Search

In 2023, a second wave of the global mpox epidemic, which is mainly affecting men who have sex with men (MSM), was observed in some countries. Herein, we benefited from a large viral sequence sampling (76/121; 63%) and vast epidemiological data to characterise the re-emergence and circulation of the Monkeypox virus (MPXV) in Portugal during 2023. We also modelled transmission and forecasted public health scenarios through a compartmental susceptible-exposed-infectious-recovered (SEIR) model. Our results suggest that the 2023 mpox wave in Portugal resulted from limited introduction(s) of MPXV belonging to C.1.1 sublineage, hypothetically from Asia, followed by sustained viral transmission and potential exportation to other countries. We estimated that the contribution of the MSM high sexual activity group to mpox transmission was 120 (95% CrI: 30–3553) times higher than that of the low sexual activity group. However, among the high sexual activity group, vaccinated individuals likely contributed approximately eight times less [0.123 (95% CrI: 0.068–0.208)] than the unvaccinated ones. Vaccination was also linked to potential reduced disease severity, with a Mpox Severity Score of 6.0 in the vaccinated group compared to 7.0 in unvaccinated individuals. Scenario analysis indicated that transmission is highly sensitive to sexual behaviour, projecting that a slight increase in the MSM sub-population with high sexual activity can trigger new mpox waves. This study strongly supports that continued vaccination, targeted awareness among risk groups and routine genomic epidemiology is needed to anticipate and respond to novel MPXV threats (e.g. global dissemination of clade I viruses).

Introdução: A Organização Mundial de Saúde e a comunidade médica têm vindo a reconhecer a necessidade de intervir nos grupos considerados como minorias sexuais e de género, nomeadamente na comunidade de lésbicas, gays, bissexuais, “trans” (transgéneros e transsexuais), queer e intersexuais (LGBTQI). Objetivos: O presente artigo pretende rever a terminologia utilizada na distinção dos vários grupos de orientação sexual, identidade de género, outros conceitos relevantes e o seu impacto clínico. Materiais e métodos: Revisão da literatura com recurso à base de dados científica Pubmed utilizando as palavras-chave gender identity, gender variance, transgender, sexual orientation, transsexualism. Foi realizada pesquisa da terminologia e conceitos LGBTQI em websites e jornais de associações de apoio à comunidade LGBTQI. Resultados: A identidade de género é a forma como uma pessoa se identifica internamente e que determina a expressão de género, a qual resulta da combinação do comportamento, linguagem, apresentação estética e contexto cultural. A orientação sexual corresponde à atração sexual e/ou emocional que pode contribuir para o estabelecimento de relações sexuais e/ou emocionais e é determinada por três dimensões: a atração, o comportamento e a identidade sexual. Discussão: Alguns estudos mostram que utentes LGBTQI podem ter uma menor procura de cuidados de saúde, em particular devido ao receio de discriminação. Estes apresentam também necessidades específicas em cuidados de saúde, conforme os fatores de risco de exposição sexual ou inerentes à redesignação sexual cirúrgica/médica. Conclusão: O género e a sexualidade são determinantes sociais para a saúde que devem ser distinguidos e aferidos na prestação de cuidados de saúde. O clínico deve estar sensibilizado para reconhecer esses problemas e intervir.

Ozone is increasingly utilized in dental caries treatment due to its antibacterial properties. In a context of limited studies and no consensus on protocols, this research aims to assess ozone’s antibacterial efficacy on cariogenic bacteria and its potential adverse impact on dentin bond strength. Streptococcus mutans, Streptococcus sobrinus, Lactobacillus casei, and Actinomyces naeslundii suspensions were exposed to 40 μg/mL of ozone gas and 60 μg/mL of ozonated water (80 s) via a medical ozone generator. Negative and positive control groups (chlorhexidine 2%) were included, and UFC/mL counts were recorded. To examine microtensile bond strength (µTBS), 20 human molars were divided into four groups, and class I cavities were created. After ozone application, samples were restored using an etch-and-rinse and resin composite, then sectioned for testing. The SPSS v. 28 program was used with a significance level of 5%. The µTBS results were evaluated using one-way ANOVA, Tukey HSD, and Games-Howell. Bacterial counts reduced from 106 to 101, but dentin µTBS was significantly impacted by ozone (ANOVA, p < 0.001). Despite ozone’s attractive antibacterial activity, this study emphasizes its detrimental effect on dentin adhesion, cautioning against its use before restorative treatments.

Leishmania infantum, a zoonotic vector-born parasite, is endemic in the Mediterranean region, presenting mostly as visceral (VL), but also as cutaneous (CL) and mucosal leishmaniasis (ML). This study aimed to describe the epidemiological and clinical aspects of the CL and ML cases diagnosed in mainland Portugal between 2010 and 2020. Collaboration was requested from every hospital of the Portuguese National Health System. Cases were screened through a search of diagnostic discharge codes or positive laboratory results for Leishmania infection. Simultaneously, a comprehensive literature search was performed. Descriptive statistics and hypothesis testing were performed using IBM® SPSS® Statistics. A total of 43 CL and 7 ML cases were identified, with a predominance of autochthonous cases (86%). In CL, immunosuppressed individuals constituted a significant proportion of patients (48%), and in this group, disseminated CL (22%) and simultaneous VL (54%) were common. In autochthonous cases, lesions, mostly papules/nodules (62%), were frequently observed on the head (48%). The approach to treatment was very heterogeneous. ML cases were all autochthonous, were diagnosed primarily in older immunosuppressed individuals, and were generally treated with liposomal amphotericin B. The findings suggest a need for enhanced surveillance and reporting, clinical awareness, and diagnostic capacity of these forms of leishmaniasis to mitigate underdiagnosis and improve patient outcomes. A holistic One Health approach is advocated to address the multifaceted challenges posed by leishmaniases in Portugal and beyond.

Mental health is on the agenda, especially in times of pandemic due to the COVID-19 virus. Nowadays, psychological problems, such as anxiety and depression, have been more discussed and have become even more critical during confinement. This paper proposes the development process of an innovative product whose active ingredient - ellagic acid, extracted from the chestnut shell - has anxiolytic properties and can be potentially used in consumers' daily lives, preventing this type of illness. The product presented, Do Nut Stress – Acid ellagic enriched pancakes for anxiety control, consists of a pancake powder, considered a healthy and nutritious meal.

Gonadal development in limpets is well-known. However, the integration of fecundity data on coastal management actions remains overlooked. Here, we use fecundity of two exploited limpets (Patella ordinaria and P. aspera) to demonstrate its potential as a conservation tool to preserve the harvested populations of both species. From October 2021 to June 2022, 158 females of P. ordinaria and 70 of P. aspera were collected from the coastal rocky shores of the archipelago of Madeira (NE Atlantic Ocean). The fecundity in both species appears to be determinate, and estimated batch fecundity 365,638 ± 204,462 oocytes for P. ordinaria and 73,029 ± 43,496 oocytes for P. aspera. The presence of spawning individuals of both species until May is of significant relevance to their management and conservation. A harvest-ban (November-March) is currently implemented in the coastal governance actions of P. ordinaria and P. aspera. Based on the fecundity results, small adjustments can be made to further improve the conservation of adult individuals, which are important for the continuity of future generations. So far, fecundity data constitute an overlooked life trait of key importance to preserve populations of exploited species, primarily those with limited mobility such as semi-sessile littoral limpets.

Abstract Background The current standard of care is to start antiretroviral therapy in all patients diagnosed with HIV-1, as for HIV-2 current DHHS guideline suggests ART for HIV-2 as soon as diagnosis is established, although this practice is not universal, for instance, in Portugal there are specific criteria to start treatment. Case presentation We present a case of a man, chronically infected with HIV-1, HIV-2 and hepatitis B virus who developed resistance to HIV-2 while maintaining HIV-1 under control. 6 years after starting antiretroviral therapy he had his first virologic failure. We performed HIV-2 resistance tests that revealed high-grade resistance to all nucleoside reverse-transcriptase inhibitors except tenofovir and to all protease inhibitors except darunavir. After a decade of permanent poor adherence to therapy he developed resistance to both tenofovir and darunavir. We put together a new regiment with tenofovir alafenamide + emtricitabine + dolutegravir + maraviroc and nowadays he is with undetectable HIV-1 and HIV-2 viral loads. Conclusions This shows the importance of having access to HIV-2 viral load determination and HIV-2 resistance testing.

The objectives of this study were to characterize the microtensile bond strength to enamel of two experimental adhesive systems, one containing a novel monomer and the other having the same composition as commercial adhesive systems, and comparing them to commercial materials. Two experimental adhesive systems were developed in the lab, one with Bisphenol A diglycidyl methacrylate (Bis-GMA) and the other with G(2)-isocyanatoethyl methacrylate (G-IEMA) as a substitute for Bis-GMA. Twenty healthy human permanent molars were cut into halves and randomly divided into eight groups based on the application mode. The experimental universal adhesive system without Bis-GMA demonstrated comparable adhesive strength to enamel as the other universal adhesive systems containing Bis-GMA.

Currently, composite resins are widely used as aesthetic restorative materials. The success of any aesthetic restoration depends on the stability of the material’s colour. Colour change in composite resin restorations is one of the most frequent reasons for their replacement. The aim of this study is to evaluate the change in colouration, using the CIE L*a*b* colour system, of nanohybrid and microhybrid composite resins when they are exposed to potential staining solutions over a period of 14 days.

Abstract Studies on microbial communities are pivotal to understand the role and the evolutionary paths of the host and their associated microorganisms in the ecosystems. Meta-genomics techniques have proven to be one of the most effective tools in the identification of endosymbiotic communities of host species. The microbiome of the highly exploited topshell Phorcus sauciatus was characterized in the Northeastern Atlantic (Portugal, Madeira, Selvagens, Canaries and Azores). Alpha diversity analysis based on observed OTUs showed significant differences among regions. The Principal Coordinates Analysis of beta-diversity based on presence/absence showed three well differentiated groups, one from Azores, a second from Madeira and the third one for mainland Portugal, Selvagens and the Canaries. The microbiome results may be mainly explained by large-scale oceanographic processes of the study region, i.e., the North Atlantic Subtropical Gyre, and specifically by the Canary Current. Our results suggest the feasibility of microbiome as a model study to unravel biogeographic and evolutionary processes in marine species with high dispersive potential.

Chronic hepatitis B (CHB) is a potentially life-threatening and prevalent disease worldwide. Far from attaining the ultimate treatment goal, hepatitis B virus (HBV) infection eradication, the two current therapeutic options aim to prevent progression to end-stage liver disease, maintaining long-term suppression of HBV replication. Pegylated interferon-α (PEG-INFα) is often poorly tolerated and disregarded considering the orally administered nucleos(t)ide analogues. However, PEG-INFα may achieve similar treatment endpoints with a finite course of treatment. We report a case of PEG-INFα-treated CHB that attained sustained off-treatment virological response with only 16 weeks of treatment, with loss of both HBeAg and HBsAg (this latter the optimal treatment endpoint).

The genetic polymorphism and phenotypic variation are key in ecology and evolution. The morphological variability of the contour of fish otoliths has been extensively used for the delimitation of stocks. These studies are conventionally based on average phenotype using elliptic Fourier analysis and lineal discriminant analysis as classifier. Considering new analytical options, such as the wavelet transform and non-parametric algorithms, we here analyzed the otolith shape of Trachurus picturatus (blue jack mackerel) from mainland Portugal, Madeira, and the Canaries. We explore the phenotypic variation throughout a latitudinal gradient, establish a hypothesis to explain this variability based on the reaction norms, and determine how the use of average phenotype and/or morphotypes influences in the delimitation of stocks. Four morphotypes were identified in all regions, with an increase of phenotypes in warmer waters. The findings demonstrated that stocks were clearly separated with classification rates over 90%. The use of morphotypes, revealed seasonal variations in their frequencies and per region. The presence of shared phenotypes in different proportions among fishing grounds may open new management approaches in migratory species. These results show the importance of the phenotypic diversity in fisheries management.

The aim of this study is to compare the adhesive interface formed in dentin, using self-adhesive composites applied with different bonding strategies, by testing the microtensile bond strength (μTBS) and ultramorphology through the use of light microscopy. Permanent, sound human molars were randomly allocated to six experimental groups. The groups included a negative control group, where only etching was performed via EtchOnly; a positive control group where an adhesive was applied, OptiBondFL (OBFL); and an experimental group where a primer was applied using a co-curing strategy together with a composite (Primer_CoCuring). The samples were sectioned into microspecimens for μTBS (n = 8) and into 1-mm thick slabs for light microscopy using Masson’s trichrome staining protocol (n = 3). The statistical analysis included a two-way ANOVA for μTBS data and Tukey’s HSD was used as a post-hoc test (significance level of 5%; SPSS v. 26.0). The results of the μTBS revealed that the self-adhesive composite (F = 6.0, p < 0.018) and the bonding strategy (F = 444.1, p < 0.001) significantly affected the bond strength to dentin. However, their interactions were not significant (F = 1.2, p = 0.29). Etching dentin with no additional treatment revealed the lowest μTBS (VF_EtchOnly = 2.4 ± 0.8 MPa; CC_EtchOnly = 2.0 ± 0.4 MPa), which was significantly different from using a primer (VF_CoCu = 8.8 ± 0.8 MPa; CC_CoCu = 6.3 ± 1.0 MPa) or using the full adhesive (VF_OptiBondFL = 22.4 ± 0.3 MPa; CC_OptibondFL = 21.2 ± 0.4 MPa). Microscopy images revealed that the experimental Primer_CoCuring was the only group with no collagen fibers exposed to the dentin–composite interface. Overall, the use of a primer, within the limitations of this study, increased the bonding of the self-adhesive composite and provided sufficient infiltration of the collagen based on light-microscopic imaging.

O risco infecioso associado a terapêutica biológica é cada vez mais estudado e conhecido, existindo estratégias de rastreio e profilaxia bem estabelecidas. O mesmo não se verifica na utilização de corticoide sistémico nem dos tradicionais modificadores de doença autoimune, de que são exemplo o metotrexato e a ciclosporina, apesar de usados há largos anos. A dose e tempo de terapêutica com corticoide sistémico relacionam-se com a ocorrência de infeção oportunista. Doses superiores a 5 mg/dia associam-se a infeção bacteriana, superiores a 10 mg/dia a reativação de infeção por vírus herpes zoster (VHZ), e superiores a 15 mg/dia ou por mais de 2 a 4 semanas a reativação de tuberculose latente, o que implica rastreio e aplicação de quimioprofilaxia de forma adequada. O corticoide sistémico surge ainda como dos principais fatores de risco para o desenvolvimento de pneumocistose no doente não-VIH e doses prolongadas (por mais de 4 semanas) podem levar a reativação de infeção por vírus da hepatite B (VHB) e justificar a profilaxia com tenofovir disoproxil fumarato ou entecavir. Foram ainda descritos casos de estrongiloidíase complicada de síndrome de hiperinfeção em doentes sob corticoide. O grau de imunossupressão conferido pode contraindicar a realização de vacinas vivas atenuadas. O metotrexato e ciclosporina comportam baixo risco infecioso quando utilizados em monoterapia, sendo a vigilância de sintomas a principal estratégia preventiva. Não obstante, ambos são imunomoduladores, contraindicam a realização de vacinas vivas atenuadas e associam-se a risco de infeção bacteriana e reativação de infeção por VHZ, no caso da ciclosporina, ou reativação de infeção por VHZ e VHB no caso do metotrexato, sobretudo se administrado em dose >0,4 mg/kg/semana. Ambos se associam a evolução para tuberculose ativa quando em associação terapêutica com outros imunossupressores. Compreender e estudar o risco de infeção na utilização de terapêutica imunossupressora permite a sua aplicação de forma mais informada e segura.

The deep-sea sharks associated as by-catch of the Madeiran midwater drifting longline fishery for scabbardfishes (Aphanopus spp.) were investigated by means of an experimental survey at 800-1200 m depth within the Canary Islands Exclusive Economic Zone, whose fishing grounds have been exploited during the past 15 years. Nine species of chondrichthyans were identified, belonging to five families: Pseudotriakidae, Centrophoridae, Etmopteridae, Somniosidae and Chimaeridae. Data on length, weight and sex ratio for the 436 chondrichthyan individuals caught in the March 2009 survey are given. Several voucher specimens of each species caught were deposited in the collections of the Natural History Museum of Funchal.

A vast number of adhesive formulations exist currently. However, available adhesives still have several drawbacks such as increased hydrophilicity, polymerization deficiency, potential cytotoxicity and limited monomer interdiffusion within dentin. To improve material properties, a Bisphenol A-free adhesive containing a novel dendrimer G(2)-isocyanatoethyl methacrylate (G-IEMA) in replacement of Bis-GMA was made and tested. Sound human molars were sectioned to expose mid-coronal dentin, which was bonded using four adhesives—Futurabond, Scotchbond Universal and experimentals EM1 and EM2. The experimental adhesive EM2 contained G-IEMA, while EM1 had Bis-GMA. Groups were further allocated to two different adhesive strategies: etch-and-rinse (20 s etching) or self-etch. Immediate (24 h) microtensile bond strength to dentin (n = 5) was tested using a universal testing machine (1 mm/min, 5 kN; Shimadzu AGS-X Autograph, Tokyo, Japan), while the ultrastructure of the interface (n = 2) was assessed using scanning electron microscopy-energy dispersive spectroscopy (SEM-EDS). Nanoleakage expression was evaluated using silver nitrate penetration and posterior SEM-EDS analysis (n = 3). Linear mixed models/Generalized models were used for inferential statistics (5% significance level). Bond strength results did not depend on the adhesive choice, although differences were found between strategies (p < 0.001). Regarding nanoleakage, when applied in an etch-and-rinse mode, experimental adhesives scored lower nanoleakage means than Futurabond and Scotchbond Universal. The novel adhesive shows interesting interfacial properties, with favorable nanoleakage results and a bond strength to dentin that matches current commercial adhesives.

The World Health Organization highlights fiscal policies as priority interventions for the promotion of healthy eating in its Action Plan for the Prevention and Control of Non-communicable Diseases. The taxation of sugar sweetened beverages (SSBs) in particular is noted to be an effective measure, and SSBs taxes have already been implemented in several countries worldwide. However, although the evidence base suggests that this will be effective in helping to combat rising obesity rates, opponents of SSBs taxation argue that it is illiberal and paternalistic, and therefore should be avoided. Bioethical analysis may play an essential role in clarifying whether policymakers should adopt SSBs taxes as part of wider obesity strategy. In this article we argue that no single ethical theory can account for the complexities inherent in obesity prevention strategy, especially the liberal theories relied upon by opponents of SSBs taxation. We contend that a pluralist approach to the ethics of SSBs taxation must be adopted as the only suitable way of accounting for the multiple overlapping, and sometimes, conflicting factors that are relevant to determining the moral acceptability of such an intervention.

NCREP – Consultancy in Rehabilitation of Built Heritage Ltd., surveyed the constructive features of Bhutan's vernacular rammed earth built heritage, as part of a project financed by the World Bank and commissioned by the Division for the Conservation of Heritage Sites (DCHS) of the Department of Culture - Ministry of Home and Cultural Affairs of Bhutan. This work, which aimed at better understanding the structural behaviour of this heritage and, based on this information, proposing measures to mitigate its seismic risk, included the study of 18 traditional rammed earth buildings in two villages in the Punakha district. The surveys were conducted house-to-house, based on a DCHS script, and included surveys of artisans responsible for building these constructive typologies, supported by a questionnaire integrated within the project, to collect information on the procedures, rites and practices followed in these constructions. This article focuses only on the first part of the work; it presents the main constructive characteristics assessed from the survey carried out on this built heritage and compiles the results of the surveys of the artisans.

Background: Hypoxia may contribute to the development and progression of diabetic macular oedema (DMO) and diabetic retinopathy. The photoreceptors are the most metabolically active cells in the retina and the rod photoreceptors consume the maximal amount of oxygen for dark adaptation. Therefore, a lightmask emitting 500- to 505-nm light and worn at night during sleep may prevent rod-related dark adaptation and, thereby, reduce the retinal oxygen consumption and improve or prevent progression of DMO and diabetic retinopathy as evidenced in small short-term studies. Objectives: The clinical effectiveness and safety of using a lightmask to prevent dark adaptation as a treatment and preventative option was evaluated for DMO over 24 months. Design: A Phase III, multicentre, prospective, single-masked, randomised controlled clinical trial that evaluated the clinical effectiveness and safety of a lightmask that prevents dark adaptation to treat and prevent non-central DMO versus standard care (i.e. non-lightmask arm) at 24 months. A subset of participants also enrolled for a mechanistic substudy that evaluated the role of hypoxia in DMO. Setting: Fifteen NHS clinical sites in the UK. Participants: Adults with non-centre-involving DMO. Intervention: The participants were randomly assigned (1 : 1) to being offered a lightmask (Noctura 400 Sleep Masks, Polyphotonix Medical Ltd, Durham, UK) to wear at night during sleep to prevent dark adaptation or to the non-lightmask arm (standard care) for 24 months. The participants were evaluated every 4 months. Main outcome measure: The primary outcome was defined as a change in retinal thickness at the zone of maximum thickness measured by spectral domain optical coherence tomography at 24 months in the study eye, analysed using a linear mixed-effects model that estimated adjusted treatment effects at both 12 and 24 months. Results: A total of 308 participants were recruited between April 2014 and May 2015. A total of 155 participants in the lightmask arm and 153 in the control arm contributed to the intention-to-treat strategy. The lightmask arm did not show any difference in effect compared with the non-lightmask arm [adjusted mean difference between arms –0.65 µm, 95% confidence interval –6.90 to 5.59 µm; p = 0.84). The compliance of wearing the lightmask was suboptimal, as recorded electronically, from the returned lightmasks. There were no lightmask-related severe adverse events. The mechanistic study aimed at studying the effect of improving hypoxia by inhaling 100% oxygen or by offering lightmasks to wear during sleep at night over 12 months did not demonstrate any clinically beneficial effect on DMO. Conclusion: The lightmask, as offered in this trial to prevent dark adaptation, did not show any treatment or preventative effect in participants with non-central oedema or diabetic retinopathy at 24 months. No effect was seen as early as 4 months when compliance was higher. Future work: Future research is needed to evaluate the role of rod-induced hypoxia in the pathogenesis of DMO and diabetic retinopathy. Trial registration: Current Controlled Trials ISRCTN85596558. Funding: This project was funded by the Efficacy and Mechanism Evaluation programme, a Medical Research Council and National Institute for Health Research partnership. The report will be published in full in Efficacy and Mechanism Evaluation; Vol. 6, No. 2. See the NIHR Journals Library website for further project information. The lightmasks were purchased at a discounted rate from Polyphotonix Medical Ltd.

Cutaneous leishmaniasis (CL) is the most common leishmaniasis syndrome, yet a neglected disease in industrialized non-endemic countries, where it has become an emergent problem. The lack of clinical experience, evidence-based literature and availability of some treatments complicates its management. We report a CL case in a 30 year-old man returned from Brazil, with a cutaneous ulcerated lesion, where it was possible to isolate Leishmania braziliensis/guyanensis complex (subgenus Viannia). An initial course of treatment with miltefosine was attempted, but considering the lack of response, liposomal amphotericin B was used, with very good results. Our report highlights the obstacles faced in the diagnosis and treatment of New World CL in non-endemic countries and the need for more funding and research. Keywords: Leishmania, Viannia, Cutaneous leishmaniasis, Miltefosine, Liposomal amphotericin B

Abstract Background Very brief interventions (VBIs) for physical activity are promising, but there is uncertainty about their potential effectiveness and cost. We assessed potential efficacy, feasibility, acceptability, and cost of three VBIs in primary care, in order to select the most promising intervention for evaluation in a subsequent large-scale RCT. Methods Three hundred and ninety four adults aged 40–74 years were randomised to a Motivational (n = 83), Pedometer (n = 74), or Combined (n = 80) intervention, delivered immediately after a preventative health check in primary care, or control (Health Check only; n = 157). Potential efficacy was measured as the probability of a positive difference between an intervention arm and the control arm in mean physical activity, measured by accelerometry at 4 weeks. Results For the primary outcome the estimated effect sizes (95 % CI) relative to the Control arm for the Motivational, Pedometer and Combined arms were respectively: +20.3 (−45.0, +85.7), +23.5 (−51.3, +98.3), and −3.1 (−69.3, +63.1) counts per minute. There was a73% probability of a positive effect on physical activity for each of the Motivational and Pedometer VBIs relative to control, but only 46 % for the Combined VBI. Only the Pedometer VBI was deliverable within 5 min. All VBIs were acceptable and low cost. Conclusions Based on the four criteria, the Pedometer VBI was selected for evaluation in a large-scale trial. Trial registration Current Controlled Trials ISRCTN02863077 . Retrospectively registered 05/10/2012.

Due to their polymerization characteristics, hyper-branched dendrimers have lately shown to be promising candidates for use in dental materials. In this study, a new dental adhesive system was prepared, using a dendrimer derived from 2-isocyanatoethyl methacrylate (G-IEMA), and its adhesive properties were investigated. The exposed dentin was treated with four universal adhesives (UAs): SBU (Scotchbond Universal™), FUT (Futurabond M+™), AE1 (experimental adhesive with Bis-GMA) and AE2 (experimental adhesive with G-IEMA), using Etch & Rinse (ER) or Self Etch (SE) protocols. Composite build-ups were prepared and stored for 24 h at 37 °C in distilled water. Composite/dentin beams were prepared with cross-sectional areas of 1 ± 0.3 mm2 and µTBS (Micro-tensile bond strength) test was performed at 0.5 mm/min. Failures modes were evaluated by stereomicroscopy, and bonding interfaces were observed by scanning electron microscopy (SEM). Statistical analysis of µTBS data was performed using General Linear (GLM) and Linear Mixed Models (LMM). The effect of adhesive type on µTBS was significant (p = 0.010), with AE1 presenting significantly higher µTBS than SBU (p = 0.019). No other differences between adhesives were observed. ER showed significantly better results than SE (p = 0.019), and no significant interactions between the adhesives and protocols were determined. Results obtained so far pinpoint the emergence of a new paradigm in the dental materials field, as G-IEMA can be used successfully as an alternative to Bis-GMA.

Background: Panretinal photocoagulation (PRP) has been the standard of care for patients with proliferative diabetic retinopathy (PDR) for the last 40 years. It prevents severe visual loss in PDR but is also associated with adverse effects on visual functions. Objectives: The clinical efficacy and mechanistic evaluation of aflibercept for proliferative diabetic retinopathy (CLARITY) trial evaluated the clinical efficacy, mechanisms and cost-effectiveness of intravitreal aflibercept (Eylea®, Regeneron, Tarrytown, NY, USA/Bayer Pharma AG, Berlin, Germany therapy for PDR. Design: A multicentre, prospective, individually randomised, single-masked, active-controlled trial with concurrent economic evaluation that tested the non-inferiority of intravitreal aflibercept versus standard care PRP at 52 weeks. A subset of the participants enrolled in a mechanistic evaluation substudy. Setting: 22 UK NHS clinical sites. Participants: Patients aged at least 18 years having either treatment-naive PDR or active retinal neovascularisation (NV) despite prior PRP requiring treatment and best corrected visual acuity (BCVA) of 54 Early Treatment Diabetic Retinopathy Study (ETDRS) letters or better in the study eye were included. Eyes with evidence of macular oedema at baseline confirmed by central subfield thickness > 320 µm on spectral-domain optical coherence tomography were excluded. Intervention: In the intervention arm, intravitreal aflibercept injections were given at baseline, 4 and 8 weeks and patients were subsequently reviewed every month and injected pro re nata based on the treatment response defined by degree of regression of retinal NV. In the comparator arm, PRP was completed in 2-weekly sessions and then supplemented if necessary at 8-weekly intervals. Main outcome measures: The primary outcome was the mean change in BCVA at 52 weeks utilising a linear mixed-effects model incorporating data from both week 12 and week 52. Results: A total of 232 participants (116 per arm) were recruited between August 2014 and November 2015. A total of 221 and 210 participants contributed to the intention-to-treat (ITT) model and per-protocol (PP) analysis, respectively. Economic evaluation was undertaken on 202 participants (101 per arm) with complete cost and outcome data. Aflibercept was non-inferior and superior to PRP in both the ITT population [mean BCVA difference 3.9 letters, 95% confidence interval (CI) 2.3 to 5.6 letters; p

In order to evaluate the use of parasites as biological tags to identify populations of the oceanic horse mackerel, Trachurus picturatus, two samples of 100 fish each, caught off the Madeira and Canary Islands from January to June 2009, were examined for the presence of anisakids, trypanorhynchs, acanthocephalans and liver coccidians. In T. picturatus from Madeira, prevalence of the coccidian Goussia cruciata reached 82%, whereas prevalence of the nematode Anisakis sp., the acanthocephalan Rhadinorhynchus cadenati and the trypanorhynch Nybelinia lingualis were 12.0%, 8.9% and 7.0%, respectively. In samples from the Canary Islands, prevalence of G. cruciata was 8.0%, Anisakis sp. and R. cadenati reached 5.0% and 42.0% respectively, and N. lingualis was not recovered. The absence of N. lingualis and the lower prevalence of Anisakis sp. appear to be related to the smaller size of the oceanic horse mackerels examined from the Canary Islands. Although significant differences in prevalence of two parasites, G. cruciata and R. cadenati, were found between the two regions investigated (χ2=125.13, df=1, p=0.000 and χ2=40.77, df=1, p=0.000), only G. cruciata was considered useful as a biological tag for the identification of populations of T. picturatus. In order to reach sound conclusions, an expansion of the temporal and spatial sampling strategy is recommended.

We compare the RANTES/CCL5 (R/C) chemokine production between AP and BMDJ/FDOJ. For both pathologies, the R/C expression was also compared to radiographic diagnosis in 2D-OPG, 3D-CBCT/DVT.Material and Methods: Postoperative samples were collected and divided in three different groups: HB (healthy jawbone) (n=19), APs (n=19), and BMDJ/FDOJ (n=7). The R/C expression was evaluated using multiplex analysis. In addition, two clinical cases from AP and BMDJ/FDOJ groups were randomly selected and radiographic diagnosis in 2D-OPG and 3D-CBCT/DVT was compared to TAU measurements and R/C expression in AP and in BMDJ/FDOJ.Results: BMDJ/FDOJ showed the highest R/C expression (2498.71 pg/mL), followed by AP (841.85 pg/mL) and HB (149.85 pg/mL) (AP vs BMDJ/FDOJ = p=0.01; AP vs HB = p=< 0.01; BMDJ/FDOJ vs HB = p=< 0.01). In both clinical cases, the radiographic findings depict the AP areas in OPG and CBCT/DVT, in contrast to the BMDJ/FDOJ areas. Conversely, the systemic immunological R/C expressions are threefold and fivefold excessive in both cases.Discussion: AP is recognized as a pathology requiring treatment, while the pathogenesis of BMDJ/FDOJ is controversially discussed in the literature, despite stronger potential systemic immunological effects (breast cancer (case 1) and multiple sclerosis (case 2)). The inadequate radiographic representation of reduced bone density in BMDJ/FDOJ areas could be a reason for this contradiction.Conclusion: The data presented provide the first quantitative analysis of R/C expression in AP and BMDJ/FDOJ. BMDJ/FDOJ showed high R/C expression than AP, besides the diagnostic through radiographs being extremely poor. To cover this imprecision, a radiation-free TAU device is available. [ABSTRACT FROM AUTHOR]