Search

Objective: To evaluate the impact of bariatric surgery (BS) on the oral health status of obese individuals. Material and methods: The search was performed on the Cochrane Library, Embase, Latin American and Caribbean Literature on Health Sciences (LILACS), LIVIVO, PubMed/Medline, Scopus, and Web of Science databases. Grey literature was also consulted through Google Scholar, OpenGrey, ProQuest, and MedRxiv. The risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal tool. Pre- and post-surgical moments were compared through random effects meta-analysis. The GRADE (Grading of Recommendations, Assessment, Development and Evaluations) assessment tool was used to judge the certainty of evidence. Results: After searching the databases, 908 references were retrieved, with 30 articles selected for synthesis. When comparing the pre- and postoperative moments, there was no difference in the index of decayed, missing, or filled teeth. Furthermore, salivary flow and probing depth presented a slight increase. Post-surgery patients showed an increase (%) in tooth wear at the dentin level [MD = -6.23; IC95% = -8.45—-4.01; I2 = 0%]. Conclusion: Patients undergoing BS show no difference when considering the rate of caries or missing teeth and little to no effect was observed on salivary flow rates and periodontal probing depth. On the other hand, greater attention should be given to dentin wear in post-surgical patients of BS. Clinical relevance: Patients undergoing BS should receive careful monitoring regarding oral health by doctors, dentists, and the entire multidisciplinary team involved before and after the surgical procedure. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate acute and subacute hemodynamic responses and perception of effort in individuals with CCC submitted to different IMT protocols. This was a randomized cross-over trial conducted on CCC subjects with systolic left ventricular dysfunction (<45% left ventricular ejection fraction) without or with heart failure (stages B2 and C, respectively). Twenty-one participants performed two IMT protocols, one targeting 60% maximal inspiratory pressure with 3 × 10 repetitions (MIP60) and the other targeting 30% maximal inspiratory pressure (MIP30) with 3 × 20 repetitions with a 2 min recovery between sets for both. MIP60 and MIP30 were performed on the same day with a 2 h washout period. Measurements were taken at baseline, during and 60 min after IMT. No differences in hemodynamic variables were observed across protocols. The perception of effort increased in both protocols, with higher scores for the MIP30 protocol (β = +1.6, p = 0.01; β = +1.1, p = 0.02; β = +0.9, p = 0.08 for the 1st, 2nd and 3rd sets, respectively). There were no differences in hemodynamic responses comparing MIP60 and MIP30 protocols in subjects with CCC. Despite the higher perception of effort during endurance protocol, both protocols can be considered a safe therapeutic strategy. Despite inspiratory muscle training may result in functional capacity improvements, no previous study evaluated the hemodynamic acute and subacute responses to inspiratory muscle training in chronic Chagas cardiomyopathy. The two inspiratory muscle training protocols (30% and 60% of maximal inspiratory pressure) did not cause significant hemodynamic repercussions in subjects with chronic Chagas cardiomyopathy. Inspiratory muscle training seems to be an effective strategy to improve functional capacity and can be implemented in the rehabilitation programs for patients with Chagas cardiomyopathy. Since no significant adverse responses were observed in any of the hemodynamic parameters during the inspiratory muscle training sessions, these two protocols of inspiratory muscle training (30% and 60% of maximal inspiratory pressure) seems to be safe in subjects with Chagas cardiomyopathy. [ABSTRACT FROM AUTHOR]

is study is a systematic review and aims to analyze how research on industry 4.0 is contributing to a greater understanding of the effects of the implementation of industry 4.0 on sustainability. is study was done by mapping the existing research, using selection, eligibility and inclusion criteria as the guiding principle of the PRISMA methodology technique (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). e selection of articles in the databases consulted was based on the crossing of the terms "Industry 4.0" and "sustainability". e research brings as results the main challenges for the implementation of technologies related to industry 4.0, among them the lack of technological infrastructure and resources for investment and what the possible benefits for sustainability this implementation can bring, such as the reduction in the consumption of resources at all stages of production, as well as the environmental impacts generated. rough this study it was possible to conclude that despite presenting factors that positively influence the sustainability of companies, the implementation of new technologies for the adoption of the concept of industry 4.0, is still surrounded by risks and challenges and there is a need for further studies that explore and consolidate the results of the fourth industrial revolution. [ABSTRACT FROM AUTHOR]

Background: Cranial, facial, nasal, and maxillary widths have been shown to be significantly affected by the individual's sex. The present study aims to use measurements of dental arch and maxillary skeletal base to determine sex, employing supervised machine learning. Materials and methods: Maxillary and mandibular tomographic examinations from 100 patients were analyzed to investigate the inter-premolar width, inter-molar width, maxillary width, inter-pterygoid width, nasal cavity width, nostril width, and maxillary length, obtained through Cone Beam Computed Tomography scans. The following machine learning algorithms were used to build the predictive models: Logistic Regression, Gradient Boosting Classifier, K-Nearest Neighbors (KNN), Support Vector Machine (SVM), Multi-Layer Perceptron Classifier (MLP), Decision Tree, and Random Forest Classifier. A 10-fold cross-validation approach was adopted to validate each model. Metrics such as area under the curve (AUC), accuracy, recall, precision, and F1 Score were calculated for each model, and Receiver Operating Characteristic (ROC) curves were constructed. Results: Univariate analysis showed statistical significance (p < 0.10) for all skeletal and dental variables. Nostril width showed greater importance in two models, while Inter-molar width stood out among dental measurements. The models achieved accuracy values ranging from 0.75 to 0.85 on the test data. Logistic Regression, Random Forest, Decision Tree, and SVM models had the highest AUC values, with SVM showing the smallest disparity between cross-validation and test data for accuracy metrics. Conclusion: Transverse dental arch and maxillary skeletal base measurements exhibited strong predictive capability, achieving high accuracy with machine learning methods. Among the evaluated models, the SVM algorithm exhibited the best performance. This indicates potential usefulness in forensic sex determination. [ABSTRACT FROM AUTHOR]

We present a model-based method, designated Inverse Metabolic Control Analysis ( IMCA ), which can be used in conjunction with classical Metabolic Control Analysis for the analysis and design of cellular metabolism. We demonstrate the capabilities of the method by first developing a comprehensively curated kinetic model of sphingolipid biosynthesis in the yeast Saccharomyces cerevisiae . Next we apply IMCA using the model and integrating lipidomics data. The combinatorial complexity of the synthesis of sphingolipid molecules, along with the operational complexity of the participating enzymes of the pathway, presents an excellent case study for testing the capabilities of the IMCA. The exceptional agreement of the predictions of the method with genome-wide data highlights the importance and value of a comprehensive and consistent engineering approach for the development of such methods and models. Based on the analysis, we identified the class of enzymes regulating the distribution of sphingolipids among species and hydroxylation states, with the D-phospholipase SPO14 being one of the most prominent. The method and the applications presented here can be used for a broader, model-based inverse metabolic engineering approach. [ABSTRACT FROM AUTHOR]

Autophagy is a highly regulated pathway that selectively degrades cellular constituents such as protein aggregates and excessive or damaged organelles. This transport route is characterized by engulfment of the targeted cargo by autophagosomes. The formation of these double-membrane vesicles requires the covalent conjugation of the ubiquitin-like protein Atg8 to phosphatidylethanolamine (PE). However, the origin of PE and the regulation of lipid flux required for autophagy remain poorly understood. Using a genetic screen, we found that the temperature-sensitive growth and intracellular membrane organization defects of mcd4-174 and mcd4-P301 L mutants are suppressed by deletion of essential autophagy genes such asATG1 orATG7. MCD4 encodes an ethanolamine phosphate transferase that uses PE as a precursor for an essential step in the synthesis of the glycosylphosphatidylinositol (GPI) anchor used to link a subset of plasma membrane proteins to lipid bilayers. Similar to the deletion of CHO2, a gene encoding the enzyme converting PE to phosphatidylcholine (PC), deletion of ATG7 was able to restore lipidation and plasma membrane localization of the GPI-anchored protein Gas1 and normal organization of intracellular membranes. Conversely, overexpression of Cho2 was lethal in mcd4-174 cells grown at restrictive temperature. Quantitative lipid analysis revealed that PE levels are substantially reduced in the mcd4-174 mutant but can be restored by deletion of ATG7 or CHO2. Taken together, these data suggest that autophagy competes for a common PE pool with major cellular PE-consuming pathways such as the GPI anchor and PC synthesis, highlighting the possible interplay between these pathways and the existence of signals that may coordinate PE flux. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the prevalence of signs and symptoms related to temporomandibular disorders (TMD) and orofacial pain in patients with indication for orthognathic surgery. Methods: The search was carried out in seven electronic databases and gray literature. Studies that evaluated the frequency of signs and symptoms related to TMD and orofacial pain were included. The risk of bias was assessed using the Joanna Briggs Critical Appraisal tool. A meta-analysis of proportions with a random effect model was performed and the GRADE tool judged the certainty of evidence. Results: After searching the databases, 1859 references were retrieved, 18 of which were selected for synthesis. The prevalence of individuals with at least one TMD symptom was 51% [CI95% = 44–58%], and 44% of the subjects had temporomandibular joint click/crepitus [CI95% = 37–52%]. Additionally, 28% exhibited symptoms related to muscle disorders [CI95% = 22–35%], 34% had disc displacement with or without reduction [CI95% = 25–44%], and 24% had inflammatory joint disorders [CI95% = 13–36%]. The prevalence of headache was 26% [CI95% = 8–51%]. The certainty of evidence was considered very low. Conclusion: Approximately 1 in 2 patients with dentofacial deformity presents some sign and symptom related to TMD. Myofascial pain and headache may be present in approximately a quarter of patients with dentofacial deformity. Clinical relevance: A multidisciplinary treatment is necessary for these patients, involving a professional with expertise in the management of TMD. [ABSTRACT FROM AUTHOR]

O uso de plantas medicinais tem sido passado por gerações, e mesmo nos dias atuais é altamente praticado por pessoas ao redor do mundo. Entretanto, o conhecimento sobre as plantas medicinais está se perdendo com o tempo. O Projeto Farmácia Viva tem por finalidade resgatar o conhecimento e uso tradicional das plantas medicinais, promovendo seu uso racional. A Farmácia Viva da UniFAJ foi aprovada pelo Centro Universitário de Jaguariúna em 2017, sendo construída na Interclínicas, Jaguariúna - SP e contando com o cultivo de 29 plantas medicinais. Muitas atividades estão sendo desenvolvidas como pesquisas, confecções de lâminas para microscopia, visitas, aulas, treinamentos, estágios e iniciação científica. A comunidade receberá a planta in natura, tendo todas as informações sobre o seu uso correto. Futuramente, pretende-se disponibilizar para a população chás medicinais e medicamentos fitoterápicos, bem como promover palestras, oficinas e treinamentos para aqueles que buscam o conhecimento para si ou para propagá-lo criando novas Farmácias Vivas. O projeto está sendo um campo de pesquisa para extensão do conhecimento acadêmico, e uma alternativa terapêutica que se mostra bem aceita pela comunidade. [ABSTRACT FROM AUTHOR]

Background: In the Brazilian Amazon, snakebite envenomings (SBE) disproportionately affect indigenous peoples. Communication between indigenous and biomedical health sectors in regards to SBEs has never been explored in this region. This study aims to build an explanatory model (EM) of the indigenous healthcare domain for SBE patients from the perspective of the indigenous caregivers. Methodology/Principal findings: This is a qualitative study involving in-depth interviews of eight indigenous caregivers who are representatives of the Tikuna, Kokama and Kambeba ethnic groups, in the Alto Solimões River, western Brazilian Amazon. Data analysis was carried out via deductive thematic analysis. A framework was built containing the explanations based on three explanatory model (EM) components: etiology, course of sickness, and treatment. To indigenous caregivers, snakes are enemies and present conscience and intention. Snakebites have a natural or a supernatural cause, the last being more difficult to prevent and treat. Use of ayahuasca tea is a strategy used by some caregivers to identify the underlying cause of the SBE. Severe or lethal SBEs are understood as having been triggered by sorcery. Treatment is characterized by four components: i) immediate self-care; ii) first care in the village, mostly including tobacco smoking, chants and prayers, combined with the intake of animal bile and emetic plants; iii) a stay in a hospital, to receive antivenom and other treatments; iv) care in the village after hospital discharge, which is a phase of re-establishment of well-being and reintroduction into social life, using tobacco smoking, massages and compresses to the affected limb, and teas of bitter plants. Dietary taboos and behavioral interdictions (avoiding contact with menstruating and pregnant women) prevent complications, relapses, and death, and must be performed up to three months after the snakebite. Caregivers are in favor of antivenom treatment in indigenous areas. Conclusions/Significance: There is a potential for articulation between different healthcare sectors to improve the management of SBEs in the Amazon region, and the aim is to decentralize antivenom treatment so that it occurs in indigenous health centers with the active participation of the indigenous caregivers. Author summary: The Brazilian Amazon is the region of the Americas that has the highest incidence of SBEs, and indigenous populations are disproportionately affected. In order for Brazil to achieve a reduction in mortality and disability from snakebite envenomations, it is vital to understand how indigenous and professional healthcare sectors interact in indigenous villages. The indigenous caregivers interviewed explained that the occurrence of a snakebite can be a natural event, usually due to the lack of attention of an indigenous person during their daily activities in the forest, or a supernatural event that was caused as a punishment or by witchcraft. The latter type of snakebites is more serious and it is difficult to intervene to promote healing. Indigenous caregivers recommend a series of rituals in order to protect an individual from snakebite or heal the already diseased body. In addition, a series of therapeutic resources derived from plants and animals is used for treatment and rehabilitation of the indigenous person. In this itinerary, there is no impediment on the part of the caregivers to include a stay in hospital in order to carry out the treatment with antivenom and other care deemed necessary by the doctors. This finding is crucial to improve the effectiveness of snakebite treatment in an integrated biomedical-indigenous model, thus reducing the contradictions and tensions present in the daily practices of both health teams and indigenous caregivers. The engagement with local caregivers to combine the indigenous health care model with a timely referral of SBE patients to a facility equipped with antivenom is a major determinant of success in the control of SBEs. [ABSTRACT FROM AUTHOR]

The aim of the present study was to evaluate the effects of cardiovascular rehabilitation (CR) on functional capacity of patients with chronic chagasic cardiomyopathy (CCC) and to compare the responses between CCC patients without and with heart failure (HF). A longitudinal observational retrospective study was carried out including 36 patients with CCC without HF (stage B2 [n = 7]) and with HF (stage C [n = 29]), who participated in a CR program. Functional capacity was assessed by a maximal progressive cardiopulmonary exercise test performed on a treadmill. The longitudinal effects of the CR on functional capacity were determined by linear mixed models that included an interaction term to evaluate the differential responses between patients without and with HF. Significant improvements in peak oxygen consumption, resting heart rate and blood pressure, and maximum pulmonary ventilation were observed for the overall study sample, with no apparent differential effects according to the presence of HF. CR significantly improved functional capacity of patients with CCC. The responses to CR appear to be similar among patients without and with HF, reinforcing the need for its inclusion as a standard treatment strategy of CCC. Exercise-based cardiovascular rehabilitation (CR) is a safe strategy that improves functional capacity, cardiac function, and quality of life in patients with several cardiovascular diseases, and recent studies also suggested a potential beneficial effect of CR in chronic chagasic cardiomyopathy (CCC). In this observational study, CR seems to equally improve exercise capacity, resting heart rate, resting blood pressure, and maximum pulmonary ventilation in patients with CCC without (stage B2) and with heart failure (stage C). Cardiovascular rehabilitation should be included as a standard treatment strategy for patients with CCC, regardless the severity of cardiomyopathy. [ABSTRACT FROM AUTHOR]

The cuticle is the outermost region of the epidermal cell wall of plant aerial organs. The cuticle acts as a two-way lipid barrier for water diffusion; therefore, it plays a vital role in foliar water uptake (FWU). We hypothesised that the chemical composition of the cuticular waxes influences the FWU strategy that plants adopt in a foggy tropical ecosystem. We analysed the leaf cuticular waxes of six plant species known by their different FWU strategies, in both qualitative and quantitative approaches, to test this hypothesis. We also investigated the fine structure of the plant cuticle by scanning electron microscopy. Neither the total wax loads nor the amounts of single wax compound classes correlated to the FWU. In contrast, the qualitative chemical composition of the cuticular waxes was related to the water absorption speed but not to the maximum water absorbed. The presence of wax crystals might interfere with the FWU. Our findings suggest that a complex three-dimensional network of the cuticular compounds contributes to different strategies of FWU in six plant species from foggy tropical mountaintops. Cuticular waxes are the main barrier against cuticular water permeability. Leaf surface composition and structure alter wettability and permeability. [Display omitted] [ABSTRACT FROM AUTHOR]

Objectives: To describe the clinical and sociodemographic characteristics of participants as well as discontinuation and mortality rates in a cardiac rehabilitation programme (CRP) tailored to Chagas disease (CD). Methods: Participants underwent functional capacity, anthropometry and cardiac function evaluations before beginning a CRP. Univariate and multivariate Cox proportional hazards models were performed to investigate the associations between clinical and sociodemographic characteristics at baseline with discontinuation rates and deaths. Results: Forty‐two patients were enrolled in the CRP (61.9% men, mean age of 58.1 ± 11.8 years). During a median follow‐up period of 10.8 months, 74% discontinued and 14% died while enrolled in CRP. 34% of the patients who discontinued CRP died during follow‐up. White race (HR = 0.09; 95% CI 0.01–1.00), right ventricular systolic dysfunction (HR = 10.54; 95% CI 1.24–89.50) and oxygen pulse (HR = 0.69; 95% CI 0.48–0.99) were independently associated with death while enrolled in CRP. Married status (HR = 0.44; 95% CI 0.21–0.95) was independently associated with discontinuation rates from CRP. VO2 peak (HR = 0.85; 95% CI 0.74–0.98) and CRP discontinuation due to CD‐related reasons (HR = 8.33; 95% CI 1.91–36.27) were the variables independently associated with death after discontinuation of CRP. Conclusion: In this population, sociodemographic aspects and severity of CD were important determinants of CRP discontinuation and mortality. [ABSTRACT FROM AUTHOR]