Parthenolide (PTN) is a secondary metabolite of the plant Tanacetum parthenium (L.) Schulz Bip. and is considered the chemical marker of this species. This sesquiterpene lactone (germacrene skeleton) has been described as responsible for the biological activity of the leaf extract. In addition, several studies in the literature have demonstrated its antiparasitic and antineoplastic activity. However, there is a need for knowledge of other safety parameters, such as pharmacokinetic, pharmacodynamic and toxicity evaluations. Therefore, in this investigation, the in vitro metabolism of parthenolide was performed with rat liver microsomes and biomimetic metabolism (such as cytochrome P-450 system) using organometallic catalysts. The biomimetic procedure was validated since the major compound of biomimetic oxidative reaction with meta-chloroperbenzoic acid catalyzed by metalloporphyrin 5,10,15,20-tetrakis(pentafluorophenyl)-porphyrin iron(III) chloride was also observed with rat liver microsomes. Previous chemoenzymatic synthesis studies of PTN afforded the same epoxide formation, this major oxidative compound was isolated and fully characterized as (1 R,10R)-epoxyparthenolide based on experimental and theoretical calculations of infrared (IR) and vibrational circular dichroism (VCD) data at the B3PW91/6-311G. Furthermore, for the first time, this metabolite was evaluated for trypanocidal and leishmanicidal activity. The mean inhibitory concentration (IC50) values were lower for PTN than its metabolite and showed significant cytotoxic effects for both parasites. This finding holds promise for addressing neglected diseases.

Palicourea tomentosa (Aubl.) Borhidi (Rubiaceae, Palicoureeae), earlier classified as Psychotria poeppigiana Müll. Arg., is used in folk medicine for a variety of diseases. Biological studies on the plant describes their vasorelaxant, antiplasmodial, antitumoural and anticholinesterase activities. To expand the knowledge on the chemical and biological potential of this species, in this work, phytochemical and dereplication studies, as well as antimicrobial and anticholinesterase evaluation of Palicourea tomentosa were carried out. Phytochemical investigation deals with the isolation of lutein (1), a mixture of dehydrovomifoliol (2) and megastigma-4,7-dien-3-one (3), loliolide (4), 5,13-epoxy-9-hydroxy-megastigma-7-en,3-one (5), vomifoliol (6), asperuloside (7), 3-O-p-coumaroylquinic acid (8), and a mixture of the pyrrolizidinoindoline alkaloids hodgkinsine (9), chimonanthine (10) and psychotriasine (11). The ultra-high performance liquid chromatography coupled to high-resolution mass spectrometry (UHPLC HRMS/MS) based on molecular networking dereplication of dichloromethane fraction led to putative identification of other two megastigmanes, one terpene lactone and three carotenoids, besides seven triterpenes and four indole alkaloids. The dichloromethane, ethyl acetate and hydromethanol fractions of P. tomentosa were able to inhibit Candida albicans with minimum inhibitory concentrations (MICs) of 125, 250 and 125 µg mL-1, respectively. The methanol crude extract, dichloromethane and alkaloid fractions inhibited selectively the butyrilcholinesterase (BuChE) at percentages of 63.09, 60.39 and 56.22%, respectively.

RESUMO: No estado do Amazonas cultiva-se, tradicionalmente, a laranjeira ‘Pêra’ sobre o limoeiro ‘Cravo’. O uso restrito de uma única combinação de copa-porta-enxerto tem deixado os pomares locais vulneráveis à condições adversas e a incidência de pragas e doenças, podendo interferir negativamente tanto na produtividade como na qualidade dos frutos e sustentabilidade citrícola do Estado. A ampliação do número de combinações-copas-porta-enxertos torna-se uma alternativa viável para superar tais problemas. Para atender a esta demanda dos produtores de citros foram avaliadas 30 combinações com 10 copas e três porta-enxertos no sexto e sétimo ano após o plantio das mudas no campo, no município de Rio Preto da Eva, AM. Nesse experimento foram avaliadas: a produtividade, o rendimento de suco, os sólidos solúveis, o pH, a acidez titulável, o ratio e o índice tecnológico. A copa ‘Pineapple’ com os porta-enxertos tangerineira ‘Sunki Tropical’ e ‘BRS Bravo’ podem ser alternativas produtivas em relação a tradicional combinação laranja ‘Pêra’ sob limoeiro ‘Cravo’ no Amazonas. A copa laranja ‘Lima’ com os porta-enxertos tangerineira ‘Sunki Tropical’, limoeiro ‘Cravo Santa Cruz’ e ‘BRS Bravo’ podem ser alternativas para o mercado in natura no estado. As combinações que apresentaram boa qualidade do fruto são as copas ‘Pêra’, ‘Salustiana’, ‘Valência Tuxpan’ e ‘Westin’ com o porta-enxerto ‘BRS Bravo’, e a copa ‘Pêra D6’ com o porta-enxerto limoeiro ‘Cravo Santa Cruz’. Estas combinações são alternativas para a diversificação dos pomares do estado do Amazonas. RESUMO cultivase, cultivase cultiva se, se cultiva-se tradicionalmente Pêra ‘Cravo. Cravo . copaportaenxerto porta enxerto doenças Estado combinaçõescopasportaenxertos enxertos tornase torna problemas 3 1 portaenxertos campo Eva AM suco solúveis pH titulável tecnológico ‘Pineapple Pineapple Sunki Tropical BRS Bravo ‘Lima Lima Tropical, , Cruz ‘Pêra, ‘Salustiana, Salustiana ‘Salustiana ‘Salustiana’ Valência Tuxpan ‘Westin Westin portaenxerto Bravo, D6 D Cruz.

ABSTRACT: In the state of Amazonas, the ‘Pêra’ orange scion is traditionally cultivated on ‘Rangpur’ lime tree. The restricted use of a single scion-rootstock combination has left local orchards vulnerable to adverse conditions and incidence of pests and diseases, which may negatively interfere with both productivity and fruit quality and the citrus activity sustainability in the state. The expansion of the number of scion-rootstock combinations becomes a viable alternative to overcome such problems. To meet this demand from citrus growers, 30 combinations with 10 scions and 3 rootstocks were evaluated in the sixth and seventh year after planting seedlings in the field in the municipality of Rio Preto da Eva, AM. In this experiment, productivity, juice yield, soluble solids, pH, titratable acidity, ratio and technological index were evaluated. ‘Pineapple’ scion with ‘Sunki Tropical’ and ‘BRS Bravo’ rootstocks can be productive alternatives in relation to traditional ‘Pêra’ orange scion under ‘Rangpur’ lime combination in the state of Amazonas. ‘Lima’ orange with ‘Sunki Tropical’ mandarin, ‘Rangpur lime SC’ and ‘BRS Bravo’ lime rootstocks can be alternatives for the fresh market in the state. Combinations that showed good fruit quality are ‘Pêra’, ‘Salustiana’, ‘Valência Tuxpan’ and ‘Westin’ scions with ‘BRS Bravo’ rootstock, and ‘Pêra D6’ scion with ‘Rangpur lime SC’ lemon rootstock. These combinations are alternatives for the diversification of orchards in the state of Amazonas. ABSTRACT Amazonas Pêra Rangpur tree scionrootstock rootstock diseases problems growers 1 Eva AM experiment yield solids pH acidity ‘Pineapple Pineapple Sunki Tropical BRS Bravo ‘Lima Lima mandarin SC ‘Pêra, , ‘Salustiana, Salustiana ‘Salustiana ‘Salustiana’ Valência Tuxpan ‘Westin Westin D6 D

ABSTRACT Purpose: To evaluate the current scenario of rehabilitation services for people with retinal diseases in Brazil. Methods: An exploratory study was conducted between February 2023 and June 2023 using a Google Forms questionnaire that was distributed by patient associations. Results: A total of 142 patients, aged 18-80 were included in the study. Forty-eight participants (33.8%) were undergoing rehabilitation, while 94 (66.2%) were not. The main reason for not undergoing rehabilitation was a lack of knowledge about the service (n=41, 43.6%). Healthcare professionals made the most referrals (n=20, 41.7%). Rehabilitation improved the quality of life in 38 (80.9%) participants, and 28 (62.2%) participants were satisfied with the process. There was a statistically significant disparity between patient satisfaction and the locale of rehabilitation implementation. Twenty-three (69.7%) participants who underwent rehabilitation at a specialized center reported satisfaction. Conclusion: The rehabilitation process directly increases the quality of life of individuals with retinal diseases. However, despite the availability of rehabilitation centers in large parts of Brazil, most patients with retinal diseases are not acquainted with the rehabilitation process and do not receive referrals for it. Thus, healthcare providers should increase referrals to rehabilitation centers, and public policies should be formulated to raise awareness among the population regarding the availability of rehabilitation services. Purpose Brazil Methods 202 associations Results 14 1880 18 80 18-8 Fortyeight Forty eight 33.8% 338 33 8 (33.8% 9 66.2% 662 66 2 (66.2% n=41, n41 n 41 (n=41 43.6%. 436 43.6% . 43 6 43.6%) n=20, n20 20 (n=20 41.7%. 417 41.7% 7 41.7%) 3 80.9% 809 (80.9% 62.2% 622 62 (62.2% implementation Twentythree Twenty three 69.7% 697 69 (69.7% Conclusion However it Thus 1 188 18- 33.8 (33.8 66.2 (66.2 n=41 n4 4 (n=4 43.6 n=20 n2 (n=2 41.7 80.9 (80.9 62.2 (62.2 69.7 (69.7 33. (33. 66. (66. n=4 (n= 43. n=2 41. 80. (80. 62. (62. 69. (69. (33 (66 n= (n (80 (62 (69 (3 (6 (8 (

ABSTRACT Purpose: To describe the ophthalmological findings of dry eye disease and its relation to the quality of life of COVID-19 survivors. Methods: COVID-19 survivors who had previously been hospitalized at Hospital das Clínicas de Ribeirão Preto complex underwent an ophthalmological evaluation, which included a dry eye disease questionnaire, break-up time, fluorescein staining, and Schirmer test. We collected the presenting and best-corrected visual acuity, sociodemographic data, personal medical history, and scores from a self-reported quality of life questionnaire (WHOQOL-bref). According to the severity of the acute phase of the disease, the patients were classified into mild-to-moderate, severe, and critical groups. Results: Ninety-five patients (190 eyes) were evaluated 100 ± 44 days after the onset of COVID-19 symptoms. Of these, 83 patients (87.3%) completed the WHOQOL-bref questionnaire. Ten patients (12.0%) had mild-to-moderate COVID-19, 41 (49.4%) had severe COVID-19, and 32 (38.6%) had critical COVID-19. The median best-corrected visual acuity was logMAR 0 (0-1). Approximately 26.3% patients had a history of dry eye disease or severe dry eye symptoms (frequent or constant ocular dryness and irritation). There was an association between the proportion of patients with dry eye disease and the quality of life (p=0.014) and health (p=0.001). Furthermore, there was a significant trend between the proportion of patients with dry eye disease and how they rated their health and quality of life (p=0.0004 and 0.0027, respectively. Conclusions: There is a significant negative correlation between the proportion of patients with dry eye disease and their self-reported quality of life. Purpose COVID19 COVID 19 COVID-1 Methods evaluation breakup break up time staining test bestcorrected best corrected data selfreported self reported WHOQOLbref. WHOQOLbref WHOQOL bref . (WHOQOL-bref) mildtomoderate, mildtomoderate mild moderate, moderate groups Results Ninetyfive Ninety five 190 (19 eyes 10 4 these 8 87.3% 873 87 3 (87.3% 12.0% 120 12 (12.0% COVID19, 19, 49.4% 494 49 (49.4% 38.6% 386 38 6 (38.6% COVID19. 19. 01. 01 1 (0-1) 263 26 26.3 frequent irritation. irritation irritation) p=0.014 p0014 p 014 (p=0.014 p=0.001. p0001 p=0.001 001 (p=0.001) Furthermore p=0.0004 p00004 0004 (p=0.000 00027 0027 0.0027 respectively Conclusions COVID1 COVID- (WHOQOL-bref (1 87.3 (87.3 12.0 (12.0 49.4 (49.4 38.6 (38.6 (0-1 2 26. p=0.01 p001 (p=0.01 p000 p=0.00 00 (p=0.001 p=0.000 p0000 000 (p=0.00 0002 002 0.002 ( 87. (87. 12. (12. 49. (49. 38. (38. (0- p=0.0 p00 (p=0.0 0.00 (87 (12 (49 (38 (0 p=0. p0 (p=0. 0.0 (8 (4 (3 p=0 (p=0 0. p= (p= (p

ABSTRACT Purpose: The microbiology pattern of neonatal conjunctivitis has changed over time, and the incidence of gonococcal conjunctivitis is almost nil. This study aimed to determine the etiology of neonatal conjunctivitis cases referred to a tertiary health center in Brazil. Methods: From 2017 to 2020, conjunctival swabs were taken from neonates with clinical signs of conjunctivitis and tested with bacterial culture and polymerase chain reaction for Neisseria gonorrhoeae and Chlamydia trachomatis. Results: A total of 51 neonates were included in the 3-year study. Chlamydial conjunctivitis was diagnosed in 39 (76.5%) patients, and microbial growth was detected in 13 (25.5%) patients. The most isolated bacterium was Staphylococcus epidermidis (n=6, 11.8%), followed by other coagulase-negative Staphylococcus species (n=4, 7.8%) and S. aureus (n=2, 3.9%). One S. aureus isolate was resistant to oxacillin. There were no cases of gonococcal conjunctivitis. Ten (19.6%) patients showed polymerase chain reaction-negative C. trachomatis and negative bacterial culture test results. Conclusion: Findings show that C. trachomatis is the most common pathogen causing neonatal conjunctivitis. The high prevalence of C. trachomatis infection highlights the importance of screening and treating pregnant woman. Purpose time nil Brazil Methods 201 2020 Results 5 3year year 3 76.5% 765 76 (76.5% 1 25.5% 255 25 (25.5% n=6, n6 n 6 (n=6 11.8%, 118 11.8% , 11 8 11.8%) coagulasenegative coagulase n=4, n4 4 (n=4 7.8% 78 7 S n=2, n2 2 (n=2 3.9%. 3.9% . 9 3.9%) oxacillin 19.6% 196 19 (19.6% reactionnegative C results Conclusion woman 20 202 76.5 (76.5 25.5 (25.5 n=6 (n= 11.8 n=4 7.8 n=2 3.9 19.6 (19.6 76. (76. 25. (25. n= (n 11. 7. 3. 19. (19. (76 (25 (19 (7 (2 (1 (

ABSTRACT Purpose: This study aimed to characterize retinitis pigmentosa associated with the eyes shut homolog gene, which causes hereditary retinal degeneration. Methods: The anatomical and functional findings of retinitis pigmentosa in patients with variants of the eyes shut homolog gene were characterized and compared using multimodal imaging and genetic analysis of the variants. Clinical data such as visual acuity, lens status, and refraction were obtained from medical records. Patients underwent an ophthalmic examination, including static visual field, microperimetry, optical coherence tomography, fundus autofluorescence, and fundus photography. Results: Twenty-two patients were included in the study. Several anatomical and functional characteristics of retinitis pigmentosa-eyes shut homolog were identified, including the presence of cataracts, cystoid macular edema, epiretinal membrane, and a tubular visual field. Genetic results revealed 26 distinct variants in the cohort, with 7 novel variants not previously documented or reported in the scientific literature or databases. Conclusion: The findings demonstrate that eyes shut homolog-retinitis pigmentosa manifests in specific patterns, starting in adolescence with mild progression and advancing with age. The integration of multimodal imaging and genetic analysis has provided a detailed understanding of the anatomical and functional features of retinitis pigmentosa-eyes shut homolog. Seven novel variants of the eyes shut homolog gene have been identified. These findings enhance the understanding of eyes shut homolog-related retinitis pigmentosa characteristics of by detailing the spectrum of mutations in this gene within the Brazilian population. Purpose degeneration Methods acuity status records examination field microperimetry tomography autofluorescence photography Results Twentytwo Twenty two pigmentosaeyes identified cataracts edema membrane 2 cohort databases Conclusion homologretinitis patterns age homologrelated related population

ABSTRACT Purpose: To evaluate the presence of congenital hypertrophy of the retinal pigment epithelium in a large family affected by familial adenomatous polyposis and identify the causative mutation in the adenomatous polyposis coli gene. Thus, we aimed to determine the significance of congenital hypertrophy of the retinal pigment epithelium as a phenotypic marker of the disease. Methods: A family consisting of 95 individuals was evaluated. Among these, 45 individuals were randomly selected by convenience sampling method to undergo ophthalmological evaluation. A funduscopic exam, including slit lamp and indirect ophthalmoscopy, were performed in the selected patients. In those with retinal lesions, a retinography was obtained. The adenomatous polyposis coli gene was sequenced in one affected family member to identify the pathogenic mutation. Once the variant was identified, six undiagnosed family members were tested for the mutation via capillary electrophoresis sequencing. Results: Congenital hypertrophy of the retinal pigment epithelium was observed in 13 (28.9%) of the 45 individuals evaluated. Of these, nine patients were confirmed to have familial adenomatous polyposis (via colonoscopy or molecular testing). However, four patients had not been investigated. Of the 32 (71.1%) family members without the lesion, 14 did not have familial adenomatous polyposis and 18 were yet to be evaluated. The lesions were bilaterally present and exhibited a peculiar fish-tail shape in all the evaluated individuals. Adenomatous polyposis coli gene sequencing revealed a pathogenic variant c.4031del. (Ser1344*), in heterozygosity (49.27%), in exon 16. Conclusions: The study findings confirmed the significance of congenital hypertrophy of the retinal pigment epithelium as a phenotypic marker for familial adenomatous polyposis. Furthermore, it is an effective first-line screening method for at risk family members of such patients. The novel mutation identified in our study participants, which is yet to be described in the literature, causes an aggressive form of the disease. Purpose Thus disease Methods 9 these 4 evaluation exam ophthalmoscopy obtained Results 1 28.9% 289 28 (28.9% testing. testing . testing) However investigated 3 71.1% 711 71 (71.1% lesion fishtail fish tail c4031del cdel c 4031del del c.4031del Ser1344*, Ser1344 Ser Ser1344* , (Ser1344*) 49.27%, 4927 49.27% 49 27 (49.27%) 16 Conclusions Furthermore firstline first line participants literature 28.9 2 (28.9 71.1 7 (71.1 Ser134 (Ser1344* 492 49.27 (49.27% 28. (28. 71. (71. Ser13 (Ser1344 49.2 (49.27 (28 (71 Ser1 (Ser134 49. (49.2 (2 (7 (Ser13 (49. ( (Ser1 (49 (Ser (4

ABSTRACT Purpose: To compare objective and subjective intraocular pressure measurements immediately after cataract surgery and intraocular pressure measurements between less experienced surgeons (Group 1) and experienced surgeons (Group 2). Methods: Surgeons were asked to estimate the IOP after corneal sealing after surgery based on their tactile perception of eye tension (subjective intraocular pressure) Objective intraocular pressure was measured using a Perkins tonometer while patients were still in the surgical field. Objective intraocular pressure was compared to subjective intraocular pressure. Results from less experienced surgeons were compared to more experienced surgeons. Results: The study comprised 81 surgeries (81 eyes) performed by 27 surgeons. The mean objective intraocular pressure (9.14 mmHg; SD=5.86) was statistically significantly lower (p<0.001) than the mean subjective intraocular pressure (19.21 mmHg; SD=4.82). Hypotony (intraocular pressure <6mmHg) was observed in 25 eyes (30.86%). The mean subjective intraocular pressure was 18.8 mmHg (SD=5.19) for less experienced surgeons and 19.5 mmHg (SD=4.46) for more experienced, without statistically significant difference (p=0.541). No statistically significant difference (p=0.71) was observed when comparing objective intraocular pressure in Group 1 (10.32 mmHg; SD=6.65) and Group 2 (7.97 mmHg; SD=4.7). Conclusion: Objective intraocular pressure was significantly lower than subjective intraocular pressure, regardless of surgeons’ experience. This study showed that the subjective method is unreliable compared to the gold standard (Perkins tonometer) and does not improve with surgeons’ experience. Establishing standard training methods is paramount to developing surgeons’ skills. Purpose 2. . 2) Methods field 8 (8 9.14 914 9 14 (9.1 SD=5.86 SD586 SD 5 86 p<0.001 p0001 p 0 001 (p<0.001 19.21 1921 19 21 (19.2 SD=4.82. SD482 SD=4.82 4 82 SD=4.82) <6mmHg 6mmHg 30.86%. 3086 30.86% 30 (30.86%) 188 18 18. SD=5.19 SD519 (SD=5.19 195 19. SD=4.46 SD446 46 (SD=4.46 p=0.541. p0541 p=0.541 541 (p=0.541) p=0.71 p071 71 (p=0.71 10.32 1032 10 32 (10.3 SD=6.65 SD665 6 65 7.97 797 7 97 (7.9 SD=4.7. SD47 SD=4.7 SD=4.7) Conclusion experience skills ( 9.1 91 (9. SD=5.8 SD58 p<0.00 p000 00 (p<0.00 19.2 192 (19. SD48 SD=4.8 308 30.86 3 (30.86% SD=5.1 SD51 (SD=5.1 SD=4.4 SD44 (SD=4.4 p054 p=0.54 54 (p=0.541 p=0.7 p07 (p=0.7 10.3 103 (10. SD=6.6 SD66 7.9 79 (7. SD4 SD=4. 9. (9 SD=5. SD5 p<0.0 p00 (p<0.0 (19 30.8 (30.86 (SD=5. (SD=4. p05 p=0.5 (p=0.54 p=0. p0 (p=0. 10. (10 SD=6. SD6 7. (7 SD=4 SD=5 p<0. (p<0. (1 30. (30.8 (SD=5 (SD=4 (p=0.5 p=0 (p=0 SD=6 SD= p<0 (p<0 (30. (SD= p= (p= p< (p< (30 (SD (p (3

ABSTRACT Purpose: This study aimed to evaluate the total macular thickness as well as the thickness of the inner and outer retinal layers in patients with Parkinson’s disease. It also aimed to verify the correlation of these parameters with motor symptoms and cognitive function. Methods: A total of 46 eyes of 23 patients with Parkinson’s disease and 40 eyes of 20 healthy controls were included in the study. The patients’ cognitive, functional, and nonmotor symptoms were evaluated using the Katz Index of Independence and Pfeffer’s Activities of Daily Living, Mini-Mental State Examination, Frontal Assessment Battery, Schwab and England Staging Scales, and Movement Disorders Society Nonmotor Symptoms Scale. The macular thickness measurements obtained via total, inner, and outer optical coherence tomography were recorded. Furthermore, the correlation of the parameters of optical coherence tomography with cognitive, functional, and nonmotor symptoms was assessed. Results: The scores of the Katz Index of Independence and Pfeffer’s Activities of Daily Living as well as the Movement Disorders Society Nonmotor Symptoms Scale were significantly lower in patients with Parkinson’s disease than in healthy controls. Moreover, the former had greater total macular thickness. The temporal and inferior outer sectors were significantly greater for the ganglion cell complex thickness in patients. A significant correlation was observed between the total macular thickness and the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale, Parte III (MDS-UPDRS-III) values. Contrarily, there was a negative correlation between the outer macular thickness and the MDS-UPDRS-III values. Meanwhile, the total macular thickness and ganglion cell complex thickness were significantly correlated with the scores of the Mini-Mental State Examination, Schwab and England Staging Scale, Frontal Assessment Battery, and Katz Index of Independence and Pfeffer’s Activities of Daily Living. In addition, the Schwab and England scale was correlated with the outer macular thickness. Conclusion: The total and inner macular thicknesses at the temporal and inferior outer sectors were greater in patients with Parkinson’s disease than in the control group. These findings indicate that macular thickness may be greater in those with Parkinson’s disease, particularly when associated with mild motor symptoms. In addition, the parameters of the total, inner, and outer optical coherence tomography were significantly associated with motor and nonmotor symptoms as well as cognitive function impairment. Purpose Parkinsons Parkinson s Methods 4 2 functional Pfeffers Pfeffer MiniMental Mini Mental Examination Battery Scales recorded Furthermore assessed Results Moreover SocietyUnified Unified MDSUPDRSIII MDS UPDRS (MDS-UPDRS-III values Contrarily Meanwhile addition Conclusion group impairment

ABSTRACT Purpose: Keratoconus presents certain peculiarities in pediatric patients when compared with adults. The greatest challenge in children is that the disease is more severe and faster in progression. In this retrospective study, we aimed to compare the accelerated and Dresden protocols for corneal crosslinking in patients aged <18 years who were followed-up for at least 12 months. Methods: A total of 36 eyes from 27 patients were included in the study. The best corrected and uncorrected visual acuity, maximal keratometry, corneal thickness, foveal thickness, and endothelial microscopy findings were evaluated at baseline and during the postoperative period at one, three, and six months. Thereafter, the patients were evaluated at one, three, six and twelve months postoperative. Corneal crosslinking was performed in all patients via the Dresden protocol (n=21 eyes) or the accelerated protocol (n=15 eyes). Data between the two groups were compared and XY statistical analysis was used. Results: Both protocols were effective in halting keratoconus progression. No patient had progression at the 12-month follow-up. A significant reduction in Kmax and improvement in the corrected distance visual acuity were observed only in the Dresden protocol group. Although the Dresden protocol was superior to the accelerated protocol in reducing Kmax (p=0.002), there was no significant difference in corrected distance visual acuity between the two groups. Conclusion: The accelerated protocol is as efficient as the Dresden protocol in stabilizing keratoconus progression. Although the Dresden protocol was superior to the accelerated protocol in reducing the Kmax, it did not produce better clinical results. Thus, the accelerated protocol is an efficient option. Furthermore, considering the advantages of reduced surgical time, the accelerated protocol is effective in halting keratoconus progression in the pediatric age group. Purpose adults study 18 <1 followedup followed up 1 Methods 3 2 keratometry thickness one three Thereafter n=21 n21 n 21 (n=2 n=15 n15 15 (n=1 eyes. . used Results 12month month followup. followup follow up. follow-up group p=0.002, p0002 p p=0.002 , 0 002 (p=0.002) Conclusion results Thus option Furthermore time < n=2 n2 (n= n=1 n1 p000 p=0.00 00 (p=0.002 n= (n p00 p=0.0 (p=0.00 p0 p=0. (p=0.0 p=0 (p=0. p= (p=0 (p= (p

RESUMO: A batata (Solanum tuberosum L.) é uma fonte cada vez mais importante de alimento, de emprego rural e de aumento de renda, contribuindo para a estabilização social do meio rural, principalmente nos países em desenvolvimento. Entretanto, trata-se de uma cultura bastante sensível às doenças, as quais afetam drasticamente a produtividade, além da necessidade de controle elevar o custo de produção e o risco de contaminação ambiental. O objetivo do trabalho foi avaliar o controle da requeima (Phytophthora infestans) da batata cv. Ágata com base no sistema de previsão de doenças Blitecast e sua produtividade de tubérculos em duas safras. Os experimentos foram conduzidos na primavera de 2022 e no outono de 2023, no município de Passo Fundo. Diferentes valores de severidade (VS) acumulada, calculados pelo modelo Blitecast, constituíram os tratamentos VS 18, VS 24 e VS 30, acrescentando o tratamento semanal e a testemunha, sem aplicação. O delineamento foi em blocos casualizados com quatro repetições, sendo cada parcela composta de cinco fileiras de plantas com 3 metros de comprimento. Foram avaliadas a severidade da requeima e a produtividade final de tubérculos. A utilização do sistema de previsão Blitecast para o controle da requeima da batata, permite reduzir o número de aplicações de fungicidas sem afetar a produtividade final de tubérculos. O sistema de previsão deve ser utilizado como ferramenta para o manejo integrado de doenças da batata. RESUMO Solanum L. L alimento renda desenvolvimento Entretanto tratase trata se ambiental Phytophthora infestans cv safras 202 2023 Fundo (VS acumulada 18 2 30 testemunha aplicação repetições comprimento 20 1

ABSTRACT: Potato (Solanum tuberosum L.) is an increasingly important source of food, rural employment, and financial income, contributing to the social stabilization of rural areas, especially in developing countries. However, this crop is very sensitive to diseases, which drastically affect yield, in addition to increasing production costs for their control and the risk of environmental contamination. This study evaluated the control of late blight (Phytophthora infestans) in potato cv. Ágata based on the Blitecast disease forecast system and tuber yield in two growing seasons. The experiments were conducted in the spring of 2022 and autumn of 2023 in the municipality of Passo Fundo. Different accumulated severity values (SV) were calculated by the Blitecast model, which constituted the treatments SV 18, SV 24 and SV 30, in addition to a weekly treatment and a control without application. The experimental design consisted of randomized blocks with four replications, in which each plot had five rows of plants measuring 3 m in length. Late blight severity and the final tuber yield were evaluated. The use of the Blitecast forecast system to control potato late blight allows for a reduction in the number of fungicide applications without affecting the final tuber yield. The forecast system should be used as a tool for the integrated management of potato diseases. ABSTRACT Solanum L. L food employment income areas countries However diseases contamination Phytophthora infestans cv seasons 202 Fundo (SV model 18 2 30 application replications length 20 1

Abstract Background: Acute chest pain (ACP) is a common symptom in patients with acute coronary syndrome (ACS) that often requires emergency care. Objective: Examine the out-of-hospital response time and the role of immediate life support nurses in the presence of ACP in patients with suspected ACS, in two districts in the interior north of Portugal. Methodology: Observational, analytical, cross-sectional, retrospective, quantitative study with a sample of 75 occurrences. Results: Total out-of-hospital response times were high, exceeding 95 minutes in both districts. In ST-elevation myocardial infarction (STEMI), total mean times were 131 ± 22.23 minutes, which occurred in 10.66% of the total sample. The nurses used the chest pain protocol in the majority of occurrences (98.7%), performed electrocardiogram (97.3%), and contributed to symptom improvement (72%). Conclusion: Although the nurse’s role is crucial for establishing the diagnosis and managing symptoms, the response times, especially in STEMI cases, exceed the recommended time for the procedure of choice (angioplasty).

Resumen Marco contextual: El dolor torácico agudo (DTA) es un síntoma frecuente en las personas con síndrome coronario agudo (SCA) que a menudo requiere atención de urgencias. Objetivo: Conocer el tiempo de respuesta prehospitalaria y el papel del enfermero de la ambulancia de soporte vital inmediato en casos de DTA en personas con posible SCA en dos distritos del norte de Portugal. Metodología: Estudio observacional, analítico, transversal, retrospectivo, cuantitativo, con una muestra de 75 casos. Resultados: Se registraron tiempos totales de respuesta prehospitalaria largos, superiores a 95 minutos en ambos distritos, y en infarto agudo de miocardio con elevación del segmento ST (EAMCSST), con tiempos medios de 131 ± 22,23 minutos, seguido del 10,66% de la muestra total. Los enfermeros utilizaron el protocolo de dolor torácico en la mayoría de los casos (98,7%), realizaron electrocardiogramas (97,3%) y contribuyeron a la mejoría de los síntomas (72%). Conclusión: El enfermero es fundamental para diagnosticar y controlar los síntomas, pero los tiempos de respuesta, sobre todo en el IAMCEST, superan los recomendados para el procedimiento de elección, la angioplastia.

Resumo Enquadramento: A dor torácica aguda (DTA) é um sintoma comum na pessoa com síndrome coronária aguda (SCA) que requer frequentemente cuidados de emergência. Objetivo: Conhecer o tempo de resposta pré-hospitalar e a atuação do enfermeiro da ambulância suporte imediato de vida nas ocorrências de DTA, na pessoa com suspeita de SCA, relativamente a dois distritos do interior norte de Portugal. Metodologia: Estudo observacional, analítico transversal, retrospetivo, de cariz quantitativo, numa amostra de 75 ocorrências. Resultados: Verificaram-se tempos totais longos na resposta pré-hospitalar, ultrapassando os 95 minutos em ambos os distritos e, no enfarte agudo miocárdio com elevação do segmento ST (EAMCSST), apresentando tempos médios de 131 ± 22,23 minutos, sucedido em 10,66% da amostra total. Os enfermeiros utilizaram o protocolo da dor torácica na generalidade das ocorrências (98,7%), realizaram eletrocardiograma (97,3%) e contribuíram para a melhoria dos sintomas (72%). Conclusão: O enfermeiro é essencial no diagnóstico e controlo da sintomatologia, mas os tempos de resposta, particularmente no EAMCSST, ultrapassam o recomendado para a realização do procedimento de eleição, a angioplastia.

ABSTRACT Introduction/framework/objectives Over the last few years, most countries have developed standards relating to reducing the number of places where smoking continues to be possible, particularly in the workplace. This review was intended to summarize the most recent publications on the topic. Methodology This is a Bibliographic Review, initiated through a search carried out in April 2023 in the databases “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina and RCAAP”. Content Passive Smoking is defined as "second-hand" smoke that encompasses a complex mixture of pollutants, remaining in the dust on local surfaces where it was smoked, consisting of the original tobacco products and the components originating in the direct consumer's breath, eventually reacting to other agents gifts. These can remain on inert surfaces, sometimes for months and transmission can occur by simple touch. Some researchers estimate that there are around 4000 chemical agents in this context, of which 250 are toxic and 50 are even carcinogenic. Tobacco is one of the preventable causes of death worldwide and a modifiable risk factor, through mechanisms that include DNA damage, inflammation and oxidative stress. It involves health costs and reduced labor productivity, due to associated pathologies, namely cardiovascular, respiratory, oncological, obstetric and infectious diseases. Discussion and Conclusions Over the last few decades, there has been a global decrease in passive smoke, due to the introduction of increasingly restrictive standards in relation to places where smoking is still permitted, in society in general and, obviously, in the workplace as well. The selected articles did not highlight the following detail much but, by creating areas where smoking is permitted in the company, these should minimize the exposure of all workers, smokers and, above all, non-smokers. It would be desirable for countries/institutions where standards are less restrictive and/or enforced to change, so that all workers have a safe working environment. Furthermore, it would be interesting to understand what opinion Portuguese workers have regarding this topic, how standards are complied with in their workplaces and what are the most effective techniques to achieve greater success in this context.

RESUMO Introdução/enquadramento/objetivos Ao longo dos últimos anos a generalidade dos países foi desenvolvendo normas relativas à diminuição dos locais onde continua a ser possível fumar, nomeadamente em contexto laboral. Pretendeu-se com esta revisão resumir o que de mais recente se publicou sobre o tema. Metodologia Trata-se de uma Revisão Bibliográfica, iniciada através de uma pesquisa realizada em abril de 2023 nas bases de dados “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina e RCAAP”. Conteúdo O Tabagismo Passivo é definido como fumo de "segunda mão" que engloba uma mistura complexa de poluentes, permanecendo na poeira das superfícies locais onde se fumou, constituída pelos produtos tabágicos originais e os componentes originários pela respiração do consumidor direto, eventualmente reagindo a outros agentes presentes. Estes podem permanecer nas superfícies inertes, por vezes, por meses e a transmissão pode ocorrer pelo simples toque. Alguns investigadores estimam que existam neste contexto cerca de 4000 agentes químicos, dos quais 250 são tóxicos e 50 são inclusivamente carcinogénicos. O tabaco é uma das causas preveníveis de morte mundialmente e fator de risco modificável, por mecanismos que abarcam o dano de DNA, inflamação e stress oxidativo. Ele implica custos de saúde e de diminuição da produtividade laboral, em função das patologias associadas, nomeadamente cardiovascular, respiratória, oncológica, obstétrica e infeciosa. Discussão e Conclusões Ao longo das últimas décadas verificou-se, globalmente, uma diminuição ao Tabagismo Passivo, devido à introdução de normas cada vez mais restritivas em relação aos locais onde ainda é permitido fumar, na sociedade em geral e, obviamente, em contexto de trabalho também. Os artigos selecionados não realçaram muito o seguinte detalhe mas, criando-se áreas onde é permitido fumar na empresa, estas devem minimizar a exposição de todos os trabalhadores, tabagistas e, sobretudo, não fumadores. Seria desejável que os países/instituições onde as normas são menos restritivas e/ou cumpridas, tal se alterasse, de forma a todos os trabalhadores terem um ambiente laboral seguro. Para além disso, seria interessante perceber qual a opinião que os trabalhadores portugueses têm em relação a este tema, de que forma as normas são cumpridas nos seus locais de trabalho e quais as técnicas mais eficazes para obter mais sucesso neste contexto.

ABSTRACT Introduction/framework/objectives Multiple Sclerosis has a reasonable prevalence and the diagnosis is generally made at working age, at a stage that is still demanding on a professional level, a time when there are also generally personal/family particularities that require some dedication. Furthermore, given the incidence, diversity and severity of the symptoms presented, limitations often arise that can seriously affect the ability to work or even lead to unemployment. It is then desirable that the members working in Occupational Health and Safety teams have some knowledge on the subject, in order to better guide their performance, safeguarding the interests of everyone involved. Methodology This is a Bibliographic Review, initiated through a search carried out in April 2023, in the databases “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina and RCAAP”. Content It is a demyelinating and autoimmune disease of the Central Nervous System; it is characterized by recurrent and intermittent episodes of inflammation, with generally progressive destruction of axonal myelin. In most cases there is a cycle of relapses and remissions and symptoms of varying intensity; the evolution is unpredictable. Causes autonomic, visual, motor and sensory symptoms; which makes independent daily living and the ability to work difficult; sometimes becoming debilitating. It is incurable and neurodegenerative. The severity varies depending on the neurological areas most affected. The function of myelin is to facilitate conduction at the level of axons; with changes in this, the electrical impulses that coordinate mental and physical functions become less effective. As myelin deteriorates, it is replaced by scars of abnormal tissue, with different consistency (stiffness, plaques), which further disrupts conduction. Injuries to the frontal and parietal lobes often result in cognitive and emotional changes; in the spinal cord, problems arise more easily in the lower limbs. Changes in the optic nerve and occipital lobe can cause visual problems. This is the neurological desease that causes most limitations in the young adult active population. Given the reasonably young age at which symptoms begin, there will be a decrease in quality of life, more significant than in other chronic diseases. Discussion and Conclusions Although the bibliography is not scarce, the emphasis in the vast majority of articles is not on Occupational Health or Safety. It would be relevant for some teams working in large companies with some prevalence, to evaluate the cases in detail, describing the main problems detected, proposed measures and their subsequent evaluation, in order to publish not only the path, but also the conclusions obtained, for greater dissemination of the subject.

RESUMO Introdução/enquadramento/objetivos A Esclerose Múltipla tem uma prevalência razoável e o diagnóstico faz-se geralmente em idade ativa, numa fase ainda exigente a nível profissional, altura essa onde geralmente também existem particularidades pessoais/familiares que necessitam de alguma dedicação. Para além disso, dada a incidência, diversidade e gravidade dos sintomas apresentados, com frequência surgem limitações que podem condicionar seriamente a capacidade de trabalho ou até levar ao desemprego. Será então desejável que os elementos a exercer em equipas de Saúde e Segurança Ocupacionais tenham alguns conhecimentos sobre o tema, de forma a melhor orientar o seu desempenho, salvaguardando os interesses de todos os envolvidos. Metodologia Trata-se de uma Revisão Bibliográfica, iniciada através de uma pesquisa realizada em abril de 2023, nas bases de dados “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina e RCAAP”. Conteúdo É uma doença desmielinizante e auto-imune do Sistema Nervoso Central; carateriza-se por episódios recorrentes e intermitentes de inflamação, com destruição de mielina axonal, geralmente progressiva. Na maioria dos casos existe um ciclo de relapsos e remissões e sintomas de intensidade oscilante; a evolução é imprevisível. Causa sintomas autonómicos, visuais, motores e sensoriais; o que dificulta a vida quotidiana independente e o trabalho, tornando-se por vezes debilitante. É incurável e neurodegenerativa. A gravidade varia com as áreas neurológicas mais atingidas. À medida que a mielina se detiora, ela é substituída por cicatrizes de tecido anormal, com diferente consistência (rigidez, placas), o que perturba ainda mais a condução. Lesões nos lóbulos frontal e parietal geralmente resultam em alterações cognitivas e emocionais; na espinal medula, mais facilmente surgem problemas nos membros inferiores. Alterações no nervo ótico e lobo occipital podem originar alterações visuais. Trata-se da doença neurológica que mais limitações causa na população ativa jovem adulta. Dada a idade razoavelmente jovem do início de sintomas, irá ocorrer diminuição da qualidade de vida, mais significativa que noutras doenças crónicas. Discussão e Conclusões Ainda que a bibliografia não seja escassa, a enfase da grande maioria dos artigos não é dada à Saúde ou Segurança Ocupacionais. Seria relevante que algumas equipas a exercer em empresas grandes e com alguma incidência, avaliassem com detalhe os casos, descrevendo os principais problemas detetados, medidas propostas e avaliação posterior das mesmas, de forma a publicar não só o caminho, mas também as conclusões obtidas, para maior divulgação do assunto.