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Background: Heart failure demands self-care skills and behaviors that can be negatively impacted by a low level of perceived control (PC), a belief about having the necessary resources to deal with negative events. Having valid and reliable instruments to measure PC is important to support interventions that improve self-care and related outcomes. The Control Attitudes Scale-Revised (CAS-R)was developed in the United States to measure PC in cardiac conditions. In Brazil, there are no instruments available to measure this construct. Objective: The aims of this study were to translate and adapt the CAS-R to the Brazilian population and to assess the content validity of the adapted version. Methods: The CAS-R was translated, back-translated, and assessed by an expert committee for linguistic equivalences. An agreement > 80%was considered adequate. Content validity (clarity, theoretical relevance, and practical pertinence) wasassessedbyboth an expertprofessionalpanel (n=6-8) and a panel of patientswith heart failure (n = 40). A content validity coefficient > 0.70was considered acceptable. Results: The translations to Brazilian Portuguesewere considered consistentwith the original CAS-R. In the third round of linguistic equivalence assessment, all items achieved acceptable agreement, except for 2 items. After modifications to the instrument to achieve adequate equivalences, the adapted version had a final content validity coefficient of 0.93. Most patients were able to understand the instrument. Conclusions: The CAS-R-Brazilian version is equivalent to the original CAS-R and has satisfactory evidence of content validity. Additional psychometric testing will be performed to allow for the assessment of PC in individuals with heart failure in Brazil. [ABSTRACT FROM AUTHOR]

The tissue tropism and the wide host range of influenza A viruses are determined by the presence of sialic acid (SA) α2,3-Gal and SA α2,6-Gal receptors. Recent studies have shown that animals possessing both receptors allow for the rearrangement and emergence of new viral strains of public health importance. This study aimed to evaluate the expression and distribution of human and avian influenza A receptors in nine Neotropical snake species using lectin immunohistochemistry. We selected 17 snakes that were examined post mortem at the Veterinary Pathology Sector of the Universidade Federal de Minas Gerais between 2019 and 2023. Sections of nasal turbinate, trachea, lung, oral mucosa, stomach and intestine were subjected to immunohistochemical analysis using the lectins Maackia amurensis and Sambucus nigra. This research detected, for the first time, co-expression of SA α2,3-Gal and SA α2,6-Gal receptors in the respiratory and digestive tracts of snakes, indicating the possible susceptibility of these species to influenza A virus of avian and human origin. Consequently, snakes can be considered important species for monitoring influenza A in wild, urban and peri-urban environments. More studies should be conducted to investigate the role of snakes in influenza A epidemiology. [ABSTRACT FROM AUTHOR]

A newer integrase strand transfer inhibitor (INSTI) cabotegravir was recently approved for both therapy and prophylaxis and can play an essential role in the fight against AIDS. It shares similar resistance profile to dolutegravir, the cornerstone of Brazilian antiretroviral (ARV) treatment, with about 600 thousand people living with HIV in Brazil currently on regimens that contain this INSTI. Health services in the São Paulo metropolitan area are responsible for a large proportion of ARV dispensation in the country. Estimating transmitted drug resistance mutation (TDRM) in the area before cabotegravir introduction may provide a useful baseline information. Partial HIV-1 pol gene was sequenced (Sanger) from 192 newly diagnosed individuals from São Paulo and nearby cities (2020 to March 2023) at integrase, with 85 also at protease/reverse transcriptase regions. Retrotranscribed plasma RNA, amplified with nested PCR, was edited (Recall or Sequencher) and analyzed at Rega and Stanford db. Surveillance drug resistance mutations (SDRM) to INSTI class was detected in three cases (1.6%; 95% CI: 0.5%−5%), two E138K and one R263K, with 7.8% (95% CI: 5%−13%) with resistance mutations (major or accessory). SDRM for nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, and PI classes were identified in 7 (8.2% CI: 95% 4%−16%) cases. Subtype B predominated (69%), followed by subtype C (16%), now the second most prevalent infection in this area. Among 131 patients treated for over 6 months, 92% were virally suppressed below 200 copies/mL, with low TCD4 counts independently associated to failure. SDRM to INSTI class is rare in the area. Intermediate rates of transmitted resistance to other ARV classes are comparable to previous estimates. Viral suppression rates may depend on TCD4 counts, another negative impact of late diagnosis in care that deserves more attention. [ABSTRACT FROM AUTHOR]

Gestational complications are common in radiological practice and can be identified and evaluated using various imaging methods. Each complication typically presents with specific imaging features; however, there is a lack of comprehensive literature that consolidates this information to facilitate a diagnostic algorithm and focused study. In this context, this review aims to revisit the theoretical basis of differentials in pregnancy-related complications, discussing classic imaging features and providing examples of key features for each diagnosis. The focus is on essential information for accurate diagnosis, emphasizing the role of radiologists in contributing to better outcomes. [ABSTRACT FROM AUTHOR]

The Baveno VII guidelines were proposed to identify which patients could safely avoid screening esophagogastroduodenoscopy (EGD) for gastroesophageal varices. We aimed to evaluate the frequency of gastric neoplasia in compensated advanced chronic liver disease (cACLD) patients who underwent EGD for screening of gastroesophageal varices (GOEV) compared to a healthy population. Retrospective study that enrolled all cACLD patients who underwent EGD for GOEV screening (January 2008-June 2018) in a tertiary reference center. cACLD patients were compared with asymptomatic healthy individuals who underwent EGD in a private hospital setting (April 2017-March 2018). We evaluated 1845 patients (481 cACLD patients, 1364 healthy individuals). A significantly higher frequency of gastric neoplasia was observed in patients with cACLD compared to healthy individuals (4.0% vs. 1.0 %; p < 0.001). Rare histopathological subtypes (WHO Classification) accounted for 28.7 % of gastric carcinoma cases in the cACLD cohort. Seven cases of gastric neoplasia (36.8 % of gastric neoplasia cases in the cACLD patients) were diagnosed in patients who, according to the Baveno VII criteria, would have not been submitted to EGD. We found an increased frequency of gastric neoplasia in patients with cACLD in comparison with healthy individuals. In countries with intermediate-high risk for GC, continuing to perform EGD could be beneficial. [ABSTRACT FROM AUTHOR]

There are no clinical trials with a head-to-head comparison between the 2 most commonly used oral anticoagulants (apixaban and rivaroxaban) in patients with atrial fibrillation (AF). The comparative efficacy and safety between these drugs remain unclear, especially in older patients who are at the highest risk for stroke and bleeding. The purpose of this study was to compare the risk of major bleeding and thromboembolic events between apixaban and rivaroxaban in older patients with AF. We conducted a population-based retrospective cohort study of all adult patients (66 years or older) with AF in Ontario, Canada, who were treated with apixaban or rivaroxaban between April 1, 2011, and March 31, 2020. The primary safety outcome was major bleeding, and the primary efficacy outcome was thromboembolic events. Secondary outcomes included any bleeding. Rates and hazard ratios (HRs) were adjusted for baseline comorbidities with inverse probability of treatment weighting. This study included 42,617 patients with AF treated with apixaban and 30,725 patients treated with rivaroxaban. After inverse probability of treatment weighting using the propensity score, patients in the apixaban and rivaroxaban groups were well balanced for baseline values of demographic characteristics, comorbidities, and medications; both groups had a similar mean age of 77.4 years, and 49.9% were female. At 1 year, the apixaban group had a lower risk for both major bleeding with an absolute risk reduction at 1 year of 1.1% (2.1% vs 3.2%; HR 0.65; 95% confidence interval [CI] 0.59–0.71]) and any bleeding (8.1% vs 10.9%; HR 0.73; 95% CI 0.69–0.77), with no difference in the risk for thromboembolic events (2.2% vs 2.2%; HR 1.02; 95% CI 0.92–1.13). In patients with AF, 66 years or older, treatment with apixaban was associated with lower risk for major bleeding, with no difference in the risk for thromboembolic events compared with rivaroxaban. [ABSTRACT FROM AUTHOR]

Hypertension is a leading risk factor for cardiovascular disease among patients living with HIV (PLWH). Understanding the predictors and patterns of antihypertensive medication prescription and blood pressure (BP) control among PLWH with hypertension (HTN) is important to improve the primary prevention efforts for this high-risk population. We sought to assess important patient-level correlates (eg, race) and inter-facility variations in antihypertension medication prescriptions and BP control among Veterans living with HIV (VLWH) and HTN. We studied VLWH with a diagnosis of HTN who received care in the Veterans Health Administration (VHA) from January 2018 to December 2019. We evaluated HTN treatment and blood pressure control across demographic variables, including race, and by medical comorbidities. Data were also compared among VHA facilities. Predictors of HTN treatment and control were assessed in 2-level hierarchical multivariate logistic regression models to estimate odds ratios (ORs). The VHA facility random-effects parameters from the hierarchical models were used to calculate the median odds ratios to characterize the variation across the different VHA facilities. A total of 17,468 VLWH with HTN (mean age 61 years, 97% male, 54% Black, 40% White) who received care within the VHA facilities in 2018-2019 were included. 73% were prescribed antihypertension medications with higher prescription rates among Black vs White patients (75% vs 71%) and higher prescription rates among patients with a history of cardiovascular disease, diabetes, and kidney disease (>80%), and those receiving antiretroviral therapy and with controlled HIV viral load (∼75%). Only 27% of VLWH with HTN had optimal BP control of systolic BP <130 mmHg and diastolic BP <80 mmHg, with a lower rate of control among Black vs White patients (24% v. 31%). In multivariate regression, Black patients had a higher likelihood of HTN medication prescription (OR 1.32, 95% CI: 1.22-1.42) but were less likely to have optimal BP control (OR 0.82; 0.76-0.88). Important positive correlates of antihypertensive prescription and optimal BP control included: number of outpatient visits in prior year, and histories of diabetes, coronary artery disease, and heart failure. There was about 10% variability in both antihypertensive prescription and BP control patterns between VHA facilities for patients with similar characteristics. There was increased inter-facility variation in antihypertensive prescription among those with a history of heart failure and those not receiving antiretroviral therapy. In a retrospective analysis of large VHA data, we found that VLWH with HTN have suboptimal antihypertensive medication prescription and BP control. Black VLWH had higher HTN medication prescription rates but lower optimal BP control. [ABSTRACT FROM AUTHOR]

This article deals with the methodological review of the differentiation of urban and rural areas and enumerations areas in the 2022 Demographic Census. As such a methodology is the result of an evolutionary process of understanding the territory, involving a wide range of techniques, instances and scales, our study sought, in a synthetic manner, to rescue the history of this differentiation in Brazilian territorial planning, confronting different objectives and conceptual bases, such as statistical purposes, territorial management, and geographic analyses. Subsequently, the new conceptual framework of the Census Cartography is presented, constructed, for the first time, based on the use of high-resolution orbital images that, supported by fieldwork, brought the census section closer to the space lived and perceived by people. This context gives the initiative an innovative character, which will guide the dissemination of updated data for both urban and rural scenarios, as well as for rural settlements, cities, and towns, an important input necessary to understand the concentration and dispersion of the population throughout the country and their respective modes of life. [ABSTRACT FROM AUTHOR]

• Older adults with dynapenic abdominal obesity and dynapenic obesity have a longer exposure time to sedentary behavior and spend less time on physical activity; • Physical activity and sedentary behavior are accurate for screening older adults with dynapenic abdominal obesity and dynapenic obesity; • Time spent in physical activity and time exposed to sedentary behavior can be combined to optimize screening for dynapenic abdominal obesity and dynapenic obesity in the older adults. To investigate the discriminatory capacity of habitual physical activity (HPA) and sedentary behavior (SB) when screening for dynapenic abdominal obesity (DAO) and dynapenic obesity (DO) in older adults. A cross-sectional population epidemiological investigation was conducted with 207 older adults. Obesity was diagnosed by high waist circumference and body mass index. Dynapenia was identified through low handgrip-strength. In men, the best HPA cutoff points to discriminate DAO and DO were, respectively, 80 minutes/week (sensitivity: 100%; specificity: 71.95%) and 145 minutes/week (sensitivity: 100%; specificity: 54.88%). The best SB value for DAO was 351.43 minutes/day (sensitivity: 100%; specificity: 65.85%) and 400 minutes/day (sensitivity: 100%; specificity: 79.27%) for DO. In women, 150 minutes/week was the best HPA value for both DAO (sensitivity: 75%; specificity: 57.84%) and DO (sensitivity: 90.91%; specificity: 56.76%). The best SB cutoff points for DAO and DO were 381.43 minutes/day (sensitivity: 60%; specificity: 82.35%) and 337.14 minutes/day (sensitivity: 72.73%; specificity: 65.80%), respectively. Both HPA and SB demonstrated discriminatory capacity for screening DAO and DO in the study population. [ABSTRACT FROM AUTHOR]

To analyze the relevance of a set of clinical elements to represent the content domain of the nursing diagnosis Ineffective Protection. This study employed content validation, using expert judgment to assess the appropriateness of clinical indicators, etiological factors, and conceptual and operational definitions, integrating the collective wisdom framework, the theory of predictive diversity, and the determination of rater skill level. From the middle range theory, 28 clinical indicators and 17 etiological factors were identified, which were rated by 34 raters. The analysis showed that the clinical indicators restlessness and insomnia and the etiological factors ambient temperature and humidity were not considered relevant for the nursing diagnosis of Ineffective Protection, because the median content validity index was lower than 0.9. Content validation verified that most of the components of the nursing diagnosis of Ineffective Protection were considered relevant by judges. It is believed that the data obtained can help nurses to more easily evaluate the related factors and clinical indicators of Ineffective Protection presented by adolescents with cancer, which favors the process of diagnostic inference. • Relevant clinical elements for ineffective protection in adolescents are presented. • Clinical indicators point to a more specific assessment in adolescents with cancer. • Etiological factors show the causal chain complexity of ineffective protection. [ABSTRACT FROM AUTHOR]

Objective: To test the association between socioeconomic and sociodemographic status of Brazilian dental students with discriminatory experiences suffered by them. Methods: This multicenter cross‐sectional study was conducted with 531 undergraduate dental students from four different Brazilian states. The Explicit Discrimination Scale (EDS) was used to measure the experience of discrimination in several daily situations. A questionnaire about sociodemographic and socioeconomic characteristics, form of admission, and permanence in dental schools was developed and validated by experts and six dental students through cognitive interviews. The EDS and questionnaire were sent to students by an online platform using snowball sampling. Descriptive analysis, bivariate tests, and multiple Poisson regression were performed. Results: Among the participants, most were female, white, heterosexual, and cisgender. The mean EDS total score was higher among those students who used Brazilian Affirmative Actions for higher education access and permanence (p < 0.005). The multiple analysis indicated that students who were black (prevalence ratio [PR] = 1.484; 95% confidence interval [95%CI]: 1.291–1.705), women (PR = 1.227; 95%CI: 1.030–1.462), had lower monthly income (PR = 1.212; 95%CI: 1.043–1.409) and were lesbian, gay, bisexual, transgender, intersex, queer, pansexual, and plus (LGBTQIAP+) (PR = 1.466; 95%CI: 1.238–1.735) showed a higher probability of discriminatory experiences when compared to white, male and heterosexual students with higher monthly income. Conclusion: There is a racial and social class pattern among dental students. The exclusionary factors such as black race, female gender, lower monthly income and being LGBTQIAP+ make students more vulnerable to discriminatory experiences. [ABSTRACT FROM AUTHOR]

Objective: This study described and analysed key recommendations from Clinical Practice Guidelines (CPGs) concerning urinary incontinence (UI) treatment in women. Materials and methods: We carried out searches in the following databases: MEDLINE, EMBASE, Web of Science, Virtual Health Library, among others. The reviewers, in duplicate and independently, selected the documents and extracted the data. The quality assessment of the guidelines was carried out, in triplicate, using the Appraisal of Guidelines REsearch and Evaluation (AGREE II) instrument. Results: Six CPGs were selected for analysis. Pelvic Floor Muscle Training (PFMT) is the primary treatment for UI, with adjunctive therapies (biofeedback, vaginal cones, dynamic lumbopelvic stabilisation, and electrical stimulation) recommended alongside PFMT. Discrepancies among CPG were noted in recommendations for drug treatments and invasive procedures, suggesting the need for individualised approaches. When conservative non-pharmacological treatments failed, drugs are recommended. Mid-urethral slings were endorsed, with alternatives like colposuspension or autologous rectus fascial slings considered when mid-urethral slings were unsuitable. Botulinum toxin type A was suggested for urge UI patients unresponsive to conservative therapy. Conclusion: UI treatment must prioritise the conservative non-pharmacological therapies and progressing to invasive options, as necessary. These evidence-based findings aim to guide patients, healthcare professionals, and policy managers in effectively managing UI. Level of evidence: Not applicable [ABSTRACT FROM AUTHOR]

Objective: Oral dissolution therapy is a recognised treatment option for radiolucent kidney stones. A standardised nurse-led protocol was developed. Efficacy and compliance was audited and results reviewed. Methods: Twenty-two patients with radiolucent stones were prescribed oral sodium bicarbonate. Patients monitored their urinary pH and the Urology Nurse Practitioner checked compliance. Follow-up with non-contrast computerised tomography of the kidneys, ureters and bladder (CT KUB) was evaluated at 6 weeks. Results: Twenty patients with radiolucent stones completed treatment. Mean stone size was 8 mm (2–23 mm). Nine patients (45%) had complete dissolution, three (15%) had partial dissolution and eight (40%) had no visible response on follow-up CT KUB. The Hounsfield unit (HU) average was 464 (116–1285). Those patients with complete dissolution had HU of less than 605. Three patients with encrusted ureteric stents underwent complete dissolution. Conclusions: Utilisation of a nurse-led sodium bicarbonate dissolution therapy protocol for the treatment of radiolucent stones is effective and acceptable to patients in carefully selected cases. Orally dissolution therapy (ODT) is a suitable option in patients with multiple co-morbidities and high anaesthetic risk. In our series, ODT was also highly effective in treating radiolucent stent encrustation. [ABSTRACT FROM AUTHOR]

Nanomedicine, an area that uses nanomaterials for theragnostic purposes, is advancing rapidly, particularly in the detection and treatment of neurodegenerative diseases. The design of nanocarriers can be optimized to enhance drug bioavailability and targeting to specific organs, improving therapeutic outcomes. However, clinical translation hinges on biocompatibility and safety. Nanocarriers can cross the blood-brain barrier (BBB), potentially causing neurotoxic effects through mechanisms such as oxidative stress, DNA damage, and neuroinflammation. Concerns about their accumulation and persistence in the brain make it imperative to carry out a nanotoxicological risk assessment. Generally, this involves identifying exposure sources and routes, characterizing physicochemical properties, and conducting cytotoxicity assays both in vitro and in vivo. The lack of a specialized regulatory framework creates substantial gaps, making it challenging to translate findings across development stages. Additionally, there is a pressing need for innovative testing methods due to constraints on animal use and the demand for high-throughput screening. This review examines the mechanisms of nanocarrier-induced neurotoxicity and the challenges in risk assessment, highlighting the impact of physicochemical properties and the advantages and limitations of current neurotoxicity evaluation models. Future perspectives are also discussed. Additional guidance is crucial to improve the safety of nanomaterials and reduce associated uncertainty. Nanocarriers show tremendous potential for theragnostic purposes in neurological diseases, enhancing drug targeting to the brain, and improving biodistribution and pharmacokinetics. However, their neurotoxicity is still a major field to be explored, with only 5% of nanotechnology-related publications addressing this matter. This review focuses on the issue of neurotoxicity and safety assessment of nanocarriers for brain delivery. Neurotoxicity-relevant exposure sources, routes, and molecular mechanisms, along with the impact of the physicochemical properties of nanomaterials, are comprehensively described. Moreover, the different experimental models used for neurotoxicity evaluation are explored at length, including their main advantages and limitations. To conclude, we discuss current challenges and future perspectives for a better understanding of risk assessment of nanocarriers for neurobiomedical applications. [Display omitted] [ABSTRACT FROM AUTHOR]

Peri-implantitis is an inflammatory disease around dental implants that induces progressive bone resorption. Several procedures for decontaminating the implant surface and promoting bone growth have been established to treat this condition. The purpose of the present case report was to describe the decontamination method used to achieve peri-implant health in a 60-year-old man who had a single implant that had been in function in the mandibular left molar region for 10 years. The implant, in the region of the first molar, was osseointegrated and showed radiographic bone loss associated with a probing depth of 8 mm and bleeding on probing. The diagnosis was peri-implantitis, and a surgical treatment approach was selected to enable decontamination of the area with a combination of mechanical debridement, tetracycline hydrochloride (500 mg/mL), and photo-dynamic therapy. After the decontamination process, a sodium bicarbonate spray device was used, and a guided bone regeneration protocol with a xenogeneic graft and collagen membrane was performed to reestablish the peri-implant bone height. A connective tissue graft was placed to obtain a better biological seal and increase the peri-implant keratinized mucosa. Follow-up examinations performed 30 days, 5 months, 3 years, and 6 years after the surgical procedure revealed new bone formation and progressively reduced probing depths. The successful outcome in this case suggests that combining different decontamination procedures and a bone regeneration protocol could be an effective approach to inducing bone formation around dental implants in patients with peri-implantitis. [ABSTRACT FROM AUTHOR]

Background and Aims Quality of life in patients with active Crohn's disease may be significantly reduced. We evaluated the effects of upadacitinib induction and maintenance therapy on fatigue, quality of life, and work productivity in the phase 3 trials U-EXCEL, U-EXCEED, and U-ENDURE. Methods Clinical responders to upadacitinib 45 mg in U-EXCEL and U-EXCEED induction trials were re-randomised 1:1:1 to upadacitinib 30 mg, 15 mg, or placebo for 52 weeks of maintenance in U-ENDURE. Clinically meaningful improvements in Inflammatory Bowel Disease Questionnaire [IBDQ] response, IBDQ remission, Functional Assessment of Chronic Illness Therapy–Fatigue [FACIT-Fatigue], and Work Productivity and Activity Impairment were evaluated. Percentages of patients achieving clinically meaningful improvements were assessed at induction Weeks 4 and 12 and maintenance Week 52. Clinical Registration number U-EXCEED induction trial [NCT03345836], U-EXCEL induction trial [NCT03345849], U-ENDURE maintenance trial [NCT03345823]. Results Analysis included 1021 and 502 patients assessed at induction and maintenance, respectively. In U-EXCEL, greater improvements [all p  ≤ 0.001] in IBDQ response [71.0% vs 50.2%], IBDQ remission [44.2% vs 23.7%], and FACIT-Fatigue [42.0% vs 27.0%] were observed in upadacitinib-treated patients versus placebo at Week 4. Improvements in IBDQ response, IBDQ remission, and FACIT-Fatigue were similar or greater at Week 12. Clinically meaningful improvement in overall work impairment [52.1% vs 38.1%, p  ≤ 0.05] was demonstrated at Week 12. Similar results were observed in U-EXCEED. Improvements were sustained through 52 weeks of upadacitinib maintenance treatment. Conclusions In patients with active Crohn's disease, upadacitinib treatment relative to placebo significantly improved fatigue, quality of life, and work productivity as early as Week 4. These effects were sustained through 52 weeks of maintenance. [ABSTRACT FROM AUTHOR]

Pulmonary hypertension (PH) is a rare and severe condition characterized by increased pressure in the pulmonary circulation, often resulting in right ventricular failure and death. The autonomic nervous system (ANS) plays a crucial role in the cardiovascular and pulmonary controls. Dysfunction of ANS has been implicated in the pathogenesis of cardiopulmonary diseases. Conversely, dysfunctions in ANS can arise from these diseases, impacting cardiac and pulmonary autonomic functions and contributing to disease progression. The complex interaction between ANS dysfunction and PH plays a crucial role in the disease progression, making it essential to explore interventions that modulate ANS, such as physical exercise, to improve the treatment and prognosis of patients with PH. This review addresses autonomic dysfunctions found in PH and their implications for the cardiopulmonary system. Furthermore, we discuss how physical exercise, a significant modulator of ANS, may contribute to the prognosis of PH. Drawing from evidence of aerobic and resistance exercise training in patients and experimental models of PH, potential cardiovascular benefits of exercise are presented. Finally, we highlight emerging therapeutic targets and perspectives to better cope with the complex condition. A comprehensive understanding of the interaction between ANS and PH, coupled with targeted physical exercise interventions, may pave the way for innovative therapeutic strategies and significantly improve the treatment and prognosis of vulnerable patients. [ABSTRACT FROM AUTHOR]

To assess the clinical scenarios in which nerve blocks are employed in the context of burning mouth syndrome (BMS). This scoping review followed the PRISMA-ScR. A protocol was generated on Open Science Framework. Electronic searches were performed in the following databases: PubMed, Scopus, EMBASE, Web of Science, LILACS, and Cochrane, in addition to the grey literature and citations from Grémeau-Richard et al. (2010). Nerve blocks were used for treatment purposes in all cases. The mandibular nerve and the stellate ganglion were both blocked in 50% studies, while the maxillary nerve and lingual nerve were blocked in 25% study each. The anesthetics used were lidocaine (50%) and bupivacaine (50%). Relief was generally reported after immediate block, and at a mean follow-up of 4.5 weeks, there was considerable improvement compared to the initial conditions when the mandibular and/or maxillary nerve were targeted. The use of nerve blocks has been employed in the treatment of patients with refractory BMS. Clinical studies with standardized methodology are necessary to validate and understand the potential role of mandibular and maxillary nerve block in this setting. [ABSTRACT FROM AUTHOR]

This study aimed to analyze the scope, nature, and extent of the applicability of terahertz (THz) spectroscopy in dentistry. A scoping review was conducted following the 5-step methodology of Arksey and O'Malley, the PRISMA-ScR checklist, and the Evidence Synthesis Manual of the Joanna Briggs Institute. Electronic literature searches were performed in the PubMed/MEDLINE, Scopus, and Cochrane Library databases, including full-text articles with no specific publication period. The following research question was formulated: "What are the applications of THz spectroscopy in the field of dentistry?" Seventeen laboratory studies were identified, detailing oral and dental applications of THz. In restorative dentistry, 8 investigations sought to identify the properties of human and animal dental tissues and differentiate between healthy and decayed tissue. In oral pathology, 5 articles analyzed the identification of cancer cells in comparison to the identification of these cells in histological or cytological analysis. In biomaterials, 4 papers studied the changes in properties of restorative materials and effects on polymerization. While the potential for early diagnosis using THz spectroscopy in dentistry is evident, our findings underscore its limitations. The studies were exclusively conducted in vitro, emphasizing the need for innovative clinical research using intraoral devices. Bridging this gap is essential to unlock the full potential of this noninvasive technology for early diagnosis and informed clinical decision-making. [ABSTRACT FROM AUTHOR]

Population-based studies suggest an inverse relationship between the dietary share of ultra-processed foods (UPF), as defined by NOVA classification, and the overall dietary nutritional quality. However, few studies have evaluated the impact of ultra-processed foods on the fatty acid profile of the diet. The aim of this study was to assess the association between consumption of UPF and the fatty acids profile of the diet in Portugal. Cross-sectional data from IAN-AF 2015–2016 were used for this study. Food consumption data were collected through two 24-h food recalls, and food items were classified according to the NOVA system. For both adults and elderly, the contents of total fatty acids (TFA), saturated fatty acids (SFA) and trans fatty (TRFA) were higher in the fraction of UPF, compared to the other three NOVA groups, while [monounsaturated fatty acids (MUFA)+, polyunsaturated fatty acids (PUFA)/SFA] ratio was lower. The UPF population attributable fraction (PAF) demonstrated that if the dietary contribution of UPF was reduced to levels observed in the first quintile, statistically significant reductions in the prevalence of inadequate intakes of fatty acids would be observed for adults [TRFA (PAF 98.37%, 95% CI 87.27–99.79) and SFA (PAF 37.26%, 95% CI 25.46–47.19)] and for elderly [TRFA (PAF 94.61%, 95% CI 77.59–98.71) and PUFA (PAF 98.28, 95% CI 48.22–99.94)]. In this study the consumption of UPF was associated with a worse fatty acids profile in the Portuguese diet, adding evidence regarding the negative impact of UPF on diet quality. • The consumption of ultra-processed foods was associated with a worse fatty acids profile in the Portuguese diet. • Reduction in consumption of ultra-processed foods can lead to significant reductions in the inadequate fatty acids intake. • Reducing consumption of ultra-processed foods may represent an important prevention strategy against cardiovascular diseases. [ABSTRACT FROM AUTHOR]

This article presents a new architecture for the surgery scheduling process in hospitals, integrating Artificial Intelligence (AI) and Business Analytics (BA) techniques to optimise information flows and decision-making. The proposed platform has been designed as a modular architecture to monitor key performance indicators such as the number of surgeries scheduled, the percentage of shift occupancy, surgeries scheduled outside of deadlines and the total penalty. The AI algorithms automate the flow of information between surgeries on hold and scheduling dates, but also allow manual adjustments by healthcare professionals, guaranteeing total autonomy in user decision-making throughout the surgical scheduling process. The main aim is to reduce scheduling delays and patients on the waiting list, optimise the use of existing resources and minimise the financial penalties that are increasing every year. Through exhaustive analysis and a rigorous development process, the platform ensures a balance between the automation of processes and the indispensable analysis and human clinical intervention. [ABSTRACT FROM AUTHOR]

The study of avoidable hospitalizations has gained international prominence due to its potential to assess the performance of healthcare systems. In Canada and Spain, these hospitalizations are analyzed through Ambulatory Care Sensitive Conditions (ACSC), indicating situations that could have been pre-vented or treated without hospitalization. In Portugal, this concept is represented by the term ICSCSP, focusing on care provided in Primary Health Care (PHC). The data analysis in this study aims to determine the impact that medical appointments at PHC may have on the number of hospitalizations, namely, to determine whether where the number of medical appointments is greater, the number of hospital stays is lower. During the COVID-19 pandemic in Portugal, many hospitalizations of the elderly were due to the decompensation of chronic diseases, highlighting the importance of access to PHC during health emergencies. Data pre-processing was carried out using the Pandas library in Python, merging two datasets monitoring the evolution of hospitalizations and medical appointments in PHC. Despite some challenges encountered during the analysis, such as population bias in district comparisons and the need to adjust metrics to properly reflect the relationship between appointments and hospital stays, it was concluded that the number of appointments in PHC does not have a direct impact on hospitalizations. For a more accurate analysis, it would be necessary to consider other factors, such as patient and district characteristics, and conduct more targeted studies, especially after disruptive events like the COVID-19 pandemic. This more detailed analysis would allow for a better understanding of the relationship between medical appointments and hospitalizations, contributing to improvements in the healthcare system. [ABSTRACT FROM AUTHOR]

The Healthcare is changing, driven by the adoption of new technologies, including the growth of Artificial Intelligence (AI). Innovations in data management include OpenEHR, an open-source architecture that standardizes and shares Electronic Health Records (EHR). Its ability to structure data for Interoperability and long-term use offers a unique advantage, especially when combined with AI and Business Analytics (BA). Throughout this document, an architecture is introduced, presenting a SWOT analysis comparing with other use cases. The paper highlights its benefits compared to other architectures and how this combination could revolutionize Healthcare in the future. [ABSTRACT FROM AUTHOR]

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Ménière's disease (MD) is a chronic disorder of the inner ear characterized by vertigo, hearing loss, tinnitus, and aural fullness. The pathophysiology of MD involves endolymphatic hydrops, an abnormal accumulation of endolymph fluid, although the exact cause remains unclear, potentially involving genetic, environmental, and autoimmune factors. Recent advancements in magnetic resonance imaging have significantly enhanced diagnostic capabilities. This technique uses gadolinium-based contrast agents to differentiate between endolymph and perilymph. Imaging techniques such as 3-dimensional fluid-attenuated inversion recovery and 3-dimensional-real-inversion recovery sequences are used to classify endolymphatic hydrops into grades based on the severity of dilation in the cochlea and vestibule. The degree of perilymphatic enhancement, indicative of blood-labyrinthine barrier breakdown, further aids in diagnosing MD. Accurate diagnosis relies on distinguishing between perilymphatic and endolymphatic enhancement patterns and recognizing mimicking conditions. [ABSTRACT FROM AUTHOR]

Inspiratory muscle training (IMT) has been used in sports to improve factors that can positively influence sports performance. However, the effects of IMT on athletes with disabilities are less well explored. This study aimed to investigate the effects of IMT on the pulmonary function, respiratory muscle strength, aerobic performance, sports skills, and quality of life (QoL) of wheelchair rugby (WCR) athletes. A pre–post-intervention case series study of IMT was carried out with six WCR athletes. Pulmonary function (spirometry), respiratory muscle strength (manovacuometry), aerobic (cardiopulmonary exercise test) and WCR skills (Beck Battery) performance and QoL (WHOQOL-DIS) were investigated. Participants were submitted to a six-week IMT with a linear load resistor involving 30 dynamic inspiratory maneuvers twice daily for five days/week. Increases in maximum load (+14.6%; p = 0.03), maximum effort time (+19.4%; p = 0.03), absolute and percent of predicted maximal expiratory muscle pressure (both +13.2%; p = 0.04) and absolute and percent of predicted maximal inspiratory muscle pressure (both +28.6%; p = 0.04) were observed. No significant differences were observed for pulmonary function variables, WCR skills performance or QoL. IMT seemed to be effective at improving the respiratory muscle strength and aerobic performance of WCR players but there was no impact on pulmonary function, sports skills or QoL. [ABSTRACT FROM AUTHOR]

BACKGROUND The ISCHEMIA trial (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) demonstrated greater health status benefits with an initial invasive strategy, as compared with a conservative one, for patients with chronic coronary disease and moderate or severe ischemia. Whether these benefits vary globally is important to understand to support global adoption of the results. METHODS: We analyzed participants' disease-specific health status using the validated 7-item Seattle Angina Questionnaire (SAQ: >5-point differences are clinically important) at baseline and over 1-year follow-up across 37 countries in 6 international regions. The average effect of initial invasive versus conservative strategies on 1-year SAQ scores was estimated using Bayesian proportional odds regression and compared across regions. RESULTS: Considerable regional variation in baseline health status was observed among 4617 participants (mean age=64.4±9.5 years, 24% women), with the mean SAQ summary scores of 67.4±19.5 in Eastern Europe participants (17% of the total), 71.4±15.4 in Asia-Pacific (18%), 74.9±16.7 in Central and South America (10%), 75.5±19.5 in Western Europe (26%), and 78.6±19.2 in North America (28%). One-year improvements in SAQ scores were greater in regions with lower baseline scores with initial invasive management (17.7±20.9 in Eastern Europe and 11.4±19.3 in North America), but similar in the conservative arm. Adjusting for baseline SAQ scores, similar health status benefits of an initial invasive strategy on 1-year SAQ scores were observed (ranging from 2.38 points [95% CI, 0.04-4.50] in North America to 4.66 points [95% CI, 2.46-6.94] in Eastern Europe), with an 88.3% probability that the difference in benefit across regions was <5 points. CONCLUSIONS: In patients with chronic coronary disease and moderate or severe ischemia, initial invasive management was associated with a consistent health status benefit across regions, with modest regional variability, supporting the international generalizability of health status benefits from invasive management of chronic coronary disease. [ABSTRACT FROM AUTHOR]

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INTRODUCTION: Multi‐omics studies in Alzheimer's disease (AD) revealed many potential disease pathways and therapeutic targets. Despite their promise of precision medicine, these studies lacked Black Americans (BA) and Latin Americans (LA), who are disproportionately affected by AD. METHODS: To bridge this gap, Accelerating Medicines Partnership in Alzheimer's Disease (AMP‐AD) expanded brain multi‐omics profiling to multi‐ethnic donors. RESULTS: We generated multi‐omics data and curated and harmonized phenotypic data from BA (n = 306), LA (n = 326), or BA and LA (n = 4) brain donors plus non‐Hispanic White (n = 252) and other (n = 20) ethnic groups, to establish a foundational dataset enriched for BA and LA participants. This study describes the data available to the research community, including transcriptome from three brain regions, whole genome sequence, and proteome measures. DISCUSSION: The inclusion of traditionally underrepresented groups in multi‐omics studies is essential to discovering the full spectrum of precision medicine targets that will be pertinent to all populations affected with AD. Highlights: Accelerating Medicines Partnership in Alzheimer's Disease Diversity Initiative led brain tissue profiling in multi‐ethnic populations.Brain multi‐omics data is generated from Black American, Latin American, and non‐Hispanic White donors.RNA, whole genome sequencing and tandem mass tag proteomicsis completed and shared.Multiple brain regions including caudate, temporal and dorsolateral prefrontal cortex were profiled. [ABSTRACT FROM AUTHOR]

To assess the effect of combinations of two different endodontic sealers used in initial and endodontic retreatment on the bond strength of the secondary obturation and the penetrability of the sealers. Forty-eight mandibular premolars were used, receiving standardized endodontic access and biomechanical preparation. Twenty-four teeth received AH Plus sealer (AHP) in primary obturation and the others received Bio-C Sealer (BCS). Retreatment protocol was performed with an R50 instrument. The samples were further subdivided into four groups (n = 12) based on the combination of primary/secondary obturation sealers: AHP/AHP; AHP/BCS; BCS/AHP; and BCS/BCS. Four samples from each subgroup received the addition of fluorophores to the sealer for penetrability analysis using laser scanning confocal fluorescence microscopy. The root portion on the 8 push-out samples was sectioned into 6 slices of 1.0 mm. Bond strength (BS) was assessed using a universal testing machine until displacement of the filling mass. Failure pattern was evaluated under a stereomicroscope (20× magnification). BS data were analyzed using two-way analysis of variance followed by Tukey's test (P <.05), and the association between the failure pattern and BS value was assessed using the chi-square test (P <.05). Penetrability was qualitatively evaluated. The highest BS values were observed in the AHP/AHP (4.54 ± 1.5 MPa) and BCS/AHP (5.00 ± 1.0 MPa) groups (P <.05), with a higher percentage of adhesive failures to the filling material for all groups. Laser scanning confocal fluorescence microscopy images indicated greater penetrability of AHP compared to BCS, both in initial treatment and retreatment. AHP sealer exhibited higher BS and greater penetrability compared to BCS sealer. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the volume of dentin removal and the volume of remnants of restorative material after the removal of an esthetic restorative coronal set and cervical barrier in endodontically treated mandibular molars with the aid of different magnification methods using 3-dimensional (3D) micro–computed tomographic (micro-CT) morphometric analysis. A sample of 30 mandibular first molars (N = 30) was used. All teeth were endodontically treated, and the specimens were initially scanned using micro-CT imaging and reconstructed. The molars were filled by a single-cone technique, and immediately the material at the initial 2-mm cervical level was removed. Cervical barriers were confected using ionomer glass cement with fluorescein 0.1%, filling the 2 mm at the cervical level of the canals and an additional 2 mm as the base. The coronal restoration set was performed using esthetic resin composites. A simulated tooth aging process was performed with 20,000 thermocycling cycles. The sample was distributed into the following 3 groups (n = 10) for the removal of the restoration set and cervical barrier with diamond burs based on the magnification aid: no magnification aid (naked eye), operative microscope aid, and REVEAL device (Design for Vision Inc, Bohemia, NY) aid. After removal, the final 3D micro-CT scanning and reconstruction were conducted with the same parameters as the initial scanning, and superposition of the final and initial scanning was performed. Morphometric analysis was conducted using CTAn software (Bruker microCT, Kontich, Belgium) to assess the volume of remnant restorative material (mm³), the volume of dentin removal (mm³), and the direction and site of dentin removal. Data were analyzed using 1-Way analysis of variance (P <.05). The REVEAL group showed better results regarding the volume of remnant material (3.17 ± 1.65) and the percentage of dentin removal (2.56 ± 1.34). The microscope group showed no statistical difference compared with the REVEAL group regarding dentin removal (3.30 ± 1.48) and was statistically similar to the naked eye group in the volume of remnant material (9.63 ± 4.33). The naked eye group showed the worst results for the volume of remnant material (7.60 ± 2.68) and the percentage of dentin removal (6.60 ± 3.70). The use of fluorescence associated with magnification was the method that presented the best results, with lower percentages of dentin removal and smaller volumes of remaining restorative material. This is an innovative technology in endodontics that shows potential to overcome the challenge of reaccessing root canals in the context of endodontic retreatment. [ABSTRACT FROM AUTHOR]

Cooperative learning is a pedagogical practice widely endorsed in the literature to enhance students' creative writing skills. This methodology promotes the development of originality, fosters openness to new ideas, provides opportunities for interaction and tossing ideas around, and subsequently contributes to boosting creative textual production. This study aims to assess the impact of incorporating cooperative learning strategies on developing creative writing skills and enhancing self-efficacy among 6th-grade students. Additionally, this study reflects on using cooperative learning methods in the classroom setting, namely the roundtable and the cooperative graffiti. The participants were 34 students from two classes of the 6th grade of the 2nd cycle of basic school: an experimental group, where cooperative learning applies, and a control group, conducted using a traditional lecture. The study used a quasi-experimental design, incorporating pre-test and post-test. The non-parametric Wilcoxon signed-rank test was used to assess within-group changes in pre-test and post-test scores for both the experimental and control groups. The findings from both classes suggest that cooperative learning is more effective than a traditional lecture in building creative writing skills and selfefficacy in Portuguese (first language) and maths. [ABSTRACT FROM AUTHOR]