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The use of invasive or noninvasive intracranial pressure (ICP) monitoring post-decompressive craniectomy (DC) has been a continuous matter of debate. Accordingly, this meta-analysis aims to examine the existing evidence of both approaches and compare their impact among patients undergoing DC, guiding clinical decision-making in the management of elevated ICP. The databases used were Pubmed, Cochrane, Web of Science, and Embase. Inclusion criteria included: (1) English studies; (2) randomized and nonrandomized studies; (3) reporting on invasive OR noninvasive ICP monitoring after DC; (4) with at least one of the outcomes of interest: incidence of mortality, new cerebral hemorrhages, and the Glasgow Outcome Scale. The study followed the Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Thirty-six studies were included in this meta-analysis, resulting in a sample of 1624 patients. One thousand two hundred eighty-six underwent invasive monitoring, and 338 underwent noninvasive methods. In the invasive group, a mortality rate of 17% (95% confidence interval [CI]: 12%-22%), a good outcome rate of 58% (95% CI: 38%-49%), a poor outcome rate of 42% (95% CI: 21%-62%), and an overall incidence of new hemorrhages of 4% (95% CI: 0%-8%) were found. Whereas in the noninvasive sample, a mortality rate of 20% (95% CI: 15%-26%) and a good outcome rate of 38% (95% CI: 25%-52%) were obtained. It seems that the effectiveness of invasive and noninvasive ICP monitoring methods are comparable in post-DC patients. While invasive monitoring remains gold standard, noninvasive methods offer a safer and cost-effective alternative, potentially improving post-DC patient care, and can mostly be used simultaneously with invasive methods.

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BACKGROUND: Diverse antidepressants were recently described to bind to TrkB (tyrosine kinase B) and drive a positive allosteric modulation of endogenous BDNF (brain-derived neurotrophic factor). Although neurotrophins such as BDNF can bind to p75NTR (p75 neurotrophin receptor), their precursors are the high-affinity p75NTR ligands. While part of an unrelated receptor family capable of inducing completely opposite physiological changes, TrkB and p75NTR feature a crosslike conformation dimer and carry a cholesterol-recognition amino acid consensus in the transmembrane domain. As such qualities were found to be crucial for antidepressants to bind to TrkB and drive behavioral and neuroplasticity effects, we hypothesized that their effects might also depend on p75NTR. METHODS: Enzyme-linked immunosorbent assay-based binding and nuclear magnetic resonance spectroscopy were performed to assess whether antidepressants would bind to p75NTR. HEK293T cells and a variety of in vitro assays were used to investigate whether fluoxetine (FLX) or ketamine (KET) would trigger any α- and γ-secretase-dependent p75NTR proteolysis and lead to p75NTR nuclear localization. Ocular dominance shift was performed with male and female p75NTR knockout mice to study the effects of KET and FLX on brain plasticity, in addition to pharmacological interventions to verify how p75NTR signaling is important for the effects of KET and FLX in enhancing extinction memory in male wild-type mice and rats. RESULTS: Antidepressants were found to bind to p75NTR. FLX and KET triggered the p75NTR proteolytic pathway and induced p75NTR-dependent behavioral/neuroplasticity changes. CONCLUSIONS: We hypothesize that antidepressants co-opt both BDNF/TrkB and proBDNF/p75NTR systems to induce a more efficient activity-dependent synaptic competition, thereby boosting the brain's ability for remodeling.

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Microwave-assisted pyrolysis (MAP) is a cutting-edge technology that converts biomass into fuels, chemicals, and materials. In this study, an Arduino was used to control and automate a MAP system built from a microwave oven with a cordierite chamber filled with silicon carbide. Sugar cane bagasse was pyrolyzed at 250, 350, 450, and 550 °C to validate the MAP system and obtain pyrolytic products with different yields and chemical compositions. Lower temperatures led to high biochar yields, but the highest surface area of 25.14 m2 g-1 was only achieved at 550 °C. By contrast, higher temperatures favored the recovery of pyrolysis liquids. BET and scanning electron microscopy analyses revealed a porous biochar structure, while Fourier transform infrared spectroscopy analysis showed that the availability of functional groups on the biochar surface decreased with an increase in pyrolysis temperature. GC-MS analysis quantified valuable low molecular mass compounds in pyrolysis liquids, including aldehydes, ketones, phenols, and alcohols. With its unprecedented hybrid heating device, the MAP system promoted suitable heating rates (31.9 °C min-1) and precise temperature control (only 19 °C of set point variation), generating pyrolysis products devoid of microwave susceptor interferences. Therefore, MAP provided a rapid, safe, and efficient means of depolymerizing biomass, thus holding promise for biorefinery applications.

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Adapters and Low-Rank Adaptation (LoRA) are parameter-efficient fine-tuning techniques designed to make the training of language models more efficient. Previous results demonstrated that these methods can even improve performance on some classification tasks. This paper complements existing research by investigating how these techniques influence classification performance and computation costs compared to full fine-tuning. We focus specifically on multilingual text classification tasks (genre, framing, and persuasion techniques detection; with different input lengths, number of predicted classes and classification difficulty), some of which have limited training data. In addition, we conduct in-depth analyses of their efficacy across different training scenarios (training on the original multilingual data; on the translations into English; and on a subset of English-only data) and different languages. Our findings provide valuable insights into the applicability of parameter-efficient fine-tuning techniques, particularly for multilabel classification and non-parallel multilingual tasks which are aimed at analysing input texts of varying length.

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BACKGROUND: Glaucoma is a progressive optic neuropathy and it is the main cause of irreversible blindness worldwide. Intraocular pressure (IOP) is the only modifiable one and trabeculectomy is commonly considered the surgical "gold standard" to decrease IOP. In particular cases, other kind of surgeries, as the Ahmed Glaucoma Valve (AGV) implant, are a reliable alternative. Usually, the silicone tube of AGV surgery is inserted into the anterior chamber. Sometimes it is necessary to place the AGV silicone tube in the ciliary sulcus, especially in cases of endothelial decompensation. This surgical procedure is not always easy to perform. CASE PRESENTATION: This article describes and presents a technique for inserting the AGV tube into the posterior chamber using a guide-wire, in a total of 12 cases are reported. This procedure has been mostly applied in a group of pseudophakic patients who need AGV placement to control elevated IOP. In exceptional situations, this procedure was applied in pseudophakic patients previously with AGV tube implanted in the anterior chamber and with loss of endothelial cells or in phakic patients with previously implanted AGV anterior chamber tube, simultaneously to cataract surgery. CONCLUSION: The purpose of these cases presentations attended at our service is to demonstrate the passage of the AGV silicone tube was performed with the aid of a guide wire.

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Clinical depression is characterized by multiple concurrent symptoms, manifesting as a complex heterogeneous condition. Although some well-established classical behavioral assessments are widespread in rodent models, it remains uncertain whether rats also display stress-induced depression-related phenotypes in a multidimensional manner, i.e., simultaneous alterations in multiple behavioral tests. Here, we investigated multivariate patterns and profiles of depression-related behavioral traits in male Wistar rats subjected to inescapable footshocks (IS) or no-shocks (NS), followed by a comprehensive battery of behavioral tests and ethological characterization. We observed generalized stronger intra-test but weaker inter-test correlations. However, feature clustering of behavioral measures successfully delineated variables linked to resilience and susceptibility to stress. Accordingly, a noteworthy covariation pattern emerged, characterized by increased open field locomotion, reduced time in the elevated plus maze open arms, lower sucrose preference, and increased shuttle box escape failures that consistently differentiated IS from NS. Surprisingly there is little contribution from forced swim. In addition, individual clustering revealed a diversity of behavioral profiles, naturally separating NS and IS, including subpopulations entirely characterized by resilience or susceptibility. In conclusion, our study elucidates intricate relationships among classical depression-related behavioral measures, highlighting multidimensional individual variability. Our work emphasizes the importance of a multivariate framework for behavioral assessment in animal models to understand stress-related neuropsychiatric disorders.

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Brain disturbances during development can have a lasting impact on neural function and behavior. Seizures during this critical period are linked to significant long-term consequences such as neurodevelopmental disorders, cognitive impairments, and psychiatric symptoms, resulting in a complex spectrum of multimorbidity. The hippocampus-prefrontal cortex (HPC-PFC) circuit emerges as a potential common link between such disorders. However, the mechanisms underlying these outcomes and how they relate to specific behavioral alterations are unclear. We hypothesized that specific dysfunctions of hippocampal-cortical communication due to early-life seizure would be associated with distinct behavioral alterations observed in adulthood. Here, we performed a multilevel study to investigate behavioral, electrophysiological, histopathological, and neurochemical long-term consequences of early-life Status epilepticus in male rats. We show that adult animals submitted to early-life seizure (ELS) present working memory impairments and sensorimotor disturbances, such as hyperlocomotion, poor sensorimotor gating, and sensitivity to psychostimulants despite not exhibiting neuronal loss. Surprisingly, cognitive deficits were linked to an aberrant increase in the HPC-PFC long-term potentiation (LTP) in a U-shaped manner, while sensorimotor alterations were associated with heightened neuroinflammation, as verified by glial fibrillary acidic protein (GFAP) expression, and altered dopamine neurotransmission. Furthermore, ELS rats displayed impaired HPC-PFC theta-gamma coordination and an abnormal brain state during active behavior resembling rapid eye movement (REM) sleep oscillatory dynamics. Our results point to impaired HPC-PFC functional connectivity as a possible pathophysiological mechanism by which ELS can cause cognitive deficits and psychiatric-like manifestations even without neuronal loss, bearing translational implications for understanding the spectrum of multidimensional developmental disorders linked to early-life seizures.

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Tinnitus is a conscious attended awareness perception of sourceless sound. Widespread theoretical and evidence-based neurofunctional and psychological models have tried to explain tinnitus-related distress considering the influence of psychological and cognitive factors. However, tinnitus models seem to be less focused on causality, thereby easily misleading interpretations. Also, they may be incapable of individualization. This study proposes a Conceptual Cognitive Framework (CCF) providing insight into cognitive mechanisms involved in the predisposition, precipitation, and perpetuation of tinnitus and consequent cognitive-emotional disturbances. The current CCF for tinnitus relies on evaluative conditional learning and appraisal, generating negative valence (emotional value) and arousal (cognitive value) to annoyance, distress, and distorted perception. The suggested methodology is well-defined, reproducible, and accessible, which can help foster future high-quality clinical databases. Perceived tinnitus through the perpetual-learning process can always lead to annoyance, but only in the clinical stage directly cause annoyance. In the clinical stage, tinnitus perception can lead indirectly to distress only with experiencing annoyance either with (" I n d - 1 C " = 1.87; 95% CI 1.18-2.72)["1st indirect path in the Clinical stage model": Tinnitus Loudness → Attention Bias → Cognitive-Emotional Value → Annoyance → Clinical Distress]or without (" I n d - 2 C "= 2.03; 95% CI 1.02-3.32)[ "2nd indirect path in the Clinical stage model": Tinnitus Loudness → Annoyance → Clinical Distress] the perpetual-learning process. Further real-life testing of the CCF is expected to express a meticulous, decision-supporting platform for cognitive rehabilitation and clinical interventions. Furthermore, the suggested methodology offers a reliable platform for CCF development in other cognitive impairments and supports the causal clinical data models. It may also enhance our knowledge of psychological disorders and complicated comorbidities by supporting the design of different rehabilitation interventions and comprehensive frameworks in line with the "preventive medicine" policy.

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This article presents the rare case of a patient with gemination and fusion involving conical supernumerary teeth and the second mandibular molar, along with its treatment. The 13-year-old girl, without any associated syndromes and currently undergoing orthodontic treatment, was referred for evaluation due to the presence of a supernumerary tooth. Following a clinical examination and analysis of a panoramic radiograph, a cone beam computed tomography was requested for a more detailed assessment of the supernumerary tooth and its relationship with adjacent structures. The sagittal sections revealed the presence of two conical paramolar supernumerary teeth, which were geminated and fused to the mesial root of tooth 47. The suggested treatment was the surgical removal of the supernumerary teeth, which was successfully performed without complications and with good healing. After one-year post-procedure, the formation of periodontal ligament was verified at the site where the supernumerary teeth were extracted. The simultaneous occurrence of gemination of two supernumerary teeth and their fusion to a mandibular molar is extremely rare, and their surgical removal provided the patient with better plaque control in the region and contributed to the progress of orthodontic treatment. Key words:Gemination and fusion of supernumerary teeth and second mandibular molar.

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Background This study aimed to assess functional and anatomical outcomes after one month of treatment with a single intravitreal injection (IVI) of brolucizumab in patients with diabetic macular edema (DME). Methodology A retrospective study was conducted on eyes with DME who received a single IVI of brolucizumab. The study was designed to assess visual function and optical coherence tomography (OCT) biomarkers at baseline and one month following a single brolucizumab IVI. A sub-analysis was conducted between the following two groups: group 1 - treatment with brolucizumab due to burden, needle phobia, or non-compliance (responders to standard anti-vascular endothelial growth factor (VEGF) or naïve); and group 2 - non-responsive to previous therapies (standard anti-VEGF ± corticosteroids). The main outcome measures included best-corrected visual acuity (BCVA; Early Treatment of Diabetic Retinopathy Study (ETDRS) letters), central foveal thickness, and OCT biomarkers such as the presence of subretinal fluid, the number of hyperreflective dots, the disorganization of retinal inner layers, the disruption of outer plexiform layer, external limiting membrane and ellipsoid zone, the presence of cysts in the nuclear layers (outer (ONL) and inner (INL)), and the number of cysts in ONL versus those in the INL. Safety outcomes were assessed. Results A total of 59 eyes from 42 patients were included, of which 47 eyes were in group 1 and 12 eyes were in group 2. At one month, patients had an improvement of two ETDRS letters on BCVA (p = 0.020), lower central foveal thickness (p < 0.001), fewer hyperreflective dots (p = 0.016), less outer plexiform layer disruption (p = 0.004), less inner and outer nuclear layer cysts (p < 0.001 and p = 0.001, respectively) and better relationship between ONL and INL cysts (p = 0.022). Results were significant in the subgroup of patients with previous responsive DME. No adverse events were reported. Conclusions This study demonstrates the effectiveness and safety after one injection of brolucizumab 6 mg in the management of DME, especially in previously responsive DME patients.

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Sponges are not routinely employed as metal bioindicators in Brazil. In this sense, this study reports baseline metal and metalloid concentrations, determined by inductively coupled plasma mass spectrometry, for two Demospongiae sponge species, Hymeniacidon heliophila and Desmapsamma anchorata, sampled from two Southeastern Brazil areas. Sponges from Ilha Grande Bay, an Environmental Protection Area, exhibited higher Al, As, Cd, Co, Cr, Fe, and Ni levels compared to Vermelha Beach, a metropolitan area in the Rio de Janeiro city. Several strong correlations were noted between elemental pairs, indicating common contamination sources and/or similar metabolic detoxification routes. Comparisons of the means determined herein for each study site to other reports indicate mostly lower Ag, As, Co, Cd, and Cu levels, while Al levels were higher than other studies, and Cr, Ni, and Fe were within reported ranges. These baseline data further knowledge on metal pollution in Desmspongiae members, which are still limited.

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INTRODUCTION: A detailed understanding of the anatomical and structural changes occurring in the retina following intravitreal fluocinolone acetonide implantation may help improve the management and prognosis of persistent or recurrent diabetic macular edema (DME). METHODS: Overall, 45 eyes (from 35 patients) with refractory center-involved DME received an intravitreal fluocinolone acetonide implant. They were monitored at baseline and at 6, 12, 24, and 36 months for best-corrected visual acuity (BCVA), central foveal thickness (CFT), and the seven retinal parameters used in the classification of diabetic maculopathy recently developed at the European School for Advanced Studies in Ophthalmology (ESASO). RESULTS: Within 6 months of implantation, significant improvements were evident in BCVA, CFT, maculopathy stage, and the percentage of eyes with: intraretinal cysts; CFT > 30% above the upper normal value; and disrupted or absent ellipsoid zone (EZ) and/or external limiting membrane (ELM). Significant improvements were still maintained at 36 months post-implantation. At month 36, early treatment with the implant (i.e., after < 6 previous intravitreal injections for DME) trended toward being more effective than later treatment in improving BCVA, CFT, maculopathy stage, and the percentage of eyes with CFT > 30% above the upper normal value. However, statistical significance was not achieved. CONCLUSION: In persistent or recurrent DME, fluocinolone acetonide implantation can be effective in improving maculopathy stage and reducing the percentage of eyes with: intraretinal cysts; CFT > 30% above the upper normal value; and disrupted or absent EZ and/or ELM. It can also increase BCVA and reduce CFT.

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The withanolides are naturally occurring steroidal lactones found mainly in plants of the Solanaceae family. The subtribe Withaninae includes species like Withania sominifera, which are a source of many bioactive withanolides. In this work, we selected and evaluate the ADMET-related properties of 91 withanolides found in species of the subtribe Withaninae computationally, to predict the relationship between their structures and their pharmacokinetic profiles. We also evaluated the interaction of these withanolides with known targets of Alzheimer's disease (AD) through molecular docking and molecular dynamics. Withanolides presented favorable pharmacokinetic properties, like high gastrointestinal absorption, lipophilicity (logP ≤ 5), good distribution and excretion parameters, and a favorable toxicity profile. The specie Withania aristata stood out as an interesting source of the promising withanolides classified as 5-ene with 16-ene or 17-ene. These withanolides presented a favourable pharmacokinetic profile and were also highlighted as the best candidates for inhibition of AD-related targets. Our results also suggest that withanolides are likely to act as cholinesterase inhibitors by interacting with the catalytic pocket in an energy favorable and stable way.Communicated by Ramaswamy H. Sarma.

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Trata-se de uma revisão integrativa da literatura que propôs traçar o estado da arte em relação à vulnerabilidade da população trans na assistência de saúde. Metodologia: Considerou-se o período de 2010/2020 nas bases de dados: BVS, LILACS, MEDLINE, PubMED, SciELO, Cinahl e Scopus e nos idiomas português, inglês e espanhol. Os descritores utilizados foram: transexualidade, vulnerabilidade em saúde, cuidados de enfermagem, humanização da assistência, e doenças sexualmente transmissíveis, sendo apurados 1474 trabalhos publicados. Resultados: Após realizada a análise desses, foram considerados 17 artigos, desencadeando uma subdivisão deles em três categorias, sendo elas: vulnerabilidade de acesso ao serviço de saúde, vulnerabilidade em saúde devido ao acesso nos serviços de saúde, vulnerabilidade com relação ao HIV/AIDS. Conclusão: As vulnerabilidades mais prevalentes relacionadas a assistência de saúde foram o medo da discriminação, a dificuldade de acesso, e por fim, a falta de preparo e manejo por parte da equipe na assistência (AU).

This is an integrative literature review that proposes to outline the state of the art in relation to the vulnerability of the trans population in health care. Methodology: The period 2010/2020 was considered in the databases: BVS, LILACS, MEDLINE, PubMED, SciELO, Cinahl and Scopus and in Portuguese, English and Spanish. The descriptors used were: transsexuality, health vulnerability, nursing care, humanization of care, and sexually transmitted diseases, with 1474 published works being verified. Results: After analyzing these, 17 articles were considered, triggering a subdivision of them into three categories, namely: vulnerability in access to health services, vulnerability in health due to access to health services, vulnerability in relation to HIV/AIDS . Conclusion: The most prevalent vulnerabilities related to health care were fear of discrimination, difficult access, and finally, lack of preparation and management by the care team (AU).

Se trata de una revisión integrativa de la literatura que se propuso delinear el estado del arte en relación a la vulnerabilidad de la población trans en la atención a la salud. Metodología: Se consideró el período 2010/2020 en las bases de datos: BVS, LILACS, MEDLINE, PubMED, SciELO, Cinahl y Scopus y en portugués, inglés y español. Los descriptores utilizados fueron: transexualidad, vulnerabilidad en salud, cuidado de enfermería, humanización del cuidado y enfermedades de transmisión sexual, siendo verificados 1474 trabajos publicados. Resultados: Después del análisis de estos, se consideraron 17 artículos, lo que provocó una subdivisión de los mismos en tres categorías, a saber: vulnerabilidad en el acceso a los servicios de salud, vulnerabilidad en la salud por el acceso a los servicios de salud, vulnerabilidad en relación al VIH/SIDA. Conclusión: Las vulnerabilidades más prevalentes relacionadas con la atención de la salud fueron el miedo a la discriminación, el difícil acceso y, por último, la falta de preparación y gestión por parte del equipo de atención (AU).

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Abstract The aquatic insects of the genus Phylloicus play a crucial role in aquatic ecosystems, shredding leaves and contributing to nutrient cycling in streams. Therefore, this genus is often used in laboratory experiments. However, in Cerrado regions such as Araguaia, these studies are impractical due to a lack of knowledge about basic aspects, such as their feeding preferences for local plants. Hence, our objective is to determine the native plant species in the Araguaia region preferred as food by Phylloicus. We conducted an experimental study comparing the consumption of three native Cerrado plant species: Casearia sylvestris, Astronium fraxinifolium, and Ficus guaranítica by Phylloicus. To assess differences in consumption, we performed an Analysis of Variance. The results revealed that Phylloicus larvae exhibited a feeding preference for Casearia sylvestris (F = 9.71; p = 0.004). This finding will contribute to the development of future experimental studies using Phylloicus in the Araguaia region, as understanding the feeding preferences of animals used in experiments is essential for their maintenance in the laboratory.

Resumo Os insetos aquáticos do gênero Phylloicus desempenham um papel essencial nos ecossistemas aquáticos, fragmentando folhas e contribuindo para a ciclagem de nutrientes nos riachos. Por isso, esse gênero é frequentemente utilizado em experimentos de laboratório. No entanto, em regiões de Cerrado como o Araguaia, esses trabalhos são inviáveis por não se conhecer aspectos básicos como a sua preferência alimentar por plantas locais. Por isso, nosso objetivo é responder quais são as espécies vegetais nativas da região do Araguaia preferidas para a alimentação de Phylloicus. Fizemos um trabalho experimental comparando o consumo de três espécies vegetais nativas do Cerrado: Casearia sylvestris, Astronium fraxinifolium e Ficus guaranítica pelos Phylloicus. Para avaliar as diferenças no consumo, realizamos uma Análise de Variância. Os resultados obtidos revelaram que as larvas de Phylloicus demonstraram preferência alimentar por Casearia sylvestris (F = 9.71; p = 0.004). Esse achado ajudará no desenvolvimento de futuros trabalhos experimentais utilizando Phylloicus na região do Araguaia, uma vez que é essencial o conhecimento da preferência alimentar dos animais utilizados nos experimentos para sua manutenção em laboratório.

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BACKGROUND: Diabetic macular edema is the main cause of vision loss in patients with diabetic retinopathy. In this work, we aimed to assess the role of Optical Coherence Tomography (OCT) biomarkers in patients treated with ranibizumab. METHODS: A prospective study enrolling 46 eyes with DME under ranibizumab intravitreal therapy with 12 months of follow-up. The primary endpoint was to assess the association between OCT biomarkers at baseline and the type of treatment response. RESULTS: Good responders, compared with partial/non responders, had lower number of inner nuclear layer cysts (INLc) at baseline, (26.5% vs 73.5%, p = 0.035) and presented, at 12 months of follow-up, lower percentage of disorganization of retinal inner layers (12.0% vs 88.0%, p = 0.001), lower disruption of outer plexiform layer (8.7% vs 91.3%, p < 0.001) and lower outer nuclear layer cysts (17.4% vs 82.6%, p = 0.013). At the end of follow-up, it was observed a higher frequency of inner nuclear layer cysts in patients with higher glycated haemoglobin (p = 0.028). CONCLUSION: This study showed the value and importance of OCT parameters, such as absence of INLc, as a prognostic therapeutic response. A normalization of the macular anatomy with ranibizumab is more likely to happen in early complete responders. The association between INLc and higher glycated haemoglobin levels showed the importance of systemic metabolic control in systemic diabetic manifestations. Clinicaltrials.gov NCT04387604.

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Cobalt (Co), copper (Cu), manganese (Mn), molybdenum (Mo), and zinc (Zn) are essential trace elements (ETEs) and important cofactors for intermediary metabolism or redox balance. These ETEs are crucial during pregnancy, their role on specific pregnancy outcomes is largely unknown. This prospective study (#NCT04010708) aimed to assess urinary levels of these ETEs in pregnancy and to evaluate their association with pregnancy outcomes. First trimester pregnant women of Porto and Lisbon provided a random spot urine sample, and sociodemographic and lifestyle data. Clinical data were obtained from clinical records. Urinary ETEs were quantified by inductively coupled plasma mass spectrometry (ICP-MS). A total of 635 mother:child pairs were included. Having urinary Zn levels above the 50th percentile (P50) was an independent risk factor for pre-eclampsia (PE) (aOR [95% CI]: 5.350 [1.044-27.423], p = 0.044). Urinary Zn levels above the P50 decreased the risk of small for gestational age (SGA) birth head circumference (aOR [95% CI]: 0.315 [0.113-0.883], p = 0.028), but it increased the risk SGA length (aOR [95% CI]: 2.531 [1.057-6.062], p = 0.037). This study may provide valuable information for public health policies related to prenatal nutrition, while informing future efforts to de-fine urinary reference intervals for ETEs in pregnant women.

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Sustainability labelling on food products can help consumers make informed purchasing decisions and support the urgent transition to sustainable food systems. While there is a relatively robust body of evidence on health and nutrition labelling, less is known about the effectiveness of sustainability labelling in facilitating sustainable food choices. This paper investigates the impact of sustainability labelling on consumer understanding, attitudes, and behaviour to support a more nuanced, detailed, and holistic understanding of the evidence. Using a narrative literature review methodology, the paper assesses studies covering environmental, social, and/or animal welfare aspects of sustainability labelling on food products. We found that consumer understanding of sustainability information is often limited, which could hinder behaviour change. While sustainability labelling can influence consumer attitudes and purchasing behaviours, evidence from real consumer settings tends to show small effect sizes. Consumers are generally willing to pay more for sustainability-labelled products, and organic labelling often leads to the highest reported willingness to pay. The review emphasises the importance of trust, suggesting a preference for labelling backed by governments or public authorities. Sustainability labelling that uses intuitively understandable cues has an increased impact, with visual aids such as traffic light colours showing promise. We conclude that further research is needed in real-world settings, using representative populations and exploring the influence of demographic factors, values, and attitudes.

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Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease was first reported in 2019 and was initially associated with respiratory pathology. With the improvement of knowledge about this disease, it was noticed that, among other symptoms, some patients presented visual acuity changes associated with retinal vascular changes, mainly associated with thrombotic phenomena. Later, with the development of vaccines against SARS-CoV-2 disease, cases of visual acuity alterations secondary to thrombotic phenomena were also reported. Case Presentation: In this article, a series of clinical cases with retinal vascular alterations after COVID-19 infection and vaccination are described. Conclusion: COVID-19 infection and vaccination increase the risk of retinal vascular events. The purpose of this article is to present a set of clinical cases with various manifestations of vascular changes in the retina associated with COVID-19 infection and COVID-19 vaccination observed in the Department of Ophthalmology of Centro Hospitalar Universitário de Santo António, in Porto, Portugal.