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Beach–dune systems are highly dynamic features of the coastal system, the evolution of which is influenced by several processes that occur at very different spatial and temporal scales. To mitigate shoreline retreat that threatens extensive coastal areas worldwide, coastal erosion mitigation measures are implemented, aiming to make coastal areas resilient to the effects induced by coastal erosion and the anticipated climate change related to storms, flood events and sea level rise. Numerical modelling can support planned and sustainable coastal management from a medium-to-long-term perspective (decades). This research focuses on presenting contributions regarding the numerical modelling of subaerial beach dynamics (berm width and dune systems interactions) from a medium-term perspective. The method applied is based on a combination of the results of two simplified numerical models (the LTC and CS-Model). The results demonstrate the potential of the proposed combined model for medium-term projections, allowing for the interpretation of beach–dune dynamics and the evaluation of the importance of longshore and cross-shore sediment transport processes. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the progression of chorioretinal atrophic areas associated with myopic choroidal neovascularization (CNV) in high myopic patients followed by a minimum period of 10 years. Patients and Methods: Patients with myopic CNV lesions that achieved clinical and structural remissions over 10 years of follow-up were included. Medical records were reviewed for CNV characterization and treatment, best-corrected visual acuity at baseline (BCVA0), immediately after the last treatment (BCVA1) and at the latest visit (BCVA2). Fundus autofluorescence (FAF) was used to quantify the amount of atrophic area increase per year associated with the treated myopic CNV lesion. The first FAF performed after treatment suspension (FAF1) was compared with the most recent exam (FAF2). Results: Thirty-six eyes from 36 patients were included. Mean total follow-up was 12.38 ± 2.68 years. Mean number of intravitreal injections (IVI) was 12.50 ± 12.40 and 25% of the eyes had previous treatment with photodynamic therapy (PDT). Mean improvement between BCVA0 and BCVA1 was 5.58 ± 15.98 letters (p < 0.001). However, a drop of 8.03 ± 12.25 letters was noticed between BCVA1 and BCVA2. FAF1 was 6.34 ± 4.92mm2 and increased to 9.88 ± 7.56mm2 (3.54 ± 3.79mm2 variation p < 0.001). The mean growth rate of the atrophic area was 0.89 ± 0.84mm2 per year. BCVA2 negatively correlated with FAF2 (k = − 0.498, p = 0.002) being worse in patients with higher atrophic area growth rate (k = − 0.341, p = 0.042). Eyes treated with PDT needed less IVI (5.89 ± 5.21 vs 14.70 ± 13.36, p = 0.008) but had larger FAF1 (9.80 ± 5.33 vs 5.19 ± 4.27, p = 0.013) and FAF2 (16.05 ± 7.10 vs 7.83 ± 6.63, p = 0.003). Hypothyroidism was associated with higher atrophy growth rate (1.55 ± 1.15 vs 0.73 ± 0.67, p = 0.016). Conclusion: This research demonstrates the importance of chorioretinal atrophy progression after myopic CNV lesions regression and its impact on visual prognosis, reporting a mean yearly growth of 0.89 mm2 in atrophic areas. Previous treatment with PDT and hypothyroidism were identified as risk factors associated with larger atrophic areas and worse visual outcomes. [ABSTRACT FROM AUTHOR]

Purpose: To report the 4-year outcomes of transepithelial accelerated corneal collagen crosslinking (TE-ACXL) in the treatment of eyes with progressive keratoconus (KC). Methods: Eyes of patients who underwent TE-ACXL (6mW/cm2 for 15 minutes) for progressive KC and presented 48 months of follow-up were included. Corrected distance visual acuity (CDVA), keratometry measurements (Kmax, maximum keratometry, Kmean, mean keratometry and Astg, corneal astigmatism), thinnest corneal thickness (PachyMin), and topographic, and tomographic indices (specifically the posterior radius of curvature from the 3.0 mm centered on the thinnest point of the cornea (PRC), and the D-index) were analysed preoperatively and every 12 months after TE-ACXL, up to 48 months. Progression after TE-ACXL was considered when eyes presented ≥ 1 criteria: (1) increase of ≥ 1D in Kmax or increase of ≥ 0.75D in Kmean or increase of ≥ 1D in Astg; (2) reduction of ≥ 0.085 mm in PRC; (3) decrease ≥ 5% in PachyMin. Results: 41 eyes from 30 patients were included, with a mean age at crosslinking of 20.90± 4.69 years. There was a significant increase in Kmean (+0.64± 1.04 D, p< 0.001; +0.98 ± 1.49 D, p< 0.001; +1.27± 2.01 D, p< 0.001; +1.13± 2.00 D, p=0.006) and a significant decrease in PRC throughout follow-up (− 0.12± 0.22, p=0.002; − 0.15± 0.24, p< 0.001; − 0.17± 0.43, p=0.021; − 0.16± 0.43, p=0.027). PachyMin decreased significantly at 36 and 48 months (− 8.50± 15.93 μm, p=0.004; − 7.82± 18.37, p=0.033). According to our progression criteria, there was a major progression rate throughout follow-up (57.1%, 61.1%, 58.8%, and 67.9%, respectively). Surgery and follow-up were uneventful in all subjects. Eleven eyes (26.8%) required further procedures, ≥ 36 months after the initial TE-ACXL, due to persistent progressive disease. Conclusion: TE-ACXL proved to be a safe therapeutic option for progressive KC. However, its efficacy is deemed unsatisfactory, as a notable proportion of affected eyes may continue to advance within a 4-year timeframe, necessitating additional procedures to halt the disease's course. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate whether repeated intravitreal injections (IVI) with an anti-vascular endothelial growth factor (anti-VEGF) agent are associated with glaucomatous progression in eyes with glaucoma spectrum diseases (GSD).Methods: Single-center, retrospective, longitudinal study of patients with bilateral and similar GSD who: (1) received ≥ 8 IVI in only one eye during the study period; (2) had ≥ 2 retinal nerve fiber layer thickness (RNFL) measurements obtained by spectral-domain optical coherence tomography (SD-OCT) at least 12 months apart. The primary outcome was the absolute RNFL thickness change, comparing injected and fellow uninjected eyes. Linear mixed effects models were constructed, including a multivariable model.Results: Sixty-eight eyes from 34 patients were included, 34 injected and 34 fellow uninjected eyes. Average baseline age was 67.68± 21.77 years with a follow-up of 3.66± 1.89 years and 25.12± 14.49 IVI. RNFL thickness decreased significantly from 80.92± 15.78 to 77.20± 17.35 μm (p< 0.001; − 1.18± 1.93 μm/year) in injected eyes and from 79.95± 17.91 to 76.61± 17.97 μm (p< 0.001; − 1.07± 0.98 μm/year) in uninjected eyes. In a multivariable linear mixed model of injected eyes, only higher baseline RNFL thickness (p < 0.001) significantly predicted higher absolute RNFL thickness loss. Neither absolute RNFL thickness variation (p=0.716) nor RNFL rate (p=0.779) was significantly different between paired injected and uninjected eyes. Absolute IOP variation was not significantly different between groups (16.62± 4.77 to 15.09± 4.34 mmHg in injected eyes and 17.68± 5.01 to 14.50± 3.39 mmHg in fellow uninjected eyes; p=0.248). The proportion of eyes receiving glaucoma medical treatment increased significantly in both groups (55.9% to 76.5% in injected eyes; p=0.039; 58.8% to 76.5% in uninjected eyes; p = 0.031). The number of glaucoma medications also increased significantly in both groups (1.03± 1.11 to 1.59± 1.18 glaucoma medications in injected eyes; p=0.003; 1.09± 1.11 to 1.56± 1.19 glaucoma medications in uninjected eyes; p=0.003).Conclusion: Repeated IVI do not seem to accelerate glaucomatous progression. Future studies with a longer follow-up are needed. [ABSTRACT FROM AUTHOR]

The purpose of this clinical report was to describe a case of Cohen syndrome with its classical ophthalmological manifestations and novel VPS13B genetic variants. A 39-year-old Caucasian male patient with severe rod-cone retinal dystrophy and no history of parental consanguinity was referred to our ophthalmology department. Ophthalmologic history included high bilateral myopia and a 3-year prior bilateral cataract surgery. Systemic history included facial dysmorphism, intellectual disability, transient neutropenia, microcephaly, truncal obesity, and joint hyperextensibility. The patient presented classic fundoscopic features of pigmentary retinopathy in both eyes (OU). Optical coherence tomography (OCT) revealed bilateral central and diffuse retinal pigment epithelium (RPE) and outer retinal atrophy without concomitant macular edema, while fluorescein angiography (FA) demonstrated diffuse RPE atrophy with prominent choroidal vessels. The full-field ERG (ffERG) showed no dark-adapted or light-adapted responses and the P50 wave was not identified in the pattern ERG (pERG). The genetic study revealed two novel heterozygous variants in the VPS13B gene: (1) c.5138T>C p.(Leu1713Pro) and (2) c.10179del p.(Asn3393Lysfs*37), thus confirming the diagnosis of Cohen syndrome. This case report introduces these two novel genetic variants to the literature, in a patient with classic phenotypic characteristics of Cohen syndrome, a rare genetic disease which has been increasingly reported since its first description in 1973. [ABSTRACT FROM AUTHOR]

The artificial sand bypassing systems are coastal interventions designed to transfer sediments from areas of accretion to areas where erosion is observed. The goal of these systems is to reduce the littoral drift gradients where sediment transport is interrupted (vicinity of river mouths or port structures) and maintain a balanced sediment distribution along the shoreline. However, these systems present high initial investment costs as well as ongoing expenses for operation and maintenance. To assess the feasibility of sand bypassing systems in mitigating coastal erosion from a long-term perspective (decades), a comprehensive understanding of their performance is necessary, considering both physical and economic aspects. Thus, a cost–benefit assessment numerical tool, COAST, is applied to evaluate and discuss the effectiveness of bypassing systems during their life cycle. First, a comprehensive analysis is conducted for a generic study area, and then, the feasibility of the systems is discussed for two real study areas of the Portuguese West coast (Barra-Vagueira and Figueira da Foz-Leirosa). The generic results demonstrate as the importance of systems location or transposed flow volumes. On the other hand, the analysis of the two real case studies revealed that, under similar conditions, the results of the cost–benefit analysis can be contradictory. For the Barra-Vagueira stretch, the work indicates that the bypass system is not economically viable, whereas for Figueira da Foz-Leirosa, it is cost-effective. The study shows the importance of the site-specific conditions to evaluate the best option for a medium to long-term planned coast, highlighting the relevance of the proposed approach to assess the physical and economic feasibility of sand bypassing systems. [ABSTRACT FROM AUTHOR]

A study was conducted to analyze the characterization of the glycolipids from the type strains of Meiothermus ruber, Meiothermus chliarophilus, Meiothermus silvanus and Meiothermus cerbereus. Fast atom bombardment and chemical techniques were utilized to carry out the analysis. Results indicated that the presence of glycolipids supporting 2-hydroxyacyl groups N-linked to hexosamine is a stable phenotypic marker that distinguishes the genus Meiothermus from the genus Thermus.

We present a series of new open-source deep-learning algorithms to accelerate Bayesian full-waveform point source inversion of microseismic events. Inferring the joint posterior probability distribution of moment tensor components and source location is key for rigorous uncertainty quantification. However, the inference process requires forward modelling of microseismic traces for each set of parameters explored by the sampling algorithm, which makes the inference very computationally intensive. In this paper we focus on accelerating this process by training deep-learning models to learn the mapping between source location and seismic traces for a given 3D heterogeneous velocity model and a fixed isotropic moment tensor for the sources. These trained emulators replace the expensive solution of the elastic wave equation in the inference process. We compare our results with a previous study that used emulators based on Gaussian processes to invert microseismic events. For fairness of comparison, we train our emulators on the same microseismic traces and using the same geophysical setting. We show that all of our models provide more accurate predictions, ∼ 100 times faster predictions than the method based on Gaussian processes, and a O(105) speed-up factor over a pseudo-spectral method for waveform generation. For example, a 2 s long synthetic trace can be generated in ∼ 10 ms on a common laptop processor, instead of ∼ 1 h using a pseudo-spectral method on a high-profile graphics processing unit card. We also show that our inference results are in excellent agreement with those obtained from traditional location methods based on travel time estimates. The speed, accuracy, and scalability of our open-source deep-learning models pave the way for extensions of these emulators to generic source mechanisms and application to joint Bayesian inversion of moment tensor components and source location using full waveforms. [ABSTRACT FROM AUTHOR]

A study which was aimed at characterizing new Thermus strains and confirming the presence of glycerol-linked and diol-linked glycolipids within these strains was conducted. The methods used were extraction and purification of polar lipids, hydrolysis and analysis of glycolipids, preparation of fatty acid methyl esters (FAMEs) and derivatization. Results showed that partial structures of intact diol-containing lipids were present in the bacteria and some Thermus strains contain a mixture of diol- and glycerol-based glycolipids which were not present in the Thermomicrobium roseum.

We present a series of new open source deep learning algorithms to accelerate Bayesian full waveform point source inversion of microseismic events. Inferring the joint posterior probability distribution of moment tensor components and source location is key for rigorous uncertainty quantification. However, the inference process requires forward modelling of micro-seismic traces for each set of parameters explored by the sampling algorithm, which makes the inference very computationally intensive. In this paper we focus on accelerating this process by training deep learning models to learn the mapping between source location and seismic traces, for a given 3D heterogeneous velocity model, and a fixed isotropic moment tensor for the sources. These trained emulators replace the expensive solution of the elastic wave equation in the inference process. We compare our results with a previous study that used emulators based on Gaussian Processes to invert microseismic events. For fairness of comparison, we train our emulators on the same microseismic traces and using the same geophysical setting. We show that all of our models provide more accurate predictions and ~100 times faster predictions than the method based on Gaussian Processes, and a O(105) speed-up factor over a pseudo-spectral method for waveform generation. For example, a 2-s long synthetic trace can be generated in ~10 ms on a common laptop processor, instead of ~1 hr using a pseudo-spectral method on a high-profile Graphics Processing Units card. We also show that our inference results are in excellent agreement with those obtained from traditional location methods based on travel time estimates. The speed, accuracy and scalability of our open source deep learning models pave the way for extensions of these emulators to generic source mechanisms and application to joint Bayesian inversion of moment tensor components and source location using full waveforms. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The ECAS (Entrepreneurial Cultural Affinity Spaces) framework seeks to transform social design theory and practice, through an emergent instructional paradigm of heritage-led, local learning ecosystem approaches, to leverage on diverse assets of people in community settings. OBJECTIVES: This paper addresses the theoretical backdrop of how such ecosystems can be co-designed, implemented, and evaluated, to include disadvantaged and underrepresented groups. METHODS: We seek to introduce the ECAS framework and how it can present an inclusive and open instructional paradigm that improves design for social change, innovation, and entrepreneurship in practice. RESULTS: In this paper, we address implementation through an Erasmus Plus, Adult Education research project, discussing the framework, conditions, and support mechanisms developed. CONCLUSION: Reconfiguration of design for social change and our collective mind-set, will create the conditions for more dynamic and powerful collaborations that stimulate and enable social innovation, entrepreneurship and inclusion. [ABSTRACT FROM AUTHOR]

Copyright of RPDI - Revista Portuguesa de Doenças Infecciosas is the property of Sociedade Portuguesa de Doencas Infecciosas e Microbiologia Clinica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper presents a preliminary attempt to estimate the awareness and value that society gives to the maintenance and protection of marine protected areas, linking the ecological and economic value scale assigned to the study. To accomplish this, we took as illustrative example the Biophysical Interest Zone of Avencas (ZIBA), in Portugal. The ZIBA spans over one ha and its coastal ecosystems present a very rich biodiversity, providing several socio-economic opportunities to society. To estimate the value that society attributes to this area we conducted a contingent valuation exercise, considering two different aspects: 1) the direct economic value that people state to conserve the ecosystem and 2) the willingness to contribute through the allocation of hours of voluntary work to its conservation. The values obtained indicate the dependence and importance of this ecosystem to local population (willing to pay to conserve it of 60 € per household per year and willing to give 3 h of voluntary work per year). The proximity of the local population to the protected area increases the willing to pay for its conservation; this could reveal a good local indicator of ecosystem valuation. This valuation exercise highlights the importance of coastal ecosystem services to society and draws attention to the benefits that local populations derive from those systems. These results have also implications in future governance actions regarding protected areas, as well as to justify for sustainable investments in coastal management efforts, to sustain the flow of coastal ecosystem services for current and future generations. [ABSTRACT FROM AUTHOR]

Cowden syndrome (CS) is a rare dominantly inheritedmultisystemdisorder, characterized by an extraordinarymalignant potential. In 80% of cases, the human tumor suppressor gene phosphatase and tensin homolog (PTEN) is mutated. We present a case of a 17-year-old boy with genetically confirmed CS and Graves' disease (GD). At the age of 15, he presented with intention tremor, palpitations, andmarked anxiety. On examination, he hadmacrocephaly, coarse facies, slight prognathism, facial trichilemmomas, abdominal keratoses, leg hemangioma, and a diffusely enlarged thyroid gland. He started antithyroid drug (ATD) therapy with methimazole and, after a 2-year treatment period without achieving a remission status, a total thyroidectomy was performed. Diagnosis and management of CS should be multi disciplinary. Thyroid disease is frequent, but its management has yet to be fully defined. The authors present a case report of a pediatric patient with CS and GD and discuss treatment options. [ABSTRACT FROM AUTHOR]

Background. Ulcerative colitis (UC) is associated with an increased risk of colorectal cancer (CRC). Aberrant crypt foci (ACF) are important biomarkers of sporadic CRC risk. Their correlation with the risk of intraepithelial neoplasia (IN) in UC remains unclear. Aims. To assess whether ACF are a risk factor for IN in long-standing UC and to investigate any correlation between the clinico-epidemiological characteristics and prevalence/number of ACF in these patients. Methods. Seventy-six patients with long-standing UC were prospectively screened by colonoscopy with chromoendoscopy-guided endomicroscopy. ACF were sought in the lower rectum. Results. Eight INs were detected in seven (9.2%) patients. The ACF prevalence and mean number were 60.5% and 2.4 ± 2.8, respectively. The number of ACF was independently associated with the risk of having IN (odds ratio = 1.338; 95% confidence interval 1.030-1.738). ACF number revealed a good calibration (area under the receiver operating characteristic curve = 0.829) and discriminative ability ( p = 0.205, Hosmer-Lemeshow test) for the prediction of synchronous IN. Patients with ≥3 ACF have a significantly higher prevalence of IN than patients with <3 ACF (22.6% vs. 0%, p = 0.001). Using this cut-off value, the performance of ACF in predicting the presence of IN was as follows: sensitivity = 100%, specificity = 65.2%, positive predictive value = 22.6%, and negative predictive value = 100%. Age >40 years, family history of CRC, and increased body mass index (BMI) were associated with a significantly higher number of ACF. Conclusion. Long-standing UC patients with ≥3 ACF have a significantly higher likelihood of having IN. Age >40 years, family history of CRC, and increased BMI have significant positive associations with the number of ACF. [ABSTRACT FROM AUTHOR]

Background: Audit Trails (AT) are fundamental to information security in order to guarantee access traceability but can also be used to improve Health information System's (HIS) quality namely to assess how they are used or misused. This paper aims at analysing the existence and quality of AT, describing scenarios in hospitals and making some recommendations to improve the quality of information. Methods: The responsibles of HIS for eight Portuguese hospitals were contacted in order to arrange an interview about the importance of AT and to collect audit trail data from their HIS. Five institutions agreed to participate in this study; four of them accepted to be interviewed, and four sent AT data. The interviews were performed in 2011 and audit trail data sent in 2011 and 2012. Each AT was evaluated and compared in relation to data quality standards, namely for completeness, comprehensibility, traceability among others. Only one of the AT had enough information for us to apply a consistency evaluation by modelling user behaviour. Results: The interviewees in these hospitals only knew a few AT (average of 1 AT per hospital in an estimate of 21 existing HIS), although they all recognize some advantages of analysing AT. Four hospitals sent a total of 7 AT - 2 from Radiology Information System (RIS), 2 from Picture Archiving and Communication System (PACS), 3 from Patient Records. Three of the AT were understandable and three of the AT were complete. The AT from the patient records are better structured and more complete than the RIS/PACS. Conclusions: Existing AT do not have enough quality to guarantee traceability or be used in HIS improvement. Its quality reflects the importance given to them by the CIO of healthcare institutions. Existing standards (e.g. ASTM: E2147, ISO/TS 18308:2004, ISO/IEC 27001:2006) are still not broadly used in Portugal. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Integrated Coastal Zone Management / Revista de Gestão Costeira Integrada is the property of Associacao Portuguesa dos Recursos Hidricos and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Propolis is a resin collected by bees from plant buds and exudates, which is further processed through the activity of bee enzymes. Propolis has been shown to possess many biological and pharmacological properties, such as antimicrobial, antioxidant, immunostimulant and antitumor activities. Due to this bioactivity profile, this resin can become an alternative, economic and safe source of natural bioactive compounds. Antitumor action has been reported in vitro and in vivo for propolis extracts or its isolated compounds; however, Portuguese propolis has been little explored. The aim of this work was to evaluate the in vitro antitumor activity of Portuguese propolis on the human colon carcinoma cell line HCT-15, assessing the effect of different fractions (hexane, chloroform and ethanol residual) of a propolis ethanol extract on cell viability, proliferation, metabolism and death. Methods: Propolis from Angra do Heroísmo (Azores) was extracted with ethanol and sequentially fractionated in solvents with increasing polarity, n-hexane and chloroform. To assess cell viability, cell proliferation and cell death, Sulforhodamine B, BrDU incorporation assay and Anexin V/Propidium iodide were used, respectively. Glycolytic metabolism was estimated using specific kits. Results: All propolis samples exhibited a cytotoxic effect against tumor cells, in a dose- and time-dependent way. Chloroform fraction, the most enriched in phenolic compounds, appears to be the most active, both in terms of inhibition of viability and cell death. Data also show that this cytotoxicity involves disturbance in tumor cell glycolytic metabolism, seen by a decrease in glucose consumption and lactate production. Conclusion: Our results show that Portuguese propolis from Angra do Heroísmo (Azores) can be a potential therapeutic agent against human colorectal cancer. [ABSTRACT FROM AUTHOR]

Serious erosion problems related to significant negative sediments budgets in the coastal systems are referred worldwide. Artificial nourishments are a coastal erosion mitigation strategy that allow for a decrease in those negative budgets by adding sediment to the coastal system. Thus, it is essential to understand and adequately model the shoreline response after a nourishment operation, in order to support the definition of the best intervention scenarios. The main goal of this work was to study the artificial nourishment effects on the longshore sediment transport and consequently on the morphological evolution at the intervention site and nearby areas, in a time horizon of 5 years. The longshore transport of the nourished sediments was evaluated, aiming to contribute to the evaluation of the sediment's permanence at the deposition site and the frequency required for new nourishments. The shoreline evolution numerical long-term configuration (LTC) model was applied in order to evaluate the spatial and temporal distribution of the nourished sediments along the coast, considering different types of beaches and incident wave climates. The adopted approach is generic and supported by simple numerical models, which can be useful for preliminary site-specific evaluations. The results show that the nourishment impact is mainly observed nearby the intervention site. It is highlighted that higher longshore sediment transport rates are associated with more energetic wave climates, but not necessarily with incident waves more oblique to the shoreline. [ABSTRACT FROM AUTHOR]

The purpose of this clinical report is to describe a 10-year clinical outcome of advanced surface ablation with photorefractive keratectomy (PRK) in a patient who had been previously incorrectly diagnosed with keratoconus (KC). Corneal ectasia is a rare but extremely relevant complication of laser vision correction, and KC represents a major contraindication for these procedures. Nonetheless, some surface ablation procedures, such as PRK, might be a valid option for particular patients with atypical corneal topography or subclinical or mild forms of KC. Patient education and complete preoperative refractive multimodal imaging are essential for a more conscious therapeutic decision, minimizing iatrogenic ectasia, as well as decreasing the number of patients who are incorrectly denied refractive surgery, as was the patient presented in this study., Competing Interests: The authors have declared financial relationships, which are detailed in the next section., (Copyright © 2024, Vilares Morgado et al.)

Diagnosing polycystic ovary syndrome (PCOS) during adolescence is challenging since normal pubertal development overlap typical features of this syndrome. The authors aim to summarize the existing evidence concerning PCOS in adolescence, particularly its diagnostic criteria and therapeutic options. A search throughout medical databases such as PubMed and MedScape was performed. Diagnostic criteria include irregular menstrual cycles according to time postmenarche and evidence of clinical hyperandrogenism and/or biochemical hyperandrogenism, provided other causes have been excluded. Polycystic ovarian morphology ought not to be used as a diagnostic criterion. Treatment should target manifestations and/or comorbidities, even in the absence of a definite diagnosis. Lifestyle interventions are the first-line treatment. Combined oral contraceptives, metformin or antiandrogens may also be considered as adjuvants. Screening for PCOS in adolescence is crucial as it allows an early intervention on the symptoms and comorbidities presented leading to better long-term reproductive and metabolic outcomes., Competing Interests: The authors have no conflict of interests to declare., (Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).)

Introduction: Endoscopy remains the exam of choice in the evaluation of activity in Crohn's disease (CD) after surgery (ACD-AS). However, intestinal ultrasound (IUS) may represent a noninvasive alternative. The objective of this study is to determine the diagnostic accuracy of this modality compared to endoscopy., Material and Methods: This is a cross-sectional study, comprising a period of 14 months, carried out in patients with established CD and ileocecal resection due to the disease. IUS (HI-VISION Avius®, Tokyo, Japan) was performed with linear probe B-mode/Doppler prior to ileocolonoscopy. IUS and ileocolonoscopy were performed on the same day by 2 specialists in Gastroenterology dedicated to ultrasound and inflammatory bowel disease, in a double-blind mode. Collected demographic and clinical data (Harvey-Bradshaw Index [HBI]; remission ≤4), serological/fecal inflammatory parameters (leukocytes [4-10 × 10 9 cells/L], C-reactive protein [≤0.5 mg/dL], and fecal calprotectin [<50 mg/kg]), endoscopy (Rutgeerts score: remission 3 mm and/or Limberg score >1) was abnormal in 61.5% ( n = 24) of the cases. Endoscopic remission (Rutgeerts score

Background: High-quality cardiopulmonary resuscitation (CPR) remains essential to improve the outcome of patients in sudden cardiorespiratory arrest. Feedback on performance is a crucial component of the learning processes associated with simulation and has been shown to improve CPR quality during simulated cardiac arrest on mannequins. This study aims to evaluate skills acquisition using a new low-cost feedback device for CPR self-training when compared to standard training methods., Methods: Thirty-nine pregraduated medical and biomedical engineering students were recruited for a longitudinal double-blinded randomized control study. For training Basic Life Support skills, the control group used a standard task-trainer and received feedback from an instructor. The intervention group used the same standard task-trainer, instrumented with the CPR Personal Trainer that provided automated performance feedback (with no instructor) on compression-related parameters. Students' knowledge and skills were assessed before and after training, through a theoretical knowledge test and 2 minutes of CPR practical performance., Results: The theoretical tests showed an improvement both in the intervention and in the control group. For each compression-related parameters (hands position, recoil, rate, and depth), significant increase in scores is observed, between the pre- and the post-test, in both groups. The intervention and control groups presented identical mean differences for the total score (0.72 vs 0.72), with no statistical difference ( P  = 0.754)., Conclusions: The proposed tool proved to be effective in the acquisition of compression-related skills, with similar outcomes as the traditional instructor-based method, corroborating the hypothesis that a low-cost tool with feedback for CPR self-training can provide an alternative or a complementary extension to traditional training methods. The system can also be considered cost-efficient as it reduces the permanent presence of an instructor for the chest compressions training, promoting regular training outside formal training courses., Competing Interests: Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.The authors declare no conflicts of interest., (Copyright © 2018 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of PBJ-Associação Porto Biomedical/Porto Biomedical Society. All rights reserved.)

Ileal intussusception is the invagination of the small intestine within itself and accounts for 1% of cases of acute obstruction. However, physicians do not initially consider intussusception as a possible diagnosis of obstruction due to its rarity in adults. Herein, we report the case of a 22-year-old male who was admitted to the Emergency Department with continuous abdominal pain. Ultrasonography and computed tomography revealed an ileal intussusception. The patient underwent surgical removal of the segment of the small bowel. Unexpectedly, pathology revealed that the invagination occurred due to a parasite egg, with features suggestive of Schistosoma species. Schistosomiasis, although considered a parasitic disease in tropical countries, is not absent from Europe and though it is highly improbable, it may be responsible for cases of intussusception in adults.

Chemical investigation of the aerial part and the roots of Euphorbia hyberna L. subs. hyberna. resulted in the isolation and identification of four triterpenoids (3β-O-octadecanoyllupeol (1), glut-5-en-3β-ol (2), 24-methylenecicloartan-3β-ol (3) and cicloart-23-ene-3β,25-diol (6)) along with the phenolic compounds ellagic acid (4) and 3,3'-di-O-methylellagic acid (7). Although these are all known compounds, this is the first report of their isolation from this plant. Their structures were elucidated on the basis of spectral methods, including 2D NMR experiences, and confirmed by comparing with the literature data.

A new xanthone (2), 3-(2-hydroxyethoxy)xanthone, and three known compounds, 1-hydroxyxanthone, salicylic acid and the sesquiterpene oplopanone, were isolated for the first time from the rhizomes of Hedychium gardnerianum Rosc. The structures of these compounds were elucidated on the basis of detailed spectral analysis, including 2D NMR experiments.

A new diterpene tetraester, from the jatrophane family, and two new diterpene triesters, with a lathyrane skeleton, have been isolated from the chloroform extract of the roots of Euphorbia hyberna L. The structures of these compounds have been established by spectroscopic methods, including 2D NMR experiments.

An isolate, designated strain FS-1T, was recovered from a ripe fig. Phylogenetic analysis of the 16S rRNA genes and DNA-DNA reassociation values showed that the organism represented a novel species of the genus Leuconostoc closely related to Lactobacillus fructosus. The novel isolate could be distinguished from the type strain of Lactobacillus fructosus by the fatty acid composition and several phenotypic and growth characteristics. In strain FS-1T, 18:1 delta9 (18:1omega9c) was present in relatively large amounts whilst, in Lactobacillus fructosus, this fatty acid was a minor component. Strain FS-1T and Lactobacillus fructosus produced acid in API 50CHL microtubes from glucose, fructose and mannitol within 48 h, whereas only strain FS-1T also fermented trehalose, gluconate, turanose and sucrose after 48 h. Other differences in acid production from carbohydrates also distinguished strain FS-1T from Lactobacillus fructosus. Both organisms were heterofermentative with fructose as a substrate and fermented glucose only in the presence of fructose, as determined by nuclear magnetic resonance studies. Strain FS-1T was catalase-positive. On the basis of the phylogenetic analysis, DNA-DNA reassociation values, physiological and biochemical characteristics and fatty acid composition, the name Leuconostoc ficulneum is proposed for the novel species represented by strain FS-1T, and it is proposed that Lactobacillus fructosus be reclassified in the genus Leuconostoc as Leuconostoc fructosum comb. nov.