de 335,4ng/dl (N 2-70 ng/dl) e renina de 1684 mUI/L (N

A prevenção da obesidade infantil é uma questão crítica para a saúde pública, pois a grande maioria do excesso de peso é adquirido ainda em idade pré-escolar. De acordo com a Organização Mundial de Saúde, em 2016, 41 milhões de crianças apresentavam excesso de peso ou obesidade com menos de 5 anos. A obesidade é difícil de combater, persistindo na idade adulta, e aumenta o risco de doenças crónicas. Embora os comportamentos de estilo de vida modificáveis, como alimentação saudável e atividade física, sejam determinantes no sucesso do combate à obesidade, outros fatores da sociedade atual decorrentes do avanço tecnológico têm um peso marcado nesta doença. Para prevenir a obesidade na primeira infância, é importante entender os fatores de risco e as suas interações. As intervenções multidisciplinares demonstram ser eficazes, quando há disponibilidade e motivação, principalmente do ambiente familiar e escolar, onde as crianças estão inseridas. No entanto, desenvolver e avaliar intervenções complexas para a prevenção da obesidade é um desafio para todos os envolvidos, profissionais de saúde, crianças, famílias e outros cuidadores.Esta revisão tem como objetivo discutir as linhas mais recentes para a prevenção e abordagem da obesidade infantil, analisando as evidências das intervenções e discutindo as barreiras da sua aplicação.

Paulo Cruchinho,1 María Dolores López-Franco,2 Manuel Luís Capelas,3 Sofia Almeida,4 Phillippa May Bennett,5– 7 Marcelle Miranda da Silva,1,8 Gisela Teixeira,1 Elisabete Nunes,1 Pedro Lucas,1 Filomena Gaspar1 On Behalf of the Handovers4SafeCare1Nursing Research, Innovation and Development Center (CIDNUR) of Lisbon, Nursing School of Lisbon, Lisboa, Portugal; 2CTS-464 Nursing and Innovation in Healthcare, University of Jaén, Jaén, Spain; 3Universidade Católica Portuguesa, Faculty of Health Sciences and Nursing, Center for Interdisciplinary Research in Health (CIIS), Lisboa, Portugal; 4Universidade Católica Portuguesa, Faculty of Health Sciences and Nursing, Center for Interdisciplinary Research in Health (CIIS), Porto, Portugal; 5Center for English, Translation, and Anglo-Portuguese Studies (CETAPS), Lisboa, Portugal; 6Faculty of Social Sciences and Humanities of the New University of Lisbon, Lisboa, Portugal; 7Faculty of Arts and Humanities of the University of Coimbra, Department of Languages, Literatures and Cultures, Coimbra, Portugal; 8Federal University of Rio de Janeiro, Anna Nery Nursing School, Rio de Janeiro, BrazilCorrespondence: Paulo Cruchinho, Nursing School of Lisbon, Avenida Prof. Egas Moniz, Lisboa, 1600-190, Portugal, Tel +351 217913400, Email pjcruchinho@esel.ptAbstract: Cross-cultural validation of self-reported measurement instruments for research is a long and complex process, which involves specific risks of bias that could affect the research process and results. Furthermore, it requires researchers to have a wide range of technical knowledge about the translation, adaptation and pre-test aspects, their purposes and options, about the different psychometric properties, and the required evidence for their assessment and knowledge about the quantitative data processing and analysis using statistical software. This article aimed: 1) identify all guidelines and recommendations for translation, cross-cultural adaptation, and validation within the healthcare sciences; 2) describe the methodological approaches established in these guidelines for conducting translation, adaptation, and cross-cultural validation; and 3) provide a practical guideline featuring various methodological options for novice researchers involved in translating, adapting, and validating measurement instruments. Forty-two guidelines on translation, adaptation, or cross-cultural validation of measurement instruments were obtained from “CINAHL with Full Text” (via EBSCO) and “MEDLINE with Full Text”. A content analysis was conducted to identify the similarities and differences in the methodological approaches recommended. Bases on these similarities and differences, we proposed an eight-step guideline that includes: a) forward translation; 2) synthesis of translations; 3) back translation; 4) harmonization; 5) pre-testing; 6) field testing; 7) psychometric validation, and 8) analysis of psychometric properties. It is a practical guideline because it provides extensive and comprehensive information on the methodological approaches available to researchers. This is the first methodological literature review carried out in the healthcare sciences regarding the methodological approaches recommended by existing guidelines.Keywords: cross-cultural comparison, decision-making, psychometric properties, research design, validation studies, health services research

Fernanda Patrícia Jeronymo Pinto,1 Renata de Medeiros Dutra,1 Livia Cafundo Almeida,1 Marcela Maria Silvino Craveiro,2 Julio Pinheiro Baima,1 Rogerio Saad-Hossne,2 Ligia Yukie Sassaki1 1Department of Internal Medicine, São Paulo State University (Unesp), Medical School, Botucatu, São Paulo State, Brazil; 2Department of Surgery, São Paulo State University (Unesp), Medical School, Botucatu, São Paulo State, BrazilCorrespondence: Ligia Yukie Sassaki, Department of Internal Medicine, São Paulo State University (Unesp), Medical School, Botucatu, São Paulo State, 18618687, Brazil, Tel +551438801171, Email ligia.sassaki@unesp.brBackground: Inflammatory bowel disease (IBD) affects young adults of reproductive age, and questions related to pregnancy and breastfeeding are common in clinical practice. Most medications used to treat IBD are considered safe during pregnancy, except methotrexate and small molecules such as tofacitinib. Despite few studies regarding vedolizumab (VDZ) safety, it appears to be safe during pregnancy. Therefore, this study aimed to report the management of ulcerative colitis in pregnant patient refractory to anti-tumor necrosis factor (TNF) agents using VDZ.Case Report: A female, 38 years old, with ulcerative colitis was refractory to conventional treatment with mesalazine, sulfasalazine, and azathioprine. She was hospitalized at six weeks of gestation with severe acute colitis requiring the use of infliximab (IFX) to induce remission. She had a spontaneous abortion at nine weeks of gestation after the second dose of IFX. Since there was no endoscopic improvement after six months of IFX treatment, VDZ treatment was initiated. During the VDZ infusion period, the patient discovered that she was pregnant with twins, leading to the discussion of the risks and benefits of continuing the VDZ. The patient presented with disease clinical remission with the use of VDZ, and the babies were born at 34 weeks of gestation without complications. Breastfeeding was also performed without complications.Conclusion: Continued VDZ medication is safe during pregnancy and breastfeeding, with adverse events similar to anti-TNF therapy.Keywords: gestation, biological therapy, safety, inflammatory bowel disease

Guilherme Peixoto Tinoco Arêas,1,2 Cássia da Luz Goulart,3 Thaís Sant’Anna,4 Tiótrefis Gomes Fernandes,4 Rafael de Oliveira Alvim,1 Fernanda Facioli dos Reis Borges,1 Camila Miriam Suemi Sato Barros do Amaral,3 Suzy Cristina França Rodrigues,1 Jefferson Valente,3 João Marcos Bemfica Barbosa Ferreira,5 Anna Gabriela Rezende,1,3 Edival Ferreira de Oliveira Júnior,6 Marcus Vinícius Guimarães de Lacerda,3,7,8 Fernando Fonseca de Almeida-Val1– 4 1Department of Physiological Sciences, Exercise Physiology Laboratory, Federal University of Amazonas, Manaus, AM, Brasil; 2Cardiopulmonary Laboratory, Getúlio Vargas University Hospital, UFAM, Manaus, AM, Brasil; 3Dr Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, AM, Brasil; 4Faculty of Physical Education and Physiotherapy, Respiratory and Cardiovascular Physiotherapy Laboratory, Federal University of Amazonas, Manaus, AM, Brasil; 5Higher School of Health Sciences, Faculty of Medicine, State University of Amazonas, Manaus, AM, Brasil; 6Francisca Mendes University Hospital, Manaus, AM, Brasil; 7Leônidas and Maria Deane Institute, Fiocruz Amazonas, Manaus, AM, Brasil; 8University of Texas Medical Branch at Galveston, Galveston, TX, USACorrespondence: Guilherme Peixoto Tinoco Arêas, Departamento de Ciências Fisiológicas, Universidade Federal Do Amazonas, Avenida Rodrigo Otávio, 6200, Manaus, AM, 69080-900, Brasil, Email guilhermepta@ufam.edu.brBackground: The coronavirus disease-2019 (COVID-19) pulmonary rehabilitation (PR) seems to be a better choice to improve physical and functional capacity after acute infection. However, there is a lack of evidence regarding the effects of different strategies to optimize post-acute phase rehabilitation and reduce long COVID-19 physical deteriorations.Objective: To compare the use of a noninvasive ventilation (NIV) plus aerobic exercise strategy during PR program with to a standard PR (without NIV) on physical capacity and quality of life outcomes in post-COVID-19.Methods: Double-blinded randomized controlled clinical trial. A total of 100 individuals discharged from hospital in a post-acute phase of severe COVID-19 will be randomized into two groups: PR + NIV (Group 1) and PR (Group 2). Inclusion criteria include participants who present symptomatic dyspnea II and III by the modified Medical Research Council, aged 18 years or older. Both groups will receive aerobic and resistance exercise, and inspiratory muscle training. However, group 1 will perform aerobic training with bilevel NIV. Cardiopulmonary exercise test will assess the O2 peak uptake, 6-minute walk test will assess the walking distance and short-form 36 will assess the quality of life before and after 8 weeks (after 24 PR sessions). Moreover, patients will be contacted by telephone every 3 months for one year to record possible adverse events, hospitalizations, and death. All data will be registered in RedCap, and analyses will be performed in the STATA v13 software.Clinical Trial Registration: RBR-3t9pkzt.Keywords: COVID-19, noninvasive ventilation, pulmonary rehabilitation

The growing demand for land for slash-and-burn cultivation, driven by human population growth, has led to the creation of scattered cultivated fields and a mosaic of fallow areas in various stages of regeneration. While tropical forests have demonstrated the ability to rebound regarding tree species diversity and forest structure following disturbances, the extent of recovery in coastal vegetation in southern Africa remains uncertain and poorly understood. To address this knowledge gap, our study collected biophysical data from smallholder fields, fallow land, and forests to evaluate the structure and functioning of coastal vegetation in Gaza province, southern Mozambique. We established 90 sample plots of 0.1 ha each at different stages of plant succession using opportunistic sampling approach. Within these plots, we recorded the diameter at breast height, total height, and species name of all trees and shrubs. Litter and soil samples were collected in 1 m² quadrats embedded within the main plot. Our findings indicate a high capacity for regeneration following the disturbance caused by slash-and-burn cultivation. Species composition varied significantly across different stages of succession, with 52 species identified in forests (FL), 34 in old fallow (OF), 29 in middle fallow (MF), 28 in initial fallow (IF), and 15 in cropland (CL). Richness and diversity increased over time after the practice of slash-and-burn cultivation, with a noticeable enhancement from the initial fallow stage. We observed a gradual recovery of soil carbon stocks in young fallow areas, while litter biomass decreased throughout the recovery phase of the fallow lands. Our study highlights that areas abandoned after agriculture can regenerate in terms of structure, floristic composition, and tree carbon content.

The scientific breakthrough in understanding the role of sports volunteers, as well as the importance of motivation and expectations management in decision-making, has boosted several studies, helping to reinforce the conceptual idea of a sports legacy, especially in relation to the participation and involvement of Olympic volunteers. In this sense, and reinforcing this idea, this study aimed to analyse and measure the perception of sports volunteers regarding the motivations and expectations arising from their participation in the Rio 2016 Olympic Games. The study followed a quantitative-descriptive and inferential methodology, with a validated sample of 828 responses collected through a semi-structured questionnaire adapted from the original VMS-ISE motivation scale. The results point to a reinforcement of the perceived importance and value associated with participation in the Olympic Games that translate into high levels of motivation and satisfaction by most of the volunteers involved. The most valued factors were the feeling of pleasure promoted by the experience, the possibility of personal and professional development, the passion for the Olympic Games, and the passion for sport. The majority of the candidates validated the post-event expectations as having exceeded their initial ones, and 92.0% of the volunteers would participate in a similar event again. The study allows the reinforcement of sports volunteers intentions and expectations, while validating and confirming previous studies on the importance of motivation and personal development in a successful recruitment strategy that fosters regular and consolidated participation of previous volunteers.

Food insecurity, deforestation, and forest degradation are significant challenges to achieving the Sustainable Development Goals in sub-Saharan Africa. Slash-and-burn cultivation and conventional logging (timber and charcoal production) are two interrelated activities that lead to forest loss and undermine food security. However, the environmental and economic incentives to clear or conserve the forest have yet to be discovered. To address this gap, our study collected costs and benefits data to assess financial profitability and viability related to forest conversion to slash-and-burn cultivation options (e.g., mono-cropping of maize and intercropping between maize, cassava and pigeon peas) and forestry exploitation (logging and charcoal production) practices in smallholders in Zambézia province, central Mozambique. Conventional logging was the highest cost activity (1662 US$ ha−1) compared to charcoal production (278 US$ ha−1) and cropping systems. Estimated total costs for cropping ranged from 302 US$ ha−1 to 508 US$ ha−1. Cropping systems appear more profitable in the first year of investment (30 to 1495 US$ ha−1) than forestry activities. On the other hand, the estimated profits for logging and charcoal production are negative at 15 US$ ha−1 and 782 US$ ha−1, respectively. Regarding viability, cropping systems showed the highest indicators compared to forestry activities. Based on the financial assessment, cropping systems seem attractive land use options with the fastest and highest financial returns and the lowest production costs. As such, it is not easy to prevent them. The long-term implications of increasing deforestation to the detriment of the cropping system can translate into rapid ecosystem degradation that can worsen livelihoods.

RESUMO A Prefeitura do Recife, a partir da articulação entre onze distintas Secretarias municipais lançou a Ação Integrada de Atenção ao crack e outras drogas, buscando o fortalecimento de uma rede de cuidado de abordam ampliada, descentralizada e qualificada, que considera o vínculo, o acolhimento, as singularidades, as vulnerabilidades e a responsabilização compartilhada. Este estudo teve como objetivo descrever o processo de implantação dessa política e seu desenvolvimento no período de agosto de 2010 a abril de 2012, bem como a identificação dos principais desafios, avanços e dificuldades encontradas durante este percurso na prevenção e no tratamento de usuários de crack e outras drogas.

Sewage sludge can be used as an organic amendment as long as it is ensured that there is no risk of environmental contamination or risk to public health. In this study, sewage sludge from two wastewater treatment plants (WWTPs) subjected to two disinfection and stabilization treatments [40% (mass/mass), calcium oxide, and calcium hydroxide] and their respective untreated sewage sludge were used. Three control treatments were also added: conventional farmyard manure (FYM), a nitrogen (N) mineral fertilizer (ammonium nitrate 34.5% N) applied at a rate of 50 kg N ha−1 (N50) (the same rate of all organic amendments), and an unfertilized control (N0), totaling nine treatments. Lettuce (Lactuca sativa L.) was cultivated in pots for two growing cycles. The dry matter yield (DMY) was higher in the N50 treatment (13.5 and 10.6 g plant−1 in the first and second growing cycles, respectively), followed by sewage sludge (10.8 to 12.4 and 8.4 to 8.7 g plant−1), FYM (8.5 and 7.2 g plant−1), and the control (7.7 and 6.0 g plant−1). The DMY was related to the N provided by the different treatments, assessed by the N and nitrate concentrations in tissues, N uptake, and apparent N recovery (ANR). Sewage sludge, due to its high N concentration and low carbon (C)/N ratio, mineralized rapidly, providing a significant amount of N to plants, as well as other nutrients, such as phosphorus (P) and boron (B). FYM, with a higher C/N ratio, provided less N to plants, also due to the short duration of the lettuce growing cycle. Alkalized sewage sludge increased soil pH and calcium (Ca) availability for plants. Fertilizer treatments minimally influenced cationic micronutrients. Heavy metals in the initial sewage sludge were below the threshold values established in international legislation, and the levels in soil and lettuce tissues were generally not higher than those in other treatments. Both of the sewage sludges used in this study showed high fertilizing value and very reactive behavior, making nutrients available much more quickly than FYM. This information is relevant to consider in defining their agricultural use.

Eduardo José Pereira Ferreira,1– 4 Lucas Villar Shan de Carvalho Cardoso,3,5 Carlos José Oliveira de Matos,6 Igor Larchert Mota,3,4 Juliana Maria Chianca Lira,3,5 Mayara Evelyn Gomes Lopes,3,5 Giulia Vieira Santos,3,5 Maria Luiza Dória Almeida,2,3,5 Manuel Herminio Aguiar-Oliveira,2,3,5 Antônio Carlos Sobral Sousa,2– 5 Enaldo Vieira de Melo,3,5 Joselina Luzia Menezes Oliveira2– 5 1Department of Medicine, Federal University of Sergipe, Lagarto, 49400-000, Brazil; 2Postgraduate Program in Health Sciences, Federal University of Sergipe, Aracaju, 49100-000, Brazil; 3University Hospital, Federal University of Sergipe, Aracaju, 49100-000, Brazil; 4São Lucas Clinic and Hospital- Rede D’Or São Luiz, Aracaju, 49060-676, Brazil; 5Department of Medicine, Federal University of Sergipe, Aracaju, 49100-000, Brazil; 6Department of Physiotherapy, Federal University of Sergipe, Lagarto, 49400-000, BrazilCorrespondence: Eduardo José Pereira Ferreira, Federal University of Sergipe, Avenida Marechal Rondon, s/n- Jardim Rosa Elze, São Cristóvão, Sergipe, 49100-000, Brazil, Tel + 55 79 999319810, Email ejpferreira@yahoo.com.brBackground: Chronic obstructive pulmonary disease (COPD) worsens prognosis in patients with coronary artery disease (CAD). However, the cardiovascular prognosis in patients with stable or mildly symptomatic COPD remains unclear. Here, we sought to determine the long-term cardiovascular events in patients with subclinical or early-stage COPD with concomitant CAD.Methods: This was a longitudinal analytical study involving 117 patients with suspected or established CAD who underwent assessment of pulmonary function by spirometry and who were followed up for six years (March 2015–January 2021). The patients were divided into two groups, one comprising COPD (n=44) and the other non-COPD (n=73) patients. Cox regression was used to evaluate the association between COPD and cardiovascular events, with adjustment for the established CAD risk factors, and the effect size was measured by the Cohen test.Results: COPD patients were older (p=0.028), had a greater frequency of diabetes (p=0.026), were more likely to be smokers (p< 0.001), and had higher modified Medical Research Council scores (p< 0.001). There was no difference between the groups regarding gender, body mass index, hypertension, dyslipidemia, family history of CAD, and type of angina. CAD frequency and the proportion of patients with severe and multivessel CAD were significantly higher among COPD than among non-COPD patients (all p< 0.001). At six-year follow-up, patients with COPD were more likely to have experienced adverse cardiovascular events than those without COPD (p< 0.001; effect size, 0.720). After adjusting for established CAD risk factors, COPD occurrence remained an independent predictor for long-term adverse cardiovascular events (OR: 5.13; 95% CI: 2.29– 11.50; p< 0.0001).Conclusion: COPD was associated with increased severity of coronary lesions and a greater number of adverse cardiovascular events in patients with suspected or confirmed CAD. COPD remained a predictor of long-term cardiovascular events in stable patients with subclinical or early-stage of COPD, independently of the established CAD risk factors.Keywords: COPD, coronary artery disease, risk factors, ischemic heart disease, myocardial infarction

O artigo visa demarcar o acervo de conhecimentos indígenas sobre as plantas presentes na documentação produzida na viagem filosófica do naturalista luso-brasileiro Alexandre Rodrigues Ferreira pela Amazônia colonial portuguesa (1783-1792). A expedição científica percorreu os territórios das capitanias do Pará, São José do Rio Negro e Mato Grosso e Cuiabá e teve entre os seus objetivos inventariar a flora, a fauna, os minerais e as populações locais. Em campo, o naturalista recorreu aos saberes indígenas sobre as ervas, raízes, madeiras, palmeiras, procurando instrumentalizá-los para geração de riqueza para Coroa portuguesa e/ou para a sobrevivência nos sertões. Os conhecimentos associados ao manejo indígena da natureza foram ainda incorporados aos interesses da história natural, em um momento em que a ciência moderna se estruturava com base na razão, observação e experimentação. Na arena historiográfica posta, dialoga-se com estudos interessados em pensar que o conhecimento científico ilustrado foi produzido a partir dos trânsitos/contatos recíprocos, embora marcados por relações de poder assimétricas, com sujeitos cuja pretensão era a de subalternizar

Salmonellosis, an infectious disease caused by the Salmonella species, encompasses a broad spectrum of clinical manifestations, ranging from mild self-limiting gastroenteritis to severe systemic infections. It affects millions of people annually, causing immense morbidity and economic losses worldwide. This study aims to evaluate the occurrence of Salmonella in water and raw foods, focusing on meat, fish, shellfish, and vegetables consumed in the city of Nampula, north of Mozambique. A total of 81 samples of meat, fish and shellfish, vegetables, and water were collected from nine of the ten municipal markets in Nampula City. Salmonella detections were performed according to ISO 6579-1. A chi-square test was performed in the Python programming language to detect associations between positive samples and market localization. The results showed a high frequency of Salmonella. From the total sample, 38.5% were Salmonella positive. Fresh vegetables were the most contaminated samples, followed by fish, shellfish, raw meat, and water. The outcomes of this study did not find an association between the sample collection location and the test results for Salmonella. In this study, serovars of Salmonella were not identified which hinders the association of Salmonella occurrence with diseases. Consequently, we propose that the next study should focus on detecting the serotypes of Salmonella strains.

Avik Roy, Argentino Almeida, Aparna Rao Glaucoma Service, L.V Prasad Eye Institute, Bhubaneswar, Odisha, IndiaCorrespondence: Avik Roy, Email dravik@lvpei.orgPurpose: To evaluate the outcomes of operating on “complex cataracts” by the glaucoma fellows.Patients and Methods: This was a retrospective study done at a tertiary referral eye care centre in eastern India. After obtaining IRB approval, a retrospective chart review of all patients who underwent “complex” cataract surgery by one of four long-term (2 years) glaucoma fellows between January 2016 and November 2020 was conducted. ‘Complex’ was defined as cataracts complicated with pseudoexfoliation syndrome, phacodonesis with or without blunt ocular trauma, posterior polar cataract, small pupil, co-existent corneal opacity or uveal coloboma, post-glaucoma filtering surgery, post-vitreoretinal surgery, co-existent glaucoma or post-laser iridotomy and monocular patients.Results: Out of a total of 677 eyes done by the glaucoma fellows during the study period, 83 eyes had complex cataract surgery and completed the six-week post-operative follow-up. Intraoperative surgical complications like posterior capsular rent or vitreous loss were noted in 36 of the cases. Thirty of the eyes were left aphakic. Despite a high rate of complications, the LogMAR best-corrected visual acuity (mean ± standard deviation) improved from the preoperative level of 1.7 (± 0.5) to 1.0 (± 0.8) at post-operative six weeks, significant at p < 0.001. As far as the surgeon’s experience was concerned—less than or more than a year since joining the fellowship—there was statistically no difference in the final visual acuity. The group with greater experience had shorter surgical time and lesser complications though this difference was not statistically significant.Conclusion: This is the first study in the literature reporting the outcomes of “complex” cataract surgery performed by glaucoma fellows. Though high rates of postoperative complications were noted in this study, the mean best-corrected visual acuity improved significantly in all eyes after the surgery.Keywords: complex cataract surgery, complicated cataract surgery, glaucoma fellows