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Andréa Pecce Bento,1 Leonardo Costa Pereira,2 Kerolyn Ramos Garcia,1 Luiz Fernando Ramos Ferreira,3 Emília Vitória da Silva,1 Margô Karnikowski1 1Sciences and Health Technologies Program, University of Brasilia, Brasilia, DF, Brazil; 2Physical Education, University UNIEURO, Brasilia, DF, Brazil; 3Academic League of Project Management, Florence College, São Luis, Maranhão, BrazilCorrespondence: Margô Karnikowski, University Campus, s/n, Metropolitan Center, Brasília, DF, 72220-275, Brazil, Tel/Fax +5 613107 8418, Email margounb@gmail.comAim: The use of potentially inappropriate medications (PIM) can impair the safety and effectiveness of pharmacotherapy in the older adults. Thus, several countries have lists and criteria to indicate these drugs, in order to promote the safety of prescription and the rational use of drugs in geriatric practice.Objective: This study sought to contribute to the inclusion of PIM for the older adults in the Brazilian criterion (BCPIM/2016) – current list used in Brazil and reference in Latin American countries – through expert approval, comparing convergences with international AGS lists BEERS/2019, STOPP/START/2015, PRISCUS/2010 and EU (7)-PIM List/2015.Methods: This is a critical analysis of potentially inappropriate medications for use in the older adults present in the list of Brazilian criteria, together with their absence of some drugs that are on international lists (BEERS/2019; Priscus/2010; Stopp/Start/2015; EU7-PIM list/2015). This study was subdivided in 6 stages: selection of national criteria, classification of drugs according to Anatomic Therapeutic Chemical, comparison between BCPIM/2016 with international lists, selection of drugs not included in the Brazilian list, selection of experts for evaluation and suggestions about drugs not included in the Brazilian list and the synthesis of the analysis carried out by the specialists.Results: We cataloged 66 drugs marketed in Brazil that are on international lists, but not in the Brazilian consensus, of which 24 were validated by experts as necessary for inclusion in this consensus, considering the risks and benefits in health care for the older adults. However, the lists have divergences and similarities between them. We observed that eight drugs were common to all criteria studied, mainly related to the nervous system.Conclusion: The results suggest the need for periodic validation of PIM against research clinics, new drugs and the inclusion of this agenda by the Ministry of Health in the revision of the National List of Essential Drugs and other Clinical Protocols and Therapeutic Prescription Guidelines for the older adults.Keywords: list of potentially inappropriate drugs, seniors, aging, side effects, drug-related adverse reactions

El presente estudio investiga el creciente papel de las fake news en las comunidades digitales y el posible impacto resultado de su rápida propagación. Para ello, se usó la metodología netnográfica, junto con la observación lurking. Esta última se usó para preservar la integridad de los participantes. La recopilación de datos se enfocó en dos grupos políticos de ideologías similares con libre acceso en WhatsApp. Dichos datos permitieron una comprensión más detallada sobre la influencia de las fake news en la toma de decisiones, además de las posibles razones de su fácil y rápida propagación por internet.

Oropouche virus (OROV) is the causative agent of Oropouche fever, an urban febrile arboviral disease widespread in South America, with >30 epidemics reported in Brazil and other Latin American countries during 1960-2009. To describe the molecular epidemiology of OROV, we analyzed the entire N gene sequences (small RNA) of 66 strains and 35 partial Gn (medium RNA) and large RNA gene sequences. Distinct patterns of OROV strain clustered according to N, Gn, and large gene sequences, which suggests that each RNA segment had a different evolutionary history and that the classification in genotypes must consider the genetic information for all genetic segments. Finally, time-scale analysis based on the N gene showed that OROV emerged in Brazil ≈223 years ago and that genotype I (based on N gene data) was responsible for the emergence of all other genotypes and for virus dispersal. [ABSTRACT FROM AUTHOR]

Objective: The biological behavior of Cerebral Cavernous Malformation (CCM) is still controversial, lacking a clear-cut signature for a mechanistic explanation of lesion aggressiveness. In this study, we evaluated the predictive capacity of genetic variants concerning the aggressive behavior of CCM and their implications in biological processes., Methods: We genotyped the variants in VDR rs7975232 , VDR rs731236 , VDR rs11568820 , PTPN2 rs72872125 and FCGR2A rs1801274 genes using TaqMan Genotyping Assays in a cohort study with 103 patients, 42 of whom had close follow-up visits for 4 years, focusing on 2 main aspects of the disease: (1) symptomatic events, which included both intracranial bleeding or epilepsy, and (2) the onset of symptoms. The genotypes were correlated with the levels of several cytokines quantified in peripheral blood, measured using the x-MAP method., Results: We report a novel observation that the PTPN2 rs72872125 CT and the VDR rs7975232 CC genotype were independently associated with an asymptomatic phenotype. Additionally, PTPN2 rs72872125 CC genotype and serum level of GM-CSF could predict a diagnostic association with symptomatic phenotype in CCM patients, while the FCGR2A rs1801274 GG genotype could predict a symptomatic event during follow-up. The study also found a correlation between VDR r s731236 AA and VDR rs11568820 CC genotype to the time to the first symptomatic event., Conclusions: These genetic markers could pave the way for precision medicine strategies for CCM, enhancing patient outcomes by enabling customized therapeutic approaches., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Cerebral Cavernous Malformations (CCM) is a genetic disease characterized by vascular abnormalities in the brain and spinal cord, affecting 0.4-0.5 % of the population. We identified two novel pathogenic mutations, CCM1/KRIT1 c.811delT (p.Trp271GlyfsTer5) and CCM2/MGC4607 c.613_614insGG p.Glu205GlyfsTer31), which disrupt crucial protein domains and potentially alter disease progression., Objective: The study aims to comprehensively analyze a Brazilian cohort of CCM patients, integrating genetic, clinical, and structural aspects. Specifically, we sought to identify novel mutations within the CCM complex, and explore their potential impact on disease progression., Methods: We conducted a detailed examination of neuroradiological and clinical features in both symptomatic and asymptomatic CCM patients, performing genetic analyses through sequencing of the CCM1/KRIT1, CCM2/MGC4607, and CCM3/PDCD10 genes In silico structural predictions were carried out using PolyPhen-2, SIFT, and Human Genomics Community tools. Protein-protein interactions and docking analyses were explored using the STRING database., Results: Genetic analysis identifies 6 pathogenic mutations, 4 likely pathogenic, 1 variants of uncertain significance, and 7 unclassified mutations, including the novel mutations in CCM1 c.811delT and CCM2 c.613_614insGG. In silico structural analysis revealed significant alterations in protein structure, supporting their pathogenicity. Protein-protein interaction analysis indicated nuanced impacts on cellular processes. Clinically, we observed a broad spectrum of symptoms, including seizures and focal neurological deficits. However, no statistically significant differences were found in lesion burden, age of first symptom onset, or sex between the identified CCM1/KRIT1 and CCM2/MGC4607 mutations among all patients studied., Conclusion: This study enhances the understanding of CCM by linking clinical variability, genetic mutations, and structural effects. The identification of these novel mutations opens new avenues for research and potential therapeutic strategies., Competing Interests: Declaration of competing interest The authors declare that all authors agreed with the final manuscript, that they do not have any conflict of interest and there is no financial/personal interest of beliefs that could affect this research., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Genital self-image (GSI) involves subjective perceptions, experiences, and feelings of individuals regarding their genitalia. A negative GSI contributes to lower sexual esteem and, consequently, negative sexual experiences and sexual dysfunction. In men, self-perception may be influenced by several factors, including penis size or shape, personal experiences, body image, general health status, sex education, and even the media they consume. This study aimed to understand the reasons that lead to dissatisfaction with GSI among Brazilian men. With a mixed approach, we present male perceptions regarding dissatisfaction with GSI captured from the following question: "If you are dissatisfied with your genitals, tell us for what reason(s)? (Optional)," which integrated the last questionnaire element of the original survey. Brazilian men over 18 years of age from different Brazilian states were eligible. In this analysis, 376 responses were obtained. The data were analyzed using thematic content analysis. The participants expressed the reasons for dissatisfaction, which were grouped into two categories: (1) anatomical aspects and beliefs in the construction of GSI and (2) functional aspects. The results offer an understanding of men's perceptions of their genitals and may aid in clinical practice and research on how Brazilian men perceive their genitals. It is possible to improve knowledge about sexual health and increase positivity regarding genital perception by providing information about the reasons that lead to dissatisfaction with the genitals., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Cerebral cavernous malformation (CCM) is a vascular disease that affects the central nervous system, which familial form is due to autosomal dominant mutations in the genes KRIT1(CCM1), MGC4607(CCM2), and PDCD10(CCM3). Patients affected by the PDCD10 mutations usually have the onset of symptoms at an early age and a more aggressive phenotype. The aim of this study is to investigate the molecular mechanism involved with CCM3 disease pathogenesis. Herein, we report two typical cases of CCM3 phenotype and compare the clinical and neuroradiological findings with five patients with a familial form of KRIT1 or CCM2 mutations and six patients with a sporadic form. In addition, we evaluated the PDCD10 gene expression by qPCR and developed a bioinformatic pipeline to understand the structural changes of mutations. The two CCM3 patients had an early onset of symptoms and a high lesion burden. Furthermore, the sequencing showed that Patient 1 had a frameshift mutation in c.222delT; p.(Asn75Thrfs*14) that leads to lacking the last 124 C-terminal amino acids on its primary structure and Patient 2 had a variant on the splicing site region c.475-2A > G. The mRNA expression was fourfold lower in both patients with PDCD10 mutation. Using in silico analysis, we identify that the frameshift mutation transcript lacks the C-terminal FAT-homology domain compared to the wild-type PDCD10 and preserves the N-terminal dimerization domain. The two patients studied here allow estimating the potential impact of mutations in clinical interpretation as well as support to better understand the mechanism and pathogenesis of CCM3., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Male genital self-image (GSI) refers to how men feel about their genitals. Studies suggest that GSI is influenced by several psychosocial and physical factors, such as frequency of sexual activities, anxiety, and sexual dysfunctions. In Brazil, no studies have investigated the factors associated with satisfaction with male GSI. This is a cross-sectional and online study conducted with Brazilian men over 18 years of age. The Male Genital Self-Image Scale (MGSIS), Body Appreciation Scale-2 (BAS-2), and International Index of Erectile Function (IIEF) were used. Body appreciation and frequency of sexual activity were included as confirmatory variables and other variables were explored as factors associated with GSI. Data were analyzed by binary logistic and multiple linear regression, according to the MGSIS cut-off point for satisfaction with male GSI and total score of MGSIS, respectively. A total of 1,235 men (M = 26.14, SD = 7.28 years) participated in the study. The mean of the total MGSIS score was 23.02 (SD = 4.45; absolute range, 7-28) points, with 62.11% of men being classified as satisfied with GSI. Men satisfied with GSI were more likely to have a partner, higher body appreciation, lower body mass index (BMI), and not have phimosis (excess skin covering the penis, making it difficult to expose the glans). Satisfaction with GSI of Brazilian men was associated with relationship status, body appreciation, BMI, and phimosis., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Ocular prosthesis rehabilitation has an important social, psychological, esthetic, and functional role. Congenital factors, trauma, and tumors, among others, can cause anophthalmia, and it is essential to identify the etiology to guide its prevention and treatment., Methods: The aim of this study was to retrospectively investigate the records of patients treated from 2013 to 2020 by the Oral and Maxillofacial Prosthesis Group, aiming to identify the prevalence of patients with anophthalmia and the etiology of their anophthalmia. After approval by the Human Research Ethics Committee, two calibrated researchers evaluated 520 records, identifying those from patients with anophthalmia. The inclusion criteria were records with complete and legible information from patients with anophthalmia and a description of their etiology. Descriptive statistics were performed, and etiological factors were categorized into trauma, congenital cause, end-stage eye disease, and tumor. Spearman's correlation was performed to verify the relation between gender and anophthalmia etiology, with a 5% significance level. Seventy-two records were included in the study., Results: It was observed that 33.4% of patients were women and 66.6% were men. The etiologies were physical trauma (52.4%), tumor (21.8%), end-stage eye disease (16.6%), and congenital cause (9.2%), and there was no correlation between gender and these etiologies ( p =  .301)., Conclusion: Most of the cases identified were of traumatic origin, which allows the establishment of preventive and educational measures to avoid new cases of anophthalmia., Competing Interests: The authors have none to declare., (© 2021 Director General, Armed Forces Medical Services. Published by Elsevier, a division of RELX India Pvt. Ltd.)

Zika virus (ZIKV) is an arbovirus of the Flaviviridae genus that has rapidly disseminated from across the Pacific to the Americas. Robust evidence has indicated a crucial role of ZIKV in congenital virus syndrome, including neonatal microcephaly. Moreover, emerging evidence suggests an association between ZIKV infection and the development of an extensive spectrum of central nervous system inflammatory demyelinating diseases (CNS IDD), such as multiple sclerosis-like clinical phenotypes. However, the underlying mechanisms of host-pathogen neuro-immune interactions remain to be elucidated. This study aimed to identify common transcriptional signatures between multiple sclerosis (MS) and ZIKV infection to generate molecular interaction networks, thereby leading to the identification of deregulated processes and pathways, which could give an insight of these underlying molecular mechanisms. Our investigation included publicly available transcriptomic data from MS patients in either relapse or remission (RR-MS) and datasets of subjects acutely infected by ZIKV for both immune peripheral cells and central nervous system cells. The protein-protein interaction (PPI) analysis showed upregulated AP-1 transcription factors (JUN and FOS) among the top hub and bottleneck genes in RR-MS and ZIKV data. Gene enrichment analysis retrieved a remarkable presence of ontologies and pathways linked to oxidative stress responses, immune cell function, inflammation, interleukin signaling, cell division, and transcriptional regulation commonly enriched in both scenarios. Considering the recent findings concerning AP-1 function in immunological tolerance breakdown, regulation of inflammation, and its function as an oxidative stress sensor, we postulate that the ZIKV trigger may contribute as a boost for the activation of such AP-1-regulated mechanisms that could favor the development of MS-like phenotypes following ZIKV infection in a genetically susceptible individual., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Evidence indicates a strong link between Zika virus (ZikV) and neurological complications. Acute myelitis, optic neuritis, polyneuropathy, and encephalomyelitis that mimic inflammatory idiopathic demyelination disorders (IIDD) after ZikV infection have been reported in Brazil., Objective: The present study aims to investigate the possible occurrence of molecular mimicry between ZikV antigens and Multiple Sclerosis (MS) autoantigens, the most frequent IIDD of the central nervous system (CNS)., Methods: A retrospective cohort study with 305 patients admitted due to suspected arbovirus infection in Rio de Janeiro was performed, all subjects were submitted to neurological examination, and a biological sample was collected for serologic and molecular diagnostic. Bioinformatics tools were used to analyze the peptides shared between ZikV antigens and MS autoantigens., Results: Of 305 patients, twenty-six were positive for ZikV and 4 presented IDD patterns found in MS cases. Sequence homology comparisons by bioinformatics approach between NS5 ZikV and PLP MS protein revealed a homology of 5/6 consecutive amino acids (CSSVPV/CSAVPV) with 83% identity, deducing a molecular mimicry. Analysis of the 3D structures revealed a similar conformation with alpha helix presentation., Conclusions: Molecular mimicry between NS5 Zika virus antigen and PLP MS autoantigens emerge as a possible mechanism for IDD spectrum in genetically susceptible individuals., Competing Interests: There is no conflict of interest to declare., (Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/).)

Background: City-led interventions are increasingly advocated to achieve the UN's Sustainable Development Goal to reduce violence for all. We used a new quantitative evaluation method to examine whether a flagship programme, called the "Pelotas Pact for Peace" (the Pacto), has been effective in reducing violence and crime in the city of Pelotas, Brazil., Methods: We used synthetic control methodology to assess the effects of the Pacto from August 2017 to December 2021, and separately before and during the COVID-19 pandemic. Outcomes included monthly rates of homicide and property crime, and yearly rates of assault against women and school drop-out. We constructed synthetic controls (counterfactuals) based on weighted averages from a donor pool of municipalities in Rio Grande do Sul. Weights were identified using pre-intervention outcome trends and confounders (sociodemographics, economics, education, health and development, and drug trafficking)., Findings: The Pacto led to an overall 9% reduction in homicide and 7% reduction in robbery in Pelotas. These effects were not uniform across the full post-intervention period as clear effects were only seen during the pandemic period. A 38% reduction in homicide was also specifically associated with the criminal justice strategy of Focussed Deterrence. No significant effects were found for non-violent property crimes, violence against women, and school dropout, irrespective of the post-intervention period., Interpretation: City-level interventions that combine public health and criminal justice approaches could be effective in tackling violence in Brazil. Continued monitoring and evaluation efforts are increasingly needed as cities are proposed as key opportunities for reducing violence for all., Funding: This research was funded by the Wellcome Trust [grant number: 210735_Z_18_Z]., Competing Interests: JM collaborated with the Municipal Government of Pelotas on one project included in the Pelotas Peace Pact. That was a randomised trial of two of the early childhood parenting interventions, as documented in Murray et al. (2019),43 and the municipal government contributed funds to conduct the trial. All other authors declare no competing interests., (© 2023 The Authors.)

Background: The aim of this study was to verify if there is a relationship between self-reported pain, PPT (pressure pain threshold) of the masseter, temporal and sternocleidomastoid muscles, pain catastrophizing and quality of life in patients with TMD (temporomandibular disorder) of muscular origin., Material and Methods: Ninety-seven patients with muscular TMD (TMD group) and 97 asymptomatic (control group) were included in the study. The evaluation methods used were: 1) Self-reported pain was assessed using the Visual Analogue Scale (VAS) for questions 7, 8 and 9 of the RDC/TMD Axis I questionnaire; 2) The PPT assessment was performed using a digital algometer on the masseter, temporal, and sternocleidomastoid muscles (both sides); 3) Pain catastrophizing was assessed using the PCS (Pain Catastrophizing Scale); and 4) Oral health-related quality of life was assessed using the OHIP-14 (Oral Healthy Impact Profile-14). Data were submitted to Spearman correlation and logistic regression ( p <0.05)., Results: There were significant positive correlations between self-reported pain (VAS-Q7, VAS-Q8 and VAS-Q9), pain catastrophizing (PCS-Helplessness, PCS-Magnification, PCS-Rumination and PCS-Total) and quality of life (OHIP-14) ( p <0.05). There was a significant negative correlation of self-reported pain (VAS-Q8) with PPT of the temporal (left) and sternocleidomastoid (both sides) ( p <0.05). The rumination and magnification domains increased the chance of high self-reported pain in all situations (VAS-Q7, VAS-Q8 and VAS-Q9) ( p <0.05). The helplessness domain only increased the chance of high self-reported pain for VAS-Q8 ( p <0.05). The presence of TMD of muscular origin, high self-reported pain (VAS-Q7) or pain catastrophizing increased the chance of a low quality of life in relation to the control group ( p <0.05). In addition, the reduction in sternocleidomastoid PPT increased the chance of poor quality of life ( p <0.05). Key words: Myofascial pain syndromes, pain catastrophizing, myalgia, quality of life, surveys and questionnaires, temporomandibular joint disorders., Competing Interests: Conflicts of interest None of the authors has any conflict of interest related to the conduct of this study., (Copyright: © 2023 Medicina Oral S.L.)

Objective: Evaluate the data on the psychotropic drugs dispensed by private community pharmacies before and during the SARS-CoV-2 pandemic. Methods: This cross-sectional study compared the quarterly and annual consumption of psychotropic drugs per Defined Daily Dose per 1000 inhabitants-day (DHD). Interrupted time series were also constructed to expose changes in the consumption pattern in the periods before and after March 2020. Results: Among the 20 most consumed psychoactive drugs, 12 were antidepressants, for example, escitalopram (DHD 7.996 and 10.626; p < 0.001), and sertraline (DHD 6.321 and 8.484; p < 0.001), in addition to the hypnotic zolpidem (DHD 6.202 and 8.526; p < 0.001). The time series reveals ( R 2 value) a variation in drug dispensing, in DHD values, during the pandemic. Conclusion: Despite the higher variance, a significant increase is clearly seen in the consumption trends of psychoactive drugs, particularly antidepressants, consistent with the pandemic's influence on the general population's mental health., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Escalante Saavedra, Galato, de Souza Silva, Rodrigues da Silva and da Silva.)

Statement of Problem: Biofilms can be retained on dental prostheses leading to the development of infections. The indiscriminate use of antifungal drugs can result in the development of microorganisms that are resistant to these antimicrobial agents. Whether probiotics are a suitable alternative for reducing the prevalence of oral candidiasis is unclear., Purpose: The purpose of this in vitro study was to evaluate the influence of 6 different live strains of probiotics and 2 commercially available probiotic supplements used for inhibiting the growth of Candida albicans biofilm in heat-polymerized acrylic resin denture base material and to determine whether biofilm byproducts modify the surface of specimens., Material and Methods: Biofilms of C. albicans were formed on acrylic resin specimens in the presence of probiotics and quantified by colony-forming units (CFUs), and the surface roughness (Ra) of the specimens was assessed before and after the formation of biofilms. The CFU and roughness data were analyzed by analysis of variance and the Tukey HSD test (α=.05)., Results: A significant decrease in the number (CFU/mL) of C. albicans cells was found when they were cultured with 4 probiotics: B. lactis (P=.045), B. longum (P<.001), L. casei (P<.001), and L. helveticus (P<.001) and with the commercially available probiotic Prolive (P=.05). The Ra of specimens decreased after exposure to different microbial biofilms (P≤.05) except in 3 experimental groups., Conclusions: In general, the tested probiotics had an antagonistic effect on the growth of C. albicans, and the surface of acrylic resin was altered after exposure to biofilm byproducts., (Copyright © 2020 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Background: Concerns about genital self-image (GSI) can influence sexual function and quality of life, and instruments that assess male GSI, such as the Male Genital Self-Image Scale (MGSIS), need to be adapted and validated in different cultures., Aims: To culturally adapt and validate the measurement properties of MGSIS in Brazilian men, according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guideline, and to create a cutoff point for satisfaction with male GSI., Methods: We assessed the validity of content through a committee of experts and cognitive interviews. The internal consistency and test-retest reliability were assessed using Cronbach's α and Intraclass Correlation Coefficient (ICC). We also calculate measurement errors using the Bland and Altman graph. The structural validity was investigated through exploratory and confirmatory factor analysis. The hypothesis test for construct validity was assessed using Spearman correlation from MGSIS with the International Index of Erectile Function (IIEF), Body Appreciation Scale (BAS-2) and Rosenberg Self-Esteem Scale (RSES). To create a cutoff point for satisfaction with the GSI, the item response theory and the classic test theory were used., Outcomes: Male's (i) GSI, (ii) sexual function, (iii) body appreciation, and (iv) self-esteem were assessed., Results: In this study, 518 men with a mean age of 33.90 (±13.83) years participated. The Brazilian version of MGSIS demonstrated good content validity and a single factor that explained 64.57% of the variance. Cronbach's α and ICC values were 0.905 and 0.806, respectively. By assessing measurement errors, we found no systematic bias in the sample. MGSIS showed a moderate to weak correlation with IIEF, BAS-2 and RSES. A cut-off point of 23 in the MGSIS total score was found to rate satisfaction with the GSI., Clinical Translation: MGSIS is a valid and reliable measurement instrument for measuring male GSI in Brazil., Strengths and Limitations: This study evaluated the measurement properties of MGSIS according to COSMIN, which is a powerful and useful guideline for measurement properties. However, due to the lack of a gold standard for measuring the GSI, we have not assessed the criterion validity., Conclusion: MGSIS is valid, reliable and can be useful to assess the GSI and classify the satisfaction with the GSI of Brazilian men. de Arruda GT, da Silva EV, Braz MM. Male Genital Self-Image Scale (MGSIS): Cutoff Point, Cultural Adaptation and Validation of Measurement Properties in Brazilian Men. J Sex Med 2021;18:1759-1767., (Copyright © 2021 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)

Objectives: This study aimed to assess the relation between the insertion torque and implant stability quotient (ISQ recorded immediately and 6 months after implant placement)., Materials and Methods: Twenty-five patients over the age of 18 years were selected for this study. One implant was placed per patient after tooth extraction. All implants had the same size (11.5 × 3.75 mm) and brand (Hexagonal Morse cone, DSP Biomedical). The insertion torque (Ncm) and resonance frequency analysis (ISQ value) (Osstell Mentor) were used to assess the primary stability (on the day of surgery). After 6 months, resonance frequency analysis was used to assess the secondary stability of each implant., Statistical Analysis: The insertion torque data were correlated with ISQ measurements by using Pearson's correlation. The significance level was 5%., Results: There was a positive correlation between insertion torque and initial ISQ (correlation: 0.457; p = 0.022); however, no correlation was found between insertion torque and final ISQ ( p = 0.308)., Conclusion: The present study demonstrated that there is a positive correlation between the insertion torque and the initial ISQ. Therefore, the higher the insertion torque, the higher the initial ISQ (and vice versa)., Competing Interests: None declared., (European Journal of Dentistry. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

Background: This study aimed to compare the masticatory efficiency, the maximum voluntary occlusal bite force (MVOBF) and the electrical activity (EMG) of masticatory muscles of practitioners of upper limb bodybuilding before and after physical activity., Material and Methods: Twenty healthy individuals (10 men and 10 women, age from 18 to 30 (mean of 24.7 years old) without masticatory system disorders, that regularly practice hypertrophic physical activity were submitted to the analyses of masticatory efficiency, MVOBF, and surface EMG of the temporalis and masseter muscles. The masticatory efficiency was analyzed by comminution of the artificial material (Optocal®) and a sieving method. The MVOBF was measured by a dynamometer, and EMG was evaluated during resting mandibular position, maximum voluntary clenching (MVC), and MVC with a Parafilm M tape between teeth, and free mastication of chewing gum. The analyses were made before (T0) and immediately after the performance of upper limb bodybuilding exercises (T1). The data of masticatory efficiency and MVOBF were submitted to the Student T-test, and their correlations were analyzed by the Pearson correlation test, and the EMG data were submitted to the 2-way repeated measures ANOVA, all tests with a 5% significance., Results: There was a significant decrease of masticatory efficiency after the training. No statistical difference in the MVOBF and EMG was found, and there was a positive correlation between masticatory efficiency and MVOBF., Conclusions: Therefore, changes were found for masticatory efficiency only, which decreased after hypertrophic exercise. There was a positive correlation between masticatory efficiency and MVOBF. Key words: Masticatory efficiency, bite force, physical activity, electromyography., Competing Interests: Conflicts of interest None declared., (Copyright: © 2021 Medicina Oral S.L.)

Background: Cerebral Cavernous Malformations (CCM) predispose patients to a lifetime risk of seizures and symptomatic hemorrhage. Only a small percentage of people affected will develop clinical symptoms and the molecular mechanisms underlying lesional activity remain unclear. We analyzed a panel of Single Nucleotide Polymorphisms (SNPs) in CCM patients. We looked for plasmatic inflammatory cytokines, checking for a pattern of plasma expression heterogeneity and any correlation with genetic variations identified with different CCM clinical phenotypes., Methods: This was a case-control study from a long-term follow-up cohort including 23 CCM patients, of which 16 were symptomatic, and 7 were asymptomatic. A 200-SNP panel was considered through next-generation sequencing and 18 different plasma molecules were assessed through a suspension array system., Results: Fcγ receptor IIa rs1801274 (FCGR2A) and protein tyrosine phosphatase non-receptor type 2 rs72872125 PTPN2 were statistically different between groups. Patients who had a combination of the presence of FCGR2A and the absence of PTPN2 also had symptoms earlier in life. The combination of genetic polymorphisms and serum level of GM-CSF showed the best diagnostic biomarker to distinguish symptomatic patients as formulated: [0.296*(FCGR2A)] + [-0.788*(PTPN2)] + [-0.107*(GM-CSF)]., Conclusion: We have shown that SNPs in inflammation genes might be related to a symptomatic phenotype in CCM. We also demonstrated that a formula based on two of these polymorphisms (FCGR2A+ and PTPN2+) is possibly capable of predicting a symptomatic phenotype during a patient's lifetime., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Statement of Problem: Exposure of silicone prostheses to environmental factors can alter their properties, affecting longevity. However, whether nonthermal plasma (NTP) can prevent these alterations is unclear., Purpose: The purpose of this in vitro study was to evaluate the surface roughness (Ra), sorption, solubility, and color stability (ΔE 00 ) of the MDX4-4210 and A-120 silicones, with and without NTP treatment in accordance with an independent analysis of the use of 2 pigmentations., Material and Methods: One hundred sixty specimens were fabricated and distributed into 16 groups (n=10) as per the silicone, pigmentation, and NTP coating. The NTP was applied, and the Ra, sorption, solubility, and ΔE 00 were evaluated before and after accelerated aging. ANOVA was used, and the HSD Tukey test was applied (α=.05)., Results: NTP generated an increase in roughness after aging, regardless of pigmentation or silicone. A-120 silicone without NTP showed a reduction in roughness after aging, regardless of pigmentation. For sorption and solubility, the bronze pigmentation (for A-120 and MDX4-4210) presented the smallest results after NTP treatment. For MDX4-4210 with pink pigmentation and NTP, sorption decreased and solubility increased. For A-120 with pink pigmentation and NTP, sorption and solubility increased. Sorption was reduced in all situations, except for A-120 with pink pigmentation, which increased. Regardless of the silicone used, solubility was reduced after NTP for bronze pigmentation. For A-120 and MDX4-4210 with pink pigmentation and NTP, the solubility increased. For both pigmentations, the NTP treatment promoted lower color alteration only for the A-120 silicone after accelerated aging (within the acceptability threshold)., Conclusions: The NTP protocol of this study, which was applied to facial silicones, generated inconsistent results between the evaluated properties. Therefore, the NTP protocol used does not seem to be ideal for the treatment of silicone surfaces after aging., (Copyright © 2020 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Background: The present study aims to report traumatic brain injury (TBI) among soccer players in the 2017 Brazilian Soccer Championship and discuss the protocols for concussion evaluation., Materials & Methods: This is an observational study utilizing video analysis of 380 matches. TBI was considered as any event in which one or more soccer player(s) had a head trauma. For potential concussion diagnosis, we analyzed players with one of the following signs: slowness to get up, disorientation, motor incoordination, loss of consciousness, head clutching and impact seizure., Results: There were 374 TBIs in total. The average time for medical assessment was 1'35". 13 players had concussion with an average time of 3'19″ for medical evaluation. Four players were replaced after having a concussion., Conclusion: There is a gap between concussion protocols and medical practices in Brazilian elite soccer. Further discussion about soccer replacement rules are imperative., Competing Interests: Financial & competing interests disclosure The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. No writing assistance was utilized in the production of this manuscript., (© 2020 Carmine Porcelli Salvarani.)

Objective:  The aim of this study is to evaluate the color alteration and shore A hardness of a medical silicone with extrinsic pigmentation, before and after accelerated aging., Materials and Methods:  Twenty samples (Silastic Q7-4735) were made with an intrinsic pigmentation. This intrinsic pigmentation was composed of a pink pigment (H-109-P, Factor II) and an opacifier (ZnO). All samples had standardized dimensions (45-mm diameter and 2-mm thickness). Half of the 20 samples manufactured subsequently received an extrinsic pigment (Tan FE-215, Factor II). Therefore, two groups were created ( n = 10): Group 1, group with intrinsic pigmentation and without extrinsic pigmentation (control) and Group 2, group with intrinsic and extrinsic pigmentation. Samples were submitted to color and Shore A hardness tests, before and after 1,008 hours of aging., Statistical Analysis:  Color alteration data were submitted to Student's t -test ( α = 0.05). Shore A hardness data were submitted to two-way analysis of variance and Tukey test ( α = 0.05)., Results:  The incorporation of the extrinsic pigment on the silicone did not affect its color (ΔE) when the two groups were compared ( p = 0.232). Regarding the hardness test, the interaction between group and period did not interfere with the hardness results( p =0.599). However, the period factor showed that there was a reduction in the hardness of the silicone after aging ( p < 0.05)., Conclusion:  In this study, all the hardness and color results of the silicone used were clinically acceptable, regardless of the presence of extrinsic pigmentation., Competing Interests: None declared.

Objective: To evaluate the influence of different pigmentations and accelerated aging on the hardness and tear strength of the A-2186 and MDX4-4210 silicones., Materials and Methods: The samples A-2186 and MDX4-4210 were manufactured without and with pigmentations (black, bronze, and pink). For the Shore A hardness test, 80 samples of each silicone were fabricated, and for the tear strength test, 320 samples of each silicone were fabricated. Eight groups were created for each test ( n  = 10). These tests were performed before and after 252, 504, and 1008 hours of aging. Three-way repeated-measures analysis of variance and the Tukey test were performed ( α  = 0.05)., Results: The A-2186 silicone showed higher hardness and tear strength when compared with the MDX4-4210 silicone ( p < 0.05), except in the hardness of the A-2186 and MDX4-4210 groups without pigmentation after 1008 hours ( p > 0.05). All hardness values were between 25 and 35 units, regardless of the silicone type, period, and pigmentation (or no pigmentation). In most situations, the hardness of silicones used increased after 252 hours ( p < 0.05). The nonpigmented MDX4-4210 group and all A-2186 groups showed an increase in tear strength after 252 hours ( p < 0.05). For the nonpigmented MDX4-4210 group, from 252 to 1008 hours, there was no change in tear strength ( p > 0.05). All pigmented MDX4-4210 groups showed no change in tear strength from 0 (initial) to 1008 hours of aging ( p > 0.05). In all A-2186 groups, from 252 to 504 hours, there was a reduction in tear strength ( p < 0.05), and from 504 to 1008 hours, there was an increase in tear strength ( p < 0.05), except in the bronze A-2186 group ( p > 0.05)., Conclusion: In most situations, the A-2186 silicone showed significantly higher values of hardness and tear strength than the MDX4-4210 silicone. All hardness values were considered clinically acceptable. Accelerated aging could increase, decrease, or not significantly change the hardness and tear strength of the silicones used. The results of hardness and tear strength suggest that MDX4-4210 was more influenced by the presence of pigmentation after aging., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2020 Estefânia Marrega Malavazi et al.)

Background: Different ceramic surface cleaning methods have been suggested after the acid conditioning. The aim was to evaluate the effect of different protocols used to remove the remaining hydrofluoric acid on the shear bond strength (SBS) between lithium disilicate and resin cement., Material and Methods: Forty-four specimens of lithium disilicate (IPS e.max Press) were divided in 4 groups (n=11): group C (control, no treatment); group HF+S (5% hydrofluoric acid + silane); group HF+US+S (5% hydrofluoric acid + ultrasound cleaning + silane); group HF+PH+S (5% hydrofluoric acid + 37% phosphoric acid + silane). Scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS) were performed to characterize the surface morphology. The SBS test was performed on the resin/ceramic interface, and the failure mode was characterized. SBS values were submitted to 1-way ANOVA and the Tukey test (α=.05). The relation between surface treatment and failure modes was analyzed using the chi-squared test (α=.05)., Results: The surface treatment type interfered in the shear strength ( p <.001) and higher SBS values were observed for the groups HF+US+S (17.87 MPa) and HF+PH+S (16.37 MPa). The surface treatment did not influence the failure mode ( p =.713). No fluorsilicate salts were observed after ultrasound cleaning., Conclusions: The utilization of ultrasound cleaning was an effective procedure to remove remaining fluorsilicate salts, promoting the highest SBS values. Key words: Bond strength, ceramics, fluorsilicate, lithium disilicate, resin cement., Competing Interests: Conflicts of interest The authors have declared that no conflict of interest exist., (Copyright: © 2020 Medicina Oral S.L.)

Objective: The aim of this study was to evaluate the tear strength of MDX4-4210 and A-2186 silicones with different intrinsic pigments incorporated by mechanical and industrial methods, comparing nonaged and aged groups., Materials and Methods: Twenty-four groups were created according to the American Society for Testing and Materials D-624/type C, half nonaged and half aged ( n  = 10): bronze mechanical MDX4-4210, bronze industrial MDX4-4210, black mechanical MDX4-4210, black industrial MDX4-4210, pink mechanical MDX4-4210, pink industrial MDX4-4210, bronze mechanical A-2186, bronze industrial A-2186, black mechanical A-2186, black industrial A-2186, pink mechanical A-2186, and pink industrial A-2186. All specimens were submitted to tear strength analysis. Data were submitted to the ANOVA and Tukey test ( p < 0.05)., Results: An increase in the tear strength values was observed only for the bronze and black MDX4-4210, comparing nonaged and aged silicones ( p < 0.05), regardless of the manufacturing method. There was a difference in all comparisons between MDX4-4210 and A-2186 silicones with the same pigment type ( p < 0.05), regardless of the manufacturing method. In all cases, there was no difference in the manufacturing method comparing the MDX4-4210 or A-2186 groups with the same pigment., Conclusion: Accelerated aging did not influence the tear strength in all aged A-2186 silicones and in aged pink industrial and mechanical MDX4-4210 silicones. The other MDX4-4210 groups had an increase in the results after aging. In all cases compared, the A-2186 groups had higher tear strength values than the MDX4-4210 groups. Mechanical and industrial methods can be used for silicone preparation, without changing the tear strength., Competing Interests: The authors declare that there are no conflicts of interest regarding the publication of this paper., (Copyright © 2019 Marcelo Coelho Goiato et al.)

Background: The aim of this study was to evaluate the distribution of stress in complete fixed mandibular prostheses with infrastructures (IE) fabricated with different materials and techniques, under compressive force., Material and Methods: A model of an edentulous mandible, which received five 4x11 mm external hexagon implants between the mental foramens, was fabricated. The groups were divided into: Group I - IE in nickel-chromium with an acrylic resin occlusal coating; Group II - IE in nickel-chromium with a ceramic occlusal coating; Group III - IE milled in zirconia with a ceramic coating. For the photoelastic methodology, 70 N axial loads were applied in three regions. Photographic images were taken and analyzed according to the number of high-intensity fringes. For the strain gauge methodology, the measurement of stresses was performed in two distinct regions. The same compression tests described earlier were then performed. The registered stress values were grouped in tables and submitted to two-factor variance analysis (ANOVA) and the Tukey test with 5% significance., Results: The results of the two methodologies demonstrated smaller stress values for Group I, when compared to the other groups., Conclusions: It was possible to conclude that the complete fixed prostheses, with infrastructures cast in metal and acrylic occlusal coating, demonstrated better biomechanical results. Key words: Dental implants, mandibular prosthesis implantation, biomechanics., Competing Interests: Conflict of interest statement: The authors have declared that no conflict of interest exist., (Copyright: © 2019 Medicina Oral S.L.)

Purpose: To investigate if the presence of a cantilever influences the survival and success of partial fixed implant-supported prostheses, through a systematic review and meta-analysis, with additional analysis of the survival and marginal bone loss rates and prosthesis complications., Materials and Methods: The register protocol of the review in the PROSPERO database is CRD42016052008. The MEDLINE and Scopus databases were used for an electronic search of relevant studies up to November 2016, by means of two independent reviewers. The keywords included the combinations "fixed partial denture" with "dental implants", and with "extension" or "cantilever"; and "implant-supported dental prosthesis" with "extension" or "cantilever". The inclusion criteria were randomized clinical trials and prospective and retrospective clinical studies in English that addressed the comparison of success and survival of the use of implant-supported fixed prostheses, with and without cantilevers. Data from the selected studies were used to perform the statistical analysis., Results: Among the 408 articles identified, 4 articles met the eligibility criteria. The presence of a cantilever did not compromise marginal bone loss or the survival of the prostheses. However, minor complications were encountered for the group of partial fixed prostheses without cantilevers, with a statistical difference (P = .008)., Conclusion: Cantilevers can be used in fixed prostheses and do not interfere negatively in the survival or success of the prosthesis or the marginal bone loss. However, there are minor complications when prostheses without cantilevers, or short cantilevers, are used.

Zika virus (ZIKV) has recently caused a pandemic disease, and many cases of ZIKV infection in pregnant women resulted in abortion, stillbirth, deaths and congenital defects including microcephaly, which now has been proposed as ZIKV congenital syndrome. This study aimed to investigate the in situ immune response profile and mechanisms of neuronal cell damage in fatal Zika microcephaly cases. Brain tissue samples were collected from 15 cases, including 10 microcephalic ZIKV-positive neonates with fatal outcome and five neonatal control flavivirus-negative neonates that died due to other causes, but with preserved central nervous system (CNS) architecture. In microcephaly cases, the histopathological features of the tissue samples were characterized in three CNS areas (meninges, perivascular space, and parenchyma). The changes found were mainly calcification, necrosis, neuronophagy, gliosis, microglial nodules, and inflammatory infiltration of mononuclear cells. The in situ immune response against ZIKV in the CNS of newborns is complex. Despite the predominant expression of Th2 cytokines, other cytokines such as Th1, Th17, Treg, Th9, and Th22 are involved to a lesser extent, but are still likely to participate in the immunopathogenic mechanisms of neural disease in fatal cases of microcephaly caused by ZIKV.

New systems are released in the odontological market with the objective of bringing improvements and advancements in the clinical success of implants and implant-supported prostheses. The distribution of tension for the bone/implant system of these new systems is important. The purpose of this work was to evaluate, by photoelastic analysis and strain gauges, the distribution of tension for the bone/implant system, using the Slim system. A photoelastic cast with an external hexagon implant was manufactured and a metal prosthesis was screwed below it, with or without the tested system. For the photoelasticity methodology, a photoelastic cast, with or without the tested system, was positioned in a circular polariscope, and axial loads of 100 N were applied to the centre of the crown. The pattern of tension generated was photographed and analysed qualitatively in an imaging programme. For the extensometry methodology, two extensometers were placed in the mesial and distal region of the implant in the photoelastic cast. The axial loads were applied to the group again, with or without the system (n = 10). The t test of independent samples with a significance level of 5% was used for this analysis. This study demonstrated greater tension values for both the photoelastic and extensometry methods when the tested system was used. Clinical studies must be performed to evaluate the tested system because the results might not be clinically significant to a bone reabsorption.

Background: The aim of this systematic review is to evaluate the relationship between two methods used to assess implant stability, investigating whether both provide similar implant stability assessments for the same clinical case., Methods: A literature search was conducted on MEDLINE-PubMed and Scopus databases, without limitation of the publication period, up to November 2015. The following key words were used, with associations among them: "dental implant," "dental implants," "Osstell," "resonance frequency analysis," "implant stability quotient," "ISQ," "Periotest," "Periotest value," and "PTV." Inclusion criteria were English language, prospective, retrospective, and randomized controlled clinical trials that evaluated implant stability through use of resonance frequency analysis (RFA) and damping capacity analysis (DCA). The study should assess implant stability of only a specific region for all patients or discriminate results evaluated for each region if the analysis had been made in various regions; RFA and DCA should have been applied in the same implants and periods. Studies have been carefully selected, and data of interest were tabulated., Results: Six studies met the inclusion criteria. Although there was significant numerical correlation between values obtained by both methods, data showed that less than half (46%) of cases coincided in relation to implant stability classification., Conclusions: It can be considered that there is not always a consensus and standardization in the classification of implant stability related to the values obtained by RFA and DCA devices, which could create disagreements and miscommunication among dentistry professionals.

This systematic review aimed to investigate whether intra-articular injections of hyaluronic acid (HA) are better than other drugs used in temporomandibular joint arthrocentesis, for the improvement of temporomandibular disorder (TMD) symptoms. Two independent reviewers performed an electronic search of the MEDLINE and Web of Science databases for relevant studies published in English up to March 2016. The key words used included a combination of 'hyaluronic acid', 'viscosupplementation', 'intra-articular injections', 'corticosteroids', or 'non steroidal anti inflammatory agents' with 'temporomandibular disorder'. Selected studies were randomized clinical trials and prospective or retrospective studies that primarily investigated the application of HA injections compared to other intra-articular medications for the treatment of TMD. The initial screening yielded 523 articles. After evaluation of the titles and abstracts, eight were selected. Full texts of these articles were accessed and all fulfilled the inclusion criteria. Intra-articular injections of HA are beneficial in improving the pain and/or functional symptoms of TMDs. However, other drug therapies, such as corticosteroid and non-steroidal anti-inflammatory drug injections, can be used with satisfactory results. Well-designed clinical studies are necessary to identify an adequate protocol, the number of sessions needed, and the appropriate molecular weight of HA for use., (Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

The effect of a photopolymerized glaze on different properties of acrylic resin (AR) for ocular prostheses submitted to accelerated aging was investigated. Forty discs were divided into 4 groups: N1 AR without glaze (G1); colorless AR without glaze (G2); N1 AR with glaze (G3); and colorless AR with glaze (G4). All samples were polished with sandpaper (240, 600 and 800-grit). In G1 and G2, a 1200-grit sandpaper was also used. In G3 and G4, samples were coated with MegaSeal glaze. Property analysis of color stability, microhardness, roughness, and surface energy, and assays of atomic force microscopy, scanning electron microscopy, and energy-dispersive spectroscopy were performed before and after the accelerated aging (1008h). Data were submitted to the ANOVA and Tukey Test (p<0.05). Groups with glaze exhibited statistically higher color change and roughness after aging. The surface microhardness significantly decreased in groups with glaze and increased in groups without glaze. The surface energy increased after the aging, independent of the polishing procedure. All groups showed an increase of surface irregularities. Photopolymerized glaze is an inadequate surface treatment for AR for ocular prostheses and it affected the color stability, roughness, and microhardness. The accelerated aging interfered negatively with the properties of resins., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Statement of Problem: Ocular prosthesis acrylic resins should be biocompatible regardless of the polymerization method. The authors are unaware of a study that evaluated the biocompatibility of ocular prostheses., Purpose: The purpose of this in vitro study was to evaluate the cytotoxicity of different methods of polymerizing ocular prosthesis acrylic resin. This was accomplished by analyzing the cell proliferation, production of proinflammatory cytokines, and expression of extracellular matrix proteins related to tissue remodeling and repair of a human conjunctival cell line., Material and Methods: Nine acrylic resin specimens were divided into 3 groups: polymerization in a water bath, by microwave, or by autopolymerization. Eluates (prepared for 72 hours) were exposed to cells for 72 hours. A medium without specimens served as negative control (nonstimulated group). The tetrazolium dye MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide) assay was performed to evaluate the cytotoxic effect, and an enzyme-linked immunosorbent assay was executed for analysis of interleukin 1 β (IL1β), IL6, tumor necrosis factor α (TNFα), and CCL3/MIP1α production. Also, real-time reverse transcriptase (RT)-PCR was performed for analysis of mRNA expression of type IV collagen (COL IV), TGFβ, and MMP9, and data were tested using ANOVA with Bonferroni post hoc test (α=.05)., Results: Microwave-processed resin showed slight cytotoxicity due to a significant reduction in cell proliferation and an increase in IL6 quantity. Higher levels of mRNA expression of COL IV, MMP9, and TGFβ were verified in water bath-processed resin, which were similar to those in the nonstimulated group., Conclusions: Microwave-processed resin showed a significant reduction in cell proliferation and an increase in IL6 quantity. Heat-polymerized resin exhibited a higher mRNA expression of COL IV, MMP9, and TGFβ; this result was similar to that in the nonstimulated group., (Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: Different factors can influence marginal bone loss around dental implants, including the type of internal and external connection between the implant and the abutment. The evidence needed to evaluate these factors is unclear., Purpose: The purpose of this systematic review was to evaluate marginal bone loss by radiographic analysis around dental implants with internal or external connections., Material and Methods: A systematic review was conducted following the criteria defined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Initially, a population, intervention, comparison, and outcome(s) (PICO) question was defined: does the connection type (internal or external) influence marginal bone loss in patients undergoing implantation? An electronic search of PubMed/MEDLINE and Scopus databases was performed for studies in English language published between January 2000 and December 2014 by 2 independent reviewers, who analyzed the marginal bone loss of dental implants with an internal and/or external connection., Results: From an initial screening yield of 595 references and after considering inclusion and exclusion criteria, 17 articles were selected for this review. Among them, 10 studies compared groups of implants with internal and external connections; 1 study evaluated external connections; and 6 studies analyzed internal connections. A total of 2708 implants were placed in 864 patients. Regarding the connection type, 2347 implants had internal connections, and 361 implants had external connections. Most studies showed lower marginal bone loss values for internal connection implants than for external connection implants., Conclusions: Osseointegrated dental implants with internal connections exhibited lower marginal bone loss than implants with external connections. This finding is mainly the result of the platform switching concept, which is more frequently found in implants with internal connections., (Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

This paper presents an image reconstruction method to monitor the temperature distribution of electric generator stators. The main objective is to identify insulation failures that may arise as hotspots in the structure. The method is based on temperature readings of fiber optic distributed sensors (DTS) and a sparse reconstruction algorithm. Thermal images of the structure are formed by appropriately combining atoms of a dictionary of hotspots, which was constructed by finite element simulation with a multi-physical model. Due to difficulties for reproducing insulation faults in real stator structure, experimental tests were performed using a prototype similar to the real structure. The results demonstrate the ability of the proposed method to reconstruct images of hotspots with dimensions down to 15 cm, representing a resolution gain of up to six times when compared to the DTS spatial resolution. In addition, satisfactory results were also obtained to detect hotspots with only 5 cm. The application of the proposed algorithm for thermal imaging of generator stators can contribute to the identification of insulation faults in early stages, thereby avoiding catastrophic damage to the structure., Competing Interests: The authors declare no conflict of interest.

Statement of Problem: Nonthermal plasma (NTP) treatment is an alternative technique for promoting the adhesion of resin cement to lithium disilicate ceramic. However, no study has evaluated whether the surface modifications are affected by atmospheric air aging., Purpose: The purposes of this in vitro study were to characterize the lithium disilicate surface after depositing an organosilicon film with NTP treatment and to verify the surface energy before and after atmospheric air aging up to 30 days., Material and Methods: Sixteen lithium disilicate disks (10×3 mm) were prepared, and their surfaces were treated with a mixture of hexamethyldisiloxane and argon, followed by oxygen plasma treatment, both for 30 minutes. The lithium disilicate surface was characterized through scanning electron microscopy, energy-dispersive spectroscopy, and atomic force microscopy. Surface energy analysis was performed before (T0) and immediately after NTP treatment (T1) and after atmospheric air aging for 7 (T2), 15 (T3), and 30 days (T4). Data were submitted to analysis of variance followed by the Tukey HSD test (α=.05)., Results: Carbon, oxygen, and silicon were identified on the disilicate surface after NTP treatment, suggesting organosilicon film adhesion. Air aging did not modify the film morphology. At T1, the surface energy was significantly higher compared with other periods, and the water contact angle on the disilicate surface was reduced to 0 degrees. Similar surface energy was observed for T0, T2, T3, and T4., Conclusions: On the basis of the results of this in vitro study, NTP treatment can promote bonding to lithium disilicate surfaces because of its high surface wettability. However, after air aging, the wettability was not durable., (Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Conservative clinical solutions, predictable esthetic, and immediate outcomes are important concepts of restorative dentistry. The aim of this case study was to recognize the selective enamel removal as an interesting conservative alternative to achieve optimal esthetic results and discuss the clinical protocol. This clinical report described an alternative esthetic and conservative treatment to transform the long and sharp aspect of the maxillary canines with a slightly aggressive aspect into features of slightly curved teeth with delicate lines. An accurate diagnostic and esthetic analysis of the smile was initially performed. The selective enamel removal was performed, and direct composite restoration was strategically placed. Clinical assessment showed good esthetic outcomes, enabling a smile harmony with an immediate, simple, and lower-cost technique. Practitioners should be exposed to conservative approaches to create esthetic smiles based on the selective enamel removal technique combined with composite resin.

Purpose: This systematic review aimed to evaluate if the internal connection is more efficient than the external connection and its associated influencing factors., Methods: A specific question was formulated according to the Population, Intervention, Control, and Outcome (PICO): Is internal connection more efficient than external connection in mechanical, biological, and esthetical point of views? An electronic search of the MEDLINE and the Web of Knowledge databases was performed for relevant studies published in English up to November 2013 by two independent reviewers. The keywords used in the search included a combination of "dental implant" and "internal connection" or "Morse connection" or "external connection." Selected studies were randomized clinical trials, prospective or retrospective studies, and in vitro studies with a clear aim of investigating the internal and/or external implant connection use., Results: From an initial screening yield of 674 articles, 64 potentially relevant articles were selected after an evaluation of their titles and abstracts. Full texts of these articles were obtained with 29 articles fulfilling the inclusion criteria. Morse taper connection has the best sealing ability. Concerning crestal bone loss, internal connections presented better results than external connections. The limitation of the present study was the absence of randomized clinical trials that investigated if the internal connection was more efficient than the external connection., Conclusions: The external and internal connections have different mechanical, biological, and esthetical characteristics. Besides all systems that show proper success rates and effectiveness, crestal bone level maintenance is more important around internal connections than external connections. The Morse taper connection seems to be more efficient concerning biological aspects, allowing lower bacterial leakage and bone loss in single implants, including aesthetic regions. Additionally, this connection type can be successfully indicated for fixed partial prostheses and overdenture planning, since it exhibits high mechanical stability.

Purpose: The purpose of this study was twofold: 1) to characterize the zirconia (Y-TZP) surfaces through scanning electronic microscopy associated with energy-dispersive spectroscopy and atomic force microscopy after the deposition of a thin organosilicon film by nonthermal plasma (NTP) treatment, and 2) to determine the zirconia surface hydrophilicity, before and after aging, through surface energy analysis., Materials and Methods: Surfaces of 16 zirconia disks (10 x 3 mm) were treated for 30 min each with hexamethyldisiloxane and argon plasmas, followed by oxygen plasma. Disks were analyzed before NTP treatment, immediately after NTP treatment, and after aging for 7, 15, and 30 days. The surface energy of the Y-TZP disks was measured with a goniometer. Quantitative data were submitted to statistical analysis using ANOVA and Tukey's test (p < 0.05)., Results: Immediately after NTP treatment, the surface energy of the zirconia disks was significantly higher than at any other tested period (p < 0.001), and the water contact angle on the zirconia disks was reduced to 0 degrees. Similar surface energy results were obtained before NTP treatment and after 15 or 30 days of aging (p > 0.05; Tukey's test). Energy-dispersive spectroscopy results revealed the presence of carbon, oxygen, and silicon on the surface after NTP treatment., Conclusion: NTP treatment was useful for treating the zirconia surface for cementation procedures, as it produced a high level of hydrophilicity on the zirconia surface. However, this high level of hydrophilicity did not persist after aging.

Purpose: To evaluate the influence of colorant solutions on color stability and surface roughness of indirect resin composites submitted to prior immersion in mouthwashes., Methods: Five brands of indirect resin composites were assessed: Adoro, Resilab, Cristobal, Sinfony and Epricord. The specimens were immersed in five different solutions (n = 10): four mouthwashes (Listerine, Oral-B, Plax, Periogard) and artificial saliva (control). 60 hours after immersion in mouthwashes, the specimens were exposed to coffee solution. Shade stability and surface roughness were tested by a spectrophotometer and by a profilometer, respectively. A three-way repeated-measures ANOVA was performed. Differences between the values were compared by the Tukey-Kramer test (P < 0.05)., Results: The majority of the specimens showed human-perceptible color change. Greater color change was observed after immersion in coffee, except for Cristobal. The color change was even higher for specimens previously immersed in mouthwashes. The Epricord resin showed the lowest roughness value and the Cristobal showed the highest value, regardless of the period. The highest roughness change occurred after immersion in Listerine.

Background: In December 2013, an outbreak of Chikungunya virus (CHIKV) caused by the Asian genotype was notified in the Caribbean. The outbreak has since spread to 38 regions in the Americas. By September 2014, the first autochthonous CHIKV infections were confirmed in Oiapoque, North Brazil, and in Feira de Santana, Northeast Brazil., Methods: We compiled epidemiological and clinical data on suspected CHIKV cases in Brazil and polymerase-chain-reaction-based diagnostic was conducted on 68 serum samples from patients with symptom onset between April and September 2014. Two imported and four autochthonous cases were selected for virus propagation, RNA isolation, full-length genome sequencing, and phylogenetic analysis. We then followed CDC/PAHO guidelines to estimate the risk of establishment of CHIKV in Brazilian municipalities., Results: We detected 41 CHIKV importations and 27 autochthonous cases in Brazil. Epidemiological and phylogenetic analyses indicated local transmission of the Asian CHIKV genotype in Oiapoque. Unexpectedly, we also discovered that the ECSA genotype is circulating in Feira de Santana. The presumed index case of the ECSA genotype was an individual who had recently returned from Angola and developed symptoms in Feira de Santana. We estimate that, if CHIKV becomes established in Brazil, transmission could occur in 94% of municipalities in the country and provide maps of the risk of importation of each strain of CHIKV in Brazil., Conclusions: The etiological strains associated with the early-phase CHIKV outbreaks in Brazil belong to the Asian and ECSA genotypes. Continued surveillance and vector mitigation strategies are needed to reduce the future public health impact of CHIKV in the Americas.