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Purpose: In this case report study, the clinical performance of a microhybrid resin composite was compared with lined class V restorations or with restorations performed without a flowable resin composite, over a 48-month period. Case description: The patient of this case report presented 2 pairs of equivalent cervical abfraction lesions, under occlusion. Four restorations were placed in teeth 34, 35, 44 and 45. The restorations were divided into groups (Single Bond + Filtek-Flow + Filtek Z250 or Single Bond + Filtek Z250) and the materials were applied according to the manufactures instructions. Two previously calibrated operators placed the restorations and two other independent examiners evaluated the restorations at baseline and after 48 months, according to the USPHS criteria and modified criteria for color match. Conclusion: After 48 months of evaluation the lesions restored with Filtek-Flow as a liner under Filtek Z250 did not show better clinical performance than the restorations without Filtek-Flow. All the groups showed a trend toward dark yellowing after 48 months. [ABSTRACT FROM AUTHOR]

Clinical practice has benefited from new methodologies such as realistic simulation (RS). RS involves recreating lifelike scenarios to more accurately reflect real clinical practice, enhancing learners' skills and decision-making within controlled environments, and experiencing remarkable growth in medical education. However, RS requires substantial financial investments and infrastructure. Hence, it is essential to determine the effectiveness of RS in the development of skills among medical students, which will improve the allocation of resources while optimizing learning. This cross-sectional study was carried out in the simulation laboratory of a medical school, and the performance of students who underwent two different curriculum matrices (without RS and with RS, from 2021 to 2022) in the Advanced Cardiac Life Support (ACLS) course was compared. This test was chosen considering that the competencies involved in cardiac life support are essential, regardless of the medical specialty, and that ACLS is a set of life-saving protocols used worldwide. We observed that the impact of RS can be different for practical abilities when compared with the theoretical ones. There was no correlation between the general academic performance and students' grades reflecting the RS impact. We conclude that RS leads to less remediation and increased competence in practical skills. RS is an important learning strategy that allows repeating, reviewing, and discussing clinical practices without exposing the patient to risks. NEW & NOTEWORTHY Realistic simulation (RS) positively affected the performance of the students differently; it had more influence on practical abilities than theoretical knowledge. No correlation between the general academic performance and grades of the students without RS or with RS was found, providing evidence that RS is an important tool in Advanced Cardiac Life Support education.

This study evaluated the effects of inoculating corn silage and/or feeding a direct-fed microbial (PRO) on performance and nutrient digestibility of lactating dairy cows. At harvesting, corn silage was treated either with water (culated or not [CON]) or Lactococcus lactis and Lentilactobacillus buchneri (INC; SiloSolve FC) at 1.5 × 10 5 cfu/g of corn silage. Ten mini silos and one farm-scale silo bunker per treatment were prepared for the laboratory and the lactating dairy cow trial, respectively. Five mini silos per treatment were opened on days 2 or 90 post-ensiling for pH measurement, as well as chemical analysis and aerobic stability, respectively. The farm-scale silo bunkers were opened 77 d post-ensiling for the beginning of the lactating cow trial. Eighty lactating Holstein cows were assigned in a 2 × 2 factorial design to: (1) CON silage without PRO (CON-CON; n  = 20), (2) CON silage with PRO at 14 g/head/d (CON-PRO; n  = 20), (3) INC silage without PRO (INC-CON; n  = 20), and (4) INC silage with PRO at 14 g/head/d (INC-PRO; n  = 20). Concurrently with the feeding trial, eight cows per treatment were chosen for nutrient digestibility. The pH of the corn silage was not affected by the silage inoculant ( P  ≥ 0.29), but INC yielded greater concentration of acetic acid and longer aerobic stability ( P  < 0.01). Dairy cows fed INC had a lower mean total dry matter intake (DMI), milk protein content, and somatic cell counts vs. CON ( P  ≤ 0.02). On the other hand, milk and fat- and protein-corrected milk (FPCM) production efficiency, milk urea-N, DM, crude protein, and starch digestibility were greater for INC-fed cows ( P  ≤ 0.03). Feeding direct-fed microbials (DFM) improved mean body weight, milk yield, and FPCM, as well as milk protein and lactose yield ( P  ≤ 0.05), but reduced milk fat and protein content ( P  = 0.02). A silage inoculant × DFM interaction was observed for milk production efficiency, milk protein and lactose content, and somatic cell count ( P  ≤ 0.05). Dairy cows fed INC-CON had a greater milk production efficiency and milk lactose content ( P  ≤ 0.04), but INC-PRO had lower milk protein content and SCC ( P  ≤ 0.03). In summary, inoculating L. lactis and L. buchneri increased acetic acid content and aerobic stability of corn silage, reduced DMI, but improved milk production efficiency and nutrient digestibility of lactating Holstein dairy cows. On the other hand, feeding PRO improved milk, protein, and lactose yield. Additionally, combining the feeding of an inoculated corn silage with PRO reduced milk somatic cell count., Competing Interests: G. Copani, K. A. Bryan, K. L. M. Witt, R. C. do Amaral, and B. I. Cappellozza are employees of Chr. Hansen. I. Kok and W. M. van Straalen are employees of Schothorst Feed Research and declare no further conflicts of interest., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Society of Animal Science.)

Recurrent aphthous stomatitis (RAS) is a common disease in the oral cavity characterized by recurrent ulcers (RU). Usually, these cause acute pain without definitive treatment. The present study determines the efficacy of non-thermal plasma (NTP) for treating RU. NTP is applied to the patient's RU using a radiofrequency generator connected to a point reactor. The power density applied to the ulcer is 0.50 W/cm 2 , less than 4 W/cm 2 , which is the maximum value without biological risk. Each patient received two treatments of three minutes each and spaced 60 min apart at a distance of 5 mm from the RU. From a sample of 30 ulcers in patients treated for RU with an average age of 37 years, they stated that the pain decreased considerably and without the need for ingestion of analgesics and antibiotics. Regeneration took place in an average of three days. The NTP proved to be an excellent therapeutic alternative for the treatment of RU since it has a rapid effect of reducing pain and inflammation, as well as adequate tissue regeneration.

Due attention has not been given yet to workers' health problems arising from oral diseases and to the impacts of not having an appropriate professional, i.e., dental surgeon, as part of the specialized service team of large companies, even acknowledging that the participation of these professionals is positive for improving workers' quality of life and the productive performance of the company. Based on these premises, and through a literature review conducted from a search on the electronic portal of Brazilian Dentistry Bibliography, SciELO, and MEDLINE databases, the present study aimed to demonstrate factors that justify the integration of dental surgeons in occupational health programs of companies. The following advantages were mentioned: reduction in absenteeism and in the number of work accidents, productivity growth, and improvement in company image and in employees' quality of life. In conclusion, the occupational health care model cannot be dissociated from oral health, considering the significant benefits both for employees and for companies themselves., Competing Interests: Conflicts of interest: None

Objectives: To assess the association between the Human Development Index (HDI) and covariates on the mortality-to-incidence ratio (MIR) of lips and oral cavity cancer (LOCC) in Mexico., Design: Ecological study., Setting: Data from 32 Mexican states for year 2019., Participants: Data set of male and female populations from Mexico., Exposures: Socioeconomic conditions based on HDI and covariates related to healthcare system capacity (total health spending per capita, school dropout and ratio of medical personnel in direct contact with patients)., Primary and Secondary Outcome Measures: MIR of LOCC by state and sex was calculated from the Global Burden of Disease Study website for year 2019. Data for calculating HDI 2019 by state and covariates were obtained from the National Institute of Statistics and Geography. A multiple regression model was constructed to measure the effects of HDI and covariates on LOCC-MIR., Results: Among the states with the highest HDI (>0.780), Colima had the highest aged-standardised rates per 100.000 in men for incidence (5.026) and mortality (3.118). The greatest burden of the disease was found on men, with the highest Men:Women MIR in Colima (3.10) and Baja California Sur (2.73). The highest MIR (>0.65) was found among the states with the lowest HDI (Oaxaca and Chiapas). For each unit of increase of the HDI there was a decrease in the LOCC- MIR of -0.778, controlling for the covariates. The most suitable regression model explained the 57% (F (p): 0.000) of the variance., Conclusions: Men were most affected by LOCC in Mexican states. The highest MIRs of LOCC were found in the states with the highest HDI. But a worse prognosis of the disease, expressed as a higher MIR, is expected in contexts with lower HDI in the country, even with lower MIRs., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

This paper investigates a potential application of hard-to-recycle plastic waste as polymeric addition in high strength concrete, with a focus on the potential to mitigate heat-induced concrete spalling and the consequent effects on the mechanical properties. The waste corresponds to soft and hard plastic, including household polymers vastly disposed of in landfills, although technically recyclable. Mechanical and physical properties, cracking, mass loss, and the occurrence of spalling were assessed in high strength concrete samples produced with either plastic waste or polypropylene fibers after 2-h exposure to 600 °C. The analysis was supported by Scanning Electron Microscopy and X-Ray Computed Tomography images. The plastic waste is composed of different polymers with a thermal degradation between 250 to 500 °C. Polypropylene (PP) fibers and plastic waste dispersed in concrete have proved to play an essential role in mitigating heat-induced concrete spalling, contributing to the release of internal pressure after the polymer melting. The different morphology of plastic waste and polypropylene fibers leads to distinct mechanisms of action. While the vapor pressure dissipation network originated by polypropylene fibers is related to the formation of continuous channels, the plastic waste seems to cause discontinuous reservoirs and fewer damages into the concrete matrix. The incorporation of plastic waste improved heat-induced concrete spalling performance. While 6 kg/m 3 of plastic increased the mechanical performance after exposure to high temperature, the incorporation of 3 kg/m 3 resulted in mechanical properties comparable to the reference concrete.

Methods have been developed to measure the effectiveness of many roughages, but few evaluations have been conducted with tropical feeds. The objectives of this research were to determine the effectiveness of roughage sources based on bioassay and laboratory methods and identify the biological attributes of the diets that correlate with these methods. Six ruminally cannulated Nellore steers (408 ± 12 kg of BW) were randomly assigned to a 6 × 6 Latin square design within six diets: negative control diet (NC) with aNDF as 10% from corn silage (CS); positive control diet (PC) with aNDF as 20% from CS; and four diets containing 10% aNDF from CS and 10% aNDF from each of the following sources: sugarcane (SC), sugarcane bagasse (SCB), soybean hulls (SH), or low oil cottonseed hulls (LOCH). Physical effectiveness factor (pef, related to the physical characteristics of aNDF) and effectiveness factor (ef, related to the ruminal pH) were determined based on a linear model approach that uses a bioassay method in which CS aNDF was assumed to be the standard fiber source. Laboratory methods to estimate pef of roughage sources were based on the proportion of DM of roughage retained on a 1.18-mm sieve pef(>1.18 mm) or retained on the 8.0-mm Penn State Particle Separator screen pef(>8.0 mm). The pef calculated by the bioassay method (total chewing time and ruminal mat resistance) for CS, SCB, and SC were higher values (P < 0.05) compared with SH and LOCH. The pef(rumen mat) of SC and SCB were higher (P < 0.05) than that of CS, SH, and LOCH. The pef(rumen mat) of LOCH was 61% higher than SH. The ef(rumen pH) of SC and LOCH was higher (P < 0.05) than CS and SH. The pef(chewing, min/d), pef(chewing, min/kg of DM), pef(rumen mat), and ef(rumen pH) positively correlated with rumination time, total chewing time, and ruminal mat resistance (values from transit time in seconds). No correlation was observed (P > 0.05) between pef(>8.0 mm) and rumination time, chewing time, and ruminal pH. The pef calculated using the bioassay method as well as pef (>8.0 mm) were negatively correlated with rumen pH (P > 0.05). The values of the effectiveness of fiber sources obtained in this research can be used as a guideline for nutritionists aiming to replace roughage sources from tropical regions in beef cattle finishing diets. Under our conditions, the pef using the bioassay method or laboratory methods were not adequate in predicting ruminal pH., (© The Author(s) 2020. Published by Oxford University Press on behalf of the American Society of Animal Science. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

The objectives of this research were to evaluate the effects of source and concentration of α-amylase-treated neutral detergent fiber (aNDF) from roughage on feed intake, ingestive behavior, and ruminal kinetics in beef cattle receiving high-concentrate diets. Six ruminally cannulated Nellore steers (408 ± 12 kg of body weight) were randomly assigned to a 6 × 6 Latin square design with six diets: 10% aNDF from corn silage (10CS); 20% aNDF from corn silage (20CS); or four diets containing 10% aNDF from corn silage and 10% aNDF from one of the following sources: sugarcane (SC), sugarcane bagasse (SCB), soybean hulls (SH), or low oil cottonseed hulls (LOCH). The parameters of passage and degradation kinetics were estimated based on a two-compartmental model with gamma- and exponential-distributed residence times. The nonlinear models were fitted by nonlinear least squares, and a linear mixed-effects model was fitted to all variables measured from the Latin square design that were related to intake, digestibility, digestion kinetic parameters, and residence times. Mean particle size (MPS) between roughage sources (CS, SCB, and SC) and coproducts (SH and LOCH) was affected (P < 0.05). Dry matter intake (DMI) was not affected (P > 0.05) by 20CS, SC, SH, or LOCH. Steers fed 20CS or LOCH diets had 16% and 20% greater DMI, respectively, (P < 0.05) than steers fed 10CS diet. Steers fed SCB consumed the least dry matter (DM). The SH and LOCH diets had lower MPS values (about 8.77 mm) in comparison to 20CS, SCB, and SC diets (about 13.08 mm) and, consequently, affected (P < 0.05) rumen content, ruminal in situ disappearance, nutrient digestibility, and solid fractional passage rate. Chewing time was affected (P < 0.05) by roughage sources and concentration. Lower values of distance travel inside the rumen (min/cm) were observed (P < 0.05) for the SCB and SC diets in comparison with any other diet. Except for SCB, there was no difference (P > 0.05) in rumen fill, among other treatments. Mean daily ruminal pH was not affected (P > 0.05) by 20CS, SCB, SC, and LOCH diets, and it ranged from 6.1 to 6.23. Total short-chain fatty acids concentration was affected (P < 0.05) by roughage source and concentration. Based on our results, we recommend that under Brazilian finishing diets, replacing roughage sources, except for SCB, based on aNDF concentration of the roughage in high-concentrate diets containing finely ground flint corn does not affect DMI., (© The Author(s) 2020. Published by Oxford University Press on behalf of the American Society of Animal Science. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: Mortality from oral cancer, the prevalence of the main risk factors and the implementation of policies to control current trends and the distribution of data among the countries of Latin America. The objective of this study was to describe the trends of mortality from oral cancer between 2000 and 2017, by sex, in 20 countries in Latin America, and to know the effect of measures to control tobacco consumption and alcohol consumption on the Mortality from oral cancer., Methods: Ecological study that evaluates the relationship between the rates standardized by the age of cancer by oral sex, the prevalence of tobacco consumption and alcohol consumption, and the implementation of control policies. To calculate the annual percentage change of the rates, the Prais-Winsten regression was used; and the effect of measures of control of risk factors on oral cancer mortality is assessed by Spearman correlations., Results: The greatest decreases in oral cancer mortality were in men in Brazil (APC -7.83, -14.25,-0.93). Mortality from cancer the oral relationship between men and the prevalence of tobacco consumption and alcohol consumption (r = 0.358, r 0.537) (p <0.01), and between the non-implementation of control policies of smoking (r = 0.738) (p= 0.003), the restrictions on the hours and days of sale of alcohol (r = 0.777, p = 0.001), and the states on sponsorship and promotion of alcohol sales (r =0.739 , p =0.040)., Conclusions: The effect of the implementation of control policies is evidenced by a greater relationship with oral cancer mortality in the countries with the least progress in their execution., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Novel fac-[Re(CO)3(dmcb)(trans-stpyR)]+ complexes, dmcb = 4,4'-dimethoxycarbonyl-2,2'-bipyridine, have been judiciously engineered to absorb at lower energies and sensitize trans-4-styrylpyridine (trans-stpy) or trans-4-(4-cyano)styrylpyridine (trans-stpyCN) photoisomerizable ligands up to 436 nm of irradiation. Moreover, these complexes exhibit remarkable photoreversibility, in particular fac-[Re(CO)3(dmcb)(trans-stpyCN)]+ (Φ255 nmcis→trans = 0.26 ± 0.02). Their distinct and noteworthy photochemical and photophysical behavior are described in this work. The main emphasis of this study is that the complexes efficiently sensitize stilbene-like ligand isomerization toward use in potential solar device applications.

A strategic methodology has been developed to effectively synthesize the fac-[Re(CO) 3 (dcbH 2 )( trans-stpy)] + complex, where dcbH 2 = 2,2'-bipyridine-4,4'-dicarboxylic acid and trans-stpy = trans-4-styrylpyridine, which has been designed to efficiently absorb visible light. The complex exhibits outstanding trans-to- cis photoisomerization with 436 nm irradiation (Φ trans→ cis = 0.50 ± 0.03), in contrast to the photochemical behavior previously reported in the literature (Faustino, L. A.; et al. Inorg. Chem. 2018, 57, 2933-2941). The main emphasis here is to address the synthetic strategy for obtaining the actual complex, its characterization, and an accurate description of its photochemical and photophysical behavior, which reveal new insights into this complex.

In this work, efficient trans ⇌ cis photoswitchings of 4-(4-cyano)styrylpyridine (stpyCN) coordinated to organometallic bipyridyl tricarbonyl rhenium(I) complexes, fac-[Re(CO) 3 (NN)( trans-stpyCN)] + , where NN = 2,2'-bipyridine (bpy) or 4,4'-dimethyl-2,2'-bipyridine (dmb), are described. For both complexes, the true trans-to- cis quantum yields determined by 1 H NMR spectroscopy are similar at 313, 334, and 365 nm irradiations (Φ trans→ cis true(313-365 nm) ∼ 0.45), with a small decrease at 404 nm (Φ trans→ cis true(404 nm) ∼ 0.37). The investigated complexes also exhibit significant quantum yields for the reversible cis-to- trans photoreactions (Φ cis→ trans (255 nm) = 0.22). The luminescent properties of these complexes were also analyzed in different media to elucidate a key role of the 3 IL stpyCN state in photophysical and photochemical processes, giving new insights on their intriguing photobehavior.

A versatile Ru(II) complex bearing an anthracene moiety was synthesized in our search for suitable compounds towards efficient molecular devices. The new engineered dye, cis‑[Ru(dcbH 2 )(NCS) 2 (mbpy‑anth)] (dcbH 2 =2,2'‑bipyridyl‑4,4'‑dicarboxylic acid, mbpy‑anth=4‑[N‑(2‑anthryl)carbamoyl]‑4'‑methyl‑2,2'‑bipyridine), exhibits a blueish emission in a vibronically structured spectrum ascribed to the fluorescence of a 1 LC Anth (ligand centered) excited state in the anthracene and has a potential to be exploited in the fields of smart lighting and displays. This complex was also employed in dye-sensitized solar cells with fairly efficient solar energy conversion with the use of self-assembled TiO 2 compact layers beneath the TiO 2 mesoporous film to prevent meso‑TiO 2 /dye back reactions. Further photoelectrochemical investigations through incident photon-to-current efficiency and electrochemical impedance spectra showed that the all-nano-TiO 2 compact layer acts as contact layers that increase the electron harvesting in the external circuit, enhancing efficiencies up to 50%., (Copyright © 2018 Elsevier B.V. All rights reserved.)

The aim of the present study was to (i) evaluate the in vitro action of rifampicin (RIF), ethambutol or isoniazid with efflux pumps inhibitors (EPIs) in Mycobacterium tuberculosis (Mtb) H37Rv and (ii) evaluate the morphological and efflux pumps (EPs) transcriptional changes by the action of rifampicin + verapamil combination (RIF + VP). The minimal inhibitory concentration and synergic effect of drug combinations were determined by Resazurin Microtiter Plate Assay and Resazurin Drugs Combination Microtiter Assay, respectively. VP showed greater capacity of ethidium bromide accumulation and RIF + VP had the lower fractional inhibitory concentration index. The RIF + VP exerted a similar reduction of viable cell counts to RIF by time-kill curve, but decreases in the expression of EPs genes were observed by Real time PCR at 72 h of RIF + VP exposure. Accumulative morphological changes (wrinkled and rounding) caused by each drug were observed by scanning electron microscopy after RIF + VP exposure. The downexpression of EPs related genes exposed to RIF + VP, suggest an effective inhibitory activity of VP in Mtb H37Rv. The role of EPs and the use of EPIs open up a powerful approach and the RIF + VP combination should be studied in Mtb more thoroughly., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Trichophyton rubrum and Trichophyton mentagrophytes complex, or Trichophyton spp. are the main etiologic agents of dermatophytosis, whose treatment is limited by the high cost of antifungal treatments, their various side effects, and the emergence of resistance amongst these species. This study evaluated the in vitro antidermatophytic activity of 23 crude extracts from nine plant species of semiarid vegetation (caatinga) found in Brazil. The extracts were tested at concentrations ranging from 1.95 to 1,000.0 mg/mL by broth microdilution assay against the reference strains T. rubrum ATCC 28189 and T. mentagrophytes ATCC 11481, and 33 clinical isolates of dermatophytes. All plants showed a fungicidal effect against both fungal species, with MIC/MFC values of the active extracts ranging from 15.6 to 250.0 µg/mL. Selected extracts of Eugenia uniflora (AcE), Libidibia ferrea (AE), and Persea americana (AcE) also exhibited a fungicidal effect against all clinical isolates of T. rubrum and T. mentagrophytes complex. This is the first report of the antifungal activity of Schinus terebinthifolius, Piptadenia colubrina, Parapiptadenia rigida, Mimosa ophthalmocentra, and Persea americana against both dermatophyte species.

Although smoking promotes deleterious effect to bone healing, there is a lack of study investigating its role on the implant structure and biofilm growth. We hypothesized that nicotine, cotinine and caffeine would impair the corrosion resistance of commercially-pure titanium (cp-Ti) and would enhance Streptococcus sanguinis biofilm growth. Neither the smoking products nor the caffeine affected the corrosion tendency (P>.05) and the oxide layer resistance (P=.762) of cp-Ti. Lower capacitance values were noted in the presence of nicotine (P=.001) and cotinine (P=.0006). SEM showed no pitting corrosion, and the EDS spectra did not differ among groups. Nicotine (300μg/mL) induced higher surface roughness (P=.03) and greater surface change of cp-Ti. Nicotine at 3μg/mL, and cotinine at 0.3 and 3μg/mL increased the number of viable cells (P<.05). Biofilm exposed to nicotine (0.3, 3 and 30μg/mL) (P=.025, .030, .040, respectively) and cotinine (3 and 30μg/mL) (P=.027, .049, respectively) enhanced carbohydrate content. Biofilm biomass and protein content were similar among groups (P>.05). These findings suggest a greater biofilm accumulation in smokers, a risk factor that may lead to peri-implantitis., (Copyright © 2015 Elsevier B.V. All rights reserved.)

In pursuing novel efficient lighting technologies and materials, phosphorescent cyclometallated Ir(iii) complexes have been prominent due to their wide color arrays and highly efficient electroluminescence. Their photophysical properties are strongly influenced by spin-orbit coupling exerted by the iridium core, usually resulting in intense, short-lived emission, which can be systematically tuned as a triumph of molecular engineering. This Perspective aims to present recent breakthroughs and state of the art on emissive Ir(iii) compounds, in particular a personal account on heteroleptic [Ir(N^C)2(L^X)](+) complexes, addressing the mechanistic concepts behind their luminescence. Their fascinating photophysical properties strengthen application in more-efficient light-emitting technologies, such as organic light-emitting diodes and light-emitting electrochemical cells.

The aim of the present study was to evaluate the effect of the combination of rifampicin (RIF) and verapamil (VP) against the Mycobacterium tuberculosis H37Rv reference strain and six multidrug-resistant (MDR) M. tuberculosis clinical isolates by determining Time-Kill Curves and the ability to efflux drug by fluorometry. The RIF+VP combination showed synergism in one MDR clinical isolate. For the other five MDR clinical isolates, the drug combination showed no interaction. The MDR clinical isolate had lower ethidium bromide (EtBr) accumulation when exposed to the RIF+VP combination, compared with RIF and VP exposure alone. The other MDR clinical isolates showed no significant difference in EtBr accumulation. These results suggest greater efflux action in one of the MDR clinical isolates compared with the M. tuberculosis H37Rv reference strain. The other five MDR isolates may have additional mechanisms of drug resistance to RIF. The use of the RIF+VP combination made one MDR bacillus more susceptible to RIF probably by inhibiting efflux pumps, and this combination therapy, in some cases, may contribute to a reduction of resistance to RIF in M. tuberculosis.

Disorders of sex development (DSD) result from abnormalities in the complex process of sex determination and differentiation. An important consideration to guide the assignment of social sex in newborns with ambiguous genitalia is the quality of life (QoL) of these patients in adulthood. The rarity of most DSD conditions makes it difficult to conduct a long-term follow-up of affected patients through adulthood. This review of papers on the QoL of DSD patients evaluated in developing and developed countries by qualitative and quantitative instruments revealed a large spectrum of QoL, ranging from very poor to similar to, or even better than, the normal population. A more adequate QoL was found in patients from tertiary centres, indicating that the medical care of DSD patients should be multidisciplinary and carried out by specialized teams., (© 2014 John Wiley & Sons Ltd.)

Objective: To compare estimates of food behavior related to oral health obtained through a self-report measure and 24 hour dietary recalls (R24h)., Method: We applied three R24h and one self-report measure in 87 adolescents. The estimates for eleven food items were compared at individual and group levels., Results: No significant differences in mean values were found for ice cream, vegetables and biscuits without filling. For the remaining items, the values reported by the adolescents were higher than the values estimated by R24h. The percentage of adolescents who reported intake frequency of 1 or more times/ day was higher than the value obtained through R24h for all food items except soft drinks. The highest values of crude agreement between the instruments, individually, were found in the biscuits without filling (75.9%) and ice cream (72.4%)., Conclusion: The results suggest that adolescents tend to report a degree of exposure to the food items larger than what they actually experience in their daily lives.

An innovative all-nano-TiO2 thin film capable of enhancing dye-sensitized solar cell (DSC) photoefficiencies was prepared by a layer-by-layer method beneath the meso-TiO2 film, employing acid and basic nano-TiO2 sols as cations and anions, respectively. TiO2 syntheses were performed under absolute control to lead to appropriate morphological and optical properties to yield high-quality compact films using profilometry, tuning, and scanning electron microscopy. A detailed study by photoelectrochemical parameters, incident photon-to-current efficiency, electron lifetime, and electrochemical impedance spectroscopy demonstrates that the physical contact between FTO and the electrolyte is prevented and the role of the compact film has been elucidated. DSCs with TiO2 bilayers on top of FTO improved the conversion efficiency up to 62%, mainly because of the prevention of FTO/I3(-) charge recombination and an improved contact between FTO and TiO2.

Objectives: To evaluate the clinical performance of two one-step self-etch adhesives in noncarious cervical lesions (NCCL) under active or passive application mode., Methods: Thirty-one patients with four NCCL were enrolled in this study. One hundred and twenty-four restorations were placed according to one of the following conditions: 1) Adper Prompt L-Pop (AP), active application (APA); 2) AP, passive application (APP); 3) Xeno III (XE), active application (XEA), or 4) XE, passive application (XEP). The restorations were evaluated by the FDI World Dental Federation criteria at baseline and after six, 12, and 24 months of clinical service. The effects of adhesive, mode of application, and recall period were assessed via mixed generalized linear model (α=0.05)., Results: The adhesive AP and the passive application mode showed significantly higher marginal staining than did XE and active application, respectively (p<0.05). With regard to the retention rates, the active application mode yielded higher retention rates at the 24-month recall compared to the passive application, regardless of the material. The individual retention rates (95% confidence interval) of both adhesives in the active application mode were the same, 96.8% (83.8-99.4%), while in the passive application rates were 87.1% (71.2-94.9%) and 80.7% (63.7-90.8%) for XE and AP, respectively., Conclusions: The active application improved the retention rates of both adhesives after 24 months and minimized the marginal staining at enamel margins.

Conventional tilted implants are used in oral rehabilitation for heavily absorbed maxilla to avoid bone grafts; however, few research studies evaluate the biomechanical behavior when different angulations of the implants are used. The aim of this study was evaluate, trough photoelastic method, two different angulations and length of the cantilever in fixed implant-supported maxillary complete dentures. Two groups were evaluated: G15 (distal tilted implants 15°) and G35 (distal tilted implants 35°) n = 6. For each model, 2 distal tilted implants (3.5 x 15 mm long cylindrical cone) and 2 parallel tilted implants in the anterior region (3.5 x 10 mm) were installed. Photoelastic models were submitted to three vertical load tests: in the end of cantilever, in the last pillar and in the all pillars at the same time. We obtained the shear stress by Fringes software and found values for total, cervical and apical stress. The quantitative analysis was performed using the Student tests and Mann-Whitney test; p ≥ 0.05. There is no difference between G15 and G35 for total stress regardless of load type. Analyzing the apical region, G35 reduced strain values considering the distal loads (in the cantilever p = 0.03 and in the last pillar p = 0.02), without increasing the stress level in the cervical region. Considering the load in all pillars, G35 showed higher stress concentration in the cervical region (p = 0.04). For distal loads, G15 showed increase of tension in the apical region, while for load in all pillars, G35 inclination increases stress values in the cervical region.

Two experiments were conducted to evaluate whether fermentation end products in silage affect intake and digestion in beef cattle. Six rumen-cannulated Nellore steers were randomly assigned to a replicated 3 × 3 Latin square design with 14-d periods. Each period consisted of 9 d for adaptation and 5 d for sample collection. Steers were housed in a tie-stall barn and individually fed once daily at 0800 h. The dietary treatments in Exp. 1 were as follows: 60% corn silage plus 40% concentrate (CON), 60% corn silage with added ethanol (2.8% on a DM basis) and 40% concentrate (ET), and 60% corn silage with added lactic acid (5.4% on a DM basis) and 40% concentrate (LA). The DMI was similar (P = 0.41) across treatments (average 11.7 kg/d); however, the LA treatment increased the ruminal pH (P = 0.01) and decreased the acetate:propionate ratio (P < 0.01). Diet digestibility decreased by 2.2 to 2.5 percentage units when the DM content was determined by oven drying (at 105°C) rather than by toluene distillation. The treatments in Exp. 2 were as follows: 75% sugarcane silage with no volatile fraction (oven dried at 60°C and rehydrated) and 25% concentrate (75D), 75% sugarcane silage (original moisture content) and 25% concentrate (75W), and 40% sugarcane silage and 60% concentrate (40W). Approximately 21% of the DM content of sugarcane silage consisted of volatile compounds. The presence of these compounds did not alter the DMI (P = 0.36) but did increase both the acetate:propionate ratio (P < 0.01) and the fractional absorption rates of valerate (P < 0.01) and ethanol (P = 0.02) in the empty reticulorumen. The 40W diet led to a greater DMI (40W = 9.79 vs. 75W = 6.19 kg/d; P < 0.01), which altered most of the measured variables traditionally associated with high-concentrate diets. As in Exp. 1, diet digestibility decreased by 1.5 to 5.4 units when the DM content was determined by oven drying at 105°C rather than by toluene distillation. In this short-term study, volatile compounds did not inhibit the DMI or the digestion process of the animals. On the contrary, volatile compounds contributed to the energy content of the silage, composing up to 10% of the energy value as determined by digestibility. Due to the short experimental periods, the results from this study should be interpreted with caution.

Ethanol and acetic acid are common end products from silages. The main objective of this study was to determine whether high concentrations of ethanol or acetic acid in total mixed ration would affect performance in dairy cows. Thirty mid-lactation Holstein cows were grouped in 10 blocks and fed one of the following diets for 7 wk: (1) control (33% Bermuda hay + 67% concentrates), (2) ethanol [control diet + 5% ethanol, dry matter (DM) basis], or (3) acetic acid (control diet + 5% acetic acid, DM basis). Ethanol and acetic acid were diluted in water (1:2) and sprayed onto total mixed rations twice daily before feeding. An equal amount of water was mixed with the control ration. To adapt animals to these treatments, cows were fed only half of the treatment dose during the first week of study. Cows fed ethanol yielded more milk (37.9 kg/d) than those fed the control (35.8 kg/d) or acetic acid (35.3 kg/d) diets, mainly due to the higher DM intake (DMI; 23.7, 22.2, and 21.6 kg/d, respectively). The significant diet × week interaction for DMI, mainly during wk 2 and 3 (when acetic acid reached the full dose), was related to the decrease in DMI observed for the acetic acid treatment. There was a diet × week interaction in excretion of milk energy per DMI during wk 2 and 3, due to cows fed acetic acid sustained milk yield despite lower DMI. Energy efficiency was similar across diets. Blood metabolites (glucose, insulin, nonesterified fatty acids, ethanol, and γ-glutamyl transferase activity) and sensory characteristics of milk were not affected by these treatments. Animal performance suggested similar energy value for the diet containing ethanol compared with other diets. Rumen conversion of ethanol to acetate and a concomitant increase in methane production might be a plausible explanation for the deviation of the predicted energy value based on the heat of combustion. Therefore, the loss of volatile compounds during the drying process in the laboratory should be considered when calculating energy content of fermented feedstuffs., (Copyright © 2013 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)

The need for a more sensitive and time-efficient assay for malaria has led to the development of molecular assays involving real-time PCR (qPCR), a procedure that has the potential to detect low levels of parasitemia, identify mixed infections, and allow for precise differentiation of species via melting curve analysis or TaqMan fluorescence-labeled probes. Since the first study published in 2001 at least 17 assays have been developed, most of them using SSUrRNA as the target gene. We used qPCR to detect Plasmodium falciparum and P. vivax by amplification of mtDNA; this technique was evaluated on whole-blood samples from people living in areas of malaria transmission in the Brazilian Amazon region located in the area of inclusion of highway BR-163 (Cuiabá-Santarém) in Pará State: São Luiz do Tapajós, a municipal district of Itaituba (N = 74); Três Boeiras, a municipal district of Trairão (N = 134), and São Raimundo, a municipal district of Aveiro (N = 62). The results from the real-time PCR-based method were compared to conventional microscopy and to an established mtDNA-PCR assay. The qPCR (mtDNA) method was 16-19 times more efficient than the conventional PCR (mtDNA) and microscopy for detecting plasmodial infections.

The objectives of this experiment were to determine the effects of replacing ground corn with soybean hulls (SH) in high-concentrate diets on the growth (56-d period), carcass characteristics, and eating behavior of feedlot lambs. Sixty-four Santa Inês ram lambs (18.3 ± 2.8 kg of BW and 69 ± 5 d of age) were assigned to a randomized complete block design experiment with 8 blocks and 4 diets. The control diet contained 10% coastcross (Cynodon sp.) hay, 70% corn, and no SH (SH0) in the dietary DM. In the remaining diets, SH replaced corn at the rate of 15 (SH15), 30 (SH30), or 45% (SH45) of the original corn concentration, resulting in 0, 10.5, 21.0, or 31.4% SH in the dietary DM. Dry matter intake increased linearly (P < 0.01) when SH replaced ground corn (1.0, 1.0, 1.1, and 1.1 kg/d for SH0, SH15, SH30, and SH45, respectively). There was no effect on ADG of lambs, with values of 276, 278, 282, and 287 g for SH0, SH15, SH30, and SH45, respectively. Feed efficiency decreased linearly (P < 0.01) with SH inclusion. Carcass measures were not affected by SH as a replacement for ground corn. Eating time, expressed as minutes per day and minutes per gram of NDF, showed a quadratic effect (P < 0.05), whereas no effect was observed when expressed as minutes per gram of DM. Rumination, in minutes per day, was not influenced by dietary SH inclusion, but a linear decrease (P < 0.01) was observed when this variable was expressed as minutes per gram of NDF. Soybean hulls can replace up to 45% of the ground corn (31.4% of SH in the dietary DM) in high-concentrate diets fed to feedlot lambs without negative effects on ADG and carcass measures. The linear decrease in feed efficiency (11.6% reduction from SH0 to SH45) suggests that optimal dietary SH inclusion rates should be dictated by the relative costs of SH and corn.

The aim of this clinical trial was to evaluate the effects of application mode on the clinical performance of a two-step etch-and-rinse adhesive in class V cavities over 24 months. Forty patients with at least three similar-sized non-carious cervical lesions participated in this study. A total of 120 restorations with Prime & Bond NT were placed, 40 in each group. The adhesive was applied with no rubbing action, with slight rubbing action, or with vigorous rubbing action. The restorations were placed incrementally using the composite resin Esthet-X. The restorations were evaluated at baseline and after 6, 12, and 24 months following the modified United States Public Health Service criteria. Statistical analysis was conducted using Friedman repeated measures analysis of variance by rank and using the Wilcoxon signed-rank test for significance at each pair (α = 0.05). The 24-month retention rates of Prime & Bond NT were 82.5% for the no rubbing group, 82.5% for the slight rubbing group, and 92.5% for vigorous rubbing group. No significant difference in the retention rates in each recall period was detected among groups (p > 0.05); however, the retention rates in the 24-month recall was statistically lower than the baseline only for no rubbing or slight rubbing groups. The use of a vigorous application mode can be a clinical approach to improve the retention of restorations placed in non-carious cervical lesions.

Because low-fluoride toothpaste (500 p.p.m. F) has not clearly been shown to be effective for controlling caries in caries-active children, this experimental in situ study was conducted to evaluate whether its effect, when compared with a conventional toothpaste (1,000-1,500 p.p.m. F), would depend on the cariogenic challenge. During four phases of 14 d each, 14 volunteers used 500 or 1,100 p.p.m. F toothpaste and wore palatal appliances containing deciduous enamel slabs, on which biofilm was accumulated and exposed to 20% sucrose solution at frequencies increasing from two to eight times per day. The F concentration was determined in the biofilm formed, and enamel demineralization was assessed by surface hardness loss (% SHL) and integrated area of hardness x lesion depth (DeltaS). The F uptake by enamel was also determined. Fluoride in biofilm fluid and solids was statistically higher when conventional F toothpaste was used. The toothpastes did not differ statistically in terms of % SHL, DeltaS, and F in enamel, but only the conventional F toothpaste significantly reduced caries-lesion progression according to the frequency of sucrose exposure. The findings suggest that the high-F availability in biofilm, resulting from the use of conventional toothpaste compared with low-F toothpaste, may be important for reducing caries-lesion progression in conjunction with a high frequency of sucrose exposure., ((c) 2010 The Authors. Journal compilation (c) 2010 Eur J Oral Sci.)

Objectives: This study evaluated the effect of the application mode on the microtensile resin-dentin bond strength (microTBS) and silver nitrate uptake (SNU) of three one-step self-etch adhesives systems (Clearfil S3 Bond [S3], Xeno III [XE] and Adper Prompt L-Pop [AD])., Materials and Methods: The occlusal enamel of 30 caries-free extracted molars was removed with a slow-speed diamond saw under copious water-cooling in order to expose a flat dentin surface. The adhesives were applied passively or with agitation. After light-curing (600 mW/cm2 for 10 seconds), composite buildups were constructed incrementally and the specimens were stored in water (37 degrees C/24 hours). The specimens were longitudinally sectioned in the "x" and "'y" direction to obtain bonded sticks (0.8 mm2) to be tested immediately in tension at 0.5 mm/minute. For SNU, two bonded sticks from each tooth were coated with nail varnish, placed in silver nitrate and polished down with SiC paper. The microTBS and SNU data were submitted to two-way ANOVA and Tukey's test (alpha=0.05)., Results: Regarding the microTBS, only the main factor mode of application was statistically significant (p = 0.01). All adhesives showed higher microTBS when applied with agitation. Regarding SNU, only the main factor adhesive was statistically significant (p = 0.001). A higher amount of silver nitrate uptake, located in both the hybrid and adhesive layer, occurred for AD, regardless of the mode of application., Conclusions: Application with agitation on the dentin surface is a clinical tool capable of improving the resin-dentin bond strength of one-step self-etch adhesives; however, this clinical approach does not improve the hybrid layer resistance to silver nitrate uptake.

The Hemicorporectomy associated to Double-barreled wet colostomy is a high complex and heroic procedure and is to be used only exceptionally, when it is the last resource for treating locally advanced pelvic diseases in the absence of evidences of distant metastasis. We retrospectively analyzed the surgical technical details and the results from a hemicorporectomy with double-barreled wet colostomy in a single surgical time in a case of epidermoide carcinoma from a coetaneous pressure ulcer.

The current study evaluated the effect of 2% chlorhexidine digluconate (CHX) on the immediate and six-month resin-dentin bond strength (BS) and nanoleakage pattern (NL) of etch-and-rinse adhesives when applied in aqueous or associated to the phosphoric acid conditioner. The occlusal enamel of 42 caries-free extracted molars was removed in order to expose a flat dentin surface. In groups 1 and 2 (control-C), the surfaces were acid etched with conventional phosphoric acid, and the adhesives Prime&Bond NT (PB) and Adper Single Bond 2 (SB) were applied after rinsing, drying and rewetting with water. In groups 3 and 4 (Ac/CHX), the adhesives were applied in a similar manner, however, a 2% CHX-containing acid was previously applied. In groups 5 and 6 (CHX), the adhesives were applied according to the control group; however, the rewetting procedure was performed with an aqueous solution of 2% CHX for 60 seconds. Composite buildups (Opallis, FGM) were constructed incrementally, and the specimens were longitudinally sectioned in the "x" and "y" directions to obtain bonded sticks (0.8 mm2) to be tested in tension at 0.5 mm/minute immediately or after six months of water storage. For NL, two bonded sticks from each tooth were coated with nail varnish, placed in silver nitrate and polished down with SiC paper. Resin-dentin interfaces were analyzed by EDX-SEM. The BS and NL data from each adhesive was submitted to two-way repeated measures ANOVA and Tukey's test (alpha=0.05). After six months of water storage, significant reductions in BS were observed for both adhesives in the control group (p<0.05). When Ac/CHX or CHX was used, no significant reductions in BS were observed for both systems. Nanoleakage was more evident in the control group than in the experimental groups (p<0.05), even after six months. The use of CHX in an aqueous solution or associated with the acid conditioner was effective for reducing degradation of resin-dentin bonds after six months of water storage.

Background: The durability of restorations bonded with one-step self-etching (OSSE) adhesive systems is inferior compared with that of restorations bonded with conventional adhesives. The authors conducted an 18-month randomized clinical study to evaluate the clinical performance of two OSSE systems in noncarious cervical lesions applied as recommended or with an extra layer of hydrophobic adhesive layer after 18 months of clinical service., Methods: Thirty participants, each of whom had at least two pairs of similar-sized noncarious cervical lesions, took part in this study. The authors placed 120 restorations, 30 in each of four groups: Clearfil S3 Bond (Kuraray, Osaka, Japan) (CS) and iBond Gluma inside (Heraeus Kulzer, Hanau, Germany) (IB), and Clearfil S3 Bond (CSB) and iBond Gluma inside (IBB) with an extra layer of hydrophobic adhesive applied on top of them. They placed the restorations incrementally, using a resin-based composite. The authors evaluated the restorations at baseline and at 18 months following modified U.S. Public Health Service criteria., Results: At 18 months, the retention rate for the IB group was statistically lower than those for the CS, IBB and CSB groups. Marginal discoloration occurred in all groups and was statistically worse in the IB group., Conclusions: The conversion of the iBond Gluma inside and Clearfil S3 Bond adhesive systems into two-step systems by means of applying an extra hydrophobic adhesive layer improved the clinical performance of these materials after 18 months of clinical service., Clinical Implications: The application of an extra hydrophobic adhesive layer over OSSE adhesive systems, layers improved the OSSE systems clinical performance, mainly in terms of retention rate.

Objectives: To evaluate the effect of application method on immediate and 6-month resin-dentin microtensile bond strength (microTBS) and nanoleakage (NL) of three one-step self-etch adhesives systems (Clearfil S(3) Bond (S3), Xeno III (XE) and Adper Prompt L-Pop (AD))., Methods: The oclusal enamel of 30 human molar was removed in order to expose a flat dentin surface. The adhesives were applied under two modes: inactive (IN) or active (AC) application. After light-curing (600mW/cm2 for 10s), composite buildups were constructed incrementally and sectioned to obtain bonded sticks (0.8mm2) to be tested in tension immediately (IM) or after 6 months (6M) of water storage. For NL, three bonded sticks from each tooth at each time were coated with nail varnish, placed in silver nitrate and polished down with SiC paper. The microTBS data were submitted to a two-way ANOVA and Tukey's test for each adhesive (alpha=0.05)., Results: The AC showed higher microTBS to dentin when compared to IN in both periods of time (p=0.001). Only for AD, lower microTBS was seen after 6M for IN and AC techniques. XE and S3 adhesives applied under IN showed a higher amount of silver penetration throughout the hybrid layer. Low silver nitrate deposition was seen for these adhesives under AC. After 6M, AD showed a higher amount of silver nitrate uptake under IN and AC techniques., Conclusions: AC improves the bonding performance of all one-step self-etch adhesive systems tested regardless of the time and this tendency was maintained over time.