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This study aimed to analyze the 100 most-cited papers in Dentistry, with a focus on female leadership in dental research. Papers were retrieved from the Web of Science Core Collection (WoS- CC) in the category 'Dentistry, Oral Surgery & Medicine'. Gender was assessed through WoS-CC, Scopus, ResearchGate, social media, institutional websites, and software that assigns gender according to first names (https://genderapi.io). Characteristics of authors in leadership roles were retrieved, such as affiliation, publication history, citations, H factor, and i500. The 100 most-cited papers in Dentistry were authored by 394 researchers, 326 (82.7%) men, and 68 (17.3%) women - there were 4.8 male authors for each female. Among the lead authors, there were 11.3 males for each female. Among female senior authors, there were 7 males for each female. Among lead/senior authors of the 100 most-cited papers (first and last authors, respectively), 18 were women. There was an increase in the participation of women in the top cited papers regardless of authorship role across the six decades, with a peak of two female authors in the first decade of the 21st century. For female authors in leadership roles, their publication history shows the time between their first and last papers in WoS-CC ranged from 4 to 42 years for lead authors and 1 to 39 years for senior authors. Women were found to be largely underrepresented as leaders of the 100 most-cited papers, highlighting pervasive gender inequalities in dental research publications.

Antimicrobial Photodynamic Therapy (aPDT) has been extensively investigated in vitro, and preclinical animal models of infections are suitable for evaluating alternative treatments prior to clinical trials. This study describes the efficacy of aPDT in a murine model of oral candidiasis. Forty mice were immunosuppressed with subcutaneous injections of prednisolone, and their tongues were inoculated using an oral swab previously soaked in a C. albicans cell suspension. Tetracycline was administered via drinking water during the course of the experiment. Five days after fungal inoculation, mice were randomly distributed into eight groups; a ninth group of untreated uninfected mice was included as a negative control (n = 5). Three concentrations (20 µM, 40 µM, and 80 µM) of a mixture of curcuminoids were tested with a blue LED light (89.2 mW/cm 2 ; ~455 nm) and without light (C+L+ and C+L- groups, respectively). Light alone (C-L+), no treatment (C-L-), and animals without infection were evaluated as controls. Data were analyzed using Welch's ANOVA and Games-Howell tests (α = 0.05). Oral candidiasis was established in all infected animals and visualized macroscopically through the presence of characteristic white patches or pseudomembranes on the dorsum of the tongues. Histopathological sections confirmed a large presence of yeast and filaments limited to the keratinized layer of the epithelium in the C-L- group, and the presence of fungal cells was visually decreased in the images obtained from mice subjected to aPDT with either 40 µM or 80 µM curcuminoids. aPDT mediated by 80 µM curcuminoids promoted a 2.47 log10 reduction in colony counts in comparison to those in the C-L- group (p = 0.008). All other groups showed no statistically significant reduction in the number of colonies, including photosensitizer (C+L-) or light alone (C-L+) groups. Curcuminoid-mediated aPDT reduced the fungal load from the tongues of mice.

The aim of this multicenter study was to explore the early-life sugar consumption and dietary practices in Latin America as well as to investigate the association between breastfeeding duration and the age at which foods and beverages with added sugars are introduced. A cross-sectional study was conducted with 805 1- to 3-year-old children from 10 Latin American countries, as a complementary study to the Research Observatory for Dental Caries of the Latin American Region (OICAL). A Food Frequency Questionnaire previously tested in different countries was applied to children's mothers and data on breastfeeding and age at introduction of sugary foods and beverages was collected. Statistical analysis included the Kruskal-Wallis test and Poisson regression with robust variance, with the calculation of crude and adjusted mean ratios (MR) and 95% of confidence intervals (CI). The average age at introduction of sugary foods and beverages was 10.1 months (95%CI 9.7-10.4) and 9.6 (95%CI 9.2-9.9) months, respectively, with a significant variation between countries (p < 0.001). The average daily frequency of sugary foods-beverages was 3.3 times per day (95%CI 3.1-3.5) and varied significantly between countries (p = 0.004). Breastfeeding duration of over six months was associated with an increase in the age of introduction of sweet drinks (16%; MR 1.16; 95%CI 1.05-1.28) and foods (21%; MR 1.21; 95%CI 1.10-1.33). In conclusion, most children from vulnerable settings in Latin America start consuming sugary products in the first year of life and a high frequency of consumption was reported through early childhood. Additionally, breastfeeding contributes to a delay in the introduction of sugary products.

Objective: To analyze the association between risk behaviors and environmental factors and SARS-CoV-2 infection in children and adolescents in the family environment., Methods: Cross-sectional study. A total of 267 children and adolescents aged 5-19 years who have contact with COVID-19-positive essential workers were tested between June and October 2020. Behavioral and environmental variables associated with SARS-CoV-2 infection were investigated. Association between these variables was performed using Poisson regression., Results: SARS-CoV-2 prevalence was 25.1%. Following the confirmation of COVID-19 diagnosis of the index case, 92.1% of adults reported hand hygiene and 83.5% showed habits of respiratory etiquette. However, 12.7% wore masks in common areas of the residence before COVID-19. Sharing common objects was a risk factor for SARS-CoV-2 infection in the sample., Conclusion: Sharing objects among family members was identified as a risk factor associated with SARS-CoV-2 infection in children and adolescents who lived with infected adults. There was high frequency of hand hygiene and low prevalence of mask use., 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., (© 2023 Oliveira, Guimarães, Afonso, Costa, Siqueira, Marques, Rosso, Costa, Naghettini, Barbosa, Pagotto and Aredes.)

Background: Women living with human immunodeficiency virus (HIV) (WLWH) are more likely to be infected with the oncogenic human papillomavirus (HPV). We assessed the prevalence of high-risk (HR) (16/18/31/33/35/39/45/51/52/56/58/59/68/73/82), probable high-risk (pHR) (26/53/66), and low-risk (LR) (6/11/40/42/43/44/54/61/70) HPV types and their associated risk factors., Methods: This cross-sectional study of WLWH aged 18-64 years included one laboratory and eight HIV-specialty healthcare facilities in the pilot network. Descriptive statistics were used to assess sociodemographic and behavioral characteristics. Adjusted analyses were conducted to evaluate risk factors associated with HR and/or pHR HPV infection in WLWH., Results: From May/2021 to May/2022, 1,914 (92.5%) WLWH participated in the pilot study and had valid HPV-DNA results of self-collected vaginal samples. The median age of the participants was 45 years, 60.1% had ≥ 9 years of schooling, 80.5% were ≤ 18 years at first sexual intercourse, and 51.7% had > 4 sexual partners throughout life. The prevalence of any HPV type, HR HPV, pHR HPV, and LR HPV was 65.8%, 49.6%, 16.7%, and 40.0%, respectively. Age was inversely associated with pHR and/or HR-HPV (p < 0.001), and education level was inversely associated with HR-HPV (p = 0.003) types. Any HR or pHR was associated with being single (p = 0.029) and exchanging sex for drugs (p = 0.037)., Conclusions: The prevalence of HPV, especially HR HPV, among WLWH is high in Brazil, highlighting the need for HPV screening in this population. Self-collection of vaginal samples is an important strategy for increasing testing access.

Objectives: To explore the pathways by which oral health literacy is associated with dental caries in adolescents, assessing direct and indirect effects of family cohesion and socioeconomic status., Methods: A population-based, representative cross-sectional study was conducted with 740 12-year-old adolescents in Campina Grande, Brazil. Parents/guardians answered a sociodemographic questionnaire. Adolescents answered validated questionnaires addressing family cohesion and oral health literacy. Dental caries was diagnosed using Nyvad criteria. Two dentists underwent training exercises for the diagnosis and administration of the questionnaires (k > 0.80). Descriptive analysis was followed by the use of structural equation modelling to determine direct and indirect associations between the variables incorporated into the theoretical model of the study (95% CI)., Results: Oral health literacy (standardized coefficient: -3.472, p < .01) and mother's schooling (standardized coefficient: -0.405, p < .01) were directly associated with dental caries, whereas family cohesion and socioeconomic status exerted an indirect effect on the occurrence of dental caries in the adolescents., Conclusions: Sociodemographic factors, family characteristics and oral health literary are associated with dental caries in 12-year-old adolescents., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Identifying the presence of teeth in newborns is important as it may require immediate care. This study aimed to determine the worldwide prevalence of natal and neonatal teeth., Type of Studies Reviewed: Six electronic databases and the gray literature were searched on February 23, 2023 to identify observational studies reporting the prevalence of natal or neonatal teeth. Studies assuming natal and neonatal teeth as identical terms or not reporting prevalence indicators were excluded. The methodological quality of the studies was assessed using the Joanna Briggs Institute checklist for studies reporting prevalence data. The worldwide prevalence of natal and neonatal teeth was estimated via proportion meta-analysis using a β-binomial model. Heterogeneity across studies was explored via subgroup analyses and meta-regression., Results: None of the 23 included studies fulfilled all items of the methodological quality checklist. The worldwide prevalence of natal teeth was 34.55 (95% CI, 20.12 to 59.26) per 10,000, and the prevalence of neonatal teeth was 4.52 (95% CI, 2.59 to 17.91) per 10,000. Subgroup analysis by continent showed that the prevalence of natal teeth ranged from 11.26 (95% CI, 7.58 to 16.61) per 10,000 in Asia through 75.32 (95% CI, 51.11 to 99.86) per 10,000 in North America, and the prevalence of neonatal teeth ranged from 3.52 (95% CI, 1.73 to 7.06) per 10,000 in Europe through 6.01 (95% CI, 2.25 to 16.60) per 10,000 in South America. Meta-regression did not find a statistically significant association between prevalence rates and year of publication or sample size., Practical Implications: Approximately 1 in 289 newborns had natal teeth and 1 in 2,212 had neonatal teeth. Although this is not a high prevalence, professionals must be alert to identify these conditions, which often require immediate care., (Copyright © 2023 American Dental Association. Published by Elsevier Inc. All rights reserved.)

Introduction: Stage migration has been observed in renal cell carcinoma (RCC) in recent decades; however, mortality rates have continuously increased in some countries. Tumoral factors have been characterized as major predictors of RCC. Nonetheless, this concept can be improved by combining these tumoral factors with other variables, including biomolecular factors., Purpose: This study aimed to assess the immunohistochemical (IHC) expression and prognostic value of renin (REN), erythropoietin (EPO), and cathepsin D (CTSD), and to evaluate whether the concomitant expression of these markers can influence the prognostic outcomes in patients without metastasis., Material and Methods: In total, 729 patients with clear cell RCC (ccRCC) who underwent surgical treatment between 1985 and 2016 were evaluated. All the cases in the tumor bank were reviewed by dedicated uropathologists. The IHC expression patterns of the markers were assessed using a tissue microarray. REN and EPO were classified as "positive" or "negative" expression. CTSD was grouped into "absent or weak expression" or "strong expression." Associations between clinical and pathological variables and the studied markers, in addition to 10-year overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival rates, were described., Results: REN and EPO expressions were positive in 70.6% and 86.6% of patients, respectively. Absent or weak and strong expressions of CTSD were observed in 58.2% and 41.3% of the patients, respectively. EPO expression had no impact on survival rates even when assessed concomitantly with REN. Negative REN expression was associated with advanced age, preoperative anemia, larger tumors, perirenal fat, hilum or renal sinus infiltration, microvascular invasion, necrosis, high nuclear grade, and clinical stages III to IV. In contrast, strong CTSD expression was associated with poor prognostic variables. The expression patterns of REN and CTSD were unfavorable predictors of the 10-year OS and CSS. In particular, the combination of negative REN and strong CTSD expression had a negative impact on these rates, including a higher risk of recurrence., Conclusion: Loss of REN expression and strong CTSD expression were independent prognostic factors in nonmetastatic ccRCC, particularly when the concomitant expression pattern of both markers was present. EPO expression did not influence survival rates in this study., Competing Interests: Declaration of Competing Interest 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 © 2023 Elsevier Inc. All rights reserved.)

There is a need to investigate methods to increase children's health knowledge. Therefore, the aim of this study was to systematically evaluate the literature on playful educational interventions in health literacy aimed at children aged 6-12 years. For this purpose, the Cochrane Library, EMBASE, LILACS, PubMed, Scopus, Web of Science and grey literature were searched for relevant studies. Randomized, quasi-randomized or non-randomized clinical trials, in which the primary outcome was health literacy in children, were included. Due to the heterogeneity of the studies, the data were qualitatively evaluated. Eleven studies were included in this analysis. Most of the studies were randomized (n = 10). Among the health issues addressed in these studies, obesity prevention was the most studied (n = 5). All participants had low methodological quality, and the most commonly used interventions were games, dramas and theatre plays. Although most studies have pointed to an increase in health knowledge after interventions, it was not possible to determine whether such knowledge was retained over time, whether it effectively changed health behaviours, or if it led to the effective adoption of a healthier lifestyle. Health literacy through playful methods is potentially effective in increasing health knowledge and changing health behaviours. However, literature on its impact on the adoption of healthy lifestyles is inconclusive. Future research with fewer limitations and better methodological designs may help selecting the best intervention strategy to promote health literacy., (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Objectives: The aim of this article is to review and synthesize the evidence on end-of-life in burn intensive care units., Methods: Systematic scoping review: Preferred Reporting Items for Systemic Reviews extension for Scoping Reviews was used as a reporting guideline. Searches were performed in 3 databases, with no time restriction and up to September 2021., Results: A total of 16,287 documents were identified; 18 were selected for analysis and synthesis. Three key themes emerged: (i) characteristics of the end-of-life in burn intensive care units, including end-of-life decisions, decision-making processes, causes, and trajectories of death; (ii) symptom control at the end-of-life in burn intensive care units focusing on patients' comfort; and (iii) concepts, models, and designs of the care provided to burned patients at the end-of-life, mainly care approaches, provision of care, and palliative care., Significance of Results: End-of-life care is a major step in the care provided to critically ill burned patients. Dying and death in burn intensive care units are often preceded by end-of-life decisions, namely forgoing treatment and do-not-attempt to resuscitate. Different dying trajectories were described, suggesting the possibility to develop further studies to identify triggers for palliative care referral. Symptom control was not described in detail. Palliative care was rarely involved in end-of-life care for these patients. This review highlights the need for early and high-quality palliative and end-of-life care in the trajectories of critically ill burned patients, leading to an improved perception of end-of-life in burn intensive care units. Further research is needed to study the best way to provide optimal end-of-life care and foster integrated palliative care in burn intensive care units.

Purpose: To evaluate the association between the introduction of total sugar foods (TSF) in the first six months of age and the prevalence of early childhood caries (ECC) and its consequences for dental pulp in preschool children. Methods: A representative cross-sectional study was conducted with 533 preschool children (four to six years old) in Ribeirão das Neves, Brazil. The decayed, missing, and filled teeth (dmft) index was used for determining ECC. The visible pulp, oral mucosa ulceration due to root fragments, fistula, and abscess (pufa) index was used for the pulp consequences of dental caries. Parents/caregivers answered a questionnaire addressing sociodemographic characteristics and the children's diet. Statistical analysis was performed using multiple logistic regression (P<0.05). Results: The multiple logistic regression model adjusted for family income and breastfeeding showed that preschool children who were introduced to TSF prior to six months of age were 1.58 times more likely to have ECC (95 percent confidence interval equals 1.09 to 2.30). The multiple logistic regression model, adjusted for family income, breastfeeding, and brushing behaviors, showed that preschool children who were introduced to TSF prior to six months of age were 2.30 times more likely to have pulp consequences (95 percent confidence interval equals 1.35 to 3.91). Conclusion: The early introduction TSF is associated with a higher prevalence of early childhood caries and pulp consequences in preschool children. The negative effects on oral health may be greater when the introduction of TSF occurs prior to six months of age.

Parkinson's disease is the most common movement disorder, affecting about 1% of the population over the age of 60 years. Parkinson's disease is characterized clinically by resting tremor, bradykinesia, rigidity and postural instability, as a result of the progressive loss of nigrostriatal dopaminergic neurons. In addition to this neuronal cell loss, Parkinson's disease is characterized by the accumulation of intracellular protein aggregates, Lewy bodies and Lewy neurites, composed primarily of the protein α-synuclein. Although it was first described almost 200 years ago, there are no disease-modifying drugs to treat patients with Parkinson's disease. In addition to conventional therapies, non-pharmacological treatment strategies are under investigation in patients and animal models of neurodegenerative disorders. Among such strategies, environmental enrichment, comprising physical exercise, cognitive stimulus, and social interactions, has been assessed in preclinical models of Parkinson's disease. Environmental enrichment can cause structural and functional changes in the brain and promote neurogenesis and dendritic growth by modifying gene expression, enhancing the expression of neurotrophic factors and modulating neurotransmission. In this review article, we focus on the current knowledge about the molecular mechanisms underlying environmental enrichment neuroprotection in Parkinson's disease, highlighting its influence on the dopaminergic, cholinergic, glutamatergic and GABAergic systems, as well as the involvement of neurotrophic factors. We describe experimental pre-clinical data showing how environmental enrichment can act as a modulator in a neurochemical and behavioral context in different animal models of Parkinson's disease, highlighting the potential of environmental enrichment as an additional strategy in the management and prevention of this complex disease., Competing Interests: None

The objective of this study was to analyze aspects related to interprofessional education in healthcare through the assessment of the syllabi of undergraduate nursing programs in Brazil. An observational, descriptive study was conducted in two phases. The first phase involved identification of programs, and the second phase involved documental analysis of the syllabi through a script created for this purpose. One thousand two hundred and twenty nursing undergraduate programs were identified; 229 were included in the sample for the document analysis. In 2.6% of the programs, the term "interprofessional" was identified in the purpose of the programs. Seventeen percent of the programs valued interprofessional education, and 8% assessed interprofessional learning. Recognizing (9.2%) and respecting (6.6%) the attributes and roles of different professionals were the least identified interprofessional values in the syllabi. Interprofessional education was not institutionalized/stated in the documents, even though the documents indicated use of interprofessional relationships in training scenarios, especially in primary care, and in activities not included in the formal curriculum.

Purpose of Review: The physiological aspects of renin-angiotensin system (RAS) components are described in this review. Additionally, we present the main results of studies that could indicate an association between alterations in these components and cancer, particularly renal cell carcinoma (RCC)., Recent Findings: The RAS undergoes a series of homeostatic and modulatory processes that extend to hypertrophy, hyperplasia, fibrosis, and remodeling, as well as angiogenesis, pro-inflammatory responses, cell differentiation, stem cell programming, and hematopoiesis. The link between cancer-related inflammation and RAS signaling converge in the response to tumor hypoxia and oxidative stress mechanisms, particularly with the angiotensin type 1 receptor leading to activation of transcription factors such as nuclear factor κB (NF-κB), as well as members of the signal transducer and activation of transcription (STAT) family and HIF1⍺. Dysregulation of the physiological actions of RAS in the microenvironment of inflammation and angiogenesis promotes tumor cell growth., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The aim of the present study was to investigate associations between tooth loss, and oral health literacy, the use of multiple psychoactive substances, and the reason for the last dental appointment in adolescents. A cross-sectional study was conducted with a representative sample of 746 adolescents aged 15-19 years in Campina Grande, Brazil. Parents/guardians answered a sociodemographic questionnaire. The adolescents answered the Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30), the alcohol, smoking, and substance involvement screening test, and an oral health questionnaire from the National Oral Health Survey. The adolescents were then examined by two examiners who had undergone training and calibration exercises for the diagnosis of tooth loss due to caries (K > 0.80). Associations between variables were investigated using robust logistic regression analysis for complex samples (α = 5%). The prevalence of tooth loss was 17.4%. Oral health literacy (OR = 0.93; 95% CI: 0.89-0.97) was inversely associated with tooth loss, while multiple psychoactive substance use (OR = 2.01; 95% CI: 1.09-3.69) and last dental visit for treatment/symptoms (OR = 3.05; 95% CI: 1.73-5.36) were directly associated with tooth loss. Oral health literacy, multiple psychoactive substance use, and reason for last dental appointment exerted an influence on tooth loss among adolescents., (© 2022 Wiley Periodicals LLC.)

Objective: To identify a structural model for the identification of psychosocial associated factors of early childhood caries (ECC) and oral health-related quality of life (OHRQoL) in preschool children and their families., Methods: A population-based cross-sectional study was conducted with 533 preschool children from 4 to 6 years-old public and private preschools, from Ribeirão das Neves, MG. Parents/caregivers self-completed the Brazilian versions of the Early Childhood Oral Health Impact Scale (B-ECOHIS) and Resilience Scale as well as a structured questionnaire addressing socioeconomic status and child's oral health behavior. Two dentists who had undergone training and calibration exercises for ICDAS‑epi and pufa index (Kappa≥0.95) performed the examinations for ECC. Stages of ECC were classified as free of visible carious lesion, initial caries, moderate caries, extensive caries without pulp consequences and extensive caries with pulp consequences. Data were analyzed using structural equation modeling, using Mplus version 8.6., Results: Lower socioeconomic status (b=-0.250; p<0.001) and higher frequency of free sugar consumption (b = 0.122; p = 0.033) were directly associated with a more severe stage of ECC. Lower parental resilience had an indirect impact on more severe stage of ECC which was mediated by the variable 'frequency of free sugar consumption' (b=-0.089; p = 0.048). ECC was associated with lower child's OHRQoL (b = 0.587; p<0.001) and lower family's OHRQoL (b = 0.506; p<0.001)., Conclusion: Structural modeling revealed that the severity of ECC negatively impacted the OHRQoL of preschoolers and their families. The main associated factors of the severity of ECC were lower socioeconomic status, higher frequency of free sugar consumption and lower parental resilience., Clinical Significance: T The findings indicate that psychosocial and behavior variables can be associated with the severity of ECC, and ECC can be associated with negative impact on wellbeing and ability to perform daily activities of preschoolers and their families., Competing Interests: Declaration of Competing Interests 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 © 2023. Published by Elsevier Ltd.)

The literature in the field of health management mentions a concept called new public management (NPM), introduced in Brazil and France at the end of the 20th century. The objective of the study was to analyze the repercussions of the work of nurses in primary health care in Brazil and France under the influence of NPM. This is an excerpt of a double-titled thesis, which is a research intervention with nurses from two Brazilian states and five French departments. Data were produced between February 2019 and July 2021. The public policy Health on the Hour acted as an institutional transducer, provoking a reduction in access and producing effects on professional practices. In both countries, NPM amplified the predominance of technical and quantifiable acts, the focus on individual care, and the loss of autonomy. Nurses reported insurmountable situations, using the metaphor "Sophie's choice". The results showed that making dilemmatic decisions has been the daily routine of nurses, which has not resulted in debureaucratization and higher quality of care.

Objective: To determine the incidence of congenital hypothyroidism (CH) over a 10-year period at the Reference Service in Neonatal Screening of the state of Rio Grande do Sul (RSNS-RS)., Subjects and Methods: Historical cohort study including all newborns screened for CH by the RSNS-RS from January 2008 until December 2017. Data of all newborns with neonatal TSH (neoTSH; heel prick test) values ≥ 9 mIU/L were collected. According to neoTSH values, the newborns were allocated into two groups: Group 1 (G1), comprising newborns with neoTSH ≥ 9 mIU/L and serum TSH (sTSH) < 10 mIU/L, and Group 2 (G2), comprising those with neoTSH ≥ 9 mIU/L and sTSH ≥ 10 mIU/L., Results: Of 1,043,565 newborns screened, 829 (0.08%) had neoTSH values ≥ 9 mIU/L. Of these, 284 (39.3%) had sTSH values < 10 mIU/L and were allocated to the G1 group, while 439 (60.7%) had sTSH ≥ 10 mIU/L and were allocated to the G2 group, and 106 (12.7%) were considered missing data. The overall incidence of CH was 42.1 per 100,000 newborns screened (95% confidence interval [CI] 38.5-45.7/100,000) or 1:2377 screened newborns. The sensibility and specificity of neoTSH ≥ 9 mIU/L were 97% and 11%; of neoTSH 12.6 mUI/L, 73% and 85% respectively., Conclusion: In this population, the incidence of permanent and transitory CH was 1:2377 screened newborns. The neoTSH cutoff value adopted during the study period showed excellent sensibility, which matters for a screening test.

Purpose: Many countries prohibit payment for gamete donation, which means fertility clinics do not have to compensate donors. However, acquiring and utilizing donor sperm can still be expensive for fertility clinics. This study evaluates international fertility workers' views on charging patients for altruistically donated sperm., Methods: Using social media and email, we disseminated a SurveyMonkey survey with a question that was specifically focused on opinions about charging patients for altruistically donated sperm. Clinicians were able to select multiple pre-populated answer choices as well as write answers that reflected their views as an open-ended response. Snowball sampling was utilized to reach international fertility clinicians., Results: Of 112 respondents from 14 countries, 88% believe it is acceptable to charge for altruistically donated sperm based on one or more of four different assenting categories: so patients appreciate that sperm is valuable, because it generates funds for the running of the clinic, to cover specific costs associated with sperm, and to make a profit for the clinic., Conclusions: The consensus that charging for altruistically donated sperm is acceptable was not surprising since recruiting and processing donor sperm can be expensive for clinics. However, there were geographical differences for specific assenting answer choices which may be based on countries' income, and healthcare system, as well as religious and cultural beliefs., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The aims of this study were to perform an exploratory analysis of probable awake (AB) and sleep bruxism (SB) prevalence using of different diagnosis criteria based on the International Consensus; evaluate the associations between self-report and clinical signs/symptoms in adolescents. Participated in this cross-sectional study 403 adolescents aged 12- to 19-years-old enrolled in public and private schools from Belo Horizonte, Brazil. Parents/caregivers answered a questionnaire about sociodemographic status and adolescents' health status. Adolescents answered a questionnaire evaluating AB (e.g., grinding and clenching) and SB (e.g., grinding, bracing, and thrusting) activities and frequent headaches. A clinical examination was performed on adolescents to evaluate bruxism clinical signs/symptoms (pain upon palpation on masseter and temporal, linea alba, indentation on the tongue and attrition wear severity). Descriptive statistics and Pearson's Qui-square test were performed (P≤0.05). Adolescents mean age was 14.3±1.5 years, and 58.1% were female. Self-report of SB was identified in 31% of participants and self-report of AB in 51.6%. Almost all adolescents (99%) presented at least one tooth with attrition wear (98.5% on enamel and 0.5% on dentin), with a mean number of 12.4±5.7 teeth. Depending on the diagnosis criteria, the prevalence of probable SB and AB varied from 0- 99% and 0.2- 99%, respectively. A high inconsistency was found for the prevalence of probable AB and SB in adolescents, which were influenced by the different clinical sings/symptoms used as diagnosis criteria. Frequent headaches and pain upon palpation on masseter and temporal muscle were associated to self-report of AB and SB among adolescents.

Background: BCG vaccination, originally used to prevent tuberculosis, is known to "train" the immune system to improve defence against viral respiratory infections. We investigated whether a previous BCG vaccination is associated with less severe clinical progression of COVID-19 METHODS: A case-control study comparing the proportion with a BCG vaccine scar (indicating previous vaccination) in cases and controls presenting with COVID-19 to health units in Brazil. Cases were subjects with severe COVID-19 (O2 saturation < 90%, severe respiratory effort, severe pneumonia, severe acute respiratory syndrome, sepsis, and septic shock). Controls had COVID-19 not meeting the definition of "severe" above. Unconditional regression was used to estimate vaccine protection against clinical progression to severe disease, with strict control for age, comorbidity, sex, educational level, race/colour, and municipality. Internal matching and conditional regression were used for sensitivity analysis., Results: BCG was associated with high protection against COVID-19 clinical progression, over 87% (95% CI 74-93%) in subjects aged 60 or less and 35% (95% CI - 44-71%) in older subjects., Conclusions: This protection may be relevant for public health in settings where COVID-19 vaccine coverage is still low and may have implications for research to identify vaccine candidates for COVID-19 that are broadly protective against mortality from future variants. Further research into the immunomodulatory effects of BCG may inform COVID-19 therapeutic research., (© 2023. The Author(s).)

Glyphosate-resistant weeds are difficult to manage and can serve as hosts for pests that threaten cultivated crops. Chrysodeixis includens (Walker) (Lepidoptera: Noctuidae) is one of the main polyphagous pests of soybean in Brazil that can benefit from weeds' presence during season and off-season. Despite its pest status, little is known about C. includens survival and development on alternative hosts, including those resistant to glyphosate. Therefore, we assessed the biology, reproduction, preference, and survival at different feeding periods of C. includens on seven glyphosate-resistant weeds (Sumatran fleabane, Italian ryegrass, sourgrass, goosegrass, smooth pigweed, wild poinsettia, hairy beggarticks) commonly found in Brazilian agroecosystems, under laboratory conditions. Our results showed that C. includens survival and reproduction were similar on soybean and wild poinsettia. Survival and reproduction were lower on smooth pigweed and hairy beggarticks. Also, these plants prolonged the larval stage. Larvae did not pupate when fed on sourgrass, goosegrass, Italian ryegrass, and Sumatran fleabane. However, on Sumatran fleabane their biomass was higher. The mean generation time was lower on wild poinsettia. This weed was preferred to soybean. An antifeeding factor was observed on Sumatran fleabane. Larvae fed for 11 days on soybean, wild poinsettia and smooth pigweed developed into pupae. In agricultural systems, farmers must pay attention to the management of these weeds, especially wild poinsettia, smooth pigweed, and hairy beggarticks, to interrupt the cycle of this pest, since these plants can serve as main sources of infestation for the soybean crop.

Children with elevated liver enzymes are occasionally discovered through laboratory work-up from different clinical scenarios. Although the majority will have transient and/or benign conditions, a subgroup will have underlying liver disorders. The differential diagnosis is broad and therefore, a systematic approach is of utmost importance. In this article, we reviewed the most recent and relevant literature to provide a comprehensive overview of the main disease processes that cause hypertransaminasemia in children. Ultimately, we propose a practical stepwise approach to guide primary care physicians in the evaluation of abnormal liver enzymes in asymptomatic children. The first step is to obtain a complete history along with a thorough physical examination to exclude red flags, which should dictate urgent consultation with a paediatric gastroenterologist or hepatologist.  Conclusion: Hypertransaminasemia is a challenging scenario in the primary care setting. The aetiology can be broad, ranging from hepatic and extrahepatic to transient versus chronic liver disease. Timely referral to a specialised centre is of paramount importance for conducting targeted research and to not miss the chance of identifying a progressive, but still asymptomatic, treatable liver disease. What is Known: • Elevated liver enzyme is a challenging scenario in the primary care setting. • There are few studies guiding the evaluation of asymptomatic hypertransaminasemia in the paediatric population and a standardised approach is lacking. What is New: • We propose a practical stepwise approach to guide primary care physicians in the evaluation of abnormal liver enzymes., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: To cross-culturally adapt into the Brazilian Portuguese and evaluate the psychometric properties of an instrument for assessing the satisfaction of parents/guardians regarding their sons'/daughters' orthodontic treatment., Methods: Translations of the instrument from English, pre-test and evaluation of validity and reliability of the Brazilian Portuguese version were performed. The questionnaire has 25 items distributed across 3 subscales (process, psychosocial effect and outcome). Eighty-three parents/guardians of children/adolescents who had completed orthodontic treatment participated. Descriptive statistics and floor and ceiling effects were calculated. Internal consistency, stability (interval of three weeks), convergent construct validity and discriminant construct validity were determined. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) assessed dimensionality., Results: Among the 83 parents/guardians, 58 (69.9%) were mothers and 25 (30.1%) were fathers of children/adolescents. In the questionnaire's total score and the three subscales scores, an acceptable percentage (≤15%) of participants achieved the maximum score (ceiling effect). In the total questionnaire score and in the three subscales scores, no participant achieved the minimum score (floor effect). Cronbach's α coefficient for the total score was 0.72 (internal consistency). Intra-class correlation coefficient for the total score was 0.71 (stability). The questionnaire's total score presented large Pearson correlation coefficient (>0.50) with the three subscales too (construct validity). Female parents/guardians had significantly higher scores in the psychosocial effect (p=0.013) and in the treatment outcome (p=0.037) subscales, compared to male parents/guardians (discriminant validity). EFA and CFA confirmed dimensionality in a three-factor solution., Conclusions: The final obtained version is valid and reliable to be used in Brazilian populations.

Objective: To investigate the relationship between temperament traits and dental fear and anxiety (DFA) in children and adolescents by the means of a systematic review (PROSPERO #CRD42020207578)., Methods: The PEO (Population, Exposure, and Outcome) strategy was followed using children and adolescents as the population, temperament as the exposure, and DFA as the outcome. A systematic search for observational studies (cross-sectional, case-control, and cohort) without restrictions on year or language of publication was performed in seven databases (PubMed, Web of Science, Scopus, Lilacs, Embase, Cochrane, and PsycINFO) in September 2021. Grey literature search was performed in OpenGrey, Google Scholar, and in the reference list of included studies. Study selection, data extraction, and risk of bias assessment were carried out independently by two reviewers. The Fowkes and Fulton Critical Assessment Guideline was used to assess methodological quality of each study included. The GRADE approach was performed to determine the certainty of evidence of relationship between temperament traits., Results: This study recovered 1362 articles, of which 12 were included. Despite the high heterogeneity of methodological aspects, qualitative synthesis by subgroups showed a positive association/correlation between emotionality, neuroticism, and shyness with DFA in children and adolescents. Different subgroups analysis showed similar results. Eight studies were classified as having low methodological quality., Conclusion: The main shortcoming of the included studies is the high risk of bias and a very low certainty of evidence. Within its limitations, children and adolescents with a temperament-like emotionality/neuroticism and shyness are more likely to present higher DFA., (© 2023. The Author(s), under exclusive licence to British Dental Association.)

Parkinson's disease (PD) is the second most common neurodegenerative disease worldwide. The main therapeutic approach available nowadays relieves motor symptoms but does not prevent or stop neurodegeneration. Rosmarinic acid (RA), an ester of caffeic and 3,4-dihydroxyphenylacetic acids, is obtained from numerous plant species such as Salvia officinalis L. (sage) and Rosmarinus officinalis (rosemary). This compound has a wide spectrum of biological activities, such as antioxidant and anti-inflammatory, and could be an additional therapy for neurodegenerative disorders. Here we evaluated the potential neuroprotective effects of RA treatment in a murine model of PD induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). Mice were separated into four groups: CN, Control/saline; RA, Rosmarinic acid/vehicle; MPTP, MPTP/saline; MPTP+RA, MPTP/RA. RA (20 mg/kg, or vehicle) was administered orally by intra-gastric gavage for 14 days, one hour before MPTP or saline injection. MPTP groups received the drug (30 mg/kg, intraperitoneally) once a day for five days (fourth to the eighth day of the experiment). MPTP-treated animals displayed hyperlocomotion behavior, which was significantly prevented by RA treatment. In addition, RA treatment increased dopaminergic signaling in the parkinsonian mice and improved the monoaminergic system in healthy animals. Analysis of alterations in the striatal mRNA expression of dopaminergic system components showed that MAO-A expression was increased in the MPTP+AR group. Overall, this study brings new evidence of the potential neuroprotective properties of RA not only in preventing behavioral features observed in PD, but also by improving neurotransmission in the healthy brain., Competing Interests: Conflict of interest The authors declare no conflict of interest., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Adolescence is marked by changes and vulnerability to the emergence of psychological problems. This study aimed to investigate associations between anxiety/depression/chronic pain and oral health-related quality of life (OHRQoL)/happiness/polymorphisms in the COMT , HTR2A and FKBP5 genes in Brazilian adolescents. A cross-sectional study was conducted with ninety adolescents 13 to 18 years. Anxiety, depression and chronic pain were evaluated using the RDC/TMD. The Oral Health Impact Profile was used to assess oral OHRQoL. The Subjective Happiness Scale was used to assess happiness. Single-nucleotide polymorphisms in COMT (rs165656, rs174675), HTR2A (rs6313, rs4941573) and FKBP5 (rs1360780, rs3800373) were genotyped using the Taqman ® method. Bivariate and multivariate logistic regression analyses were performed ( p < 0.05). Chronic pain and depression were associated with feelings of happiness ( p < 0.05). A significant inverse association was found between anxiety and OHRQoL ( p = 0.004). The presence of minor allele C of COMT rs174675 was significantly associated with depression ( p = 0.040). Brazilian adolescents with depression and chronic pain considers themselves to be less happy than others and those with anxiety are more likely to have a negative impact on OHRQoL. Moreover, the rs174675 variant allele in the COMT gene was associated with depressive symptoms in Brazilian adolescents.

It is claimed that one g of soil holds ten billion bacteria representing thousands of distinct species. These bacteria play key roles in the regulation of terrestrial carbon dynamics, nutrient cycles, and plant productivity. Despite the overwhelming diversity of bacteria, most bacterial species remain largely unknown. Here, we used an oligotrophic medium to isolate novel soil bacteria for positive interaction with soybean. Strictly 22 species of bacteria from the soybean rhizosphere were selected. These isolates encompass ten genera ( Kosakonia , Microbacterium , Mycobacterium , Methylobacterium , Monashia , Novosphingobium , Pandoraea , Anthrobacter , Stenotrophomonas , and Rhizobium ) and have potential as novel species. Furthermore, the novel bacterial species exhibited plant growth-promoting traits in vitro and enhanced soybean growth under drought stress in a greenhouse experiment. We also reported the draft genome sequences of Kosakonia sp. strain SOY2 and Agrobacterium sp. strain SOY23. Along with our analysis of 169 publicly available genomes for the genera reported here, we demonstrated that these bacteria have a repertoire of genes encoding plant growth-promoting proteins and secondary metabolite biosynthetic gene clusters that directly affect plant growth. Taken together, our findings allow the identification novel soil bacteria, paving the way for their application in crop production.

Drug repurposing is a strategy used to develop new treatments based on approved or investigational drugs outside the scope of their original clinical indication. Since this approach benefits from the original toxicity data of the repurposed drugs, the drug-repurposing strategy is timesaving, and inexpensive. It has a higher success rate compared to traditional drug discovery. Several repurposing candidates have been identified in silico screening and in vitro methodologies. One of the best examples is non-steroidal anti-inflammatory drugs (NSAIDs). Tumor-promoting inflammation is one of the hallmarks of cancer, revealing a connection between inflammatory processes and tumor progression and development. This explains why using NSAIDs in the context of neoplasia has become a topic of interest. Indeed, identifying NSAIDs with antitumor activity has become a promising strategy for finding novel cancer treatment opportunities. Indeed, several commercial anti-inflammatory drugs, including aspirin, ibuprofen, diclofenac, celecoxib, tepoxalin and cyclovalone, naproxen, and indomethacin have presented antitumor activity, and some of them are already in clinical trials for cancer treatment. However, the benefits and complications of using NSAIDs for cancer treatment must be carefully evaluated, particularly for cancer patients with no further therapeutic options available. This review article provides insight into the drug repurposing strategy and describes some of the well-known NSAIDs that have been investigated as repurposed drugs with potential anticancer activity., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Introduction: During pregnancy, women are at an increased risk of developing iron-deficiency anemia., Objective: The objective of this study was to assess the diagnostic performance of the reticulocyte hemoglobin equivalent (RET-He) in the early detection of iron-deficiency anemia in a group of pregnant women and to establish a reference range for this parameter in a group of control individuals., Method: A total of 60 patients and 130 control subjects were included in the study. Blood samples collected from the subjects were submitted to a complete blood count and a serum ferritin test and the data were analyzed by comparing the groups and ROC curves., Results: The reference range found for the RET-He was between 29.75pg and 38.24pg, with a median of 35pg. The receiver operating characteristic (ROC) curve analysis for the ferritin parameter showed an area under the curve of 0.732 for the RET-He, 0.586 for hemoglobin, 0.551 for the mean corpuscular hemoglobin concentration and 0.482 for the mean corpuscular volume., Conclusion: Early diagnosis of iron deficiency anemia in pregnancy is essential to prevent damage to both maternal and fetal health. The RET-He presents an excellent potential as an auxiliary tool for the diagnosis of iron deficiency in pregnant women., Competing Interests: Conflicts of interest The authors report no conflicts of interest., (Copyright © 2021 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier España, S.L.U. All rights reserved.)

The Eastern Amazon is rich in bauxite ore. The extraction and processing of bauxite lead to the mobilization of Aluminum (Al) and other metals in environmental. We evaluated the metals (Al, Mn, Ba, and Cr) concentration in tissue, water, and sediment associated with antioxidant and oxidative damage responses in Bryconops caudomaculatus. The samplings were done in two hydrological periods (post-rain and post-dry periods) and at three points, located at two rivers: one in the surroundings of the mining area (P1) and other inside the mining area, upstream (P2), and downstream (P3). Defense antioxidant system biomarkers analyzed were total antioxidant capacity (ACAP) and glutathione-S-transferase (GST) activity. As an oxidative damage biomarker, the lipoperoxidation (LPO) was evaluated. Metals concentrations in the water and sediment were higher in the post-rain period compared to post-dry period. The water samples were acidic, with dissolved Al concentrations above the values established by local legislation at all points. In the gills, the metals accumulation was higher in fish from in the surrounding and upstream sites, and in the liver, was higher in fish from downstream site. Fish from the surrounding had increased antioxidant defenses, with higher ACAP in all tissues and higher GST in the gills. Consequently, they had lower levels of LPO. Fish from the mining area had decreased antioxidant defenses, with lower ACAP in all tissues and lower GST in the gills. Consequently, they had higher levels of LPO, indicating oxidative stress. The fish muscle was not responsive to GST and LPO at all sites. We conclude that the oxidative stress observed in the gills and liver of B. caudomaculatus from the area modified by the mining activity reflected the local anthropogenic impact status., 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 © 2022 Elsevier Inc. All rights reserved.)

Objective: Investigate the association between sleep disorders and probable sleep bruxism (SB) in children eight to ten years of age., Methods: A cross-sectional study was conducted with 739 schoolchildren in Brazil. Parents/guardians answered a sociodemographic questionnaire, the sleep disturbance scale for children, and the Circadian Energy Scale. Parafunctional habits were evaluated using the Nordic Orofacial Test-Screening. Multivariate logistic regression was performed (α = 5%), and a directed acyclic graph was used in the statistical model., Results: The prevalence of probable SB was 9.1% and 58.6% of the children had sleep disorders. In the final model, having unmarried parents/guardians (OR = 1.98; 95% CI: 1.07-3.65), exhibiting parafunctional habits (OR = 2.02; CI: 1.01-4.06), not practicing sports (OR = 1.92; CI: 1.04-3.54), sleep-wake transition disorders (SWTD) (OR = 2.01; 95%CI: 1.12-3.62), and excessive daytime sleepiness (EDS) (OR = 2.17; 95%CI: 1.11-4.29) were significant associated with probable SB., Conclusion: The occurrence of probable sleep bruxism was influenced by the marital status of the parents/guardians, parafunctional habits, the non-practice of sports, and sleep disturbance (SWTD and EDS). This research contributes to the planning of public policies that include educational regimens at school to prevent sleep disorders and favor the reduction in sleep bruxism prevalence., (© 2021 Wiley Periodicals LLC.)

The Patient Satisfaction Questionnaire (PSQ) is a self-administered instrument to assess adolescent patients' satisfaction with orthodontic treatment. A pre-existing North American instrument was further explored in the Netherlands. Semantic equivalence is part of cross-cultural adaptation and is necessary to achieve a valid and reliable instrument for a specific culture. The present study aimed to evaluate the semantic equivalence of the items, subscales, and overall PSQ between the original English version and the Brazilian Portuguese language version (B-PSQ). The PSQ has 58 items, distributed across 6 subscales: doctor-patient relationship, situational aspects of the clinic, dentofacial improvement, psychosocial improvement, dental function, and a residual category. Semantic equivalence was evaluated according to the following methods: (1) independent translations to Portuguese by two translators, both native in Brazilian Portuguese and fluent in English; (2) an expert committee drafted the first summarized version in Portuguese; (3) two independent back-translations into English by two native English-speaking translators fluent in Portuguese; (4) committee review; (5) committee drafted a summarized version of the back-translations; (6) expert committee drafted the second summarized version in Portuguese; (7) pre-test of the instrument using individual semi-structured interviews with 10 adolescents; (8) review and final version of the B-PSQ. Semantic equivalence between the original and the Brazilian versions of the questionnaire was achieved through diligent and rigorous methods, with effective translation and expert evaluations, incorporating the opinions of the target population.

In Brazil, prevalence of diagnosed COPD among adults aged 40 years and over is 16% although over 70% of cases remain undiagnosed. Hypertension is common and well-recorded in primary care, and frequently co-exists with COPD because of common causes such as tobacco smoking, therefore we conducted a cross-sectional screening test accuracy study in nine Basic Health Units in Brazil, among hypertensive patients aged ≥40 years to identify the optimum screening test/combinations to detect undiagnosed COPD. We compared six index tests (four screening questionnaires, microspirometer and peak flow) against the reference test defined as those below the lower limit of normal (LLN-GLI) on quality diagnostic spirometry, with confirmed COPD at clinical review. Of 1162 participants, 6.8% (n = 79) had clinically confirmed COPD. Peak flow had a higher specificity but lower sensitivity than microspirometry (sensitivity 44.3% [95% CI 33.1, 55.9], specificity 95.5% [95% CI 94.1, 96.6]). SBQ performed well compared to the other questionnaires (sensitivity 75.9% [95% CI 65.0, 84.9], specificity 59.2% [95% CI 56.2, 62.1]). A strategy requiring both SBQ and peak flow to be positive yielded sensitivity of 39.2% (95% CI 28.4, 50.9) and specificity of 97.0% (95% CI 95.7, 97.9). The use of simple screening tests was feasible within the Brazilian primary care setting. The combination of SBQ and peak flow appeared most efficient, when considering performance of the test, cost and ease of use (costing £1690 (5554 R$) with 26.7 cases detected per 1,000 patients). However, the choice of screening tests depends on the clinical setting and availability of resources.ISRCTN registration number: 11377960., (© 2022. The Author(s).)

The first step for biological insecticide production is the evaluating of the pathogenicity and strains virulence of entomopathogens against the target pests. Bacillus thuringiensis (Bt) is widespread in nature, lethal pathogen of a range of orders and the most widely used entomopathogenic biological control agent. Therefore, our objective was to study the susceptibility of six important lepidopteran pests in Brazilian agricultural production systems, Anticarsia gemmatalis (Hübner), Chrysodeixis includens (Walker) Helicoverpa armigera (Hübner), Spodoptera cosmioides (Walker), S. eridania (Cramer), and S. frugiperda (Smith), to Bt strains. In vitro bioassays were conducted with neonate larvae exposed to two Bt strains, 1680A and 775E, in seven concentrations of spores and protein crystals. After 7 days, the mortality was evaluated and indicated that lethal concentration (LC 50 ) for 775E strain ranged from 7.72 × 10 4 to 2.45 × 10 6 spores mL -1 and for 1608A strain from 5.63 × 10 3 to 1.21 × 10 6 spores mL -1 . The strain 1608A was more toxic for A. gemmatalis and H. armigera than 775E strain, and then was further evaluated in greenhouse bioassays with maize and soybean plants infested separately with target insects. The strain 1608A showed an efficient control for most insect species studied in the greenhouse bioassays, promoting considerable reduction in leaf injury and demonstrating a high potential in biological control of important lepidopteran species in crop production systems in Brazil., (© 2022. Sociedade Entomológica do Brasil.)

Objective: To evaluate the effectiveness of the Welch Allyn Connex® Spot Monitor/Hillrom Connecta™ solution in activating the rapid response team in a timely manner compared to manual activation., Methods: The Hillrom study is a single-center, open-label, superiority, cluster-randomized, parallel-group (1:1 allocation ratio) clinical trial that will be conducted in a tertiary hospital. Two sets of three wards with 28 beds will be included (one as the intervention cluster and the other as the control). The wards will be randomly assigned to use the Welch Allyn Connex® Spot Monitor/Hillrom Connecta™ automated solution (intervention cluster) or to maintain the usual routine (control cluster) regarding rapid response team activation. The primary outcome will be the absolute number of episodes of rapid response team triggering in an appropriate time; as secondary outcomes, clinical features (mortality, cardiac arrest, need for intensive care unit admission and duration of hospitalization) will be assessed according to clusters in an exploratory way. A sample size of 216 rapid response team activations was estimated to identify a possible difference between the groups. The protocol has been approved by the institutional Research Ethics Committee., Expected Results: The Welch Allyn Connex® Spot Monitor/Hillrom Connecta™ automated solution is expected to be more effective in triggering the nurse call system to activate the rapid response team in a timely and adequate manner compared to manual triggering (usual practice)., Clinicaltrials.gov: NCT04648579.

Aim: To evaluate the impact of community and individual social capital during early childhood on oral health-related quality of life (OHRQoL) over a 10-year follow-up period., Methods: A prospective cohort study was conducted in the southern Brazil. Baseline (T1) data collection occurred in 2010 with preschool children aged 1-5 years. Participants were assessed in 2012 (T2), 2017 (T3), and 2020 (T4). OHRQoL was assessed using the B-ECOHIS at T1 and T2 and through CPQ8-10 at T3 and CPQ11-14 at T4. Community social capital was evaluated through the presence of formal institutions in the neighbourhood and individual social capital by social networks, both at T1. Demographic and socioeconomic characteristics were also evaluated. Multilevel Poisson regression analysis was performed to estimate the impact of social capital measures on OHRQoL., Results: Of the 639 children assessed at T1, 469 were followed at T2 (73.3% response rate), 449 at T3 (70.3% response rate), and 429 at T4 (67.1% response rate). Individuals living in neighbourhoods with the presence of social class associations at T1 had higher OHRQoL at T3 and T4. Individuals whose families visit friends and neighbours less than once a month or never at T1 had lower OHRQoL at T1, T3 and T4. Attending religious meetings less than once a month or never at T1 was associated with lower OHRQoL at T2 and T4., Conclusion: Social capital at the community level had a long-term effect on OHRQoL, especially during adolescence, while individual social capital levels impacted OHRQoL across the assessments., Clinical Significance: The findings indicate that psychosocial variables can impact OHRQoL, a fundamental aspect of clinical practice., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest in relation to the products or methods mentioned herein., (Copyright © 2022. Published by Elsevier Ltd.)

This was a retrospective cohort study to investigate the impact of COVID-19 pandemic on the gender gap in articles submitted to three international dental journals based in Brazil. All submissions performed to Brazilian Dental Journal, Brazilian Oral Research, and Journal of Applied Oral Science before (2019) and during the pandemic (2020) were assessed. Gender of the first, last, and corresponding authors were collected. Other variables collected were journal, continent studied by authors and stage of their careers (classified according to authors' highest degree), and final decision reached in the article. Absolute and relative frequencies with 95% confidence intervals, Pearson's Chi-square tests, and Fisher's Exact test were used (α = 0.05). In total, 4,726 unique submissions were analyzed. A higher proportion of early-career authors was observed during the pandemic (44.8% to 49.3%, p = 0.021). Most articles were rejected but without association with gender. Increased proportion of male first authors from before to during the pandemic was observed (39% to 42.1%, p = 0.034). Drop in the proportion of articles with women as first authors was observed for researchers in their early- (65.9% to 58.8%, p = 0.02) and mid-career stages (63% to 55.8%, p = 0.014). Reduction in women as first authors was observed during the pandemic in South and Central Americas (66.7% to 61.5%, p = 0.010), and when the last author was a female, or the corresponding author was a male. In conclusion, a disproportionate impact on female dental researchers in submitting articles in the period from before to during the pandemic was observed when considering first authorship, suggesting that the COVID-19 may have increased the gender inequality in dental science.

This review aimed to describe the importance of the first 1000 days of a child's life as a golden period for interventions and actions to prevent dental caries and other chronic non-communicable diseases (NCDs) throughout the life course and highlight that the first 450 days of life could be even more important for oral health. During the first 1000 days of life (pregnancy and first two years of life), health care providers can identify unhealthy lifestyles, behaviors, and their determinants. Bearing in mind contextual factors like socioeconomic conditions and cultural aspects, this is a unique period to work together with the family and identify opportunities for adopting healthy habits that might last throughout the life of the expected or newborn child. This is a "window of opportunity" for the prevention of chronic NCDs of both systemic and oral origin, such as overweight, obesity, diabetes, cardiovascular diseases, and dental caries. In fact, to effectively prevent dental caries, pregnancy and the first 6 months of a child's life (first 450 days) should be considered the critical period to work together with families to facilitate the adoption of healthy habits. Knowledge about the first thousand days of life is essential and represents a crucial period for the implementation of actions and interventions that will guarantee good oral and general health development that can persist throughout life.

Introduction: Malocclusion is one of the most prevalent oral health problems and can affect self-esteem, social relations, and oral health-related quality of life. The present study aimed to evaluate associations between malocclusion and orofacial dysfunction, nonnutritive sucking habits, cavitated carious lesions, and anxiety in Brazilian children., Methods: An analytical cross-sectional study was conducted with a representative sample of 739 children aged 8-10 years. Parents or guardians provided sociodemographic data and information on the nonnutritive sucking habits of the children. The children answered the Revised Children's Manifest Anxiety Scale. Four trained examiners examined the children for the diagnosis of malocclusion (dental aesthetic index), dental caries (International Caries Detection and Assessment System), and orofacial dysfunction (Nordic Orofacial Test-Screening). The control variables were selected using a directed acyclic graph. Descriptive statistics were performed, followed by unadjusted and adjusted robust logistic regression analysis (P <0.05)., Results: The following variables remained associated with the occurrence of malocclusion in the final model: nonnutritive sucking habits (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.25-4.08), orofacial dysfunction (OR, 1.56; 95% CI, 1.13-2.17), and cavitated carious lesion (OR, 1.39; 95% CI, 1.03-1.89)., Conclusions: Nonnutritive sucking habits, orofacial dysfunction, and cavitated carious lesions were associated with the presence of malocclusion in children aged 8-10 years., (Copyright © 2022 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

The present study aimed to evaluate the association between premature primary tooth loss and oral health-related quality of life (OHRQoL) in preschool children. A cross-sectional study was conducted in 769 5-year-old preschool children. The children and their parents or guardians answered the Brazilian version of the Scale of Oral Health Outcomes for 5-Year-Old Children for the assessment of OHRQoL. Meanwhile, clinical examinations were performed for the assessment of premature primary tooth loss. Unadjusted and adjusted multilevel Poisson regression models were utilized to investigate the associations between the variables. In the parental version of the scale, premature posterior primary tooth loss (rate ratio [RR] = 2.65; 95% confidence interval [CI] = 1.51-4.68), weak sense of coherence (RR = 2.25; 95% CI = 1.62-3.11), and visit to a dentist (RR = 1.61; 95% CI = 1.04-2.52) were associated with OHRQoL. Based on the children's perceptions, only the preschool type was associated with OHRQoL (RR = 1.92; 95% CI = 1.21-3.05). Premature posterior primary tooth loss had a greater impact on OHRQoL based on the parents' perception, whereas only the preschool type was associated with OHRQoL based on the children's perception.

Purpose: To evaluate the impact of malocclusion and dental caries on oral health- related quality of life (OHRQoL) in adolescents and the differences between adoles- cents' self-reports and caregiver's proxy reports. Methods: A population-based cross-sectional study was conducted with 1,612 Brazil- ian adolescents and 1,168 caregivers. Adolescents completed the Child Perceptions Questionnaire and caregivers completed the Parental-Caregiver Perceptions Question- naire. Malocclusion (dental esthetic index) and dental caries (DMFT) were documented. Multiple Poisson regression was conducted. Results: A self-reported model demonstrated that adolescents with malocclusion had an impact on emotional (PR=1.14; 95 percent confidence interval [95% CI=1.03 to 1.26) and social domains (PR=1.35; 95% CI=1.20 to 1.50). Dental caries had an impact on the emotional domain (prevalence ratio [PR]=1.34; 95% CI=1.21 to 1.48). The caregiver model showed that malocclusion had an impact on oral symptoms (PR=1.12; 95% CI=1.03 to 1.21), functional limitations (PR=1.18; 95% CI= 1.05 to 1.33), and emotional (PR=1.23; 95% CI=1.10 to 1.54) and social domains (PR=1.22; 95% CI=1.02 to 1.45). Those with dental caries felt an impact on oral symptoms (PR=1.09; 95% CI=1.01 to 1.19), functional limitations (PR=1.18; 95% CI=1.05 to 1.33) and social domains (PR=1.24; 95% CI=1.04 to 1.45). Conclusions: Adolescents reported a negative impact on OHRQoL both in relation to dental caries and malocclusion. Caregivers observed the impact of oral conditions on more domains than the adolescents reported.

Local knowledge and uses of forage resources are highly dynamic, and can be mediated by multiple factors, such as seasonality, floristic diversity and the morphophysiological characteristics of plants. We investigate how seasonality and vegetation cover mediate the use of forage resources. The study was carried out with agro-pastoralists from two areas of Brazilian semiarid region. To select the areas, we used the normalized difference vegetation index. We selected one area with low vegetation cover (Area I) and another with high vegetation cover (Area II). Respondents were selected using the snowball technique. Using semi-structured interviews, we collect the information about forage use in the dry and rainy seasons, preferences of ruminants and specific characteristics of plant species. A total of 57 informants were interviewed in the two areas. We used the Chi-square test to assess differences in the richness of species cited between areas, seasons (dry/rainy), origins (exotic/native) and strate (herbaceous/woody). Our results revealed that agro-pastoralists living in the area with the highest vegetation cover (Area II) cited a greater number of species. We found that the use and selection of species is guided by a series of functional characters, related to palatability and nutritional value, which change between seasons. These results highlight the vast knowledge of ecological characteristics of species and diet of ruminants acquired by agro-pastoralists during field experience, with seasonality defining the use of species. Different from what we expected, the richness of exotic species mentioned did not differ between areas. This diversity of information contributes to a better understanding of the use of forage resources and indicates the importance of including local experiences as strategies to ensure proper use and provide insights for the conservation of local resources., (© 2022. The Author(s).)

This study outlines the profile of research productivity grant holders of the Conselho Nacional de Desenvolvimento Científico e Tecnológico [CNPq (National Council for Scientific and Technological Development)] in the field of pediatric dentistry. A cross-sectional study with data collected from the Brazilian academic curriculum vitae database. The eligibility criterion was being a research productivity grant holder in pediatric dentistry from 2018 to 2020. In the period of interest, 215 individuals were research productivity grant holders in the field of dentistry, 33 of whom had graduate degrees (specialization, master's or doctorate) in pediatric dentistry. The period of scientific production and work concluded of advising of scientific initiation, master, doctoral and post-doctoral degrees was 2010 to 2020. Descriptive analysis was performed and the Kruskal-Wallis test was used to analyze associations (5% significance level) between productivity grant level (2, 1D, 1C, 1B or 1A) and year of obtainment of the doctoral degree. The VOSviewer (version 1.6.17) was used to present graphically the interinstitutional collaborations. The sample was composed of Level 2 researchers (66.7%), women (66.7%), researchers linked to institutions in the southeastern region of Brazil (81.8%), with a doctoral degree concluded prior to 2002 (51.5%), began working as a professor at a higher education institution prior to 2007 (78.8%) and the title of full professor (45.5%). No significant association was found between productivity grant level and year of conclusion of the doctoral degree (p = 0.10). Median (interquartile range) of scientific articles was 119 (37-312). The prevalence of citations (57.52%) and JCR articles (62.76%) was higher among female researchers. In conclusion, CNPq research productivity grant holders in pediatric dentistry are essentially represented by females from the southeast region of the country (UFMG and USP). However, males have proportionally greater productivity.

Cardiac physiological studies in oysters are scarce and these kinds of responses can be key issues for understanding behavioral and baseline adaptive responses. In this study we characterized the electrocardiogram (ECG) tracing patterns, wave intervals (RR; QT), and complex duration (QRS) of Crassostrea gasar during immersion followed by air exposure, simulating what occurs in a tide cycle. Initially, the ECG was analyzed in the oysters under immersion for 30 min to evaluate the basal recordings (immersion exposure condition). Then, the same animals were removed from the water and the ECG was analyzed for another 30 min to assess cardiac activity under air exposure (air exposure condition). For this, a technique of cardiac recordings was developed, allowing us to analyze, beyond ECG, other cardiac parameters such as the heart rate (HR) in beats per minute, the spectral power of HR, and the amplitude. The basal cardiac parameters analyzed in oysters in the immerse condition clearly show the waves and intervals (R-R: 11.03 ± 0.63 s, P-Q: 2.09 ± 0.06 s), with a normal and regular electrocardiographic tracing and sinus rhythm without alterations. When in the air exposure condition, oysters maintained the ECG tracing of sinus rhythm, but with changes in intervals and a prolonged isoelectric period. Moreover, in this condition, oysters presented a biphasic response: initially (phase I), heart rate increased (9.83 ± 0.98 BPM), and consequently the R-R and P-Q intervals decreased (5.86 ± 2.01 s e 1.91 ± 0.13 s, respectively); in phase II, heart rate (3.68 ± 0.82 BPM) and spectral power (21.26 ± 5.44 mV2/Hz x 10 -3 ) decreased and consequently, the R-R interval increased (14.83 ± 2.92 s). But, the P-Q interval remained (2.45 ± 0.65 s) in phase II. The QRS complex of oysters in both phases decreased (Phase I: 0.57 ± 0.13 s; Phase II: 0.62 ± 0.05 s) compared to the immersion exposure condition (0.79 ± 0.09 s). We conclude that air exposure affected cardiac function in C. gasar leading to arrhythmia in response to the beginning of air exposure, as a means of maintaining oxygen supply, followed by bradycardia to decrease metabolism as a survival strategy. The basal responses of the mangrove oyster in the physiological modulation against the environmental factors of the tidal regime provide information about the species for possible application as model organisms in studies of toxicological evaluation of chemical products and in conservation and sustainability studies., (Copyright © 2022. Published by Elsevier Inc.)

Introduction: Relationships amongst attention-deficit/hyperactivity disorder (ADHD), family factors, and oral health literacy (OHL) in adolescents are unclear. The objective of this research was to investigate whether family environment and signs of ADHD are associated with OHL at the onset of adolescence., Methods: A cross-sectional study was performed with 448 twelve-year-old adolescents enrolled in schools in Cajazeiras, Brazil. Adolescents responded to an instrument measuring OHL (Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry [BREALD-30]) and a validated questionnaire addressing family cohesion and adaptability (Family Adaptability and Cohesion Scales [FACES III]). Parents and teachers answered subscales of the Swanson, Nolan, and Pelham Questionnaire (SNAP-IV) and a socioeconomic questionnaire. Adjusted Poisson regression analysis was employed for the data analysis (P < .05)., Results: Greater OHL was found in adolescents with higher family cohesion scores (rate ratio [RR], 1.02; 95% confidence interval [CI], 1.01-1.03), those whose mothers had more than 8 years of schooling (RR, 1.07; 95% CI, 1.03-1.12), and those whose families earned more than the Brazilian minimum salary (RR, 1.08; 95% CI, 1.03-1.12). Higher family adaptability scores (RR, 0.99; 95% CI, 0.98-0.99) and more signs of ADHD (teachers' reports) (RR, 0.95; 95% CI, 0.91-0.99) were associated with lower OHL., Conclusions: OHL in adolescents was influenced by family adaptability and cohesion, signs of ADHD, maternal schooling, and family income., Competing Interests: Conflict of interest None disclosed., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

It is well documented that Chagas disease (CD) can pose a public health problem to countries. As one of the World Health Organization Neglected Tropical Diseases undoubtedly calls for comprehensive healthcare, transcending a restricted biomedical approach. After more than a century since their discovery, in 1909, people affected by CD are still frequently marginalised and/or neglected. The aim of this article is to tell the story of their activism, highlighting key historical experiences and successful initiatives, from 1909 to 2019. The first association was created in 1987, in the city of Recife, Brazil. So far, thirty associations have been reported on five continents. They were created as independent non-profit civil society organisations and run democratically by affected people. Among the common associations' objectives, we notably find: increase the visibility of the affected; make their voice heard; build bridges between patients, health system professionals, public health officials, policy makers and the academic and scientific communities. The International Federation of Associations of People Affected by CD - FINDECHAGAS, created in 2010 with the input of the Americas, Europe and the Western Pacific, counts as one of the main responses to the globalisation of CD. Despite all the obstacles and difficulties encountered, the Federation has thrived, grown, and matured. As a result of this mobilisation along with the support of many national and international partners, in May 2019 the 72nd World Health Assembly decided to establish World Chagas Disease Day, on 14 April. The associative movement has increased the understanding of the challenges related to the disease and breaks the silence around Chagas disease, improving surveillance, and sustaining engagement towards the United Nations 2030 agenda.