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The emergence of the Industry 4.0 trend brings automation and data exchange to industrial manufacturing. Using computational systems and IoT devices allows businesses to collect and deal with vast volumes of sensorial and business process data. The growing and proliferation of big data and machine learning technologies enable strategic decisions based on the analyzed data. This study suggests a data-driven predictive maintenance framework for the air production unit (APU) system of a train of Metro do Porto. The proposed method assists in detecting failures and errors in machinery before they reach critical stages. We present an anomaly detection model following an unsupervised approach, combining the Half-Space-trees method with One Class K Nearest Neighbor, adapted to deal with data streams. We evaluate and compare our approach with the Half-Space-Trees method applied without the One Class K Nearest Neighbor combination. Our model produced few type-I errors, significantly increasing the value of precision when compared to the Half-Space-Trees model. Our proposal achieved high anomaly detection performance, predicting most of the catastrophic failures of the APU train system. [ABSTRACT FROM AUTHOR]

Group decision support systems (GDSSs) have been widely studied over the recent decades. The Web-based group decision support systems appeared to support the group decision-making process by creating the conditions for it to be effective, allowing the management and participation in the process to be carried out from any place and at any time. In GDSS, argumentation is ideal, since it makes it easier to use justifications and explanations in interactions between decision-makers so they can sustain their opinions. Aspect-based sentiment analysis (ABSA) intends to classify opinions at the aspect level and identify the elements of an opinion. Intelligent reports for GDSS provide decision makers with accurate information about each decision-making round. Applying ABSA techniques to group decision making context results in the automatic identification of alternatives and criteria, for instance. This automatic identification is essential to reduce the time decision makers take to step themselves up on group decision support systems and to offer them various insights and knowledge on the discussion they are participating in. In this work, we propose and implement a methodology that uses an unsupervised technique and clustering to group arguments on topics around a specific alternative, for example, or a discussion comparing two alternatives. We experimented with several combinations of word embedding, dimensionality reduction techniques, and different clustering algorithms to achieve the best approach. The best method consisted of applying the KMeans++ clustering technique, using SBERT as a word embedder with UMAP dimensionality reduction. These experiments achieved a silhouette score of 0.63 with eight clusters on the baseball dataset, which wielded good cluster results based on their manual review and word clouds. We obtained a silhouette score of 0.59 with 16 clusters on the car brand dataset, which we used as an approach validation dataset. With the results of this work, intelligent reports for GDSS become even more helpful, since they can dynamically organize the conversations taking place by grouping them on the arguments used. [ABSTRACT FROM AUTHOR]

The pandemic caused by SARS-CoV-2 remains a health care concern, despite vaccination programs. Mucormycosis, especially rhino-orbital-mucormycosis, has been described as a severe complication of COVID-19. Although it has been described mostly in India and other developing countries, few cases in the western world have also been described. We present a case of rhino-orbito-mucormycosis after recovery from severe COVID-19 in Portugal. A 75-year-old diabetic and obese man presented with right proptosis associated with right eye pain and low vision one month after recovery from severe COVID-19. Considering the most probable etiology for this clinical picture, anti-fungal therapy with liposomal amphotericin B was promptly initiated, followed by endoscopic sinus debridement. However, due to persistent and progressive infection, and after a multidisciplinary revision of the case, orbital exenteration was performed. One year after surgery, the patient is stable, without clinical or imagological signs of relapse of the disease. Although the evolution of the pandemic, along with vaccination programs, led to a lower incidence of severe COVID-19 disease, there are still patients presenting with severe COVID-19, requiring intensive care and at risk for serious complications. This case illustrates the importance of being aware of the development of post-COVID-19 mucormycosis and the need for close surveillance of patients recovering from severe COVID-19. COVID-19 prompt diagnosis and multidisciplinary approach are essential for a timely intervention achieving better survival while minimizing morbidity. [ABSTRACT FROM AUTHOR]

Thyroid eye disease (TED) characterizes by inflammation and remodeling of orbital tissues. Although the majority of pediatric TED is mild, some children present progressive and severe disease. The approach to severe disease in this group of patients, especially when noncortico-responsive, is challenging. The purpose of this work was to describe the effective use of tocilizumab as second-line therapy in steroid-resistant pediatric TED. A 13-year-old female with a history of Graves' disease presented with right eye proptosis for at least 8 months associated with mild pain on eye movements and ocular surface complaints. The ophthalmologic evaluation revealed Hertel exophthalmometry readings of 22 mm on the right eye (OD) and 19 mm on the left (OS). The remaining ophthalmic examination was unremarkable. Intravenous methylprednisolone pulses of 500 mg were initiated without any improvement after 4 treatments. Following multidisciplinary team discussion, therapy was switched to monthly tocilizumab injections at 4 mg/kg. Significant reduction of proptosis and resolution of pain and ocular surface complaints were noted immediately after the treatment switch. Exophthalmometry readings after the end of treatment that included 4 tocilizumab injections were 20 mm on OD and 19 mm on OS. No side effects were reported during the entire follow-up. Six months after treatment cessation, the patient remains stable, without any signs of orbitopathy relapse and no ophthalmologic complaints. This is the second case report showing the effectiveness of tocilizumab in pediatric TED and the first one showing its efficacy when steroids fail. Our results support the potential safety and efficacy of this immunosuppressor in children with TED. [ABSTRACT FROM AUTHOR]

We aim to report a case of a middle-aged woman with bilateral idiopathic elevated episcleral venous pressure (IEEVP) and its difficulties in the diagnostic approach. Particularly in this case, the atypical feature of ocular hypertension without glaucomatous optic nerve damage may be misleading. We present a 66-year-old woman with longstanding bilateral "red eyes." Clinical findings included bilateral episcleral vessel engorgement and tortuosity and raised intraocular pressure with open iridocorneal angles. Despite ocular hypertension, glaucomatous neuropathy was absent and confirmed by normal structural (optical coherence tomography) and functional (standard automated perimetry) tests. The systemic workup was unremarkable. Magnetic resonance angiography showed bilateral dilated superior ophthalmic veins. Cerebral digital subtraction angiography was requested, and no carotid-cavernous fistula (or other significant vascular findings) was identified. The diagnosis of IEEVP was assumed. In conclusion, our case highlights the systematic investigation necessary in cases of bilateral episcleral vessel engorgement and tortuosity and the possible differential diagnosis to be considered to rule out life-threatening causes of elevated episcleral venous pressure. It is important for clinicians to be aware of IEEVP even in patients with atypical features that despite significative ocular hypertension had no glaucomatous damage. [ABSTRACT FROM AUTHOR]

Introduction: Mucopolysaccharidosis type VI (MPS VI) is a rare inherited metabolic disorder, primarily attributed to the deficiency of the enzyme N-acetylgalactosamine-4-sulfatase, responsible for the degradation of dermatan sulfate and chondroitin-4-sulfate. Therefore, there is a widespread accumulation of partially degraded glycosaminoglycans. Corneal opacification is the hallmark ocular feature in the MPS. Retinal and scleral involvement in this MPS is extremely rare. The purpose of this work was to describe novel fundoscopic alterations present in patients with MPS VI. Case Presentation: This is a case series involving three non-related patients referred to our department from the Unit of Inherited Metabolic Diseases. Multimodal imaging was performed in every patient. Fundus photography and enhanced depth imaging optical coherence tomography (EDI-OCT) were performed. Multiple areas of yellow/orange patches were observed on fundus photography, corresponding to areas in which deposits of intermediate reflectivity in the EDI-OCT could be seen at the scleral level with associated choroidal thinning. This finding suggested the presence of scleral deposits of glycosaminoglycans. Conclusion: To our knowledge, this is the first case series in the literature encompassing patients with MPS VI with suspected deposits of glycosaminoglycans in the sclera. The better control of the systemic comorbidities, the increase in life expectancy, and the timely management of corneal disease have allowed the identification of new, late-onset ocular manifestations in MPS patients. In addition, new imaging techniques have introduced the possibility of better characterizing and understanding these manifestations. [ABSTRACT FROM AUTHOR]

Introduction: Contrast rapid sequence angiography with fluorescein or indocyanine green (ICG) is a diagnostic procedure commonly used in ophthalmology. Adverse reactions to fluorescein and ICG are rare and may be classified as toxic, of hypersensitivity and non-specific. The evaluation and management of a patient with an adverse reaction is a challenge for the majority of ophthalmologists, as is the assessment of risk factors that may contraindicate the procedure. Purpose: We aim to review the concepts underlying adverse reactions to fluorescein and ICG, especially those of hypersensitivity, and present a proposal or the evaluation of the patients in need to perform retinal angiography and for the treatment of immediate reactions to fluorescein and ICG. Methods: The available literature was examined using PubMed-Medline, and using the MeSH terms "fluorescein", "Indocyanine green", "ophthalmic dyes", "retinal angiography", "adverse reactions", and "allergic reaction". Conclusion: This review may help ophthalmologists to identify patients with higher risk of a hypersensitivity reaction and give them tools to recognize patients with suspected hypersensitivity that may benefit from an allergy study. [ABSTRACT FROM AUTHOR]

Purpose. To describe a clinical case of mucopolysaccharidosis type VI (MPS VI), or Maroteaux-Lamy syndrome, with fundoscopic alterations that may correspond to scleral deposits of glycosaminoglycans. Materials and Methods. Clinical case report. Results. A 16-year-old girl with MPS VI was examined at the Ophthalmology Department for poor vision due to opacified corneas. Treatment consisted of bilateral penetrating keratoplasty. Retinographies and enhanced depth imaging optical coherence tomography (EDI-OCT) were performed after surgery, suggesting the presence of scleral glycosaminoglycan deposits. The patient evolved with stable corneal and fundoscopic findings. Conclusions. To our knowledge, this is the first case of MPS VI described in vivo with suspected deposits of glycosaminoglycans in the sclera. Fundoscopic alterations are not usually included in the ocular pathological spectrum of MPS VI. However, with improved control of systemic comorbidities, survival rates of these patients have increased, which in turn has made it possible to observe other changes besides the ones that were classically described. Despite being particularly challenging to manage, efforts should be made to maximizing the visual acuity of these patients, in order to provide them the best possible quality of life. [ABSTRACT FROM AUTHOR]

Purpose. To evaluate the efficacy of the "fogging test," performed with a +2 diopters (D) lens, in the exclusion of clinically significant hyperopia in school-aged children. Methods. We studied 54 children between 5 and 11 years of age, with 10/10 best-corrected bilateral visual acuity (VA) without significant degree of correction. VA was assessed in each eye with a "bilateral" +2 D sphere over-refraction followed by cycloplegic retinoscopy. The capacity of the test to detect hyperopia of ≥+2 D and ≥+1.5 D was evaluated by examining the respective receiver operating characteristic (ROC) curves and sensitivity and specificity values for different cutoff values of VA. Results. For the detection of hyperopia ≥+2 D, the area under the ROC curve (AUC) was 0.955 (p≤0.001). The VA cutoff with best discriminative capacity was ≥5/10, with a sensitivity of 100%, specificity of 79%, positive predictive value (PPV) of 57%, and negative predictive value (NPV) of 100%. In respect of ≥+1.5 D hyperopia, the test capacity was lower (AUC = 0.832; p≤0.001). The best VA cutoff was also of ≥5/10, with a PPV of 81% and a NPV of 85%. Conclusion. The accuracy of the test was high for the evaluation of ≥+2 D hyperopia but lower for ≥+1.5 D hyperopia. For the detection of ≥+2 D hyperopia, the VA cutoff of <5/10 may permit the exclusion of clinically significant hyperopia in selected children, without the need for cycloplegia. For the same cutoff, the PPV was low, meaning that in children with ≥5/10 VA cycloplegic refraction remains obligatory. [ABSTRACT FROM AUTHOR]

Purpose. To report the long-term clinical outcomes after switching from intravitreal bevacizumab or ranibizumab to aflibercept therapy in eyes with AMD. Methods. Retrospective analysis of changes in BCVA, SD-OCT image, and frequency of injections after 1, 2, and 3 years of follow-up. Results. 164 eyes were analyzed, 101 eyes switched from bevacizumab (group 1) and 63 from ranibizumab (group 2). One year after the switch, there was an overall nonsignificant mean decrease of 2 ETDRS letters in BCVA. Three years after, there was an overall mean decrease of 7 ETDRS letters, which was statistically significant. A significant improvement in the mean CRT was found at 1, 2, and 3 years. There was a significant decrease in the mean number of injections per year (7.8 to 6.5, p<0.005) between the first and third year. Conclusion. Aflibercept can be useful in the management of refractory neovascular AMD, with a good morphological response. However, in the long-term, BCVA stabilization was not achieved. [ABSTRACT FROM AUTHOR]

Cystic fibrosis (CF) is one of the most common inherited diseases in the UK, affecting 1:2500 live births. There are now more adults than children with CF in the UK, with a median survival of approximately 40 years. The pulmonary complications of CF are commonly understood and are the main cause of mortality; however, gastrointestinal (GI) complications are wide ranging and remain a primary cause of morbidity. Common GI complications include malabsorption and pancreatic insufficiency; however, less well known are problems such as inflammatory bowel disease and GI cancers. Managing lung disease has historically been the principal aim of care; however, with an increasingly older population GI complications must be addressed; the CF community urgently needs to engage with gastroenterologists who are willing to develop a special interest in this area. [ABSTRACT FROM AUTHOR]

Argumentation-based dialogue models have shown to be appropriate for decision contexts in which it is intended to overcome the lack of interaction between decision-makers, either because they are dispersed, they are too many, or they are simply not even known. However, to support decision processes with argumentation-based dialogue models, it is necessary to have knowledge of certain aspects that are specific to each decision-maker, such as preferences, interests, and limitations, among others. Failure to obtain this knowledge could ruin the model's success. In this work, we sought to facilitate the information acquisition process by studying strategies to automatically predict the tourists' preferences (ratings) in relation to points of interest based on their reviews. We explored different Machine Learning methods to predict users' ratings. We used Natural Language Processing strategies to predict whether a review is positive or negative and the rating assigned by users on a scale of 1 to 5. We then applied supervised methods such as Logistic Regression, Random Forest, Decision Trees, K-Nearest Neighbors, and Recurrent Neural Networks to determine whether a tourist likes/dislikes a given point of interest. We also used a distinctive approach in this field through unsupervised techniques for anomaly detection problems. The goal was to improve the supervised model in identifying only those tourists who truly like or dislike a particular point of interest, in which the main objective is not to identify everyone, but fundamentally not to fail those who are identified in those conditions. The experiments carried out showed that the developed models could predict with high accuracy whether a review is positive or negative but have some difficulty in accurately predicting the rating assigned by users. Unsupervised method Local Outlier Factor improved the results, reducing Logistic Regression false positives with an associated cost of increasing false negatives. [ABSTRACT FROM AUTHOR]

Competing Interests: The authors report no conflicts of interest.