Combined effects of diesel and air exposure on oxidative stress parameters of mussels Perna perna (Mytilidae, Bivalvia).

This study aimed to assess the combined effect of hypoxia and exposure to diesel on biochemical parameters of Perna perna mussels. Mussels previously kept for 48 h in clean seawater were submitted to hypoxia for 24 h followed by reoxygenation in clean seawater for 48 h. The same procedure was done but using seawater containing 0.01 mL/L of diesel, before and after hypoxia. Antioxidant enzymes as well as levels of glutathione and lipid peroxidation were measured in gills and digestive glands. The neutral red retention time assay was also evaluated in hemocytes. Results showed that cycles of air exposure and reoxygenation caused oxidative stress and antioxidant modulation in both the gills and digestive glands. The presence of diesel in water triggered additional modulation of antioxidants under hypoxia and reoxygenation stress, apparently enhancing the capacity of mussels to avoid lipid peroxidation.

Continuing work in times of COVID-19: Protection measures in the workplace for health professionals.

BACKGROUND: The arrival of COVID-19 in Brazil and the accelerated process of dissemination/contamination added to the evolution of the clinical picture of the disease, and the saturation of the capacity of health services, creating new challenges for researchers, governments, and professionals involved in the occupational health area. OBJECTIVE: This article aims to systematize and synthesize the proposals adopted by the legislation and by the Brazilian State, with a focus on worker protection and guaranteeing a safe work environment for the performance of their professional activities. METHODS: This is qualitative bibliographical research of the narrative literature review type, developed from October 2020 to June 2021 in legislation databases using the strategy: "COVID-19" AND "coronavirus/coronavirus" AND "worker health" on official Brazilian government websites. RESULTS: The lack of an emergency plan for efficient actions to respond to the epidemic caused and is still causing the daily deaths of workers. CONCLUSION: There is a need to guarantee the effectiveness of national and international policies and norms that have been neglected by the Brazilian government.

Effect of 3BNC117 and romidepsin on the HIV-1 reservoir in people taking suppressive antiretroviral therapy (ROADMAP): a randomised, open-label, phase 2A trial.

BACKGROUND: The administration of broadly neutralising anti-HIV-1 antibodies before latency reversal could facilitate elimination of HIV-1-infected CD4 T cells. We tested this concept by combining the broadly neutralising antibody 3BNC117 in combination with the latency-reversing agent romidepsin in people with HIV-1 who were taking suppressive antiretroviral therapy (ART). METHODS: We did a randomised, open-label, phase 2A trial at three university hospital centres in Denmark, Germany, and the USA. Eligible participants were virologically suppressed adults aged 18-65 years who were infected with HIV-1 and on ART for at least 18 months, with plasma HIV-1 RNA concentrations of less than 50 copies per mL for at least 12 months, and a CD4 T-cell count of greater than 500 cells per µL. Participants were randomly assigned (1:1) to receive 3BNC117 plus romidepsin or romidepsin alone in two cycles. All participants received intravenous infusions of romidepsin (5 mg/m2 given over 120 min) at weeks 0, 1, and 2 (treatment cycle 1) and weeks 8, 9, and 10 (treatment cycle 2). Those in the 3BNC117 plus romidepsin group received an intravenous infusion of 3BNC117 (30 mg/kg given over 60 min) 2 days before each treatment cycle. An analytic treatment interruption (ATI) of ART was done at week 24 in both groups. Our primary endpoint was time to viral rebound during analytic treatment interruption, which was assessed in all participants who completed both treatment cycles and ATI. We used a log-rank test to compare time to viral rebound during analytic treatment interruption between the two groups. This trial is registered with ClinicalTrials.gov, NCT02850016. It is closed to new participants, and all follow-up is complete. FINDINGS: Between March 20, 2017, and Aug 14, 2018, 22 people were enrolled and randomly assigned, 11 to the 3BNC117 plus romidepsin group and 11 to the romidepsin group. 19 participants completed both treatment cycles and the ATI: 11 in the 3BNC117 plus romidepsin group and 8 in the romidepsin group. The median time to viral rebound during ATI was 18 days (IQR 14-28) in the 3BNC117 plus romidepsin group and 28 days (21-35) in the romidepsin group B (p=0·0016). Although this difference was significant, prolongation of time to viral rebound was not clinically meaningful in either group. All participants in both groups reported adverse events, but overall the combination of 3BNC117 and romidepsin was safe. Two severe adverse events were observed in the romidepsin group during 48 weeks of follow-up, one of which-increased direct bilirubin-was judged to be related to treatment. INTERPRETATION: The combination of 3BNC117 and romidepsin was safe but did not delay viral rebound during analytic treatment interruptions in individuals on long-term ART. The results of our trial could serve as a benchmark for further optimisation of HIV-1 curative strategies among people with HIV-1 who are taking suppressive ART. FUNDING: amfAR, German Center for Infection Research.

Prolonged viral suppression with anti-HIV-1 antibody therapy.

HIV-1 infection remains a public health problem with no cure. Anti-retroviral therapy (ART) is effective but requires lifelong drug administration owing to a stable reservoir of latent proviruses integrated into the genome of CD4+ T cells1. Immunotherapy with anti-HIV-1 antibodies has the potential to suppress infection and increase the rate of clearance of infected cells2,3. Here we report on a clinical study in which people living with HIV received seven doses of a combination of two broadly neutralizing antibodies over 20 weeks in the presence or absence of ART. Without pre-screening for antibody sensitivity, 76% (13 out of 17) of the volunteers maintained virologic suppression for at least 20 weeks off ART. Post hoc sensitivity analyses were not predictive of the time to viral rebound. Individuals in whom virus remained suppressed for more than 20 weeks showed rebound viraemia after one of the antibodies reached serum concentrations below 10 µg ml-1. Two of the individuals who received all seven antibody doses maintained suppression after one year. Reservoir analysis performed after six months of antibody therapy revealed changes in the size and composition of the intact proviral reservoir. By contrast, there was no measurable decrease in the defective reservoir in the same individuals. These data suggest that antibody administration affects the HIV-1 reservoir, but additional larger and longer studies will be required to define the precise effect of antibody immunotherapy on the reservoir.

Contribuições e desafios para a gestão de terapeutas ocupacionais em programas de inclusão de estudantes com deficiência no ensino superior / Contributions and challenges in the management of occupational therapists in higher education inclusion programs for students with disabilities

Resumo Introdução A deficiência é uma construção social, e a integração no ensino superior é um direito dos estudantes com deficiência. Terapeutas ocupacionais atuam diretamente nesse contexto e podem apoiar participação social desses estudantes, assumindo o papel de gestão de programas na universidade. Objetivo Discutir ações realizadas por terapeutas ocupacionais gestoras de núcleos de inclusão em instituição de ensino superior. Método Estudo ancorado em abordagem qualitativa. Participaram cinco terapeutas ocupacionais, coordenadoras de programas de inclusão em diferentes regiões do Brasil e foram analisadas suas contribuições em relação às atividades realizadas no programa. Os dados foram coletados por meio de entrevistas semiestruturadas, sendo categorizados de acordo com seu conteúdo. Resultados A especificidade da intervenção no espaço educacional pressupõe equiparar ações em diferentes contextos do ambiente universitário. As ações de terapeutas ocupacionais gestoras perpassam intervenções focalizadas nas dimensões de apoio mais individual e intervenções mais coletivas, que interferem diretamente na mudança de cultura e acesso à universidade. Conclusão Destaca-se a habilidade de terapeutas ocupacionais como gestoras, num papel de mediadoras e atuantes na implementação de ações, de modo que parcerias institucionais produzam um diálogo entre necessidades e recursos, articulando demandas institucionais e a singularidade dos estudantes e dos processos educativos.

Abstract Introduction Disability is a social construction, and integration into higher education is a right of students with disabilities. Occupational therapists work directly in this context and can support the social participation of these students, assuming the role of program management at the university. Objective To discuss actions carried out by occupational therapists who manage inclusion centers in a higher education institution. Method Study anchored in a qualitative approach. Five occupational therapists, coordinators of inclusion programs in different regions of Brazil, participated and their contributions were analyzed in relation to the activities carried out in the program. Data were collected through semi-structured interviews, being categorized according to their content. Results The specificity of intervention in the educational space presupposes equating actions in different contexts of the university environment. The actions of managerial occupational therapists permeate interventions focused on the dimensions of more individual support and more collective interventions, which directly interfere in the change of culture and access to the university. Conclusion The ability of occupational therapists as managers is highlighted, in a role of mediators and actors in the implementation of actions, so that institutional partnerships produce a dialogue between needs and resources, articulating institutional demands and the uniqueness of students and educational processes.

Enhanced SARS-CoV-2 neutralization by dimeric IgA.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), primarily infects cells at mucosal surfaces. Serum neutralizing antibody responses are variable and generally low in individuals that suffer mild forms of COVID-19. Although potent immunoglobulin G (IgG) antibodies can neutralize the virus, less is known about secretory antibodies such as IgA that might affect the initial viral spread and transmissibility from the mucosa. Here, we characterize the IgA response to SARS-CoV-2 in a cohort of 149 convalescent individuals after diagnosis with COVID-19. IgA responses in plasma generally correlated with IgG responses. Furthermore, clones of IgM-, IgG-, and IgA-producing B cells were derived from common progenitor cells. Plasma IgA monomers specific to SARS-CoV-2 proteins were demonstrated to be twofold less potent than IgG equivalents. However, IgA dimers, the primary form of antibody in the nasopharynx, were, on average, 15 times more potent than IgA monomers against the same target. Thus, dimeric IgA responses may be particularly valuable for protection against SARS-CoV-2 and for vaccine efficacy.

Neutralizing Activity of Broadly Neutralizing anti-HIV-1 Antibodies against Primary African Isolates.

Novel therapeutic and preventive strategies are needed to contain the HIV-1 epidemic. Broadly neutralizing human antibodies (bNAbs) with exceptional activity against HIV-1 are currently being tested in HIV-1 prevention trials. The selection of anti-HIV-1 bNAbs for clinical development was primarily guided by their in vitro neutralizing activity against HIV-1 Env pseudotyped viruses. Here we report on the neutralizing activity of 9 anti-HIV-1 bNAbs now in clinical development against 126 Clade A, C, D PBMC-derived primary African isolates. The neutralizing potency and breadth of the bNAbs tested was significantly reduced compared to pseudotyped viruses panels. The difference in sensitivity between pseudotyped viruses and primary isolates varied from 3- to nearly 100-fold depending on the bNAb and the HIV-1 clade. Thus, the neutralizing activity of bNAbs against primary African isolates differs from their activity against pseudovirus panels. The data have significant implications for interpreting the results of ongoing HIV-1 prevention trials.IMPORTANCE HIV remains a major public health problem worldwide, and new therapies and preventive strategies are necessary for controlling the epidemic. Broadly neutralizing antibodies (bNAbs) have been developed in the past decade to fill this gap. The neutralizing activity of these antibodies against diverse HIV strains has mostly been measured using Env-pseudotyped viruses, which overestimate bNAb coverage and potency. In this study we measured the neutralizing activity of nine bNAbs against clade A, C, and D HIV isolates derived from cells of African patients living with HIV and produced in peripheral blood mononuclear cells. We found that the coverage and potency of bNAbs were often significantly lower than what was predicted by Env-psuedotyped viruses, and that this decrease was related to the bNAb biding site class. This data is important for the planning and analysis of clinical trials that seek to evaluate bNAbs for the treatment and prevention of HIV infection in Africa.

Núcleo Poiesis: uma construção interinstitucional para o fortalecimento dos estudos e práticas sobre terapia ocupacional e trabalho / PoiesisNucleus: an interinstitutional construction to strengthen studies and practices on occupational therapy and work

O Núcleo Poiesis -Laboratório Interinstitucional de Terapia Ocupacional e Trabalho, nasceu da vontade de estabelecer ações coletivas, parcerias interinstitucionais e experimentações acadêmicas entre docentes e terapeutas ocupacionais que estudam o trabalho. Esse relato de experiência descreve o processo deconstrução do Núcleo Poiesis, apresenta o perfil de suas pesquisadoras,suas produções e parcerias, seus projetos futuros e as contribuiçõesdesse grupo para os estudos e práticas sobre terapia ocupacionale trabalho. Enquanto coletivo, as produções somaram até então doisartigos, quatro capítulos de livros, além de parcerias interinstitucionaisem ensino, pesquisa e extensão, coordenação de debates sobreterapia ocupacional e trabalho nos principais congressos, eventose instituições representativas da profissão no país. Conclui-se quea experiência coletiva de pares promoveu uma interlocução entreas universidades espalhadas por todo território nacional, o que éindispensável para promover trocas de experiências, saberes e práticas no campo do trabalho e Terapia Ocupacional.

he Poiesis Nucleus - Interinstitutional Laboratory of Occupational Therapy and Work was born from the desire to set collective actions, inter-institutional partnerships, and academic dialogues between professors and occupational therapists that study work. This experience report describes the Nucleus building process. Also, it presents a profile of its researchers' members, productions, partnerships, future projects, and the contributions of this group to the studies and practices about occupational therapy and work. As a collective, the productions have summed up to two papers, four book chapters, inter-institutional partnerships in teaching, research, and extension activities, and debates about Occupational Therapy and work in academic events, with the leading professional's institutions in the country. It is concluded that the collective experience of peers promoted a dialogue between universities spread throughout the national territory, which is essential to promote exchanges of experiences, knowledge, and practices in the work field and Occupational Therapy

Enhanced SARS-CoV-2 Neutralization by Secretory IgA in vitro.

SARS-CoV-2 primarily infects cells at mucosal surfaces. Serum neutralizing antibody responses are variable and generally low in individuals that suffer mild forms of the illness. Although potent IgG antibodies can neutralize the virus, less is known about secretory antibodies such as IgA that might impact the initial viral spread and transmissibility from the mucosa. Here we characterize the IgA response to SARS-CoV-2 in a cohort of 149 individuals. IgA responses in plasma generally correlate with IgG responses and clones of IgM, IgG and IgA producing B cells that are derived from common progenitors are evident. Plasma IgA monomers are 2-fold less potent than IgG equivalents. However, IgA dimers, the primary form in the nasopharynx, are on average 15 times more potent than IgA monomers. Thus, secretory IgA responses may be particularly valuable for protection against SARS-CoV-2 and for vaccine efficacy.

Convergent antibody responses to SARS-CoV-2 in convalescent individuals.

During the coronavirus disease-2019 (COVID-19) pandemic, severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2) has led to the infection of millions of people and has claimed hundreds of thousands of lives. The entry of the virus into cells depends on the receptor-binding domain (RBD) of the spike (S) protein of SARS-CoV-2. Although there is currently no vaccine, it is likely that antibodies will be essential for protection. However, little is known about the human antibody response to SARS-CoV-21-5. Here we report on 149 COVID-19-convalescent individuals. Plasma samples collected an average of 39 days after the onset of symptoms had variable half-maximal pseudovirus neutralizing titres; titres were less than 50 in 33% of samples, below 1,000 in 79% of samples and only 1% of samples had titres above 5,000. Antibody sequencing revealed the expansion of clones of RBD-specific memory B cells that expressed closely related antibodies in different individuals. Despite low plasma titres, antibodies to three distinct epitopes on the RBD neutralized the virus with half-maximal inhibitory concentrations (IC50 values) as low as 2 ng ml-1. In conclusion, most convalescent plasma samples obtained from individuals who recover from COVID-19 do not contain high levels of neutralizing activity. Nevertheless, rare but recurring RBD-specific antibodies with potent antiviral activity were found in all individuals tested, suggesting that a vaccine designed to elicit such antibodies could be broadly effective.

Convergent Antibody Responses to SARS-CoV-2 Infection in Convalescent Individuals.

During the COVID-19 pandemic, SARS-CoV-2 infected millions of people and claimed hundreds of thousands of lives. Virus entry into cells depends on the receptor binding domain (RBD) of the SARS-CoV-2 spike protein (S). Although there is no vaccine, it is likely that antibodies will be essential for protection. However, little is known about the human antibody response to SARS-CoV-21-5. Here we report on 149 COVID-19 convalescent individuals. Plasmas collected an average of 39 days after the onset of symptoms had variable half-maximal neutralizing titers ranging from undetectable in 33% to below 1:1000 in 79%, while only 1% showed titers >1:5000. Antibody cloning revealed expanded clones of RBD-specific memory B cells expressing closely related antibodies in different individuals. Despite low plasma titers, antibodies to three distinct epitopes on RBD neutralized at half-maximal inhibitory concentrations (IC50s) as low as single digit ng/mL. Thus, most convalescent plasmas obtained from individuals who recover from COVID-19 do not contain high levels of neutralizing activity. Nevertheless, rare but recurring RBD-specific antibodies with potent antiviral activity were found in all individuals tested, suggesting that a vaccine designed to elicit such antibodies could be broadly effective.

Combination of quadruplex qPCR and next-generation sequencing for qualitative and quantitative analysis of the HIV-1 latent reservoir.

HIV-1 infection requires lifelong therapy with antiretroviral drugs due to the existence of a latent reservoir of transcriptionally inactive integrated proviruses. The goal of HIV-1 cure research is to eliminate or functionally silence this reservoir. To this end, there are numerous ongoing studies to evaluate immunological approaches, including monoclonal antibody therapies. Evaluating the results of these studies requires sensitive and specific measures of the reservoir. Here, we describe a relatively high-throughput combined quantitative PCR (qPCR) and next-generation sequencing method. Four different qPCR probes covering the packaging signal (PS), group-specific antigen (gag), polymerase (pol), and envelope (env) are combined in a single multiplex reaction to detect the HIV-1 genome in limiting dilution samples followed by sequence verification of individual reactions that are positive for combinations of any two of the four probes (Q4PCR). This sensitive and specific approach allows for an unbiased characterization of the HIV-1 latent reservoir.

Immunization expands B cells specific to HIV-1 V3 glycan in mice and macaques.

Broadly neutralizing monoclonal antibodies protect against infection with HIV-1 in animal models, suggesting that a vaccine that elicits these antibodies would be protective in humans. However, it has not yet been possible to induce adequate serological responses by vaccination. Here, to activate B cells that express precursors of broadly neutralizing antibodies within polyclonal repertoires, we developed an immunogen, RC1, that facilitates the recognition of the variable loop 3 (V3)-glycan patch on the envelope protein of HIV-1. RC1 conceals non-conserved immunodominant regions by the addition of glycans and/or multimerization on virus-like particles. Immunization of mice, rabbits and rhesus macaques with RC1 elicited serological responses that targeted the V3-glycan patch. Antibody cloning and cryo-electron microscopy structures of antibody-envelope complexes confirmed that immunization with RC1 expands clones of B cells that carry the anti-V3-glycan patch antibodies, which resemble precursors of human broadly neutralizing antibodies. Thus, RC1 may be a suitable priming immunogen for sequential vaccination strategies in the context of polyclonal repertoires.

Broad and Potent Neutralizing Antibodies Recognize the Silent Face of the HIV Envelope.

Broadly neutralizing antibodies (bNAbs) against HIV-1 envelope (Env) inform vaccine design and are potential therapeutic agents. We identified SF12 and related bNAbs with up to 62% neutralization breadth from an HIV-infected donor. SF12 recognized a glycan-dominated epitope on Env's silent face and was potent against clade AE viruses, which are poorly covered by V3-glycan bNAbs. A 3.3Å cryo-EM structure of a SF12-Env trimer complex showed additional contacts to Env protein residues by SF12 compared with VRC-PG05, the only other known donor-derived silentface antibody, explaining SF12's increased neutralization breadth, potency, and resistance to Env mutation routes. Asymmetric binding of SF12 was associated with distinct N-glycan conformations across Env protomers, demonstrating intra-Env glycan heterogeneity. Administrating SF12 to HIV-1-infected humanized mice suppressed viremia and selected for viruses lacking the N448gp120 glycan. Effective bNAbs can therefore be raised against HIV-1 Env's silent face, suggesting their potential for HIV-1 prevention, therapy, and vaccine development.

Educação permanente: ferramenta de aprimoramento assistencial às lesões por pressão / Permanent education: assistance improvement tool for pressure ulcers

Objetivo: analisar a incidência de lesões por pressão em uma Unidade de Cuidados Especiais. Método: tratase de um estudo quantitativo, descritivo e exploratório, com intervenção educacional, em um hospital público de médio porte. Compô-se a amostra por 10 participantes. Elencou-se a técnica de coleta de dados por meio de observação direta não participante, e os resultados apresentaram-se em forma de tabelas. Resultados: observaram-se 50 amostras (n=50) onde se constatou uma incidência de lesões por pressão de 48% (n=24), com destaque para as lesões relacionadas a dispositivos médicos (15%) e sacrais (10%). Constituiu-se a capacitação teórica de dez funcionários (n=10) e observou-se que 90% dos funcionários erraram questões relacionadas à atual classificação das lesões por pressão, entretanto, 90% souberam identificar possíveis formas preventivas. Conclusão: demonstra-se, pelos resultados obtidos, que, apesar de ser um fenômeno evitável, continua presente na prática diária, necessitando da implantação de medidas de qualificação profissional como estratégia de redução desse agravo.(AU)

Objective: to analyze the incidence of pressure ulcers in a Special Care Unit. Method: this is a quantitative, descriptive and exploratory study, with educational intervention, in a medium-sized public hospital. The sample was composed by 10 participants. The technique of data collection was established through direct non-participant observation, and the results were presented in the form of tables. Results: 50 samples (n = 50) were observed, with an incidence of 48% (n = 24), with emphasis on ulcers related to medical devices (15%) and sacral (10%). The theoretical qualification of ten employees (n = 10) was established, and 90% of the employees missed questions related to the current classification of pressure ulcers, however, 90% were able to identify possible preventive forms. Conclusion: it is demonstrated by the results obtained that, despite being an avoidable phenomenon, it continues to be present in daily practice, necessitating the implementation of professional qualification measures as a strategy to reduce this aggravation.(AU)

Objetivo: analizar la incidencia de lesiones por presión en una Unidad de Cuidados Especiales. Método: se trata de un estudio cuantitativo, descriptivo y exploratorio, con intervención educativa, en un hospital público de mediano porte. Se compone la muestra por 10 participantes. Se elaboró la técnica de recolección de datos por medio de observación directa no participante, y los resultados se presentaron en forma de tablas. Resultados: se observaron 50 muestras (n = 50) donde se constató una incidencia de lesiones por presión de 48% (n = 24), con destaque para las lesiones relacionadas con dispositivos médicos (15%) y sacros (10%). Se constituyó la capacitación teórica de diez funcionarios (n = 10) y se observó que el 90% de los funcionarios erraron cuestiones relacionadas a la actual clasificación de las lesiones por presión, sin embargo, el 90% supieron identificar posibles formas preventivas. Conclusión: se demuestra, por los resultados obtenidos, que, a pesar de ser un fenómeno evitable, sigue presente en la práctica diaria, necesitando la implantación de medidas de calificación profesional como estrategia de reducción de ese agravio.(AU)

Longevity, effectiveness, safety, and impact on quality of life of low-concentration hydrogen peroxides in-office bleaching: a randomized clinical trial.

OBJECTIVE: The study evaluated the longevity, effectiveness, safety, and impact on the oral health-related quality of life of in-office dental bleaching using low-concentration hydrogen peroxides. MATERIALS AND METHODS: Randomized, parallel, and double-blinded clinical trial was performed with 54 participants using 6% or 15% hydrogen peroxide (HP) in-office bleaching activated via hybrid LED/laser light. Tooth color was evaluated at baseline (T1), 1 week of bleaching (T2), 2 weeks of bleaching (T3) and 1 week (T4) and 6 months (T5) after finishing the bleaching using the Classical Vita™ scale and spectrophotometer. Tooth sensitivity and gingival irritation were measured with Visual Numeric Scale and Modified Gingival Index. The impact on quality of life was evaluated using the Oral Impact on Daily Performance. The data were analyzed using the Friedman, Mann-Whitney, and McNemar tests (p < 0.05). RESULTS: The group HP15% presented significant color change (ΔE) from T1 to T4 (p = 0.002) and T1 to T5 (p < 0.001). Parameters L, a*, and b* differed significantly at T3, T4, and T5 compared T1 for both groups. At 6-month follow-up, 57.1% of HP6 and 43.7% of HP15% participants migrated from B1 to a darker color. No significant differences were observed between the groups in tooth sensitivity, gingival irritation, or impact on quality of life. CONCLUSIONS: Both agents showed bleaching effectiveness, but HP15% presented greater color stability than HP6%, at 6-month follow-up. The agents showed low levels of tooth sensitivity, gingival irritation, and did not affect the oral health-related quality of life of the participants. CLINICAL RELEVANCE: Despite the greater presence of sensitivity during treatment compared with 6% hydrogen peroxide, 15% hydrogen peroxide demonstrated better bleaching effectiveness, and greater color stability at the end of bleaching and at 6-month follow-up. The use of 15% hydrogen peroxide presents more suitable results.

Viability of Bovine Teeth as a Substrate in Bond Strength Tests: A Systematic Review and Meta-analysis.

PURPOSE: To assess whether bovine teeth can be used as viable alternatives for human teeth in tensile and shear bond strength testing. MATERIALS AND METHODS: Articles were selected from Web of Science, PubMed, Scopus, LILACS-Bireme, and BBO electronic databases using keywords obtained from Medical Subject Headings (MeSH). Of 1540 potentially eligible studies, 157 were selected for full text analysis. Five independent reviewers (Kappa = 0.89) selected the studies, abstracted information, and assessed quality based on standardized scales. After the analysis, 78 studies comparing bovine teeth to human teeth were found. Only 18 studies comparing bovine and human substrates in bond strength tests were included in the systematic review and 13 in the meta-analysis. Two authors independently selected the studies, extracted the data and assessed the risk of bias. Mean differences were obtained by comparing tensile and shear bond strengths between human and bovine teeth (permanent and deciduous) and considering enamel and dentin separately (subgroup analysis). Statistical analysis was performed using RevMan5.1, with a random-effect model, at a 5% significance level. RESULTS: No significant difference was found between human and bovine teeth in tensile tests (p = 0.41) for dentin (p = 0.86), but there was a difference for enamel (p = 0.01). Regarding shear bond strength, no significant difference was found between human and bovine teeth (p = 0.16) either for enamel (p = 0.07) or dentin (p = 0.68). Regarding shear bond strength on deciduous teeth, no significant difference was found between human and bovine substrates (p = 0.54), either for enamel (p = 0.42) or dentin (p = 0.05). Most studies were at high (low or unclear) risk of bias. CONCLUSIONS: In shear bond strength testing, bovine teeth can be a suitable alternative for permanent and deciduous human teeth, for both enamel and dentin substrates. However, they may not be suitable for enamel tensile bond strength testing. The findings are based on low quality studies (considerable heterogeneity) and should be interpreted with caution.

Accessibility centers in brazilian federal institutions and contributions of occupational therapists for the inclusion of persons with disabilities in higher education / Núcleos de acessibilidade em instituições federais brasileiras e as contribuições de terapeutas ocupacionais para a inclusão de pessoas com deficiência no ensino superior

Abstract Introduction: Inclusion programs for students with disabilities in Federal Institutions of Higher Education (IFES) seek to favor access and permanence based on respect for diversity in the university environment. The Occupational Therapy can help developing these programs. Objective: To analyze the access of the population with disabilities to higher education, considering the premises of the Inclusion Program INCLUIR of the Ministry of Education. Reflect on the contribution of occupational therapists in this program. Method: The descriptive-analytical research based on documentary analysis identified 55 Inclusion Program centers in the IFES, recognizing the developed actions. We studied the curriculum and research groups in the IFES with an occupational therapy course regarding this subject. We interviewed three occupational therapists that coordinated these programs. Results: We observed progress in the inclusion of people with disabilities in higher education, encouraged by government programs. The occupational therapy curriculum of the 14 IFES, as well as their research groups, do not indicate activities in the area of Education, which would make it difficult to practice professional technical actions in the area. Eight of the 55 nuclei have occupational therapists with a differential action of the professional capacity to perceive and favor the contact with the diversity of realities among students, which would potentialize equalization actions in the daily academic life, especially the permanence of people with deficiency. Conclusion: There is an urgent need to increase inclusion programs and the participation of occupational therapist, to increase the organization and management of actions for more dialogue between the IFES instances and to favor the entry and stay of students with disabilities.

Resumo Introdução: Programas de inclusão de estudantes com deficiência (EcD) em Instituições Federais de Ensino Superior (IFES) buscam favorecer acesso e permanência considerando-se o respeito à diversidade no ambiente universitário. A terapia ocupacional pode contribuir para desenvolver esses programas. Objetivo: Analisar o acesso da população com deficiência ao Ensino Superior, considerando as premissas do Programa INCLUIR do Ministério da Educação, além de refletir sobre a contribuição de terapeutas ocupacionais nesse programa. Método: Investigação descritiva-analítica baseada em análise documental identificou 55 núcleos do Programa INCLUIR em IFES, reconhecendo ações desenvolvidas. Nas IFES que ministravam graduação em terapia ocupacional, foram estudados os currículos e grupos de pesquisa relacionados ao tema. Foram entrevistadas três terapeutas ocupacionais coordenadoras desses programas. Resultados: Observou-se progresso na inclusão de pessoas com deficiência no ensino superior, incentivado pelos programas governamentais. Os currículos de terapia ocupacional das 14 IFES que oferecem graduação e seus grupos de pesquisa não indicam atividades na área da Educação, o que dificultaria o exercício de ações técnicas profissionais nesse campo. Oito dos 55 núcleos contam com terapeutas ocupacionais e neles há um diferencial da ação pela capacidade profissional de perceber e favorecer o contato com a diversidade de realidades entre estudantes, o que potencializaria as ações de equiparação no cotidiano acadêmico, favorecendo especialmente a permanência. Conclusão: Há necessidade de aumentar os programas de inclusão e a participação da terapia ocupacional, de forma a ampliar a organização e o gerenciamento de ações para maior diálogo entre as instâncias das IFES, e favorecer o ingresso e permanência de estudantes.

Relationship between intact HIV-1 proviruses in circulating CD4+ T cells and rebound viruses emerging during treatment interruption.

Combination antiretroviral therapy controls but does not cure HIV-1 infection because a small fraction of cells harbor latent viruses that can produce rebound viremia when therapy is interrupted. The circulating latent virus reservoir has been documented by a variety of methods, most prominently by viral outgrowth assays (VOAs) in which CD4+ T cells are activated to produce virus in vitro, or more recently by amplifying proviral near full-length (NFL) sequences from DNA. Analysis of samples obtained in clinical studies in which individuals underwent analytical treatment interruption (ATI), showed little if any overlap between circulating latent viruses obtained from outgrowth cultures and rebound viruses from plasma. To determine whether intact proviruses amplified from DNA are more closely related to rebound viruses than those obtained from VOAs, we assayed 12 individuals who underwent ATI after infusion of a combination of two monoclonal anti-HIV-1 antibodies. A total of 435 intact proviruses obtained by NFL sequencing were compared with 650 latent viruses from VOAs and 246 plasma rebound viruses. Although, intact NFL and outgrowth culture sequences showed similar levels of stability and diversity with 39% overlap, the size of the reservoir estimated from NFL sequencing was larger than and did not correlate with VOAs. Finally, intact proviruses documented by NFL sequencing showed no sequence overlap with rebound viruses; however, they appear to contribute to recombinant viruses found in plasma during rebound.

Combination therapy with anti-HIV-1 antibodies maintains viral suppression.

Individuals infected with HIV-1 require lifelong antiretroviral therapy, because interruption of treatment leads to rapid rebound viraemia. Here we report on a phase 1b clinical trial in which a combination of 3BNC117 and 10-1074, two potent monoclonal anti-HIV-1 broadly neutralizing antibodies that target independent sites on the HIV-1 envelope spike, was administered during analytical treatment interruption. Participants received three infusions of 30 mg kg-1 of each antibody at 0, 3 and 6 weeks. Infusions of the two antibodies were generally well-tolerated. The nine enrolled individuals with antibody-sensitive latent viral reservoirs maintained suppression for between 15 and more than 30 weeks (median of 21 weeks), and none developed viruses that were resistant to both antibodies. We conclude that the combination of the anti-HIV-1 monoclonal antibodies 3BNC117 and 10-1074 can maintain long-term suppression in the absence of antiretroviral therapy in individuals with antibody-sensitive viral reservoirs.