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Background. Probiotics prevent disease induced by Citrobacter rodentium, a murine-specific enteric pathogen. Whether probiotics can be used to interrupt the infectious process following initiation of infection was determined. Methods. C57BL/6 adult and neonatal mice were challenged with C. rodentium, and a probiotic mixture containing Lactobacillus helveticus and Lactobacillus rhamnosus was provided 1 week before bacterial challenge, concurrently with infection, or 3 days and 6 days after infection. Mice were sacrificed 10 days after infection, and disease severity was assessed by histological analysis and in vivo intestinal permeability assay. Inflammatory pathways and the composition of the fecal microbiome were assessed in adult mice. Results. Preadministration and coadministration of probiotics ameliorated C. rodentium-induced barrier dysfunction, epithelial hyperplasia, and binding of the pathogen to host colonocytes in adults, with similar findings in neonatal mice. Upregulated tumor necrosis factor [alpha] and interferon [gamma] transcripts were suppressed in the pretreated probiotic group, whereas interleukin 17 transcription was suppressed with probiotics given up to 3 days after infection. Probiotics promoted transcription of interleukin 10 and FOXP3, and increased follicular T-regulatory cells in pretreatment mice. C. rodentium infection resulted in an altered fecal microbiome, which was normalized with probiotic intervention. Conclusions. This study provides evidence that probiotics can prevent illness and treat disease in an animal model of infectious colitis. [ABSTRACT FROM AUTHOR]

Background: The wearing-off phenomenon is a key driver of medication change for patients with Parkinson's disease (PD) treated with levodopa. Common first-line options include increasing the levodopa dose or adding a catechol-O-methyltransferase (COMT) inhibitor, but there are no trials comparing the efficacy of these approaches. We evaluated the effectiveness of adjunct opicapone versus an additional 100 mg levodopa dose in PD patients with early wearing-off using pooled data from 2 randomized studies., Methods: The ADOPTION study program included two similarly designed 4-week, open-label studies conducted in South Korea (NCT04821687) and Europe (NCT04990284). Patients with PD, treated with 3-4 daily doses of levodopa therapy and with signs of early wearing-off were randomized (1:1) to adjunct opicapone 50 mg or an additional dose of levodopa 100 mg. Patient-level data from the two studies were pooled., Results: The adjusted mean [SE] change from baseline to week 4 in absolute OFF time (key endpoint) was - 62.8 min [8.8] in the opicapone group and - 33.8 min [9.0] in the levodopa 100 mg group, the difference significantly favoring opicapone (- 29.0 [- 53.8, - 4.2] min, p = 0.02). Significant differences in the Movement Disorder Society-Unified Parkinson's Disease Rating Scale Part III subscore (- 4.1 with opicapone vs - 2.5 with levodopa 100 mg), also favored opicapone (- 1.7 [- 3.3, - 0.04], p < 0.05). Dyskinesia was the most frequently reported adverse event (opicapone 7.2% vs. levodopa 100 mg 4.2%)., Conclusions: In these short-term trials, introducing adjunct opicapone was more effective at reducing OFF time than adding another 100 mg levodopa dose in PD patients with early signs of wearing-off., (© 2024. The Author(s).)

The hydrothermal pretreatment process stands out as a pivotal step in breaking down the hemicellulosic fraction of lignocellulosic biomasses, such as sugarcane bagasse and eucalyptus sawdust. This pretreatment step is crucial for preparing these materials for subsequent processes, particularly in food applications. This technique aims to disintegrate plant wall components like cellulose, hemicellulose, and lignin, and facilitating access in later phases such as enzymatic hydrolysis, and ultimately making fermentable sugars available. In this study, sugarcane bagasse and eucalyptus sawdust biomass underwent hydrothermal pretreatment at specific conditions, yielding two key components: dry biomass and hemicellulose liquor. The primary focus was to assess the impact of hydrothermal pretreatment followed by enzymatic hydrolysis, using the Celic Ctec III enzyme cocktail, to obtain fermentable sugars. These sugars were then transformed into membranes via strain Gluconacetobacter xylinus bacterial biosynthesis. Notably, the addition of a nitrogen source significantly boosted production to 14.76 g/ in hydrolyzed sugarcane bagasse, underscoring its vital role in bacterial metabolism. Conversely, in hydrolyzed eucalyptus, nitrogen source inclusion unexpectedly decreased yield, highlighting the intricate interactions in fermentation media and the pivotal influence of nitrogen supplementation. Characterization of membranes obtained in synthetic and hydrolyzed media through techniques such as FEG-SEM, FTIR, and TGA, followed by mass balance assessment, gauged their viability on an industrial scale. This comprehensive study aimed not only to understand the effects of pretreatment and enzymatic hydrolysis but to also evaluate the applicability and sustainability of the process on a large scale, providing crucial insights into its feasibility and efficiency in practical food-related scenarios, utilizing nanocellulose bacterial (BNC) as a key component., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

This study aimed at characterizing the gingival thickness (GT) and determining correlations with other local phenotypical features. Cone-beam computed tomography scans from adult subjects involving the maxillary anterior teeth were obtained to assess buccal GT at different apico-coronal levels, periodontal supracrestal tissue height (STH), the distance from the cementoenamel junction to the alveolar bone crest (CEJ-BC), and bucco-lingual tooth dimensions in mm. A total of 100 subjects and 600 maxillary anterior teeth constituted the study sample. Variations in mean values of GT were observed as a function of apico-coronal level, tooth type, and gender. GT progressively increased apically. Maxillary central incisors and males generally exhibited thicker GT. Contrarily, females exhibited thinner GT and shorter STH. Tooth dimensions were negatively correlated with GT, as the narrower the tooth crown/root in the bucco-lingual dimension, the thicker the gingiva. GT at the level of the CEJ was dichotomized to differentiate between thin (<1mm) and thick (≥1mm) gingival phenotypes (GP). Teeth with a thin GP displayed greater CEJ-BC and buccolingual tooth width dimensions. Conversely, teeth with a thick GP generally exhibited taller STH and narrower tooth dimensions.

The aim of this study was to evaluate the relationship between soft tissue dimensions and radial root position (RRP) classification for immediate implant placement on maxillary anterior teeth. Maxillary anterior teeth (n = 420) were analyzed in the radial plane of cone beam computed tomography (CBCT) scans. Each tooth was classified according to its RRP: class I, (IA, IB); class II (IIA, IIB) class III; class IV, and class V. Soft tissue thickness at different landmarks, supracrestal soft tissue height, and crestal bone thickness were measured in CBCT. Keratinized tissue width was clinically measured. Gingival phenotype (thick or thin) was evaluated by transparency of the periodontal probe and at the landmark 2 mm from the gingival margin in CBCT. Class I tooth position accounted for 31.7%, class II for 45%, class III for 13.3%, class IV for 0.5%, and class V for 9.5%. The gingival phenotype was associated with RRP (χ 2 test, p < 0.05). Soft tissue dimensions were significantly different over RRP classes (ANOVA and Tukey tests, p < 0.05). Types IA and IIA presented both thick soft and hard tissues. When planning immediate implants in the anterior maxilla, soft tissue dimensions evaluation should be incorporated into RRP classification to increase the accuracy and predictability of treatment outcomes., (© 2024. The Author(s), under exclusive licence to The Society of The Nippon Dental University.)

Lattice structures have gained attention in engineering due to their lightweight properties. However, the complex geometry of lattice structures and the high melting temperature of metals present significant manufacturing challenges for the large-scale fabrication of these structures. Direct Energy Deposition (DED) methods, such as the Wire Arc Additive Manufacturing (WAAM) technique, appear to be an interesting solution for overcoming these limitations. This study provides a detailed analysis of the manufacturing process of carbon steel lattice structures with auxetic geometry. The study includes thermal analysis using infrared thermography, microstructural characterization through metallography, and mechanical evaluation via hardness and mechanical testing. The findings reveal the significant impact of heat input, thermal cycles, and deposition sequence on the morphology and mechanical properties of the lattice structures. Fast thermal cycles are related to areas with higher hardness values, smaller strut diameters, and porous formations, which shows that controlling heat input and heat dissipation is crucial for optimizing the properties of lattice structures produced using WAAM.

Background/aims: Achalasia is a disorder characterized by impairment in lower esophageal sphincter relaxation and esophageal aperistalsis, caused primarily by loss of inhibitory innervation. However, little is known about associated changes in esophageal smooth muscle. We examined the contractile phenotype and innervation of the circular smooth muscle, as well as inflammatory status, and correlated these with patient-specific parameters., Methods: Circular smooth muscle biopsies were obtained in consecutive patients with achalasia undergoing peroral endoscopic myotomy. Axonal innervation and neurotransmitter subtypes were determined with immunocytochemistry, and this was used with quantitative Polymerase Chain Reaction (qPCR) to characterize smooth muscle proliferation and cellular phenotype, as well as collagen expression. These were compared to control tissue obtained at esophagectomy and correlated with patient demographic factors including age, onset of symptoms, and Eckhardt score., Results: Biopsies of smooth muscle were obtained from 25 patients with achalasia. Overall, there was increased mast cell number and collagen deposition but increased smooth muscle cell proliferation vs control. There was a striking drop in axon density over controls, with no differences among subtypes of achalasia. Immunocytochemical analysis showed increased expression of the contractile marker α-smooth muscle actin, principally in Type 1 achalasia, that increased with disease duration, while qPCR identified increased mRNA for smoothelin with decreased myosin heavy chain and collagen 3a1, but not collagen 1a1., Conclusions: The thickened circular smooth muscle layer in achalasia is largely denervated, with an altered contractile phenotype and fibrosis. Biopsies obtained during peroral endoscopic myotomy provide a means to further study the pathophysiology of achalasia.

Background: Hemorrhage is a common complication associated with endoscopic retrograde cholangiopancreatography (ERCP), usually following sphincterotomy. Studies investigating risk factors for hemorrhage including ERCP indication have been conflicting. Therefore, we conducted a systematic review and meta-analysis to characterize the association between the ERCP indication and hemorrhage., Methods: Database searches of MEDLINE, EMBASE, and CENTRAL were conducted to identify articles up to December 12, 2022. Randomized trials or observational studies of adult patients undergoing ERCP were included. Quality assessment using the Cochrane Risk of Bias 2.0 and Newcastle-Ottawa Scales for randomized trials and observational studies respectively was conducted. A random effects meta-analysis generating pooled odds ratios with 95% confidence intervals was conducted., Results: A total of 1323 articles were identified of which 26 were included with up to 25 121 subjects in each meta-analysis. Rates of sphincterotomy (median 96.1%; IQR 60.5-100), biliary stent placement (median 17.2%; IQR 10.6-34.4), antiplatelet use (median 6.0%; IQR 0-10.1), and anticoagulant use (median 1.9%; IQR 0%-3.2%) varied among included studies. No specific indication was associated with hemorrhage in the meta-analyses including cholangitis (OR 1.50; 95% CI 0.97-2.32), choledocholithiasis/biliary stone (OR 1.28; 95% CI 0.95-1.73), malignancy (OR 0.97; 95% CI 0.66-1.42), sphincter of Oddi dysfunction (OR 1.32; 95% CI 0.72-2.40), and acute pancreatitis (OR 0.81; 95% CI 0.44-1.49)., Conclusions: Overall, no indication was significantly associated with increased hemorrhage following ERCP. However, given limitations in the included studies (ie, significant heterogeneity between studies), additional research to better characterize these associations is needed., Protocol Registration Number: PROSPERO (CRD42021283978)., Competing Interests: L. H. has received consulting fees from Vantage Endoscopy and Pendopharm Medical, and participated in advisory boards for Astra Zeneca and Sanofi Canada. D. M. R. has grants from Medtronic for the use of Endoflip in other clinical settings, has been paid for giving lectures by Bausch, and has served on an Advisory board for Sanofi. None of these groups played any role in this study. The other authors have no conflicts of interest., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Canadian Association of Gastroenterology.)

Low glyphosate doses that produce hormesis may alter the susceptibility to herbicides of weeds or enhance their propagation and dispersal. The objective of this work was to evaluate the hormetic effects of glyphosate on the vegetative, phenological and reproductive development in resistant (R) and susceptible (S) Conyza sumatrensis biotypes. The glyphosate resistance level of biotype R was 11.2-fold compared to the S biotype. Glyphosate doses <11.25 g ae ha -1 induced temporary and permanent hormetic effects for the number of leaves, plant height and dry mass accumulation up to 28 d after application in both R and S biotypes. The S biotype required 15-19% fewer thermal units at 1.4 and 2.8 g ae ha -1 glyphosate than untreated plants to reach the bolting stage. Also, this biotype had less thermal units associated with the appearance (1225 vs 1408 units) and opening (1520 vs 1765 units) of the first capitulum than the R biotype. In addition, glyphosate affected reproductive traits of both biotypes compared to their controls, increasing the number of capitulum's and seeds per plant up to 37 and 41% (at 2.8 and 0.7 g ae h -1 , respectively) in the S biotype, and by 48 and 114% (both at 5.6 g ae ha -1 ) in the R biotype. Depending on environmental parameters, glyphosate may or may not cause hormetic effects on the vegetative and phenological development of C. sumatrenis biotypes; however, this herbicide increases the speed and fecundity of reproduction, regardless of the glyphosate susceptibility level, which can alter the population dynamics and glyphosate susceptibility of future generations., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Monitoring the intergranular variables of corn grain mass during the transportation, drying, and storage stages it possible to predict and avoid potential grain quality losses. For monitoring the grain mass along the transport, a probe system with temperature, relative humidity, and carbon dioxide sensors was developed to determine the equilibrium moisture content and the respiration of the grain mass. These same variables were monitored during storage. At drying process, the drying air and grain mass temperatures, as well as the relative humidity, were monitored. For the prediction of the physical and physical-chemical quality of the grains, the results obtained from the monitoring were used as input data for the multiple linear regression, artificial neural networks, decision tree, and random forest models. A Pearson correlation was applied to verify the relationship between the monitored and predicted variables. From the results obtained, we verified that the intergranular relative humidity altered the equilibrium moisture content of the grains, contributing to the increased respiration and hence dry matter losses along the transport. At this stage, the artificial neural network model was the most indicated to predict the electrical conductivity, apparent specific mass, and germination. The random forest model satisfactorily estimated the dry matter loss. During drying, the air temperature caused volumetric contraction and thermal damage to the grains, increasing the electric conductivity index. Artificial neural network and random forest models were the most suitable for predicting the quality of dry grains. During storage, the environmental conditions altered the moisture contents causing a reduction in the apparent specific mass, germination, and crude protein, crude fiber, and fat contents. Artificial neural network and random forest were the best predictors of moisture content and germination. However, the random forest model was the best predictor of apparent specific mass, electrical conductivity, and starch content of stored grains., (© 2024. The Author(s).)

Objective: To understand the social representations of people with tuberculosis about the disease and its implications for following treatment., Method: A descriptive, qualitative study based on the Theory of Social Representations. It was conducted in a municipal health unit in the city of Belém. The participants were people diagnosed with tuberculosis and undergoing directly observed treatment, with the sample size defined by the data saturation technique. Data collection was done through semi-structured interviews. For data analysis it was used thematic content analysis., Results: The records converged into three categories: Representations of tuberculosis and its impacts on the diagnosis; The faces of treatment: challenges facing follow-up and hope; and Constructions of living with the disease in family and society., Final Considerations: Living with the disease transforms everyday life and relationships. Discrimination and prejudice denote the need to reconfigure such representations for patients to be embraced.

High-resolution manometry (HRM) is used to evaluate the esophageal motor function. Unfortunately, there are times when testing cannot be performed accurately. Our study aimed to quantify the occurrence of failed HRM and identify the associated risk factors. HRM tests were retrospectively collected between September 2021 and August 2022. HRM reports that could not be interpreted based on standard HRM protocol as per Chicago guidelines were classified as failed tests. Information reviewed included testing indications, patient demographics, previous medical/symptom history, and follow-up testing for failed HRM. We then compared patients with successful vs. unsuccessful HRM based on our pre-specified factors. 152 HRM tests were performed, of which 28 tests (18%) were unsuccessful. Factors associated with failed manometry included a history of nausea/vomiting, dyspepsia, and achalasia. Patients who were unable to tolerate the probe during testing were more likely to have a history of dyspepsia (OR 20.3, p = < 0.001) and/or nausea/vomiting (OR 13.8, p = < 0.001). A history of achalasia was found to have an odds ratio of 13.2 when examining failure because of curling of the manometry catheter (p = 0.012). All seven patients who had repeat HRM with endoscopic placement were successful in obtaining diagnostic information. There are two groups that have risk factors for unsuccessful HRM testing. A history of nausea/vomiting and dyspepsia symptoms were associated with being unable to tolerate the manometry probe. The second group comprises patients with a history of achalasia in whom probe curling is more common. Future research targeting these risk factors may minimize diagnostic and treatment delays., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Corynebacterium pseudotuberculosis is a gram-positive bacterium and is the etiologic agent of caseous lymphadenitis (CL) in small ruminants. This disease is characterized by the development of encapsulated granulomas in visceral and superficial lymph nodes, and its clinical treatment is refractory to antibiotic therapy. An important virulence factor of the Corynebacterium genus is the ability to produce biofilm; however, little is known about the characteristics of the biofilm produced by C. pseudotuberculosis and its resistance to antimicrobials. Silver nanoparticles (AgNPs) are considered as promising antimicrobial agents, and are known to have several advantages, such as a broad-spectrum activity, low resistance induction potential, and antibiofilm activity. Therefore, we evaluate herein the activity of AgNPs in C. pseudotuberculosis , through the determination of minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), antibiofilm activity, and visualization of AgNP-treated and AgNP-untreated biofilm through scanning electron microscopy. The AgNPs were able to completely inhibit bacterial growth and inactivate C. pseudotuberculosis at concentrations ranging from 0.08 to 0.312 mg/mL. The AgNPs reduced the formation of biofilm in reference strains and clinical isolates of C. pseudotuberculosis, with interference values greater than 80% at a concentration of 4 mg/mL, controlling the change between the planktonic and biofilm-associated forms, and preventing fixation and colonization. Scanning electron microscopy images showed a significant disruptive activity of AgNP on the consolidated biofilms. The results of this study demonstrate the potential of AgNPs as an effective therapeutic agent against CL., Competing Interests: Vasco Azevedo and Debmalya Barh are Academic Editors for PeerJ., (©2024 Santos et al.)

Background and Purpose: Non-erosive reflux disease (NERD) accounts for over half of all gastroesophageal reflux cases and is characterized by reflux symptoms with pathologic acid exposure on pH monitoring but no evidence of erosions on upper endoscopy. Ambulatory pH monitoring is limited by availability and patient tolerance. The utility of performing esophageal mucosal biopsies in diagnosing NERD is unclear. We conducted a systematic review and meta-analysis to determine the sensitivity of esophageal mucosal biopsies in diagnosing NERD., Methods: Data were obtained from Embase and Ovid MEDLINE from inception to April 2021. Studies were included if esophageal mucosal biopsies were taken and analyzed using conventional histopathologic analysis in symptomatic NERD patients. Relevant data was including histologic abnormalities and location of the biopsy. Sensitivity and specificity were calculated against healthy controls or those with functional heartburn., Results: The search yielded 2871 studies, of which 10 studies met our inclusion criteria and contained raw data. Histological abnormalities included histologic sum scores, papillary elongation, basal cell hyperplasia, and dilated intraepithelial spaces. When assessing for the presence of any abnormality, biopsies taken <3 cm from the lower esophageal sphincter (LES) had a pooled sensitivity of 0.71 (95% CI 0.64-0.77) and specificity of 0.64 (95% 0.54-0.73); however, analysis of individual histologic features such as the presence of eosinophils improved the sensitivity., Conclusions: Although esophageal mucosal biopsies had poor sensitivity at diagnosing NERD, biopsies taken within 3 cm of the LES had higher sensitivity when pathologists reported upon eosinophils and dilated intraepithelial spaces., (© 2023 The Authors. Neurogastroenterology & Motility published by John Wiley & Sons Ltd.)

Background: This study aimed to evaluate the reliability and reproducibility of different non-invasive methods for the assessment of peri-implant mucosal thickness., Methods: Subjects with two adjacent dental implants in the central maxillary region were included in this study. Three different methods to assess facial mucosal thickness (FMT) were compared: digital file superimposition using Digital Imaging and Communication in Medicine (DICOM) and stereolithography (STL) files of the arch of interest (DICOM-STL), DICOM files alone, and non-ionizing ultrasound (US). Inter-rater reliability agreements between different assessment methods were analyzed using inter-class correlation coefficients (ICCs)., Results: A total of 50 subjects with 100 bone-level implants constituted the study population. Assessment of FMT using STL and DICOM files demonstrated excellent inter-rater reliability agreement. Mean ICC values of 0.97 and 0.95 were observed in the DICOM-STL and DICOM groups, respectively. Comparison between the DICOM-STL and US revealed good agreement, with an ICC of 0.82 (95% CI: 0.74 to 0.88) and a mean difference of -0.13 ± 0.50 mm (-1.13 to 0.86). Comparison between DICOM files alone versus US showed good agreement, with an ICC of 0.81 (95% CI: 0.73 to 0.89) and a mean difference of -0.23 ± 0.46 mm (-1.12 to 0.67). Comparison between DICOM-STL and DICOM files revealed excellent agreement, with an ICC of 0.94 (95% CI: 0.91 to 0.96) and a mean difference of 0.1 ± 0.29 mm (LOA -0.47 to 0.46)., Conclusions: Quantification of peri-implant mucosal thickness via analysis of DICOM-STL files, DICOM files, or US assessment are comparably reliable and reproducible methods., (© 2023 The Authors. Journal of Periodontology published by Wiley Periodicals LLC on behalf of American Academy of Periodontology.)

Importance: Depression is a leading cause of disability worldwide, and there is increasing interest in nonpharmacological treatments. Auricular acupuncture (AA) is a simple, low-cost, and well-tolerated option, but further studies are needed to establish its efficacy and safety., Objective: To estimate the efficacy and safety of auricular acupuncture as a treatment for depression., Design, Setting, and Participants: This randomized clinical trial was conducted at 4 university research centers in Brazil, from March to July 2023. Eligible patients were adults aged 18 to 50 years whose score on the Patient Health Questionnaire-9 (PHQ-9) indicated moderate depression (score 10-14) or moderately severe depression (score 15-19). Exclusion criteria included previous application of AA, risk of suicidal ideation, or severe depression (PHQ-9 score >20). An intent-to-treat analysis and modified intent-to-treat analysis were conducted., Intervention: Participants were randomized into 2 treatment groups, which included specific AA (SA) and nonspecific AA (NSA). Both groups received 12 sessions of AA with semipermanent needles with daily stimulation twice a week over 6 weeks and were followed-up for 3 months. All participants continued with their usual care for ethical reasons. The SA group's treatment protocol consisted of 6 acupuncture points on the auricular pavilion chosen according to the diagnosis of depression by traditional Chinese medicine (Shenmen, subcortex, heart, lung, liver, and kidney). The NSA group's acupuncture points were the external ear, the cheek and face area, and 4 nonspecific points in the helix region unassociated with mental health symptoms. A locator device was used to confirm which areas had neuroreactive points., Main Outcomes and Measures: The primary outcome was a reduction of at least 50% in the PHQ-9 score (ie, depression recovery) at 3 months. Secondary outcomes included depression recovery at 4 and 6 weeks; depression remission (PHQ-9 score < 5) at 4 weeks, 6 weeks, and 3 months); and adverse events., Results: A total of 304 participants were screened, and 74 participants (62 women [84%]; median [IQR] age, 29 [23-27] years) were included in the intention-to-treat analysis, with 37 participants randomized to each group (SA and NSA). A total of 47 participants (64%) were followed-up through 3 months. The results showed no statistically significant difference in depressive recovery between the groups at 3 months (14 of 24 participants in the SA group [58%] vs 10 of 23 participants in the NSA group [43%]; risk ratio [RR], 1.34; 95% CI, 0.76-2.45; P = .38). The proportions of depression recovery and remission at 4 and 6 weeks based on the PHQ-9 were higher in the SA group (except for depression recovery at 6 weeks) with no statistically significant differences. However, a statistically significant difference was observed in symptom remission at 3 months (11 of 24 participants in the SA group [46%] vs 3 of 23 participants in the NSA group [13%]; RR, 1.99; 95% CI, 1.16-3.34; P = .02) in favor of SA. There were no significant differences in adverse event rates between the groups, evidencing the intervention's safety. Most participants reported mild pain at the needle application site (33 patients [94%] in the SA group vs 32 patients [91%] in the NSA group). Five participants dropped out of the study due to adverse events., Conclusions and Relevance: The results of this randomized clinical trial suggest that SA over 6 weeks is safe. Although there was no statistically significant difference between groups for the primary efficacy outcome, patients receiving SA did experience greater symptom remission at 3 months. A larger sample size and longer intervention are needed to further evaluate the efficacy of SA for depression., Trial Registration: ClinicalTrials.gov Identifier: NCT05855421.

Statement of Problem: In a prosthetically driven treatment plan, the tomographic sagittal root position in relation to the bone housing is an important factor in the decision-making process for immediate implant placement. However, other important parameters must be considered in the bone housing of each tooth, including the alveolar ridge dimensions, the buccal and the palatal bone thickness, and the root dimensions., Purpose: The purpose of this clinical study was to evaluate the relationship between the sagittal root position of maxillary anterior teeth and the bone housing., Materials and Methods: A total of 420 maxillary anterior teeth were analyzed in 70 participants. The tomographic scans were classified as sagittal root position classes I, II, III, and IV. Measurements included buccal and palatal bone thickness, alveolar ridge height, alveolar ridge width, apical bone height, root length, and root width. The Pearson correlation, ANOVA, and Tukey post hoc tests were used to determine statistically significant differences (α=0.05)., Results: The sagittal root position distribution was 65.2%, 9.3%, 0.7%, and 24.8% for classes I, II, III, and IV, respectively. Bone housing measurements were significantly different in relation to the 4 sagittal root position classes (P<.05), except for alveolar ridge height. Post hoc analysis showed that, in class I, buccal bone thickness and alveolar bone height were significantly low, whereas root length and palatal bone thickness were high. The higher buccal bone thickness was found in class II, and lower alveolar ridge width and palatal bone thickness in class IV. These measurements in tooth groups were also significantly different over the sagittal root position classes (P<.05). The buccal bone thickness, palatal bone thickness, and alveolar ridge width presented different levels of correlation with alveolar ridge width over the sagittal root position classes. The buccal bone thickness and palatal bone thickness were weakly correlated in class I (r=0.163) and IV (r=0.222)., Conclusions: Bone housing measurements were significantly different in relation to the sagittal root position of maxillary anterior teeth., (Copyright © 2021 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

p -Coumaric acid is derived from cinnamic acid and is one of the major compounds in the Brazilian green propolis extract. Studies have shown that both p -coumaric acid and cinnamic acid have promising antiproliferative effects. In this context, aiming to increase the complexity of these active natural products and their activities, we performed coupling reactions with propargylamine and benzylamine, as well as with threonine, phenylalanine and lysine amino acids, aiming to enhance their antiproliferative effects towards the hormone-dependent breast cancer MCF-7 cells. Overall, the p -coumaric acid coupling with L -threonine amino acid (compound 15 ) had the best selectivity index (SI = 5.1), with half-maximal inhibitory concentration of 39.6  ±  1 μM, showing a high selectivity against hormone-dependent breast cancer cell lines MCF-7 and low cytotoxicity against the normal breast cell lines MCF-10A. Thus, this new natural product derivative may represent a prototype for the future development of antiproliferative agents, especially against hormone-dependent breast cancer.

Background: Alterations in eating behavior are common in infants with intrauterine growth restriction (IUGR); omega-3 polyunsaturated fatty acids (PUFA) could provide protection. We hypothesized that those born IUGR with a genetic background associated with increased production of omega-3-PUFA will have more adaptive eating behaviors during childhood., Methods: IUGR/non-IUGR classified infants from MAVAN and GUSTO cohorts were included at the age of 4 and 5 years, respectively. Their parents reported child's eating behaviors using the child eating behavior questionnaire-CEBQ. Based on the GWAS on serum PUFA (Coltell 2020), three polygenic scores were calculated., Results: Significant interactions between IUGR and polygenic score for omega-3-PUFA on emotional overeating (β = -0.15, P = 0.049 GUSTO) and between IUGR and polygenic score for omega-6/omega-3-PUFA on desire to drink (β = 0.35, P = 0.044 MAVAN), pro-intake/anti-intake ratio (β = 0.10, P = 0.042 MAVAN), and emotional overeating (β = 0.16, P = 0.043 GUSTO) were found. Only in IUGR, a higher polygenic score for omega-3-PUFA associated with lower emotional overeating, while a higher polygenic score for omega-6/omega-3-PUFA ratio was associated with a higher desire to drink, emotional overeating, and pro-intake/anti-intake., Conclusion: Only in IUGR, the genetic background for higher omega-3-PUFA is associated with protection against altered eating behavior, while the genetic score for a higher omega-6/omega-3-PUFA ratio is associated with altered eating behavior., Impact: A genetic background related to a higher polygenic score for omega-3 PUFA protected infants born IUGR against eating behavior alterations, while a higher polygenic score for omega-6/omega-3 PUFA ratio increased the risk of having eating behavior alterations only in infants born IUGR, irrespective of their adiposity in childhood. Genetic individual differences modify the effect of being born IUGR on eating outcomes, increasing the vulnerability/resilience to eating disorders in IUGR group and likely contributing to their risk for developing metabolic diseases later in life., (© 2023. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.)

This study aimed at determining the correlation between gingival stippling (GS) and other phenotypical characteristics. Adult subjects in need of cone-beam computed tomography scans (CBCT) and comprehensive dental treatment in the maxillary anterior region were recruited. Facial gingival thickness [GT] and buccal bone thickness [BT] were assessed utilizing CBCT. Standardized intraoral photographs were obtained to determine keratinized tissue width (KTW), presence of GS in all facial and interproximal areas between the maxillary canines, and other variables of interest, such as gingival architecture (GA), tooth shape, and location. Statistical analyses to assess different correlations among recorded variables were conducted. A total of 100 participants and 600 maxillary anterior teeth constituted the study population and sample, respectively. Facial GS was observed in 56% of males and 44% of females, and it was more frequently associated with flat GA, triangular and square/tapered teeth, central incisors, and males. Greater mean values of GT, BT, and KTW were observed in facial areas that exhibited GS. Interdental GS was present in 73% of the sites and it was more frequently observed in males, the central incisor region, and when facial GS was present. Multilevel logistic regression revealed a statistically significant association between the presence of GS and KTW, BT measured at 3mm apical to the bone crest, and tooth type. This information can be used in the recognition of common periodontal phenotypical patterns associated with specific features of great clinical significance.

Background: The purpose of this study was to determine the association between periodontal supracrestal soft tissue dimensions (PSSTDs) and other phenotypic features in non-molar maxillary teeth., Materials and Methods: Adult subjects in need of comprehensive dental treatment were recruited. Periodontal phenotypic variables (i.e., facial and palatal gingival thickness [GT], alveolar bone thickness [BT], and PSSTDs, namely distance from the gingival margin to the bone crest defined as periodontal supracrestal tissue height [PSTH] and distance from the cementoenamel junction to the bone crest [CEJ-BC]) were recorded using cone-beam computed tomography scans. Standardized intraoral photographs were obtained to assess facial keratinized tissue width (KTW) and other anatomical parameters (i.e., tooth type, gingival architecture, and interproximal papilla height)., Results: The study sample was constituted of 87 participants that contributed with a total of 522 maxillary anterior teeth. Differences in mean values of PSSTDs, KTW, GT, and BT were observed between tooth types and sex. Males exhibited a thicker GT and BT, and taller PSTH and KTW compared to females. Shorter CEJ-BC was associated with shorter PSTH, wider KTW, and thicker GT and BT. Shorter PSTH was associated with thicker facial BT. Notably, BT and GT were positively correlated at both facial and palatal sites, meaning that the thicker the gingival phenotype, the thicker the bone morphotype. Facial BT and facial GT were positively correlated with KTW. A flat gingival architecture was associated with the thick periodontal phenotype. Square teeth had shorter CEJ-BC, wider KTW, and thicker GT., Conclusions: Periodontal phenotypic features vary across and within subjects, between facial and palatal sites at different apico-coronal levels, and as a function of sex and tooth type. The shorter the PSSTDs, the wider the KTW and the thicker the GT and BT. PSSTDs, particularly PSTH, should be considered an integral component of the periodontal phenotype., (© 2023 American Academy of Periodontology.)

Background: Using data from the Rome Foundation Global Epidemiology Study examining prevalence of disorders of gut-brain interaction (DGBI) in 33 countries, this study explored the prevalence of all 22 disorders in Canada. It examined differences related to geography and sociodemographic factors, health impact and compared these findings to other countries., Methods: The Rome Foundation survey was conducted through the Internet, targeting 2000 Canadian participants. The survey used the validated ROME IV diagnostic questionnaire to identify the 22 DGBI and an in-depth supplemental questionnaire that included quality assurance techniques., Key Results: There were 2029 respondents with a mean age of 48 years and 50% females. Diagnostic criteria for at least one of the 22 DGBI were met by 41.3%, similar to other countries. Functional constipation, functional diarrhea, and unspecified functional bowel disorders were most common. Irritable bowel syndrome prevalence was 4.2% using Rome IV and 10.1% using ROME III criteria. DGBI were associated with poorer quality of life and increased psychological symptom scores. Prevalence of DGBI ranged from 48% in Quebec to 36% in British Columbia. Prescription pain medication was reported by 17% with DGBI compared to 9% without DGBI and correlated negatively with mental health and physical well-being. Quebecers and francophones were in limited number but reported higher DGBI prevalence and symptom severity compared to others., Conclusions & Inferences: A large proportion of Canadians suffer from DGBI which seriously impact their well-being. Findings highlight the need for further research and education, including understanding whether significant regional and cultural differences contribute to DGBI., (© 2023 John Wiley & Sons Ltd.)

Objectives: To identify and report the current landmarks used for measuring gingival thickness (GT) in healthy maxillary anterior teeth., Material and Methods: The protocol of this Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) 2020-compliant systematic review was registered in PROSPERO. A literature search was conducted to identify articles that met the eligibility criteria published up to 2022. The methods of assessing gingival thickness and the landmarks adopted on the studies were described. Primary outcomes were identified, and the frequency of reporting in the selected articles was calculated. Additionally, risk-of-bias assessments were performed for individual articles., Results: Fifty-eight articles (34 with low risk of bias and 24 with medium risk of bias) were selected. A total of 3638 individuals had their gingival thickness measured. Thirty-nine different landmarks were adopted in the studies. Fifty-six articles with 22 landmarks were included in the meta-analysis. A higher heterogeneity was found between the studies (GT ranged from 0.48 to 2.59 mm, mean GT 1.074; 95% CI: 1.024-1.104). The 3 most used landmarks were 2 mm from gingival margin (10 studies, mean GT 1.170 mm, 95% CI: 1.085-1.254), bone crest (9 studies, mean GT 1.01 mm; 95% CI: 0.937-1.083), and cemento-enamel junction (7 studies, mean GT 1.172 mm; 95% CI: 1.105, 1.239)., Conclusions: Within the limits of this study, a large heterogeneity in GT was found, and there was no consensus on the ideal landmark for GT measurement., Clinical Relevance: The landmark 2 mm from gingival margin, located at attached gingiva, can be used for GT measurement by clinical and image-based devices. This is an important step for a quantitative instead of a qualitative evaluation of phenotypes., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Green propolis produced by Apis melífera bees, having Baccharis dracunculifolia D.C. (Asteraceae) as the primary botanical source, has been used in traditional medicine to treat numerous disorders. However, studies evaluating propolis' potential in treating cardiovascular diseases via its effects on cholesterol metabolism are lacking. Therefore, this study investigated the effects of green propolis extracts on lipid metabolism in hypercholesterolemic guinea pigs. Chemical characterization of ethanolic extracts of green propolis samples was undertaken using HPLC. The in vitro characterization included an evaluation of the antioxidant capacity of the hydroalcoholic extract of green propolis (DPPH and FRAP assays) and its ability to act as an inhibitor of the HMG-CoA reductase enzyme. In vivo , we investigated the effect of the hydroalcoholic extract of green propolis on lipid metabolism in hypercholesterolemic guinea pigs. Results obtained validated previous reports of significant antioxidant activity. HPLC analysis confirmed that coumaric acid, artepillin C, and baccharin were the most common and abundant compounds in green propolis samples among the studied compounds. Furthermore, the compounds in these extracts acted as effective HMG-CoA reductase inhibitors in vitro . In vivo assays demonstrated that a hypercholesterolemic diet significantly reduced serum levels of the HDL cholesterol fraction. Simvastatin and propolis hydroalcoholic extracts promoted a significant increase in HDL cholesterol, suggesting that these extracts can improve the serum lipid profile of hypercholesterolemic guinea pigs. Results obtained in this study provide a perspective on the possible hypocholesterolemic effect of green propolis, suggesting that it can improve the serum lipid profile in hypercholesterolemic guinea pigs.

Fungal resistance to different therapeutic drugs has become a growing challenge. This crucial health problem requires new effective drug alternatives. Herein, we report the study of Eucalyptus botryoides ' resin used in folk medicine as antimicrobial. Thus, E. botryoides ' resin was extracted with aqueous-ethanol and fractionated using Sephadex chromatography, furnishing its major compounds. The crude extracts and the isolated compounds were evaluated for their in vitro antimicrobial activity against bacteria and yeasts. The crude extract displayed MIC of 25 μg/mL against S. salivarius , and for C. albicans, C. glabrata, and C. tropicalis the MIC were between 2.9 and 5.9 μg/mL. The 7- O -Methyl-aromadendrin was the most effective against C. glabrata and C. krusei (MIC = 1.6 μg/mL). 2- O -Galloyl-1,6- O -di- trans - p -coumaroyl- β -D-glycopyranoside, first time reported, showed MIC of 3.1 μg/mL against C. glabrata and C. krusei . Overall, this work gave promising results, indicating that Eucalyptus botryoides ' resin and its compounds have the potential for developing anti-yeast products.

Competing Interests: Intérêts concurrents: Aucun déclaré.

Brazil is one of the largest propolis producers in the world. Propolis is produced by bees from plant exudates and tissues, leading to many variations in the types of propolis. Generally, Brazilian propolis types are green, brown, and red. Despite not being the main research focus as the green and red propolis, brown propolis is the second most produced propolis type in Brazil and has tremendous economic and medicinal importance. Propolis has drawn attention with the rise in the search for healthier lifestyles, functional foods, biocosmetics, and natural products as therapeutic sources. This review covers the main chemical constituents identified in different types of Brazilian brown propolis, and their botanical sources, chemistry, and biological activities. The economic aspect of brown propolis is also presented. There are many gaps to be filled for brown propolis regarding the development of analytical methods, and quality control to allow its standardization, limiting its applicability in the food and pharmaceutical industries. Future perspectives regarding brown propolis research were discussed, especially biological activities, to support the medicinal uses of different types of brown propolis., Supplementary Information: The online version contains supplementary material available at 10.1007/s43450-023-00374-x., Competing Interests: Conflict of InterestThe authors declare no competing interests., (© The Author(s) under exclusive licence to Sociedade Brasileira de Farmacognosia 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Staphylococcal A and streptococcal G proteins are widely used in immunoassays when specific immunological reagents are unavailable, such as for wild animals. The affinity of bacterial proteins A and G to the immunoglobulins of seven Brazilian mammals were tested, including black-tufted marmoset ( Callithrix penicillata , n = 5), golden-bellied capuchin ( Sapajus xanthosternos , n = 13), woolly mouse opossum ( Micoureus demerarae , n = 6), long-nosed armadillo ( Dasypus novemcinctus , n = 5), collared anteater ( Tamandua tetradactyla , n = 5), ocelot ( Leopardus pardalis , n = 6), and vampire bat ( Desmodus rotundus , n = 5). Blood samples were collected from animals that were rescued in peri-urban rainforest fragments. Sera pools of each species were tested by ELISA to determine the intensity of each bacterial protein affinity to the immunoglobulins. When comparing the affinity to both proteins, immunoglobulins from D. rotundus , S. xanthosternos , and T. tetradactyla presented a higher affinity to protein G, whereas a higher affinity to protein A was found for immunoglobulins of C. penicillata and L. pardalis . The only species that presented a very low affinity to both bacterial proteins was M. demerarae . This study can be used as a reference for further studies on the development of sensitive and specific immunodiagnostic assays to be used for the monitoring of the health of these wild mammals.

Background: This cross-sectional study assessed the role of gingival landmarks (GLs) and cutting points (CPs) for gingival phenotype (GP) determination., Methods: Six maxillary anterior teeth (70 subjects) were evaluated using soft tissue cone-beam computed tomography (ST-CBCT). Gingival thickness was measured at different GLs: 1) tissue zone (gingival margin [GM], 1 and 2 mm apical to GM, cemento-enamel junction, above the bone crest); 2) bone zone (buccal bone crest [BBC], 1, 2, and 3 mm apical to BBC). CPs of 0.6, 0.8, 1.0, 1.2, and 1.5 mm were used to discriminate between thin and thick GP. The clinical determination of GP was made based on transparency of the periodontal probe (TRAN)., Results: The prevalence of thin and thick GP depended on the GL and CP. Considering the CP (1 mm), thin GP at the tissue zone ranged from 99% at the GM to 10.2% above the bone crest. In the bone zone, thick GP ranged from 28% at the BBC to 6% at 3 mm apical to the BBC. The predictability of a correct assessment of GP by TRAN compared with ST-CBCT was influenced by the GLs and CPs. A slight agreement (kappa <0.2) and low accuracy (area under the curve <0.7) were found between methods., Conclusions: The determination of thin and thick GPs is related to the gingival landmarks and CPs. Further studies are required for a well-defined treatment protocol considering different gingival landmarks in tissue and bone zones. An ST-CBCT may be useful for this purpose., (© 2022 American Academy of Periodontology.)

Competing Interests: Competing interests: None declared.

Objectives: To evaluate the correlation between smile type (ST) and the periodontal phenotype (PP)., Material and Methods: Clinical and photographic examinations of 164 participants (48 men and 116 women, mean age 22.9 ± 4.6 years) were performed, including an evaluation of ST (high, average, and low), gingival phenotype (GP) by transparency of the periodontal probe (TRAN), keratinized tissue width (KTW), gingival architecture (GA), tooth shape (TS), and papilla height (PH). A subgroup of 70 participants underwent soft-tissue cone-beam tomographic examinations (ST-CBCT), in which GP, gingival thickness (GT), buccal bone thickness (BBT), and the distances from the gingival margin and cementoenamel junction to the buccal bone crest (GM-BBC and CEJ-BBC) were evaluated. The data were analyzed using one-way ANOVA, Student's t-test, and chi-square tests, with the level of significance set at 0.05., Results: High, average, and low STs were found in 31.7%, 56.7%, and 11.6% of the participants, respectively. Sex (p=0.001), GP evaluated using TRAN (p=0.021) and ST-CBCT scans (p=0.009), GA (p<0.001), and TS (p=0.001), were associated with STs. The prevalence of thin GP was: 63% in low, 50% in average, and 38% in high smile types. KTW (p=0.004), PH (p<0.001), GT at different landmarks (p<0.05), CEJ-BBC (p=0.017), and GM-BBC (p=0.001) were significantly different among STs. The highest GT and KTW were found in the high-smile group, average-smile presented the higher CEJ-BBC while GM-BBC and PH, were higher in low-smile group., Conclusion: Periodontal phenotype components presented important difference over the smile types., Clinical Relevance: A detailed examination of smile types is an essential part of treatment planning, especially when the patient has high esthetic demands. Clinical and tomographic individual analysis of periodontal phenotypes over the smile types may be helpful for a case-by-case approach, and for the development of well-defined treatment protocols., (Copyright © 2022. Published by Elsevier Ltd.)

Background: Hypoglycemia unawareness designates failure to detect eminent hypoglycemia. Clarke's questionnaire is one of the most used systems to evaluate this problem., Aims: To relate Clarke's questionnaire (QQ) results with continuous glucose monitoring data., Methods: Application of the questionnaire in a sample of type 1 diabetes mellitus (T1DM) patients using intermittent continuous glucose monitoring (iCGM)., Results: 111 T1DM patients were evaluated, 56.8% female, mean age 35.0 ± 12.4 years and mean disease duration 18.8 ± 10.5 years. According to CQ, 13.5% had unawareness, 76.6% awareness and 9.9% indeterminate awareness to hypoglycemia. Those with unawareness had longer disease duration (25.1 ± 10.4 vs 18.2 ± 10.3 for awareness and 14.9 ± 9.9 for indeterminate awareness, p = 0.047), more time below range (10.3 ± 4.9% vs 6.3 ± 5.1 and 6.3 ± 4.8; p = 0.009) and higher mean duration of hypoglycemia (131.7 ± 38.6 vs 116.6 ± 49.6 and 131.7 ± 38.6; p = 0.008). In multivariate analysis, mean duration of hypoglycemia was an independent predictor of CQ results. In a receiver operating curve (AUC 0.746; p = 0.004) a mean duration of hypoglycemia ≥106.5 min showed 84.6% sensitivity/64.4% specificity for unawareness., Conclusions: Our sample had a significative prevalence of hypoglycemia unawareness which increased with longer diabetes duration. iCGM data can be indicative of this problem, with a mean hypoglycemia duration ≥106.5 min being suggestive, albeit unspecific., (Copyright © 2022 Diabetes India. Published by Elsevier Ltd. All rights reserved.)

Introduction: Prenatal growth impairment leads to higher preference for palatable foods in comparison to normal prenatal growth subjects, which can contribute to increased body fat mass and a higher risk for developing chronic diseases in small-for-gestational-age (SGA) individuals throughout life. This study aimed to investigate the effect of SGA on feeding behavior in children and adolescents, as well as resting-state connectivity between areas related to reward, self-control, and value determination, such as orbitofrontal cortex (OFC), dorsolateral prefrontal cortex (DL-PFC), amygdala and dorsal striatum (DS)., Methods: Caregivers and their offspring were recruited from two independent cohorts in Brazil (PROTAIA) and Canada (MAVAN). Both cohorts included anthropometric measurements, food choice tasks, and resting-state functional magnetic resonance imaging (fMRI) data., Results: In the Brazilian sample (17 ± 0.28 years, n=70), 21.4% of adolescents were classified as SGA. They exhibited lower monetary-related expenditure to buy a snack compared to controls in the food choice test. Decreased functional connectivity (n=40) between left OFC and left DL-PFC; and between right OFC and: left amygdala, right DS, and left DS were observed in the Brazilian SGA participants. Canadian SGA participants (14.9%) had non-significant differences in comparison with controls in a food choice task at 4 years old ( ± 0.01, n=315). At a follow-up brain scan visit (10.21 ± 0.140 years, n=49), SGA participants (28.6%) exhibited higher connectivity between the left OFC and left DL-PFC, also higher connectivity between the left OFC and right DL-PFC. We did not observe significant anthropometric neither nutrients' intake differences between groups in both samples., Conclusions: Resting-state fMRI results showed that SGA individuals had altered connectivity between areas involved in encoding the subjective value for available goods and decision-making in both samples, which can pose them in disadvantage when facing food options daily. Over the years, the cumulative exposure to particular food cues together with the altered behavior towards food, such as food purchasing, as seen in the adolescent cohort, can play a role in the long-term risk for developing chronic non-communicable diseases., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Dalle Molle, de Mendonça Filho, Minuzzi, Machado, Reis, Rodrigues, Mucellini, Franco, Buchweitz, Toazza, Bortoluzzi, Salum, Boscenco, Meaney, Levitan, Manfro and Silveira.)

Background: Molecular chaperones assist protein folding, facilitate degradation of misfolded polypeptides, and thereby maintain protein homeostasis. Impaired chaperone activity leads to defective protein quality control that is implicated in multiple skeletal muscle diseases. The heat shock protein A4 (HSPA4) acts as a co-chaperone for HSP70. Previously, we showed that Hspa4 deletion causes impaired protein homeostasis in the heart. However, its functional role in skeletal muscle has not been explored., Methods: We performed a comparative phenotypic and biochemical analyses of Hspa4 knockout (KO) mice with wild-type (WT) littermates., Results: HSPA4 is markedly upregulated in regenerating WT muscle in vivo, and in differentiated myoblasts in vitro. Hspa4-KO mice are marked by growth retardation and increased variability in body weight, accompanied by 35% mortality rates during the peri-weaning period. The surviving Hspa4-KO mice experienced progressive skeletal muscle myopathy, characterized by increased number of muscle fibers with centralized nuclei, heterogeneous myofiber size distribution, inflammatory cell infiltrates and upregulation of embryonic and perinatal myosin heavy chain transcripts. Hspa4-KO muscles demonstrated an accumulation of autophagosome-associated proteins including microtubule associated protein1 light chain 3-II (LC3-II) and p62/sequestosome accompanied by increased number of TUNEL-positive nuclei., Conclusions: Our findings underscore the indispensable role of HSPA4 in maintenance of muscle integrity through contribution in skeletal muscle autophagy and apoptosis, which might provide a novel therapeutic strategy for skeletal muscle morbidities., (© 2022. The Author(s).)

Background: Paracentesis is a bedside procedure to obtain ascitic fluid from the peritoneum. Point-of-care ultrasound (POCUS) improves the safety of some medical procedures. However, the evidence supporting its utility in paracentesis is limited., Objective: We aimed to assess if POCUS would yield a user-preferred site for needle insertion compared to conventional landmarking, defined as a ≥ 5 cm change in location., Design: This was a prospective non-randomized trial comparing a POCUS-guided site to the conventional anatomic site in the same patient., Participants: Adult patients at Kingston Health Sciences Centre undergoing paracentesis were included., Interventions: Physicians landmarked using conventional technique and compared this to a POCUS-guided site. The paracentesis was performed at whatever site was deemed optimal, if safe to do so., Main Measures: Data collected included the distance from the two sites, depth of fluid pockets, and anatomic considerations., Key Results: Forty-five procedures were performed among 30 patients and by 24 physicians, who were primarily in their PGY 1 and 2 years of training (33% and 31% respectively). Patients' ascites was mostly due to cirrhosis (84%) predominantly due to alcohol (47%) and NAFLD (34%). Users preferred the POCUS-guided site which resulted in a change in needle insertion ≥ 5 cm from the conventional anatomic site in 69% of cases. The average depth of fluid was greater at the POCUS site vs. the anatomic site (5.4±2.8 cm vs. 3.0±2.5 cm, p < 0.005). POCUS deflected the needle insertion site superiorly and laterally to the anatomic site. The POCUS site was chosen (1) to avoid adjacent organs, (2) to optimize the fluid pocket, and (3) due to abdominal wall considerations, such as pannus. Six cases landmarked anatomically were aborted when POCUS revealed inadequate ascites., Conclusions: POCUS changes the needle insertion site from the conventional anatomic site for most procedures, due to optimizing the fluid pocket and safety concerns, and helped avoid cases where an unsafe volume of ascites was present., (© 2021. Crown.)

Background: Suicide is a leading cause of death during the perinatal period in high-income countries (HIC). There remains a lack of population-based studies about suicidal ideation (SI) during pregnancy among low and middle income countries (LMIC)., Objectives: Using the case of Brazil, we aim to estimate the prevalence of SI during pregnancy and its association with antenatal depression (AD) and sociodemographic factors in a LMIC., Method: We used data from the Brazilian National Survey (PNS-2019), a population-based study, with a complex and probabilistic sampling method. Of the 27,136 women of reproductive age (15 to 49 years old) who participated in the PNS, a total of 769 women reported being pregnant at the time of the interview. All PNS participants answered the Patient Health Questionnaire-9 (PHQ-9) and a questionnaire with sociodemographic data. SI was defined as any answer to the PHQ-9 item 9 other than 0 (not at all). Logistic regression models were performed to obtain crude and adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) for the association between explanatory variables and SI during pregnancy., Results: Among 769 women, 33 (3.9%, 95% CI: 3.0-5.1%) reported SI during pregnancy. In the adjusted analysis, higher odds of SI were associated with being 20 to 34 years old (aOR:0.24, 95% CI: 0.08-0.74) or 35 to 49 years old (aOR:0.15; 95% CI: 0.04-0.50), having 9 to 11 years of education (aOR 0.23, 95% CI: 0.61-0.86), acheiving the highest family income category (aOR:0.08, 95% CI: 0.01-0.58), not living in the South/Southeast regions of Brazil (aOR:5.52, 95% CI: 2.36-12.9), and having probable mild AD (aOR:10.5 95% CI: 2.3-47.9) or moderate AD (aOR:241.3, 95% CI: 58.4-996.7)., Conclusions: In Brazil, SI affects almost 4% of pregnant women and is associated with sociodemographic vulnerability. Clinically, women with mild symptoms of depression may also experience SI during pregnancy. These findings are important for designing effective perinatal mental health interventions in LMICs., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Faisal-Cury, Oliveira Rodrigues, Matijasevich, Tarpinian and Tabb.)

Purpose: This cross-sectional study evaluated and categorized the tomographic sagittal root position (SRP) of the maxillary anterior teeth in a Brazilian population., Materials and Methods: Cone-beam computed tomographic scans of 420 maxillary anterior teeth of 70 patients (35 men and 35 women, mean age 25.2±5.9 years) were evaluated. The SRP was classified as class I, II, III, or IV. In class I, the root is positioned against the buccal cortical plate; in class II, the root is centered in the middle of the alveolar housing; in class III, the root is positioned against the palatal cortical plate; and in class IV, at least two-thirds of the root engage both the buccal and palatal cortical plates., Results: In total, 274 teeth (65.2%) were class I, 39 (9.3%) were class II, 3 (0.7%) were class III, and 104 (24.8%) were class IV. The frequency distribution over the teeth groups was different from the overall analysis. Important differences were found in the frequencies of classes I, II, and IV compared to other populations. Sex was not associated with the SRP classes ( P =0.307). Age distribution was significantly different over the classes ( P =0.004)., Conclusion: The findings of this study on the distribution of SRP classes among the Brazilian population compared to other populations demonstrate that the SRP should be analyzed on a case-by-case basis for an accurate treatment plan in the maxillary anterior area., Competing Interests: Conflicts of Interest: None, (Copyright © 2022 by Korean Academy of Oral and Maxillofacial Radiology.)

While classically linked to memory, the hippocampus is also a feeding behavior modulator due to its multiple interconnected pathways with other brain regions and expression of receptors for metabolic hormones. Here we tested whether variations in insulin sensitivity would be correlated with differential brain activation following exposure to palatable food cues, as well as with variations in implicit food memory in a cohort of healthy adolescents, some of whom were born small for gestational age (SGA). Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) was positively correlated with activation in the cuneus, and negatively correlated with activation in the middle frontal lobe, superior frontal gyrus and precuneus when presented with palatable food images versus non-food images in healthy adolescents. Additionally, HOMA-IR and insulinemia were higher in participants with impaired food memory. SGA individuals had higher snack caloric density and greater chance for impaired food memory. There was also an interaction between the HOMA-IR and birth weight ratio influencing external eating behavior. We suggest that diminished insulin sensitivity correlates with activation in visual attention areas and inactivation in inhibitory control areas in healthy adolescents. Insulin resistance also associated with less consistency in implicit memory for a consumed meal, which may suggest lower ability to establish a dietary pattern, and can contribute to obesity. Differences in feeding behavior in SGA individuals were associated with insulin sensitivity and hippocampal alterations, suggesting that cognition and hormonal regulation are important components involved in their food intake modifications throughout life., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Objectives: To evaluate the relationship between the tomographic sagittal root position (SRP) of maxillary anterior teeth and periodontal phenotype (PP)., Material and Methods: Seventy volunteers (420 teeth) were evaluated. Clinical and photographic exams included the evaluation of gingival phenotype (GP) by transparency of the periodontal probe, keratinized tissue width (KTW), gingival architecture, tooth shape, and papilla height (PH). Soft tissue tomographic scan (ST-CBCT) measurements included the SRP classification, GP, gingival thickness in the tissue zone (GT-TZ) and in the bone zone (GT-BZ), buccal bone thickness (BBT), and the distances from the gingival margin and from cementoenamel junction to the buccal bone crest (GM-BBC and CEJ-BBC). Kruskal-Wallis test and a linear regression analysis model were used., Results: The frequency of SRP over the 420 teeth was 65.2% (class I), 9.3% (class II), 0.7% (class III), and 24.8% (class IV). Linear regression analysis showed that SRP is related to PP (p < 0.05). Significantly different measurements of PP parameters were found in SRP classes. The higher and lower GT and BBT were found in classes II and I, respectively. Class IV presented the highest KTW, PH, CEJ-BBC, and GM-BBC. Central incisors (CI) classes I and II were most frequently square-shaped, while 89% of CI Class IV were triangular-shaped., Conclusion: The SRP of maxillary anterior teeth is related to periodontal phenotype., Clinical Relevance: Clinical and ST-CBCT individual analysis of PP and SRP may be helpful for an esthetic and functional treatment plan based on soft and hard tissue thickness and tooth positioning., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Candida spp. resistant to commercially available antifungals are often isolated from patients with oral candidiasis, a situation that points to the need for the development of new therapies. Thus, we evaluated the activity of Fusarium oxysporum -based silver nanoparticles (AgNPs) on Candida spp. isolated from denture stomatitis lesions. Candida isolates were molecularly identified and submitted to susceptibility assays using AgNPs and commercial fungicides. The interference on biofilm formation and the mechanisms of action of AgNPs on Candida spp. were also investigated. Scanning electron microscopy was used to evaluate the morphology of AgNP-treated Candida . Candida albicans was the most frequent species isolated from denture stomatitis cases. All Candida spp. were susceptible to AgNPs at low concentrations, except Candida parapsilosis . AgNPs caused surface damage, cell disruption, and biofilm formation inhibition. The ergosterol supplementation protected C. albicans against the AgNP action. AgNPs are effective against Candida spp. and can be faced as a promising new therapeutic agent against oral candidiasis.

This study analyzed the root trunk (RT) and the pre-furcation area (PFA) of mandibular first molars. Thirty lower first mandibular molars extracted due to advanced periodontal disease were evaluated in a high-energy spiral computerized micro-tomography. Two gutta-percha markings on the cementoenamel junction (CEJ) and at the furcation entrance (FE) at buccal and lingual surfaces served as reference points for measurements of RT length, and PFA width and depth, at the levels of CEJ, 1 mm apical to CEJ, 2 mm apical to CEJ, and at the FE. The mean RT length was 2.49 mm at buccal and 3.18 mm at lingual sides. The mean widths of the PFA at CEJ, at 1 and 2 mm apical to CEJ, and at FE were 2.9, 3.4, 3.9 and 4.3 mm, respectively, while the mean depths were 0.19, 0.32, 0.57 and 1.1 mm, respectively. The PFA coincided with CEJ in 10 buccal and 10 lingual surfaces, representing 33.33% of the sample. There was a negative correlation between RT length and PFA dimensions. This study concludes that the RT length was smaller than previous studies. From the CEJ up to the furcation entrance, the PFA showed a progressive increase in width and depth. The coincidence of the PFA area beginning at the CEJ in 1/3, and the negative correlation between RT length and PFA dimensions may represent greater risk factor for the early development of furcation lesions., (© 2021. The Society of The Nippon Dental University.)

Endometriosis Fertility Index (EFI) is a clinical staging system created to predict spontaneous pregnancy outcomes in patients with endometriosis. The present study aimed at evaluating the performance of EFI in symptomatic patients, submitted to laparoscopy for moderate and severe endometriosis associated to infertility in a Brazilian population. Seventy-seven women with endometriosis and pelvic pain, who desired to become pregnant, were selected from a tertiary care unit between those operated on between May 2007 and March 2017. All of them were submitted to laparoscopy for the surgical treatment of endometriosis and allowed to attempt natural conception for 36 months or immediately referred to in vitro fertilization (IVF). EFI was calculated according to surgical description and clinical information in medical records. Pregnancy rates and live birth rates after natural conception or IVF are reported and correlated to EFI. Fifty-three women tried natural conception and 24 were referred to IVF. Of the 53 who tried natural conception, 29 achieved pregnancy (54.7%) and 28 had live birth (52.8%). The majority of pregnancies (82.7%) occurred in the first 12 months after surgery and 75% of the patients who became spontaneously pregnant had EFI ≥ 7. Of the 24 patients referred to IVF, 13 became pregnant (54.1%) and 10 had live birth (41.7%). Infertility duration of 36 months or more and the presence of endometrioma increased the probability of having EFI ≤ 5. The overall live birth rate (LBR) for patients with low EFI scores (2-4) was 17% compared with 83.8% for those with higher EFI scores (6-9). EFI predicts pregnancy rates in patients operated on for moderate and severe endometriosis. Scores seem also to predict pregnancy rates after IVF.

Propolis is a natural product produced by bees that is primarily used in complementary and alternative medicine and has anti-inflammatory, antibacterial, antiviral, and antitumoral biological properties. Some studies have reported the beneficial effects of propolis in models of allergic asthma. In a previous study, our group showed that green propolis treatment reduced airway inflammation and mucus secretion in an ovalbumin (OVA)-induced asthma model and resulted in increased regulatory T cells (Treg) and polymorphonuclear myeloid-derived suppressor cells (PMN-MDSC) frequencies in the lungs, two leukocyte populations that have immunosuppressive functions. In this study, we evaluated the anti-inflammatory effects of artepillin C (ArtC), the major compound of green propolis, in the context of allergic airway inflammation. Our results show that ArtC induces in vitro differentiation of Treg cells and monocytic MDSC (M-MDSC). Furthermore, in an OVA-induced asthma model, ArtC treatment reduced pulmonary inflammation, eosinophil influx to the airways, mucus and IL-5 secretion along with increased frequency of M-MDSC, but not Treg cells, in the lungs. Using an adoptive transfer model, we confirmed that the effect of ArtC in the reduction in airway inflammation was dependent on M-MDSC. Altogether, our data show that ArtC exhibits an anti-inflammatory effect and might be an adjuvant therapy for allergic asthma.

Ethnopharmacological Relevance: Green propolis is produced by Apis mellifera honeybees using Baccharis dracunculifolia D.C. (Asteraceae) as substrate. This Southern Brazilian native plant and green propolis have been used in traditional medicine to treat gastric diseases, inflammation and liver disorders., Aim of the Study: Investigate the effects of baccharin (Bac) or p-coumaric acid (pCA) isolated from B. dracunculifolia D.C. (Asteraceae) over the inflammation induced by lipopolysaccharide (LPS) in vivo., Materials and Methods: Inflammation was induced by LPS injection into air-pouches in mice, which were subsequently treated with Bac or pCA. Lavage fluid was collected from air pouches for the quantification of cellular influx via microscopy, and quantification of inflammatory mediators via colorimetric methods, ELISA and liquid chromatography-tandem mass spectrometry (LC-MS/MS)., Results: LPS-induced inflammation increased cellular influx and increased the levels of parameters related to vascular permeability and edema formation, such as nitric oxide (NO) and protein extravasation. Moreover, LPS increased the levels of cytokines and eicosanoids in the air-pouches. Importantly, both Bac and pCA suppressed the infiltration of neutrophils, production of NO and protein extravasation. Notably, the compounds promote differential regulation of cytokine and eicosanoid production., Conclusions: Our results suggest that Bac from green propolis directly affects inflammation by inhibiting the production of cytokines and eicosanoids, while pCA may exert direct, but also indirect effects on inflammation by stimulating the production of regulatory effectors such as interkeukin-10 in vivo., (Copyright © 2021 Elsevier B.V. All rights reserved.)