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To provide an evidence-based resource for paleopathologists to consider multiple skeletal indicators of pathology associated with early tooth loss in children to aid in diagnosis. Three databases (Cochrane Library, MedLine, and Scopus) were used for a review. According to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria, a systematic review guideline, 85 articles were selected. A total of 189 children had a syndrome or disease associated with early tooth loss. Our review, based on 25 diseases, lists the bone and dental lesions observable in archeological remains. Based on a review of the literature, a synthesis of 25 diseases and syndromes that may be associated with premature loss of permanent or deciduous teeth in children was developed for paleopathologists. It highlights the importance of a thorough dental examination by paleopathologists to further assess past health conditions. This paper provides an extensive resource addressing early tooth loss in childhood to assist researchers with differential diagnosis. The articles included in this review are case reports based on living populations. Further studies into diseases and their association with early tooth loss would complement this work, as would utilizing the differential diagnoses on archeological individuals to clarify its value and limitations. [ABSTRACT FROM AUTHOR]

The objective of this study was to analyse an individual whose remains are characterised by early deciduous tooth loss and multi-focal lesions on the post-cranial skeleton. Skeletal remains of an immature individual buried between 1770 and 1849 in London. The remains were examined by visual macroscopic inspection, supplemented by radiographic examination of the mandible and maxillae. A differential diagnosis with possible conditions, frequent in this archaeological context, was conducted. A comprehensive examination of dental lesions was performed to investigate the aetiologies of deciduous tooth loss. The individual exhibited a mosaic of skeletal and dental pathological changes, including premature loss of deciduous dentition, premature eruption of permanent teeth generalised bone loss in both the mandible and maxilla; osteomyelitis of the left radius; osteolytic lesion on the body of the second lumbar vertebra, and marked expansions of the rib shafts due to sub-periosteal new bone formation. A differential diagnosis considered indicates that the pathological changes of the individual were most likely associated with a comorbidity involving hypophosphatasia and tuberculosis. We present in this study several oral signs that could alert paleopathologists and bioarcheologists to systematically consider the potential of a condition that is rarely encountered in archaeological contexts. Due to poor preservation, this study was confined to the analysis of a partial maxilla and mandible, a left radius shaft and the axial skeleton (rib heads and vertebrae) of the individual. Further radiographic, histological and genetic analyses would confirm the diagnosis. [ABSTRACT FROM AUTHOR]

Although PBL is widely used in several countries, especially in medicine courses, its application in teaching other higher education courses, which involve fundamentals applied to radiology, is still little explored. Therefore, we aim to evaluate the implementation of Problem-Based Learning (PBL) in a higher education institution's radiology and biomedicine technologist course, focusing on specific radiology-related disciplines. An interventional study was developed with 78 students. An active methodology model was created and implemented for one of the groups of participants. At the beginning of each semester, students of both groups were evaluated with pre-tests. At the end of the semesters, the students performed a post-test and a validated evaluation of the discipline methodology. Repeated measures generalized linear regressive models with robust error estimators were used to evaluate test outcomes. A significant interaction among the methodologies was found (p=0.020), with better results from students exposed to the active methodology (initial and final grades were 7.18 and 7.57 in the active methodology, respectively, and 7.45 and 6.89 in the traditional methodology, respectively). In addition, students' evaluation regarding the quality of the methodology was favorable to the active methodology with statistical significance (p<0.05) in 16 of the 22 items evaluated. The students' positive response and performance were attributed to the interaction and innovation of the methodology compared to conventional methods, highlighting the effectiveness of PBL in higher education in radiology and its potential for more participatory and contextualized learning. [ABSTRACT FROM AUTHOR]

• Meta-analysis involving 390 patients across 18 studies examined the efficacy of simultaneous biopsy and ETV techniques. • Our analysis found that 92% of patients achieved overall good clinical outcomes, with children exhibiting a remarkable 100% success rate. Moreover, adults demonstrated an 84% biopsy success rate. • In terms of complications, the study indicated minimal risks in adults, with a reported rate of 0%. Furthermore, the overall requirement for shunting post-procedure was relatively low, standing at 8%. • The research underscores the importance of individualized treatment approaches, showcasing the viability, safety, and effectiveness of the technique. Due to their delicate and deep-seated location, tumors in the pineal region of the brain pose exceptional challenges in neurosurgical management. Highly precise procedures have become crucial to address these complexities, such as the simultaneous performance of biopsy and endoscopic third ventriculostomy (ETV). Our aim was to assess the feasibility, safety, and efficacy of simultaneous biopsy and ETV for treating patients with pineal region tumors. Medline, Embase, and Web of Science were searched for English studies from January 2000 to February 2024, following Cochrane and PRISMA guidelines. Eligible studies encompassed a minimum of four patients and examined at least one of the following outcomes: good clinical outcomes and the necessity of shunt placement. Single proportion analysis with 95% confidence intervals was conducted under a random-effects model, employing the I2 statistic to assess heterogeneity. Additionally, publication bias was evaluated using the ROBINS-I tool. After a meticulous selection process, eighteen studies involving 390 patients were included in the analysis. Overall, good clinical outcomes were observed in 131 out of 147 patients, representing a rate of 92 % (95 % CI: 84 % to 100 %, I2 = 62 %) through random effects analysis. Subgroup analysis showed that children exhibited a notably high rate of good clinical outcomes, reaching 100 % (95 % CI: 96 % to 100 %, I2 = 0 %). Regarding the need for shunt placement, out of the 356 patients assessed, only 39 required shunt placement, yielding a rate of 8 % (95 % CI: 4 % to 12 %, I2 = 63 %). Further sub-analyses indicated shunt requirement rates of 12 % for children and 3 % for adults. Specifically focusing on adults, data from 46 patients who underwent biopsy revealed a success rate of 84 % (95 % CI: 62 % to 100 %, I2 = 81 %). Remarkably, no major complications were reported among adults, resulting in a rate of 0 % (95 % CI: 0 % to 6 %, I2 = 0 %). Additionally, low rates of mortality related to the procedure were observed in adults, with two deaths recorded among the 46 patients analyzed, resulting in a mortality rate of 1 % (95 % CI: 0 % to 7 %, I2 = 0 %). In conclusion, our study aimed to assess the feasibility, safety, and efficacy of performing simultaneous biopsy and ETV for patients with pineal region tumors. We meticulously examined clinical aspects and patient outcomes, including good clinical outcomes, the requirement for shunt placement after ETV, biopsy success rates, mortality, and complications. [ABSTRACT FROM AUTHOR]

Intraoral scanners commonly used in orthodontic offices now offer near-infrared imaging (NIRI) technology, advertised as a screening tool to identify interproximal caries. This study aimed to evaluate the reliability and validity of NIRI detection of interproximal carious lesions in a common intraoral scanner (iTero Element 5D; Align Technology, San Jose, Calif) with and without bitewing radiograph complement, compared with a microcomputed tomography (micro-CT) reference standard. Extracted human posterior teeth (premolars and molars) were selected for early (noncavitated) interproximal carious lesions (n = 39) and sound control surfaces (n = 47). The teeth were scanned via micro-CT for evaluation by 2 blinded evaluators using consensus scoring. The teeth were mounted to simulate anatomic interproximal contacts and underwent a NIRI scan using iTero Element 5D and bitewing radiographs. Two trained, calibrated examiners independently evaluated (1) near-infrared images alone with clinical photograph, (2) bitewing radiograph alone with clinical photograph, and (3) near-infrared images with bitewing radiograph and clinical photograph in combination, after at least a 10-day washout period between each evaluation. Interrater reliability was highest for NIRI alone (k = 0.533) compared with bitewing radiograph alone (k = 0.176) or in combination (k = 0.256). NIRI alone showed high specificity (0.83-0.96) and moderate sensitivity (0.42-0.63) compared with a micro-CT reference standard. Dentin lesions were significantly more reliably detected than enamel lesions. After rigorous training and calibration, NIRI can be used with moderate reliability, high specificity, and moderate sensitivity to detect noncavitated interproximal carious lesions. • Evaluate near-infrared imaging interproximal caries detection in iTero 5D scanner (Align Technology, San Jose, Calif). • In vitro models allow for anatomic simulation and microcomputed tomography reference standards. • We compared near-infrared imaging and bitewing radiographs alone and in combination. • Near-infrared imaging had the highest reliability, high specificity, and moderate sensitivity. [ABSTRACT FROM AUTHOR]

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Implant-supported single crowns are more prone to screw loosening than splinted prostheses. Therefore, the locking taper system, which has a screwless abutment, may perform better when associated with this type of rehabilitation. However, systematic reviews on this system are lacking. The purpose of this systematic review was to evaluate the clinical performance and complications of single crowns retained by the locking taper system. This systematic review was registered at the International Prospective Register of Systematic Reviews (PROSPERO) under CRD42020189921. An electronic search was made in 5 databases and 3 other sources up to February 2021 to select prospective clinical studies evaluating the performance of single crowns retained by the locking taper system by using the outcomes implant survival, success rate, complications, marginal bone loss (MBL), and prosthesis success rate. Four meta-analyses grouped according to the follow-up intervals were performed. The risk of bias of the selected studies was evaluated by using the RoB 2 checklist for randomized controlled trials (RCTs) and Downs and Black for uncontrolled studies. Twelve studies were included: 9 prospective cohort studies and 3 RCTs. A survival rate of 99% (98% to 99%) and a success rate of 97% (92% to 99%) after 5 years were found. Of the total, 2.6% biological and 2.9% prosthetic complications were described. The prosthesis success rate was 97% (96% to 98%) after 5 years. An average of −0.73 mm (−0.93 to −0.52) was found for the MBL after 5 years. The risk-of-bias assessment showed 2 RCTs with high risk and 1 RCT with low risk of bias. Among uncontrolled studies, 2 were classified as poor and 7 as fair. Single crowns retained by locking taper implants can be safely indicated based on the high survival and success rates achieved in the long term, the maintenance of bone level stability over time, and the low incidence of complications. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) in positron emission tomography/computed tomography (PET/CT) can be used to improve image quality when it is useful to reduce the injected activity or the acquisition time. Particular attention must be paid to ensure that users adopt this technological innovation when outcomes can be improved by its use. The aim of this study was to identify the aspects that need to be analysed and discussed to implement an AI denoising PET/CT algorithm in clinical practice, based on the representations of Nuclear Medicine Technologists (NMT) from Western-Switzerland, highlighting the barriers and facilitators associated. Two focus groups were organised in June and September 2023, involving ten voluntary participants recruited from all types of medical imaging departments, forming a diverse sample of NMT. The interview guide followed the first stage of the revised model of Ottawa of Research Use. A content analysis was performed following the three-stage approach described by Wanlin. Ethics cleared the study. Clinical practice, workload, knowledge and resources were de 4 themes identified as necessary to be thought before implementing an AI denoising PET/CT algorithm by ten NMT participants (aged 31–60), not familiar with this AI tool. The main barriers to implement this algorithm included workflow challenges, resistance from professionals and lack of education; while the main facilitators were explanations and the availability of support to ask questions such as a "local champion". To implement a denoising algorithm in PET/CT, several aspects of clinical practice need to be thought to reduce the barriers to its implementation such as the procedures, the workload and the available resources. Participants emphasised also the importance of clear explanations, education, and support for successful implementation. To facilitate the implementation of AI tools in clinical practice, it is important to identify the barriers and propose strategies that can mitigate it. [ABSTRACT FROM AUTHOR]

A systematic review with meta-analysis was conducted to define the incidence of osteoradionecrosis (ORN) in patients with oral cavity cancer (OCC) treated with intensity-modulated radiotherapy (IMRT), and to identify the risk factors influencing its development. Six databases were searched systematically. A meta-analysis was performed to determine overall, spontaneous, and dental extraction-attributed incidences of ORN. The Grading of Recommendations Assessment, Development, and Evaluation tool evaluated evidence certainty. Out of 11 eligible studies, 6 underwent meta-analysis for the overall aggregated ORN incidence in OCC patients receiving IMRT, resulting in an incidence rate of 8% (95% CI: 6%-11%). Regarding development reasons, 2 studies were assessed, revealing an incidence of 36% (95% CI: 1%-98%) for spontaneous ORN, and 17% (95% CI: 5%-44%) ensued from dental extraction exclusively pre-RT. All rates had very low certainty of evidence. Factors significantly correlated with ORN development included postoperative RT use (78%), employment of therapeutic doses above 50 Gy, and mandibular involvement (80.5%). The findings suggest that IMRT alone is not sufficient to decrease ORN rates in OCC patients, underscoring the importance of precisely identifying the involved risk factors. However, further detailed primary studies will be necessary. [ABSTRACT FROM AUTHOR]

This bibliometric review analyzed the research trends and main characteristics of articles related to Electronic Apex Locators (EALs). The search was conducted in November 2023 on the Web of Science Core Collection. Narrative and systematic reviews, observational and intervention studies, laboratory, and clinical studies were included. Two researchers selected the articles and extracted the number of citations, year of publication, journal, study design, theme, country, continent, institutions, author, and keywords. Collaborative networks were generated using the VOSviewer software. The relationship between data were determined by Spearman's correlation. The search resulted in 374 articles, of which 294 were included. Most cited article had 175 citations. The most prevalent journal was the Journal of Endodontics (n = 84). The predominant study design was the laboratory-based (n = 223). The predominant theme was the EALs accuracy (n = 175). Piasecki L was the author with the highest number of articles (n = 11). Only 8.16% of the studies were conducted in deciduous teeth. The country with the most studies was Brazil (n = 46). Asia (n = 107) was the continent with the highest number of publications. There was a weak positive correlation between the number of citations and impact factor (rho =.294), and a strong negative correlation between citations and year of publication (rho = −.710). The majority of articles were laboratory-based studies conducted on permanent teeth, focusing on the accuracy of EALs. Future studies should prioritize research on deciduous teeth, systematic reviews, and, notably, clinical trials. [ABSTRACT FROM AUTHOR]

Chronic venous disease (CVD) is a highly prevalent disease that presents a wide spectrum of clinical expressions due to abnormalities in the venous system. Patients often have major functional changes that can limit daily activities. However, the functional factors associated with the severity of the disease remain poorly understood. To identify the functional factors associated with CVD severity. Seventy-five patients with CVD (92.0% females, 49.6 ± 13.3 years) were evaluated through clinical examination, lower limb perimetry, ankle range of motion (AROM), and lower limb muscle strength by the Heel Rise test, and Sit-to-stand test. Patients were stratified according to the disease severity as mild (telangiectasia, varicose veins, or edema in the lower limbs) or severe CVD (trophic changes or venous ulcer). Patients with severe CVD (n = 13) were older (p = 0.002), predominantly male (p = 0.007), with reduced AROM in dorsiflexion (p = 0.028) and inversion (p = 0.009), reduced lower limb strength by the Heel Rise test (p = 0.040), and greater circumference of the calf (p = 0.020), ankle (p = 0.003), and plantar arch (p = 0.041) when compared to mild CVD (n = 62). Advanced age, male sex, lower ankle range of motion in dorsiflexion, and greater ankle and plantar arch circumferences were associated with CVD severity. However, the ankle circumference (OR 1.258, 95% CI: 1.008–1.570; p = 0.042), together with advanced age and male sex, was the only functional variable that remained independently associated with CVD severity. The increased ankle circumference was a determinant of the CVD severity and may assist in risk stratification and guide treatment goals in this population. [ABSTRACT FROM AUTHOR]

To evaluate the effect of eight weeks of combined physical exercise of moderate intensity on inflammatory markers, as well as its relationship with body composition in young women recently admitted to a Public Institution of Higher Education. Longitudinal, intervention study, in which 59 female participants aged 18–25 years were evaluated before and after a combined physical exercise program for eight weeks. Blood samples were collected before and after the intervention for analysis of C-reactive protein and inflammatory cytokines. Weight and height were measured to calculate body mass index and body composition was evaluated by Dual Energy X-Ray Absorptiometry before and after the intervention. Statistical analyzes performed were t -test, Willcoxon test and Spearman's correlation. This study was approved by the Human Research Ethics Committee and the Free and Informed Consent Form was signed by all participants. After the intervention, there was a reduction in the pro-inflammatory cytokines (IL-1β, IL-6, TNF and IL-12), while the anti-inflammatory (IL-10) and CRP did not change; reduction in the total body gynoid fat mass and in the percentage of body fat; increased trunk and total muscle mass. Body composition was negatively correlated with the pro-inflammatory interleukins IL-1β and IL-6 and positively correlated with CRP. Combined physical exercise for eight weeks acted to reduce pro-inflammatory cytokines, fat mass and increase in muscle mass. Inflammatory markers correlated with body fat before the intervention, suggesting the participation of visceral adipose tissue in the release of these markers in female university students. [ABSTRACT FROM AUTHOR]

This systematic review aimed to determine which interventions increase physical activity (PA) and decrease sedentary behavior (SB) based on objective measures of movement behavior in individuals with stroke. The PubMed (Medline), EMBASE, Scopus, CINAHL (EBSCO), and Web of Science databases were searched for articles published up to January 3, 2023. The StArt 3.0.3 BETA software was used to screen titles, abstracts, and full texts for studies with randomized controlled trial designs; individuals with stroke (≥18 years of age); interventions aimed at increasing PA or decreasing SB; and objective measurement instruments. Data extraction was standardized, considering participants and assessments of interest. The risk of bias and quality of evidence of the included studies were assessed. Twenty-eight studies involving 1855 patients were included. Meta-analyses revealed that in the post-stroke acute/subacute phase, exercise interventions combined with behavior change techniques (BCTs) increased both daily steps (standardized mean difference [SMD]=0.65, P =.0002) and time spent on moderate-to-vigorous intensity physical activities (MVPAs) duration of PA (SMD=0.68, P =.0004) with moderate-quality evidence. In addition, interventions based only on BCTs increased PA levels with very low-quality evidence (SMD (low-intensity physical activity)=0.36, P =.02; SMD (MVPA)=0.56, P =.0004) and decreased SB with low-quality evidence (SMD=0.48, P =.03). In the post-stroke chronic phase, there is statistical significance in favor of exercise-only interventions in PA frequency (steps/day) with moderate-quality evidence (SMD=0.68, P =.002). In general, the risk of bias in the included studies was low. In the acute/subacute phase after stroke, the use of BCTs combined with exercise can increase the number of daily steps and time spent on MVPA. In contrast, in the post-stroke chronic phase, exercise-only interventions resulted in a significant increase in daily steps. [ABSTRACT FROM AUTHOR]

This study aimed to analyze the knowledge of dental surgeons concerning the pharmacological effects of bisphosphonates (BP) and their impact on the health of patients undergoing oral surgery treatment. A quantitative study was conducted with professionals in the Cariri region of Ceará, Brazil. The data were collected using a semi-structured questionnaire to interview the dental surgeons who met the inclusion criteria. The data were analyzed by Chi-square and Fischer's Exact tests using the SPSS program version 22.0. The results indicated that most interviewed subjects have no experience with the dental treatment of individuals under treatment with bisphosphonates. When a sample of the medication was presented, a significant number of the participants (65.3%) did not recognize the drug. Among those who recognized it, 66.5% did not know how to treat bisphosphonate-using patients in the clinical routine. However, 95.1% of the professionals who recognized the need to discontinue these drugs admitted contacting the prescriber to establish the best dental conduct. Our results also showed that recently graduated professionals better understood the need to stop BP use before invasive treatment, although they did not know the protocol. In conclusion, a better knowledge of the pharmacological effects of BP is crucial for conducting adequate anamnesis, requesting additional tests, and performing medical monitoring, which has a significant impact on the clinical practice of dental surgeons. [ABSTRACT FROM AUTHOR]

Purpose: To carry out a systematic review to determine the main methods used to study the heart rate variability (HRV) in individuals after the acute phase of COVID-19. Methods : The study followed the Preferred Items for Reporting for Systematic Reviews and Meta-Analyses (PRISMA) statement. PubMed, Web of Science, Scopus and CINAHAL electronic databases were searched from the inception to November 2022. The studies were included if they used HRV assessment based on linear and non-linear methods in long-term COVID-19 patients. Review studies, theses and dissertations, conference abstracts, longitudinal studies, studies conducted on animals and studies that included individuals in the acute phase of the COVID-19 were excluded. The methodological quality of the studies was analyzed using the Joanna Briggs Institute's critical evaluation checklist for cross-sectional analytical studies. Results : HRV was mainly assessed using 24-h Holter monitoring in 41.6% (5/12) of the studies, and 12‑lead ECG was used in 33.3% (4/12). Regarding the type of assessment, 66.6% (8/12) of the studies only used linear analysis, where 25% (3/12) used analysis in the time domain, and 41.6% (5/12) used both types. Non-linear methods were combined with the previously cited linear method in 25% (3/12) of the studies. Moreover, 50% (6/12) of the studies demonstrated post-COVID-19 autonomic dysfunction, with an increase in the predominance of cardiac sympathetic modulation. The average score of the evaluation checklist was 6.6, characterized as having reasonable methodological quality. Conclusion : 24-h Holter and 12‑lead ECG are considered effective tools to assess HRV in post-COVID-19 patients. Furthermore, the findings reveal diverse effects of COVID-19 on the autonomic nervous system's sympathovagal balance, which might be influenced by secondary factors such as disease severity, patients' overall health, evaluation timing, post-infection complications, ventilatory functions, and age. [ABSTRACT FROM AUTHOR]

To verify if assessment of the danger zone (DZ) in the mesial root of mandibular molars is affected by field of view (FOV) and voxel sizes in cone beam computed tomography (CBCT) scans. Forty mandibular molars were scanned by micro-computed tomography, creating the reference standard. The teeth were then submitted for CBCT scans with FOVs of 10 × 5.5 cm and 5 × 5.5 cm and voxel sizes of 0.4, 0.2, 0.15, and 0.075 mm3. The smallest dentin thickness in the DZ from the mesiobuccal and mesiolingual canals was measured at 2, 4, and 6 mm apical to the root furcation. Descriptive statistics, paired t-tests, and intraclass correlation coefficients were used for statistical analysis with significance established at P <.05. All CBCT measurements overestimated the DZ dentin thickness (P <.001) compared to the reference standard. The greatest overestimation occurred in the 5 × 5.5 cm FOV with 0.4 mm3 voxels (P =.007). Dentin thickness measured with the 5 × 5.5 cm FOV and 0.075 mm3 voxels was significantly smaller and produced the best ICC value with the reference standard (0.936). CBCT overestimates the dentin thickness of the DZ regardless of FOV and voxel sizes. The 5 × 5.5 cm FOV showed the best performance with the 0.075 mm3 voxel size, but it performed poorly with 0.4 mm3 voxels. [ABSTRACT FROM AUTHOR]

• What is the primary question addressed by this study? This study explores the association between chronic BZD use and FDG-PET brain metabolism in the MEMENTO clinical cohort of nondemented older adults with isolated memory complaint or mild cognitive impairment. • What is the main finding of this study? The authors found that brain metabolism was significantly greater in chronic BZD users compared to non-users in the whole brain and in the right amygdala, independent of potential confounders. • What is the meaning of the finding? Chronic BZD use may induce a compensatory mechanism which consists in a global metabolism upregulation in the brain, with a specific focus on the right amygdala as a specific target for BZD action. We sought to examine the association between chronic Benzodiazepine (BZD) use and brain metabolism obtained from 2-deoxy-2-fluoro-D-glucose (FDG) positron emission tomography (PET) in the MEMENTO clinical cohort of nondemented older adults with an isolated memory complaint or mild cognitive impairment at baseline. Our analysis focused on 3 levels: (1) the global mean brain standardized uptake value (SUVR), (2) the Alzheimer's disease (AD)-specific regions of interest (ROIs), and (3) the ratio of total SUVR on the brain and different anatomical ROIs. Cerebral metabolism was obtained from 2-deoxy-2-fluoro-D-glucose-FDG-PET and compared between chronic BZD users and nonusers using multiple linear regressions adjusted for age, sex, education, APOE ε 4 copy number, cognitive and neuropsychiatric assessments, history of major depressive episodes and antidepressant use. We found that the SUVR was significantly higher in chronic BZD users (n = 192) than in nonusers (n = 1,122) in the whole brain (beta = 0.03; p = 0.038) and in the right amygdala (beta = 0.32; p = 0.012). Trends were observed for the half-lives of BZDs (short- and long-acting BZDs) (p = 0.051) and Z-drug hypnotic treatments (p = 0.060) on the SUVR of the right amygdala. We found no significant association in the other ROIs. Our study is the first to find a greater global metabolism in chronic BZD users and a specific greater metabolism in the right amygdala. Because the acute administration of BZDs tends to reduce brain metabolism, these findings may correspond to a compensatory mechanism while the brain adapts with global metabolism upregulation, with a specific focus on the right amygdala. [ABSTRACT FROM AUTHOR]

Curcuma zedoaria , commonly known as zedoary, is a plant from the Zingiberaceae family, native to India. It is currently cultivated in Brazil and countries in South and Southwest Asia. This study evaluated the bioinsecticidal potential of the essential oil (EO) obtained from C. zedoaria (Zingiberaceae) rhizomes. The EO was obtained by hydrodistillation (3 h) and identified by GC/FID/MS. In vitro toxicity of C. zedoaria essential oil was evaluated against C. felis felis and Saccharomyces cerevisiae model, and the acetylcholinesterase mechanism was analyzed. The yield was 0.15%, and the three main chemical constituents found were 1,8-cineole (24.11%), camphor (12.13%), and curzerenone (9.68%). In the bioassays of the reproductive stages of C. felis felis in contact with different concentrations of the essential oil, the impregnation method on filter paper was employed. The results showed that adult fleas exhibited 100 % mortality starting from the concentration of 800 μg.cm−2 at 24 h and 48 h, differing from the pupal stages with 94.23 % mortality at the concentration of 396 μg.cm−2, larvae with 100% mortality at the concentration of 117.5 μg.cm−2 at 24 h and 48 h, and eggs with 98% mortality at the concentration of 396 μg.cm−2. Regarding the inhibitory action of C. zedoaria EO on the acetylcholinesterase enzyme, as verified through the modified Ellman method, a decrease of approximately 20% in the enzymatic activity was observed even at the highest concentration (0.5 mg.mL−1) of C. zedoaria essential oil. In toxicity assays using the yeast S. cerevisiae as a eukaryotic model, it was observed that C. zedoaria EO exhibited toxicity, as the assay resulted in mitochondrial damage, thus impairing cellular development. Further studies are required, as despite showing bioinsecticidal potential against different developmental stages of the flea C. felis felis, the EO proved to be toxic in the assays conducted with the yeast S. cerevisiae. [Display omitted] • Biocontrol of fleas using essential oil. • Essential oil and pulicidal agents. • Brazilian plants as insecticidal. [ABSTRACT FROM AUTHOR]

An increase in the workload and use of personal protective equipment by healthcare workers was observed during the COVID-19 pandemic. Due to the connections between craniocervical structures, symptoms such as neck pain and temporomandibular symptoms could be influenced by the use of PPE. To assess the prevalence of craniocervical pain, sleep quality, physical activity, and depressive symptoms and relationship among craniocervical symptoms in healthcare workers before and during the COVID-19 pandemic in Brazil. Cross-sectional study. Healthcare workers. An online questionnaire included a self-report of craniocervical pain intensity [orofacial pain, neck pain, and headache (Numerical Rating Scale)], sleep quality (Pittsburgh Sleep Quality Index), depressive symptoms (Patient Health Questionnaire two items) and physical activity (self-report). The sample analysis was performed by descriptive statistics, the paired t-test was used to compare symptoms intensity before and during the pandemic. The relationship between dependent and independent samples was assessed through McNemar test, Pearson's chi-squared test, and Student's independent t-test. A value of p <.05 was adopted as statistical significance. Overall, 147 participants replied the questionnaires. Headache, neck pain, and orofacial pain complaints increased during the pandemic in healthcare workers (p < 0.001). Craniocervical pain was correlated with poor sleep quality, probable depression, and physical activity during the pandemic (p < 0.05). Healthcare workers self-reported more craniocervical pain during the COVID-19 pandemic compared to before the pandemic. In addition, poor sleep quality, depressive symptoms, and physical inactivity were associated with craniocervical symptoms during this period. [ABSTRACT FROM AUTHOR]

To investigate muscle strength and the prevalence of muscle weakness in adults with interstitial lung diseases (ILDs) compared to healthy subjects. Cross-sectional (description of clinical features). Public referral center (University Hospital). One hundred and twelve adults with ILD (n=48, 60±10yr, 68% female) and healthy counterparts (control group, n=64, 57±10yr, 58% female) (N=112). Not applicable. Muscle strength and prevalence of muscle weakness in adults with ILD. Muscle strength was assessed via maximal isometric voluntary contraction of dominant upper and lower limb muscle groups. Data from the control group were used to generate reference equations. Muscle weakness was defined as a muscle strength value below the lower limit of normal calculated using data from the control group. Data were expressed as mean ± SD or median [interquartile range] according to the data distribution. Compared to the control group, adults with ILD had lower muscle strength for all muscle groups assessed (values presented as %predicted: pectoralis major 75[57-86]%; quadriceps 72[58-87]%; latissimus dorsi 76[57-103]%; deltoid 74[64-98]%; biceps brachii 78[64-91]%; triceps brachii 84[62-101]%; P ≤.001 for all). Prevalence of muscle weakness in people with ILD was 40% for pectoralis major, 25% for latissimus dorsi, 16% for triceps brachii, 20% for biceps brachii, 27% for deltoid and 46% for quadriceps. Adults with ILD present a generalised reduction in peripheral Muscle strength, ranging between 20% to 46% of people depending on the muscle group assessed. and it was more prevalent in lower limb muscles. [ABSTRACT FROM AUTHOR]

This prospective study evaluated the effects of the metal-free crowns on the periodontal tissues of abutment teeth during a 12-month follow-up. A sample of 24 patients (N = 32 abutment teeth) who needed a single-tooth restoration were enrolled to receive either a metal-ceramic (n = 21) or lithium disilicate (n = 11). The single-unit crowns were evaluated at baseline, 3-and 12-month follow-up. The periodontal parameters were evaluated: plaque index (PI), gingival bleeding index (GBI), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL), radiographically and clinical crown fitting, bone resorption, and marginal finish lines. Statistical analyses were performed using the Exact Fisher and Mann-Whitney tests, and the Wilcoxon signed-rank test as a post hoc test for Friedman (95 % confidence interval). The marginal finish line showed a statistical difference with a biomaterial type (p =.004). After a 12-months, a significant increase was observed in PI and mean PD for abutment teeth of metal-ceramic crowns. The metal-free crowns presented higher values for GBI and CAL (p 2 < 0.05). Only distal cervical evaluation and dental biofilm formation in the abutment teeth showed a statistical difference between the groups at the 12-month follow-up. The supragingival margin metal-ceramic group revealed higher PI values (p 2 = 0.005) between the period and the subgingival margin of both biomaterials showed greater GBI scores (p 2 < 0.05). Metal-free crowns showed better periodontal outcomes compared to metal-ceramic crowns. Single-unit crown marginal location affects the periodontal tissue condition of the abutment teeth. The marginal fit was not changed regarding the biomaterial type. [ABSTRACT FROM AUTHOR]

Treatment of scalp malignancies may include the need for craniectomy. The decision to perform cranioplasty is not straightforward and is frequently subjective. The purpose of this study was to assess the clinical outcomes after reconstruction of complex scalp and calvarial defects by comparing patients with and without cranioplasty. Retrospective review of the clinical records of a consecutive series of patients who underwent scalp soft tissue reconstruction after craniectomy for malignancy or osteoradionecrosis between 2014 and 2022 at Royal Melbourne Hospital was conducted. Demographics, previous treatments, surgical details, and post-operative complications were assessed. Traumatic injuries and decompressive craniectomies were excluded. Minimum follow-up of 6 months. Thirty-seven patients were included in the study. Indications for surgery included skin malignancies, osteoradionecrosis, or both. There was one reconstructive failure (in the non-cranioplasty group). Infection and metalware exposure were common complications in patients who underwent cranioplasty (38.5%). No patient developed neurological symptoms subsequent to craniectomy. One patient needed revision surgery due to esthetic reasons (cranioplasty group). Transposition flaps were associated with more complications and revision procedures. Combined scalp and calvarial defects pose a difficult reconstructive challenge. Stable soft tissue coverage is more reliably achieved with free flap reconstruction. Cranioplasty is not always mandatory and should be reserved for cases with a very large bony defect or when the defect is located in a cosmetically sensitive area. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the association between psychosocial factors and the severity of Achilles tendinopathy, along with exploring their potential link to the pain's duration. A cross-sectional study involving 111 individuals with Achilles tendon pain was conducted. Methods: A cross-sectional study involving 111 individuals with Achilles tendon pain was conducted. Various psychological factors were assessed using the Pain Catastrophizing Scale, Chronic Pain Self-Efficacy Scale (CPSS), Tampa Scale for Kinesiophobia, and Hospital Anxiety and Depression Scale (HAD). Additionally, the severity of Achilles tendon pain was evaluated using the Victorian Institute of Sport Assessment-Achilles questionnaire (VISA-A-Br). Regression analyses were employed to determine the association of these psychosocial factors with pain severity and duration. Self-efficacy for chronic pain showed a slight association with Achilles tendon pain severity (β = 0.42 [95% CI: 0.06 to 0.16], p = 0.001), explaining only 19% of the dependent variable. The other variables, including anxiety, depression, pain catastrophizing, and fear of movement, did not exhibit significant associations. The study suggests that psychological factors demonstrate limited association with the severity of Achilles tendinopathy. While self-efficacy for chronic pain was weakly associated, its clinical relevance remains uncertain. Future research, particularly longitudinal studies, should explore the influence of psychosocial factors on treatment adherence and response to enhance management strategies for Achilles tendon pain. • Psychological Factors Minimally Impact Achilles Pain Severity (β = 0.42, p = 0.00). • Self-Efficacy for Chronic Pain Shows Weak Association with Pain Intensity (19%). • Anxiety, Depression, Catastrophic Thoughts, and Kinesiophobia Not Associated with Pain. • Clinical Relevance of Psychological Factors in Achilles Pain Is Inconsequential. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) treatment often requires transarterial chemoembolization (TACE). However, TACE efficacy is controversial in the presence of portal vein thrombosis (PVT). Although transarterial radioembolization (TARE) benefit was previously documented in PVT, neither the objective tumor response (OTR) after TARE with Iodine-131-lipiodol (131I-lipiodol) nor the PVT effect on the results of locoregional therapies was accurately measured in prospective clinical trials. The aim of this study was to compare OTR and survival obtained by TARE with 131I-lipiodol versus TACE in patients with cirrhosis and HCC, as well as between those with and without PVT. 33 patients were included, from whom 38 tumors were assessed. OTR was quantified by a special algorithm to measure hypervascular HCC tissue. 19 tumors received each therapy. Nine subjects (27%) had PVT, most of them in the TARE group (p = 0.026). Mean OTR according to the tumor volumes was 24.2% ± 56% after TARE and 32.8% ± 48.9% after TACE, with no difference between the treatments (p = 0.616). Similar values were also observed between those with and without PVT (p = 0.704). Mean survival was 340 days and did not differ between the two treatments (p = 0.596), but was 194 days in PVT cases (p = 0.007). This is the first study in which OTR obtained by TARE with 131I-lipiodol is accurately measured. Additionally, PVT impact on survival after TARE and TACE was precisely documented. Although the TARE group had more PVT subjects (who had shorter survival), TARE and TACE achieved similar OTR and OS rates. [ABSTRACT FROM AUTHOR]

to map the clinical parameters used in the speech-language pathology assessment of the chronic cough. a scoping review was performed to answer the clinical question: "What are the clinical parameters included in the speech-language pathology assessment of patients with chronic cough?" Evidence was searched by electronic and manual search. The electronic search included: MEDLINE, Cochrane Library, EMBASE, Web of Science, SCOPUS, and LILACS. Each database had a specific search strategy. The manual search included Journal of Voice, Chest, and Thorax, Brazilian Library of Theses and Dissertations, Open Grey, and Clinical Trials, in addition to scanning the references of the included studies. The extracted data considered information regarding the publication, sample, assessment, and measures used when assessing chronic cough. the electronic search found 289 studies; the manual search found 1036 studies; 12 were selected for the present study. The most used assessments were: self-assessment (75%), aerodynamic analysis (66.67%), the perceptual auditory judgment of the voice quality (58.33%), acoustic analysis of the voice (41.67%), cough frequency, and cough threshold (41.67%) and electroglottography (25%). the subjective instruments were used more frequently, while specific objective instruments, which are recent, were used less frequently. Complementary assessments such as vocal assessment, have been frequently used, also, with no other parameter. A lack of homogeneity was identified in the speech-language pathology assessment and measures of patients with chronic cough, thus, the comparison among studies and clinical analysis is difficult. [ABSTRACT FROM AUTHOR]

To analyze the efficacy of speech-language pathology therapy in the self-assessment, in the cough frequency, and the vocal quality of adults with chronic cough. This is a systematic review with meta-analysis that answered the clinical question: "In adults with chronic cough, what is the effect of the speech-language pathology therapy in the self-assessment, in the cough frequency, and the vocal quality, compared to another intervention?" (PROSPERO 2021/CRD42021226729). An electronic search (MEDLINE, Web of Science, EMBASE, SCOPUS, Cochrane Library, and Lilacs), and a manual search (Journal of Voice, Brazilian Library of Theses and Dissertations, Open Grey and Clinical Trials) with specific search strategies was performed. The risk of bias was assessed using the Cochrane Collaboration's tool for assessing the risk of bias in randomized trials. Meta-analysis (standardized difference of means, Inverse Variance, and random effects model) and heterogeneity analysis (Chi², Tau², and I²) were performed. We found 610 studies and selected three. There was an uncertain risk of detection bias. The data were heterogeneous, and there was no difference between interventions in self-perception of cough severity (z = 0.09, P = 0.930; tau² = 0.65, I² = 90%) and in the self-perception of the effects of chronic cough on health status (z = 0.30, P = 0.77; tau² = 0.99, I² = 97%). The estimated mean difference was 0.97 to cough frequency, and it was differ significantly from zero (z = 4.47, P < 0.001) but the results are heterogeneous (Chi² (1) = 22.22, P < 0.001, I² = 95%). The speech-language pathology therapy had a greater effect size than the control interventions on cough frequency. However, in the subjects' perception, there were no differences between the interventions. [ABSTRACT FROM AUTHOR]

To analyze breastfeeding and the factors that positively influence the first hour of life, during hospitalization, and at discharge during the SARS-CoV-2 pandemic. This is a retrospective cohort study, with data collected from medical records. Consisting of 225 mother-newborn dyads with deliveries between 2020 and 2021. Breastfeeding in the first hour of life, during hospitalization, and at discharge was considered as the outcome variable. The independent variables were sociodemographic, obstetric, and neonatal data. The analysis was performed with bivariate and multivariate regression through a generalized linear model (Poisson family), with a 5% significance level. It was approved by the Institutional Review Board (IRB), under approval number 4,911,317. Newborns of women without COVID-19 suspicion or diagnosis and who had skin-to-skin contact with their mother at birth are twice as likely to be breastfed in the first hour of life. Absence of complications in the newborn during hospitalization and no COVID-19 suspicion or diagnosis double the exclusive breastfeeding rate during hospitalization. Newborns exclusively breastfed during hospitalization present 1.6 times more chances of being exclusively breastfeeding at hospital discharge. It was evidence that women who gave birth without COVID-19 suspicion, and newborns who had skin-to-skin contact with their mother at birth represented a predictive factor for favoring exclusive breastfeeding. This research contributes to the innovation of evaluating breastfeeding in the newborn's first hour of life, during hospitalization, and at discharge in a pandemic context. • Parturient without suspicion or diagnosis for COVID-19 are more likely to breastfeed the newborn. • The study reaffirmed the importance of skin-to-skin contact to promote breastfeeding in the first hour of life. • The impact exclusivity of breastfeeding during hospitalization for continuity at hospital discharge. • Actions to promote and encourage early breastfeeding in the postpartum period should be prioritized. [ABSTRACT FROM AUTHOR]

This study investigated the effect of auditory environmental enrichment on the behavior of pregnant and lactating sows housed in mixed (cage until 35 days after insemination and then collective pens) or collective housing (cage until 72 hours after insemination and then collective pens) during the gestation period, as well as the behavior of their litters. A sample of 56 sows of a commercial strain between second and sixth parity was submitted to the treatments from artificial insemination to piglet's weaning (21 days). The sows were assigned in 2 × 2 factorial randomized block designs in the treatments: mixed housing-control (MH-C), collective housing-control (CH-C), mixed housing-music (MH-M), and collective housing-music (CH-M). The sows in the treatments with auditory enrichment were exposed daily throughout gestation and lactation to 6 hours of classical music (Bach symphonies) divided into 2-hour periods. Behavioral assessment was performed on 10 sows of each treatment once a week. At 21 days of age, their piglets were subjected to tests of novel arena, novel object, and voluntary human approach. In both phases, regardless of the housing system evaluated (CH or MH), females submitted to music had a lower incidence of agonistic and stereotyped behaviors and greater social interaction with other sows and their piglets in relation to the control group. Piglets from the CH-M treatment vocalized less and showed better results in the voluntary approach test. Music as an environmental enrichment reduced agonistic interactions between pregnant and lactating sows and the incidence of stereotypies. Piglets from sows housed in a collective system exposed to sound stimuli in the pre- and postnatal periods were more fearless at 21 days of age. • Music can enrich the environment and positively affect the quality of life of housed animals. • Auditory enrichment reduced the stress of pregnant and lactating sows. • Piglets from sows housed in a collective system exposed to sound stimuli in the pre and postnatal periods adapted better to adverse situations. • Music reduced agonistic interactions and the stereotypies incidence in sows. [ABSTRACT FROM AUTHOR]

A black skimmer (Rynchops niger) and a brown booby (Sula leucogaster) were rescued and gross, histopathological, immunohistochemical and polymerase chain reaction evaluations were conducted to investigate the cause of death. There were neoplastic infiltrations of CD3+ PAX5- lymphocytes in the black skimmer and CD3- PAX5+ lymphocytes in the brown booby. Molecular assays for viral agents were negative in both cases. This is the first report of disseminated lymphoma as the cause of stranding and death in these species in Brazil. [ABSTRACT FROM AUTHOR]

Little is known regarding the biology and behavior of the pacarana (Dinomys branickii) in both in situ and ex situ environments. A comprehensive morphological analysis of the male pacarana's genital organ is presented in this study, along with comparisons to other species belonging to the suborder Hystricomorpha. The study was conducted assessing the reproductive health of the sole ex situ male in Brazil. The findings revealed subcutaneous ellipsoidal tests and a cylindrical penis covered with distinct penile spines that was enveloped by a foreskin. The discussion draws comparisons between the aforementioned findings and those of other Neotropical rodents, emphasizing the lack of a scrotum and the existence of penile spines. This research offers vital insights into the pacarana's biology, establishing a groundwork for forthcoming reproductive biotechnological efforts that seek to safeguard the genetic diversity of little-known species and emphasizing the significance of ex situ conservation efforts. • First-ever measurements reveal external genitalia features in male pacaranas. • Pacarana lacks a defined scrotum and displays unique penile spines. • This research provides crucial insights into their reproductive biology. • Understanding the reproductive anatomy base the implementing assisted reproductive technologies. [ABSTRACT FROM AUTHOR]

to present a 12-month follow-up with photographic and tomographic analyses of the effect of polymethyl methacrylate-based bone cement graft (PMMA) in gingival exposure (GE) in patients with excessive gingival display (EGD). Twelve patients with EGD were included. The PMMA was surgically placed. A frontal and lateral photograph protocol was performed at baseline (T 0), 3 (T 3), 6 (T 6), and 12 months (T 12) post-operatively. Soft tissue cone-beam computed tomography (ST-CBCT) was performed at T 0 and T 12. Measures included GE, length of the lip vermilion (LLV), lip shape (LS), nose width (NW), filter width (FW), nasolabial angle (NAS) while smiling, and nasolabial angle at rest (NAR). The height, thickness, and volume of the cement graft were also measured in the ST-CBCT. The comparisons were performed by Kruskal-Wallis test at 5 % of significance (p < 0.05). The height, thickness, and volume of the PMMA were respectively 12.84 ± 1.59 mm, 3.83 ± 0.53, and 1532.02 ± 532.52 mm3. PMMA significantly decreased GE from 8.33 ± 1.25 mm (T 0) to 6.60 ± 0.93 mm (T 12) (p < 0.01). NAR was 98.34 ± 9.28° at T 0 and increased to 105.13 ± 7.33° at T 12 ; however, the angle value was not statistically different (p = 0.08). LLV, LS, NW, FW, and NAS did not exhibit statistical differences between the baseline and follow-up periods. PMMA significantly decreased GE in a 12-month follow-up without influencing adjacent soft tissue anatomical structures. [ABSTRACT FROM AUTHOR]

• Continuous epileptiform activity identified up to 24 months are associated with worse findings in children with congenital Zika syndrome. • Children with congenital Zika syndrome and continuous epileptiform activity have drug-resistant epilepsy more frequently. • Bilateral continuous epileptiform discharges are more common and may indicate a specific pattern of congenital Zika syndrome encephalopathy. This study aimed to identify continuous epileptiform discharges (CEDs) on electroencephalograms (EEG) and to determine their clinical significance in children with congenital Zika syndrome (CZS). This prospective cohort study included 75 children diagnosed with CZS born from March 2015 and followed up until September 2018 (age up to 36 months). EEG was performed to detect CEDs up to 24 months old. Data on obstetric, demographic, and clinical signs; cranial computed tomography (CT); ophthalmology examination; anti-seizure medication; growth; and motor development were collected. Fisher's exact test was used to verify the associations between categorical variables, and the T - test was used to compare the mean z-scores of anthropometric measurements between the groups with and without CED. CEDs were identified in 41 (54.67 %) children. The mean age of CEDs identification was 12.24 ± 6.86 months. Bilateral CEDs were shown in 62.89 % of EEGs. CEDs were associated with severe congenital microcephaly, defined by z-score >3 standard deviation of head circumference (HC) below the mean for sex and age (p = 0.025), and worse outcomes, including first seizure before 6 months (p = 0.004), drug-resistant epilepsy (p < 0.001), chorioretinal scarring or mottling (p = 0.002), and severe CT findings (p = 0.002). The CED group had lower mean z-scores of HC up to 24 months of age. This is the first description of the prevalence and significance of CEDs that also remains during wakefulness in patients with CZS. New investigations may suggest that it is more appropriate to classify the EEG not as a CED, but as a periodic pattern. Anyway, CEDs may be a marker of neurological severity in children with CSZ. [ABSTRACT FROM AUTHOR]

• Déjà Vu is classically associated with focal seizures originating from the medial temporal lobe. • 3 % of Idiopathic Generalized Epilepsy patients reported Déjà Vu (ranging from 0 to 11 % in the studies). Any type of aura was reported by 40 %. • Clinicians should recognize that Déjà Vu and other auras may experienced in Idiopathic generalized Epilepsy. • Recognizing this pitfall is crucial to avoiding diagnostic and treatment errors. Déjà vu (DV), a French term meaning "already seen," refers to inappropriate sensation of familiarity in the present moment, as if it had been experienced before without a specific recollection of when or where. Traditionally, DV has been closely associated with focal seizures originating from the medial temporal lobe. However, there are occasional reports of DV occurring in idiopathic generalized epilepsies (IGEs). The objective of our study was to assess the presence and frequency of DV in individuals with IGE. We used the Preferred Reporting Items for Systematic Review and Meta-Analysis for protocols (PRISMA-P) and searched PubMed and Embase from January 2000 to July 2022. 5 studies were included with a total of 1177 IGE and 1026 with temporal lobe epilepsy (TLE) patients. The frequency of DV in IGE ranged from 0 to 11 %, and the average was 3 %, compared to 19.6 % in TLE. Broadly, 40 % of patients with IGE reported some type of aura. EEG correlation of DV in IGE was not appropriately evaluated in the studies. Clinicians should be aware that individuals with IGE may experience DV and other types of auras. Recognizing these auras is crucial in order to avoid misdiagnosing IGE as focal epilepsy. This is important to prevent unnecessary investigations and incorrect treatment decisions. [ABSTRACT FROM AUTHOR]

Immediately loaded mandibular overdentures are clinically acceptable treatment options that have gained popularity because their use shortens the treatment duration. However, whether the immediate loading of dental implants can match the prosthetic events, satisfaction, and quality of life of delayed loading is still unclear. The purpose of this systematic review and meta-analysis was to compare the prosthetic events, satisfaction, and quality of life of immediate versus delayed loading implants in patients rehabilitated with mandibular overdentures. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and was registered at The International Prospective Register of Systematic Reviews (PROSPERO) (CRD42021258187). Electronic searches were carried out by 2 independent reviewers in the PubMed/MEDLINE, Cochrane Library, and Web of Science databases up to May 2021. Only randomized clinical trials and prospective studies with at least 10 participants that compared immediate versus delayed loading were selected. A meta-analysis was performed by using the RevMan 5 software program for complications and maintenance outcomes. Seven articles were included in the qualitative analysis, and 4 were included in the quantitative analysis. The meta-analysis demonstrated no significant difference between immediate and delayed loading for prosthetic complications (RR=1.71; 95% CI=0.67-4.37; I2=85%, P =.27) or maintenance (RR=1.92, 95% CI=0.44-8.28; I2=94%, P =.38). Although the prosthetic complications and maintenance were more likely to favor the delayed loading group, available evidence showed no statistical difference for prosthetic complications and maintenance between immediate loading and delayed loading in mandibular overdentures. [ABSTRACT FROM AUTHOR]

This study aimed to enhance the efficiency of the order picking process in Carclasse's parts warehouse in Braga to achieve this objective, a comprehensive analysis of all warehouse processes was conduct. The initial analysis revealed that approximately 59% of the references in stock were considered obsolete, as they had had zero turnover in the last 5 years. Additionally, a high error rate was identify in the order picking process, with around 6% of references being pick incorrectly. These errors led to discrepancies between the physical stock levels and the system records since some order picking errors went undetected. Moreover, queues were observed among internal customers when requesting material retrieval, which hindered workflow. Based on these findings, improvements were proposed to address the identified issues. One of the key proposals was the implementation of a Barcode scanning system to increase the digitalization of warehouse processes and rectify order picking and stock errors. Additionally, to reduce internal customers' waiting time, it was suggested to shift the responsibility of part identification for collection to mechanics and increase from 2 to 4 the number of identification stations. It is crucial to highlight that the implementation of the Barcode scanning system can not only reduce order-picking errors but also contributed to the overall optimization of Carclasse's parts warehouse. With the digitalization of processes, it is expected an enhancement in traceability and inventory accuracy, avoiding discrepancies between physical stock and system records. This can resulted in greater control and reliability of inventory data, providing a solid foundation for operational and strategic decision-making. [ABSTRACT FROM AUTHOR]

Collaborative Research and Development and Innovation (R&D&I) projects make an essential contribution to the development of knowledge-based, innovative products, processes, and services. The main objective of this paper is to gain a comprehensive understanding of project management (PM) in collaborative R&D&I projects, examining the usefulness of PM practices. The results are based on 465 valid responses from an online questionnaire survey on the perceptions of collaborative R&D&I project practitioners. The Relative Importance Index was used to classify the usefulness of the 35 key PM practices surveyed. The top 10 rank of the most useful PM practices cover the entire PM lifecycle and include well-known practices, such as 'kick-off meeting', 'progress meetings', 'Gantt chart', 'project closure report', 'project closure meeting', 'milestone list', 'requirement analysis' and 'project scope plan'. Although, there are also less emphasised PM practices such as 'alignment workshops' and 'project idea paper'. The paper contributes to supporting practitioners to decide which PM practices should be prioritised and implemented. [ABSTRACT FROM AUTHOR]

A disease is considered rare if it has a low prevalence. It is estimated that around 400 million people worldwide have a rare disease, including 15 million in Brazil. Consequently, it became a public health priority for the World Health Organization and the Brazilian Health Ministry. In 2014, the Brazilian government launched a national policy regarding the care for rare patients', the Ordinance nº199. The national politic defines guidelines, procedures, and descriptions of rare disease codes to provide access and diagnosis in the public health system to reduce mortality and improve patient's quality of life. Diseases are identified according to the International Classification of Diseases 10th Revision, a widely used terminology in this context. However, there are also different terminologies to codify a rare disease, such as the ORPHAcode provided by Orphanet. This paper proposes a complex network model using the terminologies' relationship to show that the International Classification of Diseases 10th Revision may be generic for diagnosing rare Brazilian patients. Moreover, there is no perfect nomenclature to define rare diseases, but each context has a better application. So, mapping the relationship between each terminology is fundamental for creating consistent semantic relationships in biomedical ontologies, providing a functional environment for carrying out tasks involving more than one terminology. [ABSTRACT FROM AUTHOR]

Collaborative Research and Development and Innovation (R&D&I) projects provide special challenges in understanding and expressing the value of project management (PM) practices to deliver stakeholders' expected benefits. This study aimed to contribute to understanding the relevance of PM practices on collaborative R&D&I projects' success from the perspective of firms, higher education institutions, and other research-performing organizations. It used exploratory factor analysis (EFA) to categorize the surveyed key PM practices initially grouped according to the typical project lifecycle (initiation, planning, execution, monitoring/controlling & replanning, and closure). EFA resulted in the identification of four underlying factors, designated by 'must have' practices that cover the whole PM lifecycle: 'initiation' practices; 'planning' practices; and 'execution, monitoring/controlling & replanning' practices. Significant variance in using key PM practices by respondents from different activity sectors is observed. For example, respondents from Interface Centers use more 'must have' practices than those from firms and use more 'planning' practices than those from firms and higher education institutions. This might be influenced by the reported existence of project management offices, beyond their administrative roles, in the vast majority of Interface Centers, as opposed to other activity sectors. The results suggest that this specific type of project would benefit from team capacity-building programs in PM practices tailored to the identified sector-specific needs of firms and research-performing organizations. [ABSTRACT FROM AUTHOR]

Metaplasia detection in upper gastrointestinal endoscopy is crucial to identify patients at higher risk of gastric cancer. Deep learning algorithms can be useful for detecting and localising these lesions during an endoscopy exam. However, to train these types of models, a lot of annotated data is needed, which can be a problem in the medical field. To overcome this, data augmentation techniques are commonly applied to increase the dataset's variability but need to be adapted to the specificities of the application scenario. In this study, we discuss the potential benefits and identify four key research challenges of a promising data augmentation approach, namely image combination methodologies, such as CutMix, for metaplasia detection and localisation in gastric endoscopy imaging modalities. [ABSTRACT FROM AUTHOR]

The plastics industry has revolutionized several sectors, from packaging to automotive, enabling companies to develop innovative products and enhance their economic competitiveness. However, the exponential growth of this industry has also resulted in a concerning increase in plastic waste, leading to environmental repercussions such as microplastic contamination, marine pollution and plastic landfills. Therefore, researchers, governments, and industrial stakeholders are starting to work collaboratively to address this sustainability issue by adopting a life cycle perspective. Nevertheless, plastic waste generation is not slowing down, and waste management strategies, along with other actions across the value chain, need to be improved. While limiting single-use plastics and promoting sustainable consumer practices is crucial, these measures alone may not be sufficient. Figuring out how to maximize products and materials ' lifespan by exploring circular economy opportunities is just as important as minimizing global consumption. This research explores the challenges and opportunities faced by the plastics industry and draws a prototype roadmap to identify sustainable business opportunities and routes of implementation. It builds on previous works on sustainable value roadmapping by defining a vision, identifying drives, highlighting business opportunities and discussing enablers. Results systematize and expand opportunities and challenges identified in scientific literature and industrial reports whilst clearly outlining a vision. [ABSTRACT FROM AUTHOR]

Plastic pollution is a pressing global concern due to its severe environmental impacts. Thus, the adoption of sustainable practices in product design and end-of-life management has become paramount towards a plastic's circular economy. This study delves into the transformative potential of design for recycling by examining the replacement of a multi-material skillet lid with a mono-material plastic injected solution featuring opaque and translucent zones. Through a life cycle cost and life cycle assessment, this research evaluates and compares the environmental and economic implications of both solutions. The analysis encompasses crucial life cycle phases, including raw material extraction and transformation, manufacturing, and end-of-life. The results highlight the considerable benefits of the mono-material design approach, particularly enhanced recyclability and a reduction of 31.39% and 10.97% of the total environmental and economic impact, respectively. Additionally, the environmental impact further reduces when considering a potential waste management scenario for 2035 defined based on European directives. This research not only contributes to the field of life cycle engineering by emphasizing the economic and environmental advantages of the mono-material design for recycling in a particular application but also fosters informed sustainable decision-making within the plastics industry. Furthermore, this study underscores the utmost importance of adopting design for recycling to foster a plastics circular economy. [ABSTRACT FROM AUTHOR]

Infective endocarditis continues to be a significant concern and may be undergoing an epidemiological transition. Were studied 1804 consecutive episodes of infective endocarditis between 1978 and 2022. The mean age was 48 (± 19), and 1162 (64%) patients were male. Temporal trends in demographic data, comorbidities, predisposing conditions, microorganisms, complications and in-hospital death have been studied over the decades (1978–1988, 1989–1999, 2000–2010 and 2011–2022). The outcomes and clinical characteristics were modeled using nonlinear cubic spline functions. Valve surgery was performed in 50% of the patients and overall in-hospital mortality was 30%. From the first to the fourth decade studied, the average age of patients increased from 29 to 57 years (p < 0.001), with significant declines in the occurrence of rheumatic valvular heart disease (15% to 6%; p < 0.001) and streptococcal infections (46% to 33%; p < 0.001). Healthcare-associated infections have increased (9% to 21%; p < 0.001), as have prosthetic valve endocarditis (26% to 53%; p < 0.001), coagulase-negative staphylococcal infections (4% to 11%; p < 0.001), and related-complications (heart failure, embolic events, and perivalvular abscess; p < 0.001). These changes were associated with a decline in adjusted in-hospital mortality from 34% to 25% (p = 0.019). In the 44 years studied, there was an increase in the mean age of patients, healthcare-related, prosthetic valve, coagulase-negative staphylococci/MRSA infections, and related complications. Notably, these epidemiological changes were associated with a decline in the adjusted in-hospital mortality. [ABSTRACT FROM AUTHOR]

Hepatic cirrhosis represents an advanced stage of fibrosis in the liver, resulting from various conditions such as hepatitis and chronic alcoholism. This article uses data from the Mayo Clinic's clinical trial on primary bile cirrhosis carried out between 1974 and 1984. Rapid and accurate identification of the condition is crucial for the implementation of effective interventions, capable of mitigating liver damage and preventing complications, especially in the early stages of the disease. The focus of the research is the evaluation of Data Mining (DM) techniques, using clinical data, to predict survival outcomes in patients with cirrhosis. The study uses the CRISP-DM methodology, analysing different classification algorithms, including k-Nearest Neighbours, Random Forest, Decision Trees, Gradient Boosting and Naive Bayes. The effectiveness of the model is evaluated, highlighting the Random Forest with Holdout Sampling and a ratio of 0.7, whose performance averages around 80%. The nominal attributes were also analysed in order to discover possible patterns of association. [ABSTRACT FROM AUTHOR]

The purpose of this study was to review the evidence for the potential of Tai Chi Chuan (TCC) as a model of meditative movement in benefiting people with impulsivity related disorders and provide guidance for future research. A scoping review of the literature was conducted in five databases. Eligibility criteria were original articles reporting TCC based interventions or included TCC techniques and provided any assessment on impulsivity or related measures, impulse control disorders, or other psychiatric disorders related to impulsivity (e.g., addictive disorders, ADHD, and other conduct disorders). Twenty-eight out of 304 studies initially retrieved were reviewed. The reports concentrated mostly on neurodegenerative conditions, cognitive decline, and substance use disorders (SUD). TCC had several positive effects in cognitive domains resulting in improvements in memory, executive functions, inhibitory control, attention, and verbal fluency. These improvements in memory, executive function, including inhibitory control and attention, and verbal fluency were associated with changes in the brain plasticity, resting activity, and other neurobiological markers. Albeit no study was found on the use of TCC in impulse control disorders or impulse related conditions, other than SUD, the findings suggest that considering the behavioral impact of TCC, especially the improvement of executive functions, it could be a valuable therapeutic tool for approaching impulse control related disorders. • The benefits of Tai Chi Chuan (TCC) as a form of meditational movement has been postulated as beneficial particularly for elders. • TCC movements support the development of mindfulness, generating better regulation of physical, emotional and social processes, contributing to better decision-making and self-care behaviors. • The effects of TCC on increasing mindfulness may also be beneficial for improving impulsive behaviors regardless of age. • In addition to the physical benefits, TCC has the added benefit of promoting psychological improvement, and its most robust effects seem to be centered on executive functions. • Studies have also found a correlation between the practice of TCC and stimulation of the prefrontal cortex and medial temporal lobe structures, which can be fundamental for decision-making and impulse control. [ABSTRACT FROM AUTHOR]

This article describes a digital workflow for ceramic veneer preparation using computer-aided design and computer-aided manufacturing technology. A digital waxing was planned on the exocad software program to reestablish esthetic and functional parameters. Then, the digital guides for veneer preparation were designed by using the Meshmixer design software program to control the tooth structure removed during preparation to the minimal thickness necessary for the definitive restorations. The digital guides were printed in an additively manufactured clear resin and used in the preparation appointment, allowing a more conservative and controlled preparation. [ABSTRACT FROM AUTHOR]