Search

Aim: We aim the isolated and combined effects of sedentary behaviour exposure time and physical activity levels on muscle strength in older adults., Design: This prospective observational cohort study, analytical in nature, using exploratory survey methods and physical performance testing. With 5-year longitudinal follow-up (2015-2020)., Methods: A total of 459 older adults participated in the baseline, with a total of 224 being included/located again in the follow-up. We evaluate muscle strength using handgrip tests and sit-to-stand tests. The international physical activity questionnaire was used to measure physical activity and sedentary behaviour. Generalised Estimation Equations tested both independent and combined effects, reporting results as β coefficients and confidence intervals., Results: Older adults exhibiting low sedentary behaviour displayed enhanced handgrip strength compared to those with high sedentary behaviour. Notably, older adults who were sufficiently active with low sedentary behaviour, sufficiently active with high sedentary behaviour, and insufficiently active with low sedentary behaviour showed increased handgrip strength compared to their counterparts who were insufficiently active with high sedentary behaviour. This trend was consistent for lower limb strength., Conclusion: Interventions that encourage a reduction in sedentary behaviour and an increase in physical activity are essential to maintain muscle strength among older adults., Implications for Practice: The findings of this study underscore the importance of addressing both sedentary behaviour and physical activity levels in clinical interventions aimed at preserving muscle strength in older adults. Routine assessments of physical activity and sedentary behaviour could help tailor personalised exercise programs, potentially enhancing functional independence and reducing the risk of frailty and disability in older patients., Patient or Public Contribution: Patients were involved in the sample of the study., Reporting Method: This study was conducted in accordance with the Strengthening Research in Observational Studies in Epidemiology (STROBE) guidelines., (© 2024 John Wiley & Sons Ltd.)

Introduction: Nurse practitioners are fundamental to organize patient care at the various levels of health care services. This includes exposure to various work stressors, which can affect the quality of the service as a result of physical and mental exhaustion., Objectives: This study aimed to investigate and analyze the rate and the factors associated with mental suffering in licensed practical nurses and nursing assistants in a hospital in Brazil., Methods: This is a cross-sectional study conducted with a nursing support team in a hospital in São Paulo, Brazil. The participants answered the Self-Reporting Questionnaire, which assesses mental suffering, and a questionnaire with questions about sociodemographic, occupational, clinical and health risk behavior data in 2013., Results: Their mean age was 32.8 years (standard deviation ± 8.5), and their mean length of service was 6.9 years (standard deviation ± 7.0). The participants were predominantly licensed practical nurses (53.5%), women (73.3%), working less than 40 hours per week (63.4%), with more than one job (74.3%), and no chronic illnesses (84.2%). The overall rate of mental suffering was 23.8%. The most frequent (46.5%) complaint was feeling nervous, tense or worried., Conclusions: Mental suffering is a risk factor for overall health and workers' health care services should focus on health promotion and disease prevention., Competing Interests: Conflicts of interest: None

Introduction: Healthcare workers in both the public and private systems were on the front line of the fight against the COVID-19 pandemic. As a consequence, they faced uncertainty, heavy demand, excessive working hours, and the fear of contracting the virus., Objectives: To investigate the occurrence of psychological distress among public and private healthcare workers at the start of the COVID-19 pandemic., Methods: An observational, quantitative study was conducted from April to June of 2020, enrolling workers who had cared for suspected and confirmed cases of covid-19 in Brazil. Psychological distress was assessed using the Self-Reporting Questionnaire-20. Associations between the outcome and independent variables were analyzed using the chi-square test., Results: Majorities of the 400 healthcare workers studied were nursing professionals (69.8%), worked in the Southeast region of Brazil (69.5%), were affiliated to a public healthcare institution (71.8%), and had a mean working week of 45.81 hours. The rate of psychological distress in the sample was 56.8%. There was no statistically significant association between the outcome and the type of organization (public/private). There were associations between psychological distress and professional category and between psychological distress and prior comorbidities., Conclusions: There was evidence of impact on mental wellbeing irrespective of care level or setting. Psychological distress was one of the greatest challenges faced by the healthcare workers during the pandemic, irrespective of the type of institution, and was a phenomenon of relevance to occupational health in general during the pandemic., Competing Interests: Conflicts of interest: None

Considering the prevalence of cranial cruciate ligament disease (CCLD) and concurrent medial patellar luxation (MPL) among dogs, and the concomitant bone deviations routinely identified, the aim of this study is to evaluate the efficacy of the combination between distal femoral osteotomy (DFO) and modified tibial plateau levelling osteotomy (mTPLO) for the treatment of MPL with distal femoral varus, tibial torsion, and CCLD. Dogs with concurrent MPL and CCLD that underwent DFO and mTPLO procedures were included. Subjective clinical evaluations of gait and pre-operative and immediate post-operative radiographic examinations were performed. Surgical data were documented. The anatomical lateral distal femoral angle (aLDFA), femoral varus angle, mechanical medial proximal tibial angle, and tibial plateau angle (TPA) were compared between the pre- and post-operative periods. A total of 12 dogs were included in this study. Closing-wedge DFO and mTPLO procedures were performed on 14 limbs. The mean pre-operative and post-operative aLDFA values were 104.8 ± 3.9° and 95.4 ± 2.4°, respectively. TPA values were 26.2 ± 3.7° pre-operatively and 6.3 ± 3.2° post-operatively. Bone healing was observed in 7.1 %, 71.3 %, and 85.5 % of patients at the first, second, and third follow-up, respectively. Lameness was resolved in 28.5 %, 78.5 %, and 100 % at 30, 60, and 90 days, respectively. No major peri- or post-operative complications were reported. The combination of mTPLO and DFO aligns the stifle extensor mechanism, promoting dynamic stabilization. It can be considered for the treatment of concurrent MPL and CCLD in dogs, performed as a single procedure, and is associated with favorable short-term outcomes., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Strawberry is a food rich in bioactive compounds with great antioxidant potential. However, due to the high incidence of pests that affect crop cultivation, phytosanitary management still lacks control methods for agroecological cultivation. Thus, the present research aimed to evaluate the chemical composition and the potential of the essential oil of the leaves of Piper macedoi in the control of Cerosipha forbesi in laboratory and semi-field conditions. The concentration of essential oil in the leaves of P. macedoi that showed the highest mortality was 2.0 ml/L of oil, with a mortality above 91% under laboratory conditions. A mortality rate of 80% for all concentrations tested was observed after 24 h in all conditions tested. Thus, using essential oil from the leaf of P. macedoi can be a highly viable strategy in managing the aphid C. forbesi since it showed high mortality rates with small doses of oil.

Effective bone substitute biomaterials remain an important challenge in patients with large bone defects. Glass ceramics produced by different synthesis routes may result in changes in the material physicochemical properties and consequently affect the success or failure of the bone healing response. To investigate the differences in the orchestration of the inflammatory and healing process in bone grafting and repair using different glass-ceramic routes production. Thirty male Wistar rats underwent surgical unilateral parietal defects filled with silicate glass-ceramic produced by distinct routes: BS - particulate glass-ceramic produced via the fusion/solidification route, and BG - particulate glass-ceramic produced via the sol-gel route. After 7, 14, and 21 days from biomaterial grafting, parietal bones were removed to be analyzed under H&E and Massons' Trichome staining, and immunohistochemistry for CD206, iNOS, and TGF-β. Our findings demonstrated that the density of lymphocytes and plasma cells was significantly higher in the BS group at 45, and 7 days compared to the BG group, respectively. Furthermore, a significant increase of foreign body giant cells (FBGCs) in the BG group at day 7, compared to BS was found, demonstrating early efficient recruitment of FBGCs against sol-gel-derived glass-ceramic particulate (BS group). According to macrophage profiles, CD206 + macrophages enhanced at the final periods of both groups, being significantly higher at 45 days of BS compared to the BG group. On the other hand, the density of transformation growth factor beta (TGF-β) positive cells on 21 days were the highest in BG, and the lowest in the BS group, demonstrating a differential synergy among groups. Noteworthy, TGF-β + cells were significantly higher at 21 days of BG compared to the BS group. Glass-ceramic biomaterials can act differently in the biological process of bone remodeling due to their route production, being the sol-gel route more efficient to activate M2 macrophages and specific FBGCs compared to the traditional route. Altogether, these features lead to a better understanding of the effectiveness of inflammatory response for biomaterial degradation and provide new insights for further preclinical and clinical studies involved in bone healing., (© 2023 Wiley Periodicals LLC.)

Objective: Glycaemia in newborns changes significantly after birth; however, little is known about these changes. The objective was to describe continuous interstitial glucose values in term newborns who were exclusively breast fed on the first day of life., Design: We studied 159 newborns with appropriate weights for gestational age, who were exclusively breast fed on the first day of life, using a continuous glucose monitoring device that calculates interstitial glucose every 5 min. The device was removed after 24 hours, and the results were analysed using the R program, which provides the minimum, maximum, median and a standard curve with centiles., Results: At the second hour of life, the moment in which the sensor started to identify the newborn's glycaemia, interstitial glucose levels were 2.59-4.43 mmol/L (46.7-79.9 mg/dL). The median interstitial glucose level of the newborns during the first day of life was 3.33±0.48 mmol/L (60±8.6 mg/dL). Interstitial glucose levels dropped until the sixth hour of life, reaching 2.19-3.95 mmol/L (39.5-71.1 mg/dL), and then increased again. The maximum values were found at the 20th and 21st hours of life, which were 2.81-4.64 mmol/L (50.6-83.6 mg/dL)., Conclusion: The interstitial glucose during the first 24 hours of life declined until the sixth hour of life, then increased around the 20th hour and remained stable until the end of the first day of life., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Musculoskeletal disorders and injuries (MSDI) are conditions that affect the locomotor system characterized by pain and impairment of functionality. They are the leading cause of years lived with disability. The aim of this study was to analyze the factors that influence the return to work (RTW) among workers on sick leave due to MSDI.   METHODS: A longitudinal study was conducted in the city of São Paulo, Brazil, between 2020-2022. The participants were 216 workers who required social security compensation due to MSDI. They filled out online questionnaires about their sociodemographic characteristics, health risk behaviors, work characteristics and health conditions. They were followed for 365 days after their first day of sick leave. A Cox regression was performed to identify the factors that influenced their first RTW., Results: Most participants were male (53.0%), mean age was 39.5 years (SD 10.6), 70.4% returned to work within the one-year follow-up period. The mean duration of sick leave was 192.6 days. Factors associated with a lower RTW were age 40 years and older (HR 0.54; 95%CI 0.39-0.76) and the interaction between perceptions of the need for improvement in the physical and psychological domains of quality of life (HR 0.67; 95%CI 0.48-0.94)., Conclusions: Occupational healthcare professionals should pay greater attention to patients who are aging and those with perceived worse physical and psychological conditions, in order to facilitate the reintegration process and promote sustained RTW after sick leave due to musculoskeletal disorder or injury., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Previous studies have shown that associations between obesity and other comorbidities favor worse outcomes in COVID-19. However, it is not clear how these factors interrelate and whether effects on men and women differ. We conducted an observational, cross-sectional study using a national COVID-19 inpatient database. We studied differences in direct and indirect effects of obesity and comorbidities according to sex and body mass index (BMI) categories in hospitalized COVID-19 patients in Brazil using path analysis models and logistic regression. For men, path analysis showed a direct association between BMI and death and a negative correlation of death and chronic cardiovascular disease (CCD). For women, the association of BMI and death was indirect, mediated by admission to the ICU and comorbidities and association with CCD was non-significant. In the logistic regression analyses, there was a positive association between death and BMI, age, diabetes mellitus, kidney and lung diseases and ICU admission. We highlight the need to consider the distinct impact of obesity and sex on COVID-19, of monitoring of BMI and of the design for specific male-targeted approaches to manage obesity., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Introduction: Several studies have shown that eye and vision problems are among the most significant issues reported by individuals who use computers at work., Objectives: To investigate individual and occupational environmental factors associated with visual function among workers who perform computer-based administrative tasks., Methods: This is a cross-sectional study conducted in 2014-2015 with 303 workers of a public hospital in the city of São Paulo, Brazil. The participants answered a structured questionnaire, including the 25-Item National Eye Institute Visual Function Questionnaire. Statistical analyses used descriptive analysis, tests of association and multiple linear regression analysis., Results: Most participants were female (61.1%); the mean age was 46.0 (standard deviation [SD]) ± 12.5, and approximately 91.7% of them reported wearing corrective lenses. Regarding visual function, the mean score at the 25-Item National Eye Institute Visual Function Questionnaire was 78.0, SD ±7.1. A regression analysis showed that visual function declined with age (ß -0.218; 95%CI -0.276--0.16l) and effort at work (ß -0.656; 95%CI -0.928--0.383)., Conclusions: The mean quality of visual health in the studied group was good. The younger the age and the lower the effort at work, the better the visual function. Our results point to the relevance of establishing periodical and preventive health actions, including eye health assessments., Competing Interests: Conflicts of interest: None

Malaria is an infectious and parasitic disease caused by protozoa of the genus Plasmodium , which affects millions of people in tropical and subtropical areas. Recently, there have been multiple reports of drug resistance in Plasmodium populations, leading to the search for potential new active compounds against the parasite. Thus, we aimed to evaluate the in vitro antiplasmodial activity and cytotoxicity of the hydroalcoholic extract of Jucá ( Libidibia ferrea) in serial concentrations. Jucá was used in the form of a freeze-dried hydroalcoholic extract. For the cytotoxicity assay, the(3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) method with the WI-26VA4 human cell line was used. For the antiplasmodial activity, Plasmodium falciparum synchronized cultures were treated with serial concentrations (0.2 to 50 μg/mL) of the Jucá extract. In terms of the chemical composition of the Jucá extract, gas chromatography coupled to mass spectrometry measurements revealed the main compounds as ellagic acid, valoneic acid dilactone, gallotannin, and gallic acid. The Jucá hydroalcoholic extract did not show cytotoxic activity per MTT, with an IC 50 value greater than 100 µg/mL. Regarding the antiplasmodial activity, the Jucá extract presented an IC 50 of 11.10 µg/mL with a selective index of nine. Because of its antiplasmodial activity at the tested concentrations and low toxicity, the Jucá extract is presented as a candidate for herbal medicine in the treatment of malaria. To the best of our knowledge, this is the first report of antiplasmodial activity in Jucá.

During the COVID-19 pandemic, longstanding issues involving nursing work, which has always involved significant risks of illness and infection, were intensified. It is necessary to acknowledge the risks and nurses' perceptions about the risks qualitatively during the period of the health crisis. The aim of this study was to examine the health repercussions perceived by nursing workers in emergency services during the outbreak of the COVID-19 pandemic in Brazil. This was a qualitative, descriptive, cross-sectional study. The settings of the study were emergency services with a national scope; the participants were nursing workers. Data were collected via face-to-face virtual calling interviews and analyzed via a content analysis technique, which was supported by IRAMUTEQ software. The formation of textual classes pointed in three thematic directions, from which three categories emerged: nursing workers' exposure, due to a lack of protective equipment, to the risk of being contaminated with, falling ill from, and transmitting the COVID-19 virus; changes in work environments, processes, and relations in response to the pandemic; and physical, mental, and psychosocial alterations perceived by emergency service nursing workers. The exposure to the virus, risk of contamination, and changes in the work environment and relations all resulted in health repercussions, which were perceived as physical, mental, and psychosocial alterations that were described as dietary disturbances, physical fatigue, burnout, increased smoking, anxiety, sleep alterations, fear, exhaustion, stress, social isolation, loneliness, distancing from relatives, and social stigma.

Vocational rehabilitation is an intervention to enhance the return to work and improve quality of life. The aim of this study was to evaluate sociodemographic and occupational factors associated with the length of stay at work among workers with work-related musculoskeletal disorders (WRMDs) who had undergone rehabilitation through the Brazilian public social security system. This was a longitudinal study among 680 workers with histories of disability due to WRMDs who returned to the formal job market after vocational rehabilitation between 2014 and 2018. Survival analysis was performed to identify the factors influencing permanence in work. Job dismissal occurred for 29.26% of the workers. The average duration of employment after returning to the formal job position was 56 months. The following factors were associated with shorter length of employment: living in the southeastern region (HR: 2.78; 95% CI 1.12-6.91) or southern region (HR: 2.68; 95% CI 1.04-6.90) of Brazil; working in transportation, storage or postal services (HR: 2.57; 95% CI 1.07-6.17); or working in financial activities, insurance or related services (HR: 2.70; 95% CI 1.05-6.89). These findings may contribute to the discussion about prevention of disability and interventions to ensure health care for workers with WRMD disabilities who undergo rehabilitation.

We assessed the effectiveness of lyophilised banked human milk (HM) as a fortifier to feed very-low-birth-weight infants (VLBWI). This study aimed to evaluate the safety and tolerability of HM with HM lyophilisate as an additive compared with the standard additive (cows' milk protein). In this phase I double-blind randomised controlled clinical trial, set in the intensive and intermediate care units of a tertiary hospital, forty VLBWI were enrolled and allocated into two groups: HM plus HM lyophilisate (LioNeo) or HM plus commercial additive (HMCA). The inclusion criteria were preterm infants, birth weight 750-1500 g, small or adequate for gestational age, exclusively receiving donor HM, volume ≥ 100 ml/kg per d and haemodynamically stable. Participants were followed up for 21 consecutive days. The primary outcome measures were necrotising enterocolitis (NEC), late-onset sepsis (LOS), death, gastrointestinal (GI) bleeding or perforation, diarrhoea, regurgitation, vomiting and abdominal distension. The LioNeo and HMCA groups had similar weights at baseline. The regression models showed no differences between the groups in terms of the primary outcomes. Diarrhoea, GI perforation, NEC and LOS were absent in the LioNeo group (one LOS and one NEC in the HMCA group). Multiple regression analysis with the total volume of milk as a covariate did not show significant differences. The lyophilisation of donor HM was considered safe and tolerable for use in stable haemodynamically VLBWI.

Objective: To determine the existence of association between depressive symptoms and mortality in older individuals in Latin America., Method: A systematic review with meta-analysis was performed based on published studies indexed in PubMed, Scientific Electronic Library Online (SciELO), Web of Science, Cochrane Library, Scopus, and LILACS ( Literatura Latino-Americana e do Caribe em Ciências da Saúde ). The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO), and structured according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Meta-analysis was performed using random effects models, and the data analyzed included crude relative risk (RR) and heterogeneity, with poin estimates and 95% confidence intervals (95%CI)., Results: Five studies, performed in Brazil and Mexico, were included in the meta-analysis, for a total of 8 954 older individuals. RR for mortality in the presence of depressive symptoms was 1.44 (95%CI: 1.16; 1.78). Heterogeneity was 80.87%. Meta-regression showed that the higher the proportion of women in the sample, the higher the mortality risk associated with depressive symptoms; and that the longer the study follow-up, the lower the risk of mortality associated with depressive symptoms., Conclusion: The presence of depressive symptoms was positively associated with mortality in older Latin American individuals. The RR for death was 44.0% higher in individuals with depressive symptoms as compared to those without depressive symptoms. The main study limitations were the lower number of studies retrieved through systematic review and the variety of scales used to determine the presence of depressive symptoms.

Purpose: The questionnaire "Professional Fulfillment Index" (PFI) was validated to assess emotional exhaustion, interpersonal disengagement, and professional achievement among physicians. This study presents the process of cross-cultural adaptation of the PFI to the Brazilian context., Design: Analytical cross-sectional study carried out between July and October 2020. Settings: For conceptual equivalence, a panel of experts was constituted who conducted analyzes on the translation and back-translation processes from English to Brazilian Portuguese., Subjects: For the operational equivalence, 432 physicians in the field of Occupational Medicine were invited., Measures: They answered the PFI in an online platform. Analysis: Both exploratory and confirmatory factor analysis were performed to seek evidence of the hypothesized structure of PFI item responses. Reliability was assessed using three indicators., Results: The Brazilian version can be considered similar to the original. Most of participants were female (57.6%) and mean age 49.6 years-SD 14.0. The mean time since graduation was 18.5 years-SD 9.67. Most of them had a full-time job (88.0%) and were trained through post-graduation courses 83.8%. The most frequent job task was to perform worker´s clinical evaluations (84.9%). Exploratory and confirmatory analyzes showed the adequacy of the items in measuring the instrument's construct, with stability for use in other populations and samples., Conclusion: The PFI was developed to evaluate positive and negative aspects of physicians' role and performance. The process described in this article was the first cross-cultural adaptation of the questionnaire. The PFI can help in mapping potential risk situations for negative impacts on physicians' occupational well-being and performance at work, in order to propose interventions that reduce exhaustion and expand professional fulfillment.

The 2030 United Nations Goal 8 for sustainable development focuses on decent work. There is utility in identifying the occupational safety and health aspects of Goal 8, as they pertain to the four pillars of decent work: job creation, social protection, rights of workers, and social dialogue. A workgroup of the International Commission on Occupational Health and collaborators addressed the issue of decent work and occupational safety and health (OSH) with the objective of elaborating a framework for guidance for practitioners, researchers, employers, workers, and authorities. This article presents that framework, which is based on an examination of the literature and the perspectives of the workgroup. The framework encompasses the intersection of the pillars of decent (employment creation, social protection, rights of workers, and social dialogue) work with new and emerging hazards and risks related to various selected determinants: new technologies and new forms of work; demographics (aging and gender); globalization; informal work; migration; pandemics; and OSH policies and climate change. The OSH field will need an expanded focus to address the future of decent work. This focus should incorporate the needs of workers and workforces in terms of their well-being. The framework identifies a starting point for the OSH community to begin to promote decent work.

Introduction: Dorsopathies are common among bus drivers and may result in absenteeism due to work disability. Dorsopathies have a multifactorial etiology, including those related to occupational risk factors., Objectives: To analyze the factors associated with sick leave due to dorsopathies among bus drivers from a public transport company., Methods: This was a cross-sectional, analytical study with information from a database of 2,229 professional bus drivers from a company in the city of São Paulo, Brazil. The study period was from 2016 to 2017. Independent variables were sex, age group, length of service, and work shift; the outcome was the history of sick leave due to dorsopathies in the study period. Logistic regression analysis was performed to investigate the factors associated with the outcome., Results: Mean sample age was 47.33 years, and mean length of service was 8.65 years. Most participants were men (98.06%) and worked during the day (85.9%). There was a 17% prevalence of sick leave in the study period, with an average of 1.86 days per medical certificate. Age group was the only variable with a statistically significant distribution, with a reduced probability of sick leave due to dorsopathies in those aged ≥ 40 years., Conclusions: Younger workers were more likely to be on sick leave due to dorsopathies than older workers. Actions aimed at permanent health promotion and disease prevention are important to improve the quality of life and well-being of these workers., Competing Interests: Conflicts of interest: None

Objectives: To identify the factors associated with the occurrence of sleepiness among nursing professionals., Material and Methods: A case-control study nested in a cross-sectional one, conducted with 364 controls and 121 cases. Data on demographic and occupational characteristics were collected, as well as about lifestyle, physical and psychosocial work environment and somnolence. A multiple logistic regression analysis was performed., Results: The independent factors associated with the presence of sleepiness were as follows: imbalance between efforts and rewards (ORa=3.81; p <0.001), high overcommitment (ORa=3.20; p <0.001), workload equal to or greater than 45 hours a week (ORa=2.30; p =0.001), situations that can generate pain/injury with moderate or high exposure (ORa=1.85; p =0.037), and night work (ORa=1.71; p =0.038). The model was adjusted by gender and age group., Conclusion: Individual and historical-occupational characteristics and, mainly, those related to the physical and psychosocial work environment, were associated with the occurrence of sleepiness. Public and institutional preventive policies must include improvements in the conditions of the physical and psychosocial work environment, as well as strengthening of the individual resources.

Introduction: Frontline healthcare workers providing care for COVID-19 are more likely to get infected and die compared with other professionals. Deaths or sick leaves due to COVID-19 can affect the smooth operation of health services in areas with shortage of workers., Objectives: To analyze factors associated with the death of healthcare workers due to COVID-19 in the state of Amapá, Brazil., Methods: Analytical cross-sectional study using COVID-19 data from Amapá between March 2020 and January 2021. The association of independent variables (sex, race/color, age group, region of residence, comorbidity) with death was analyzed by logistic regression., Results: Data from 1,258 workers were analyzed. The majority were women (67.7%; 852/1,258), multiracial (66.9%; 759/1,135), aged between 18 and 64 (98.3%; 1,226/1,247), with no comorbidity (86.6%; 1,090/1,258), from the Macapá metropolitan area (56.7%; 713/1,258). The mortality rate was 1.59%. Factors associated with death were: age group = 65 years (odds ratio = 10.43; 95% confidence interval [CI] = 2.78-39.11), comorbidity (odds ratio = 4.52; 95%CI = 1.74-11.74), and residence in the Macapá metropolitan area (odds ratio = 4.37; 95%CI = 1.25-15.29)., Conclusions: The recognition of factors that may have caused the death of healthcare workers in Amapá can support the recommendation of protective measures for the most susceptible, such as switching to activities with lower exposure to the virus or teleworking., Competing Interests: Conflicts of interest: None

The aim of this article is to assess the odds ratio of hospitalization and mortality due to COVID-19 in people with obesity using data from residents of Espírito Santo, Brazil. An observational, quantitative, cross-sectional study was carried out from the database available on the official channel of the State Health Secretariat of Espírito Santo. Crude odds ratio estimates (ORs) referring to the association between variables were calculated, as well as adjusted odds ratios (adjusted odds ratios-OR adj.) and their respective 95% confidence intervals (CI 95%). The results indicate that men, non-white, no education or with lower education level and age over 40 years old were more likely to be hospitalized and died of COVID-19. People with obesity are at risk of hospitalization and death due to COVID-19 54% and 113% higher than people who do not have obesity. People with obesity had a higher chance of hospitalization when they were over 40 years old, had breathing difficulty, and the comorbidities diabetes (2.18 higher) and kidney disease (4.10 higher). The odds ratio of death for people with obesity over 60 years old was 12.51 higher, and those who were hospitalized was 17.9 higher compared to those who were not hospitalized., Competing Interests: NO authors have competing interests.

This study aimed to map the prevalence of mental distress among employees at two metallurgical companies and to analyze differences according to the sex of workers and the employing company. An analytical cross-sectional study was conducted using the 20-item Self-Reporting Questionnaire to map the prevalence of mental distress. A total of 439 workers participated in the study. The overall prevalence was 10.0%, being 4 times higher in women (32.3%) than in men (8.3%) (p < 0.001). There was no significant difference between the prevalence rates of mental distress according to employing company (p = 0.271) or sector (p = 0.239). The most frequent complaint was 'nervousness, tension, and worry' (48.7%). These results indicate the need for management of workers' mental health, especially among women., Competing Interests: Conflicts of interest: None

Objective: To analyze the factors associated with mental distress among health workers who cared for patients with a suspected or confirmed diagnosis of coronavirus disease 2019 (COVID-19)., Methods: A cross-sectional analytical study of national scope, carried out between in the second quarter of 2020. A total of 437 health professionals, who filled out an electronic form about sociodemographic data, occupational aspects, psychosocial characteristics of work and mental distress. Multiple logistic regression was performed to analyze the covariables associated with mental distress., Results: There was a predominance of workers on the nursing team (65.0%), female (71.0%), from Southeastern region of the country (68.6%) and with no morbidities (36.2%). The prevalence of mental distress was 61.6%. Job strain was reported by 24% of participants, and the perception of low support from coworkers was described by 52.9%. The final multiple regression model showed that mental distress was associated with females (odds ratio - OR: 1.93; 95%CI: 1.22-3.07), age up to 40 years (OR: 1.64; 95%CI: 1.07-2.52), weekly working hours equal or over 60 hours (OR: 1.87; 95%CI: 1.15-3.11), job strain (OR: 2.45; 95%CI: 1.41-4.40) and low support from co-workers (OR: 3.47; 95%CI: 2.26-5.38)., Conclusion: Six out of ten participants presented mental distress, which was associated to both individual characteristics and factors related to the work carried out during the pandemic. There is an urgent need to map services that have such characteristics, to outline actions to promote mental health and prevent emotional distress at different levels of health care.

Objective: To examine the effects of physical activity (PA) and sedentary behaviour (SB), in isolation and combination, on all-cause mortality in older adults., Methods: Prospective, population-based cohort study. The data were collected from first wave in 2015 and the follow-up continued until 2020. The sample consisted of 332 older adult people aged ≥ 60 years-old, out of which 59 died. The level of PA and SB was assessed by the International Physical Activity Questionnaire (IPAQ). The older adults were divided into PA categorized as sufficiently active and insufficiently active and into high and low SB. We built four combinations of PA and SB. Also, we used the Cox proportional hazards regression with a 95% confidence interval with hazard ratio estimate so as to verify the mortality risks between PA, SB, and the combinations of PA and SB., Results: Insufficiently active individuals had higher risks of mortality compared to sufficiently active people. We observed no associations between SB and mortality separately; however, when evaluated in a combined way, insufficiently active individuals and with a high SB time had a higher chance of mortality compared to active individuals with a low SB time., Conclusion: Our isolated analyses demonstrate that complying with PA recommendations reduces the risk of mortality; however, no association was found between the time of PA exposure with the time of SB. When analysing the combination, being physically inactive and with a long time of SB showed higher mortality rates, with SB being an enhancer of this risk. The results of this study show the interdependence of SB for PA performed at moderate to vigorous intensity. The understanding of this interrelation must be considered in the formulation of public health guidelines.

The United Nations identified decent work and economic growth as a sustainable development goal for 2030. Decent work is a term that sums up aspirations for people in their working lives. One of the factors that influences the achievement of decent work is aging. This article examines how aspects of aging and organizational factors affect work ability across the lifespan and throughout one's work career. Additionally, the critical issue of worker physical mobility was also addressed as a practical limitation to functional aging. Through our investigation, we identified gaps in the literature where research and interventions should be promoted. These include early disability studies; population dashboards of workers' health metrics; intervention and cost effectiveness in health promotion and prevention of early functional aging at work; policies for tailoring demands to individual needs and abilities; and inequities of social protection for aging workers.

Objectives: To describe the prevalence of testing among health workers providing care for suspected and confirmed cases of COVID-19., Methods: This quantitative, cross-sectional study was conducted from April to June 2020, using a convenience sample. An online questionnaire was used for collecting sociodemographic, occupational, and clinical data, which were analyzed descriptively., Results: In total, 437 health workers participated in the study, with a predominance of nursing workers (58.68%), women (70.3%), age between 30 and 49 years (54.2%), individuals living in the Southeast region of Brazil (60.54%), working in the public care system (69.11%), and focused on primary care (30.89%). Among the participants, 36% reported comorbidities, 21.1% had symptoms suggestive of COVID-19, and only 27% had undergone some type of COVID-19 testing., Conclusions: Despite the existence of risk comorbidities and symptoms suggestive of contamination, the frequency of testing was below one third among respondents. The lack of action compromises health surveillance and protection strategies for workers providing care for the population and may favor the contamination of new patients and the community., Competing Interests: Conflicts of interest: None

Objective: This study aims to analyze factors that influence return to work (RTW) among workers on sickness absence due to mental disorders., Methods: A longitudinal study conducted between 2014 and 2017 in São Paulo, Brazil. The 385 participants answered a questionnaire including sociodemographics, habits/lifestyle, job characteristics, and clinical information. Survival analysis was performed to identify factors influencing the RTW., Results: Most of participants were females (74.5%), worked in jobs dealing with public (44.2%) and were depressed (52.4%). RTW occurred for 68.3% participants over 1-year follow-up. Mean duration of absence was 163.83 days. The risk profile for remaining absent was heavy smokers, be abstainer, obese, deal with the public, perceived great effort at work, and low self-efficacy., Conclusions: These findings can contribute in discussion about disability prevention and interventions to assure mental health care for workers., Competing Interests: The authors report no conflicts of interest., (Copyright © 2021 American College of Occupational and Environmental Medicine.)

Fatty acids play a significant role in maintaining cellular and DNA protection and we previously found an inverse relationship between blood levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and DNA damage. The aim of this study was to explore differences in proteomic profiles, for 117 pro-inflammatory proteins, in two previously defined groups of individuals with different DNA damage and EPA and DHA levels. Healthy children and adolescents ( n = 140) aged 9 to 13 years old in an urban area of Brazil were divided by k-means cluster test into two clusters of DNA damage (tail intensity) using the comet assay (cluster 1 = 5.9% ± 1.2 and cluster 2 = 13.8% ± 3.1) in our previous study. The cluster with higher DNA damage and lower levels of DHA (6.2 ± 1.6 mg/dL; 5.4 ± 1.3 mg/dL, p = 0.003) and EPA (0.6 ± 0.2 mg/dL; 0.5 ± 0.1 mg/dL, p < 0.001) presented increased expression of the proteins CDK8-CCNC, PIK3CA-PIK3R1, KYNU, and PRKCB, which are involved in pro-inflammatory pathways. Our findings support the hypothesis that low levels of n-3 long-chain PUFA may have a less protective role against DNA damage through expression of pro-inflammatory proteins, such as CDK8-CCNC, PIK3CA-PIK3R1, KYNU, and PRKCB.

Mango is a tropical fruit presenting intense postharvest metabolism. In storage at room temperature, it presents a short shelf life due to the high respiratory rate, and consequent ripening, which limits the marketing period in distant regions. This study evaluated the effect of edible coatings of hydroxypropyl methylcellulose and beeswax in concentrations of 10, 20, and 40% in 'Palmer' mangoes stored for 15 days at 21 °C. The coatings controlled ripening, maintaining peel and pulp colors, firmness, soluble solids (SS), titratable acidity (TA), SS/TA ratio, sugars, ascorbic acid, phenolic compounds, flavonoids, β-carotene, and antioxidant activity. Also, they reduced weight loss, oxidative stress, and the anthracnose (Colletotrichum gloeosporioides) incidence, without inducing alcohol dehydrogenase activity, which suggests that coated fruit did not ferment. Treatment with 20% beeswax was the most suitable for industrial applications, increasing in six days the mangoes shelf life., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Fungi are important in several aspects of human life. In particular, to agriculture, pathogenic fungi are of great importance, as they are responsible for production losses of the most diverse types. Because of this, knowledge about pathogenic fungus is of extreme importance for farmers and professionals working in agricultural areas. Among farmers who use specific agroecological practices, this knowledge is even more valuable, since by not adopting conventional methods of production, they resort to non-invasive alternatives that are less or not harmful at all to the environment in consideration of production management methods. This study aimed to assess farmer perception in the Cerrado biome in the city of Goiás (GO), Brazil, in order to understand their ethnomycological perceptions to verify historical management practices, their knowledge about phytopathogenic fungi, and how these producers perceive fungi. We used the theoretical reference method "From peasant to peasant" formulated by ANPA - National Association of Small Farmers. Some aspects of farmers' ethnomycological knowledge are discussed. These ease identification the representatives of the Fungi Kingdom is associated with organisms that present easily recognizable characteristics, such as wood-ears or disease-causing fungi. In general, farmers are able to identify representatives of the Fungi Kingdom that are found in their daily lives. The perception of farmers about fungi, a group still much unknown by society, is very relevant for future actions of ethnomycology.

This study evaluated the validity of nutrient and food group intakes estimated by an FFQ against biomarkers. A 71-item semiquantitative FFQ was administered to 210 Brazilian children and adolescents aged 9-13 years. Intakes were correlated with biomarkers in plasma and red blood cells. Correlations between nutrients and their biomarkers were presented for animal protein, myristic acid (C14:0), EPA, DHA, β-carotene, folate, and vitamins B3, B5 and B6. Food groups and biomarkers were correlated as follows: fish products with EPA and DHA; milk and dairy with C14:0, pyridoxal 5'-phosphate and vitamin B12; total vegetables and dark green and orange vegetables with β-carotene; 5-methyltetrahydrofolate with green vegetables; and flour products with para-aminobenzoylglutamic acid. This FFQ is a valid tool for ranking Brazilian children and adolescents according to their intake of several nutrients and food groups.

Purpose: To evaluate clinical outcome following minimally invasive plate osteosynthesis (MIPO) associated with percutaneous transplantation of allogeneic adipose-derived mesenchymal stem cells (AD-MSC) at the tibial fracture site in dogs., Methods: Thirty-six dogs presenting with nonarticular complete tibial fracture were included in this study. All fractures were treated by the same MIPO technique. The animals were divided in group 1 (n = 20) received a percutaneous application of 3 × 106 AD-MSC at the fracture site and group 2 (n = 16) did not receive any adjuvant treatment. Postoperative radiographic examinations were made at 15, 30, 60, 90 and 120 days., Results: Fifty-eight percent of the patients were classified as skeletally immature. The median weight of the animals was 18.8 kg. The mean radiographic union time differed statistically between the AD-MSC group (28.5 days) and the control group (70.3 days). Sixty percent of dogs in group 1 and 56.25% of the group 2 were considered immature., Conclusions: The use of allogeneic AD-MSC cell therapy and MIPO is a safe, viable and effective technique for promoting bone healing in nonarticular tibial fractures in dogs.

Background: Prostate cancer (PC) is the second most common cancer among men, behind only non-melanoma skin cancer, and the main method of screening for PC is the prostate-specific antigen (PSA). To analyze the prevalence and the factors associated with high concentration of PSA in the elderly is essential to understand this outcome, and building strategies to decrease their rates of morbidity and mortality., Methods: We performed a cross-sectional study with 96 elderly men. A high level of PSA was defined by >4.0 ng/mL. In order to identify sociodemographic, health, functional and behavioral variables, which may be associated with high levels of PSA, we carried out a multivariate analysis using Poisson regression., Results: The prevalence of high levels of PSA was 21.9% ( n = 21). High levels of PSA was associated with years of study, race/ethnicity and family arrangement, health perception, systolic blood pressure, diastolic blood pressure, metabolic diseases, alcohol consumption and sedentary behavior., Conclusions: The study found a high prevalence of high PSA concentrations in the elderly and several aspects are associated, which can be a worrying factor for their health, since PSA is an important marker of prostate cancer.

Purpose: To evaluate the use of demineralized bone matrix of caprine origin in experimental bone defects of the tibia in New Zealand rabbits., Methods: Fragments of the tibia diaphysis were collected aseptically from clinically healthy goats. The bones were sectioned into 1 cm fragments and stored at -20°C for subsequent hydrochloric acid (HCL) demineralization. A 70 mg portion of DBMc was used to fill the experimental bone defects. Twenty-four female adult New Zealand rabbits were divided into 2 groups: the MG (matrix group, left tibia) and CG (control group, right tibia). Additionally, they were separated into 4 groups with 6 animals, according to the period of analysis (15, 30, 60 and 90 days postoperatively). Using microCT, volumetric parameters were evaluated: bone volume, relationship between bone volume and total volume, bone surface area, relationship between bone surface area and total volume, number of trabeculae, trabecular thickness and trabecular separation., Results: There was a statistically significant difference (P<0.05) between groups considering bone volume (BV) and bone:total volume (BV/TV), on 15, 30 and 90 days postoperatively. Control group showed a statistically significant superiority (P < 0.05) considering the mean of the variables bone surface (BS), number of trabeculae (Tb.N) and between bone surface and total volume (BS/TV) at 15 and 90 days., Conclusions: Caprine demineralized bone matrix was safe and tolerable. No signs of material rejection were seen macroscopically. It is an alternative for the treatment of bone defects when autologous graft is not available or in insufficient quantities.

Vocational rehabilitation (VR) aims at improving work ability to facilitate workers' return to work. VR is provided in Brazil by the public social security system. The aim of the present study was to analyze trends in VR indicators for Brazil from 2007 to 2016. Based on open-access, secondary aggregate data, we calculated the cumulative incidence of VR indicators. We fitted Prais-Winsten generalized linear regression models to estimate trends and calculated annual percent variation with the corresponding 95% confidence interval (95% CI). The mean cumulative incidence of referrals to VR services was 37.16/1000 temporary disability benefits granted and exhibited a decreasing trend of -6.92% (95% CI: -8.38; -5.43). The mean cumulative incidence of admissions to VR services was 57.34/100 referrals and exhibited an increasing trend of 3.31% (95% CI: 1.13; 5.53). The mean cumulative incidence of rehabilitation was 57.43/100 admissions and remained stable along the analyzed period, -2.84 (95% CI: -5.87; 0.29). Our findings evidence a reduction in the number of workers referred for VR, an increase of admissions, and stability in the cumulative incidence of rehabilitated workers.

Host single nucleotide polymorphisms (SNPs) in different genes can play a role in chronic hepatitis C virus (HCV) infection and influence the presence of hepatic fibrosis and comorbidities such as hepatic steatosis. We assessed the combined effect of SNPs in the PNPLA3, MTTP, TM6SF2, and IFNL3/IFNL4 genes in 288 Brazilian patients who were chronically infected with HCV. Hepatic fibrosis was observed in 246 (85.4%) patients and hepatic steatosis in 141 (49.0%) patients. PNPLA3 rs738409 (CG/GG) (P = 0.044) and TM6SF2 rs58542926 (CT) (P = 0.004) were alone associated with fibrosis, and PNPLA3 rs738409 (P < 0.05, in distinct genetic models) was associated with steatosis. Multiple logistic regression of each SNP combined with HCV genotype 3 infection showed that MTTP rs1800591 (GT/TT) combined with HCV genotype 3 was associated with a 6.72-fold increased chance of hepatic steatosis (P = 0.013). In the analysis of SNPs combined 2 by 2, no influence on hepatic fibrosis or steatosis was observed., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: Butchers are exposed to biological hazards as a function of their continuous handling of meat containing blood, fat and fluids. Biological hazards include contamination with viruses, such as the papillomavirus (HPV), especially HPV type 7, which is associated with the so-called "butcher's wart.", Objective: To investigate wart-like lesions among meat handlers., Method: Cross-sectional descriptive study conducted at a supermarket in São Paulo in 2017. Twenty-four employees allocated to the meat handling section were interviewed and subjected to skin visual examination; lesions were photographed., Results: Most participants were male (87.5%) and half of them (50.0%) were within age range 31 to 40 years old. Only one employee had started working in this section less than 2 years earlier. Wart-like lesions or scars with black dots on their center were found on the hands of 11 butchers (45.8%)., Conclusion: Almost half of the participants had history of hand warts. Most of the participants with lesions were male, aged up to 40, right-handed and had worked as meat handlers for 2 years at least. We might infer we found cases of wart-like occupational dermatosis among butchers at a supermarket in São Paulo.

Certain B-vitamins and vitamin A may be involved in inflammatory pathways associated with homocysteine and omega-3 fatty acids. The aims of this study were (i) to determine whether different metabolic profiles of B-vitamins and vitamin A in Brazilian children and adolescents were positively or negatively related to homocysteine and omega-3 fatty acids using k-means clustering analysis, (ii) compare nutrient intakes and metabolites between the different metabolic profiles, (iii) evaluate if the statistically significant metabolites found between the metabolic groups, can predict the variation of leukotriene A4 hydrolase (LTA4H) levels, a biomarker of low-grade inflammation, in the total studied population. This cross-sectional study included 124 children and adolescents, aged 9-13 y old. Dietary intake was assessed by the food frequency questionnaire and 24-hour recall. Biomarkers for vitamins B2, B6, B12, folate and vitamin A were measured in plasma. Omega-3 fatty acids and homocysteine were measured in red blood cells (RBC). Two different metabolic profiles were found. Thirty of these individuals had overall average higher riboflavin, pyridoxal, and vitamin B12 plasma levels (metabolic group 1) compared to 94 individuals (group 2). Group 2 had lower dietary intake of vitamin B2, vitamin A, and vitamin B12 and higher RBC levels of homocysteine. EPA and DHA erythrocyte levels were not different between metabolic groups. Multiple linear regression analyses showed that blood cobalamin, riboflavin, pyridoxal and homocysteine combined, explained 9.0% of LTA4H levels variation in the total studied population. The metabolic group that had low plasma levels of riboflavin, pyridoxal, and cobalamin also had a lower dietary intake of B-vitamin and higher RBC homocysteine. The combined levels of the riboflavin, pyridoxal, cobalamin and homocysteine biomarkers can predict the variation of LTA4H in the total population studied, but it is not clear how this regulation occurs.

Micronutrients and their metabolites are cofactors in proteins involved in lipid metabolism. The present study was a subproject of the Harmonized Micronutrient Project (ClinTrials.gov # NCT01823744). Twenty participants were randomly selected from 136 children and adolescents that consumed a daily dose of 12 vitamins and 5 minerals supplementation for 6 weeks. The 20 individuals were divided into two pools of 10 individuals, according to their lipid profile at baseline (Pool 1 with lower triglycerides, LDL, and VLDL). The individuals were analyzed at baseline, after 6 weeks of daily supplementation, and after 6 weeks of a washout period in relation to anthropometric, body composition, food intake, lipid profile, micronutrient levels, and iTRAQ proteomic data. Genetic ancestry and its association with vitamin serum levels were also determined. After supplementation, LDL levels decreased while alpha-tocopherol and pantothenic acid levels increased in pool 2; lipid profiles in pool 1 did not change but had higher plasma levels of pantothenic acid, pyridoxal, and pyridoxic acid. In pool 2, expression of some proteins increased, and expression of other ones decreased after intervention, while in pool 1, the same proteins responded inversely or did not change their levels. Plasma alpha-tocopherol and Native American genetic ancestry explained a significant fraction of LDL plasma levels at baseline and in response to the intervention. After intervention, changes in expression of alpha-1 antitrypsin, haptoglobin, Ig alpha-1 chain C region, plasma protease C1 inhibitor, alpha-1-acid glycoprotein 1, fibrinogen alpha, beta, and gamma-chain in individuals in pool 2 may be associated with levels of LDL and vitamin E. Vitamin E and Native American genetic ancestry may also be implicated in changes of vitamin E and LDL levels. The results of this pilot study must be validated in future studies with larger sample size or in in vitro studies., Competing Interests: Funding was provided by the Nestle Institute of Health Sciences (Lausanne, Switzerland) (contract reference RDHS 000054). Sofia Moco and Jim Kaput were employees at Nestlé Institute of Health Sciences and participated in the experimental design of the study and in writing the final manuscript, as well as other authors. All other authors declare no conflict of interest., (© 2019 The Authors. Food Science & Nutrition published by Wiley Periodicals, Inc.)

Vitamins B2, B6, B12, and folate are essential for methylation reactions and possibly influence the transport of polyunsaturated fatty acids in plasma and red blood cells (RBC). Associations between B-vitamin biomarkers and fatty acid (FA) profile were analyzed in Brazilian children and adolescents. This cross-sectional study included 249 children and adolescents, aged 9-13 years old. Dietary intake was assessed by the food frequency questionnaire and the healthy eating index (HEI). Biomarkers for vitamins B2, B6, B12, and folate were measured in plasma. The FA profile and the metabolites of one-carbon metabolism were measured in RBC. Associations were tested with multiple linear regression models. An increase of 1 nmol/L in vitamin B2 was associated with an increase of 0.19 mg/dL of EPA, 0.20 mg/dL of ARA, and 0.25 mg/dL of DHA in RBC. An increase of 1 ng/mL in plasma folate was associated with an increase of 0.14 mg/dL of EPA, 0.22 mg/dL of ARA, and 0.21 mg/dL of DHA in RBC. These findings highlight the importance of an adequate intake of vitamin B2 and folate in childhood, since they may improve the FA profile in RBCs and may help prevent cardiovascular disease., Competing Interests: S.M., M.K., and J.K. were employees of NIHS, part of Nestlé group, when this study was conducted. The funder contributed to the study design, analysis of samples and data, interpretation of findings, and preparation of the manuscript. J.K. is currently employed by Vydiant and M.K. is currently employed by Frontiers. Other authors do not have any conflict of interest.

The aim of this study was to evaluate the potential use of a DNA comet assay, DNA fragmentation fluorimetric assay and reactive oxygen species levels as potential biomarkers of genome conditions of dental pulp stem cells (DPSCs) isolated from dog canine teeth. Mesenchymal stem cells were isolated from the dental pulp collected from dog teeth. The results obtained suggest the ideal moment for clinical application of cellular therapy for this type of cell. The cell culture was maintained with Dulbecco's modified Eagle's medium supplemented with 10.00% fetal bovine serum for eight passages. During each passage, cell proliferation, oxidative stress and level of DNA fragmentation were assessed by3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyltetrazolium (MTT) assay, testing 2,7 dichlorodihydro-fluorescein-diacetate and PicoGreen ® , respectively. There were important differences among the first three DPSC passages compared to passages 4-8 and a large number of nuclei with some levels of DNA damage (30.00 to 40.00% in initial DPSC passages and > 50.00% in late passages), indicating in vitro DPSC genomic fragility. Within the limitations of this study, the results suggest these relatively simple and inexpensive approaches - comet and DNA fragmentation assays - could help sort stem cells with less DNA damage for use in research or therapies., Competing Interests: The authors declare that there is no conflicts of interest.

Objective: To investigate the validity and test-retest reliability of the Brazilian version of the Dutch questionnaire "Verwachtingen over werken"., Methods: We analyzed data from a longitudinal study conducted in the city of São Paulo, Brazil, from 2014 to 2016. Participants were 411 workers on sick leave for more than 15 days due to mental disorders. A subsample of 126 participants responded the questionnaire a second time, seven to 21 days later. Factorial and concurrent validities and the test-retest reliability were analyzed., Results: Most participants were female (71.5%), the average age was 36.7 years; 83.1% had attended 12 or more years of formal schooling; the average length of sick leave was 84 days. The average self-efficacy score tended to be below the scale midpoint. The construct had a two-dimensional structure and the concurrent validity confirmed the original construct. For all items, the test-retest reliability adjusted for prevalence ranged from good (0.70) to almost perfect (0.83)., Conclusions: While the two-dimensional structure diverges from the original, other parameters were adequate. Application of the Return-to-work self-efficacy questionnaire to Brazilian workers might contribute to the planning of return-to-work process. Additional studies are needed to complement the analysis of the use of this instrument in Brazil.

Objective: The aim of this retrospective clinical study was to evaluate the incidence of ProTaper Universal System instrument fractures, associated with observation of the arch, group of teeth, and root thirds in which these fractures occurred., Methods: From analysis of charts, clinical record cards and radiographs of endodontic treatments performed by postgraduate students using the ProTaper Universal System at a reference center, a total of 1031 teeth and 2355 canals were analyzed. The general incidence of instrument fractures and their frequency, considering the group of teeth, arch and root thirds, were cataloged and the data obtained were statistically analyzed (Exact Fischer test, with level of significance of 1%)., Results: The general percentage of fractures, considering the number of teeth and number of root canals evaluated was 4.4% and 1.9%, respectively. Instrument fractures occurred more frequently in the mandibular first (8.8%) and second (9.6%) molars, however, without statistically significant difference between them (P=0.81). In the first and second maxillary molars, the incidence of fracture was 4.7% and 5.1%, respectively, also without significant difference (P=0.81). Considering the dental arches (maxillary and mandibular), the fractures occurred with significantly higher frequency in the mandibular arch (66.7%), in comparison with the maxillary arch (33.3%) (P<0.01). A significantly higher percentage of fractures occurred in the apical third (84.4%) compared with the middle third (15.6%) (P<0.01)., Conclusion: The general percentage of fractures, considering the number of teeth and number of root canals evaluated was 4.4% and 1.9%, respectively. However, the arch (mandibular) and root third (apical) had a significant effect on the incidence of instrument fractures., Competing Interests: Disclosures Conflict of interest: The authors deny any conflict of interest., (Copyright: © 2018 European Endodontic Journal.)

Scope: Micronutrients are in small amounts in foods, act in concert, and require variable amounts of time to see changes in health and risk for disease. These first principles are incorporated into an intervention study designed to develop new experimental strategies for setting target recommendations for food bioactives for populations and individuals., Methods and Results: A 6-week multivitamin/mineral intervention is conducted in 9-13 year olds. Participants (136) are (i) their own control (n-of-1); (ii) monitored for compliance; (iii) measured for 36 circulating vitamin forms, 30 clinical, anthropometric, and food intake parameters at baseline, post intervention, and following a 6-week washout; and (iv) had their ancestry accounted for as modifier of vitamin baseline or response. The same intervention is repeated the following year (135 participants). Most vitamins respond positively and many clinical parameters change in directions consistent with improved metabolic health to the intervention. Baseline levels of any metabolite predict its own response to the intervention. Elastic net penalized regression models are identified, and significantly predict response to intervention on the basis of multiple vitamin/clinical baseline measures., Conclusions: The study design, computational methods, and results are a step toward developing recommendations for optimizing vitamin levels and health parameters for individuals., (© 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)