Estimating the spatial amplification of damage caused by degradation in the Amazon.

The Amazon rainforests have been undergoing unprecedented levels of human-induced disturbances. In addition to local impacts, such changes are likely to cascade following the eastern-western atmospheric flow generated by trade winds. We propose a model of spatial and temporal interactions created by this flow to estimate the spread of effects from local disturbances to downwind locations along atmospheric trajectories. The spatial component captures cascading effects propagated by neighboring regions, while the temporal component captures the persistence of local disturbances. Importantly, all these network effects can be described by a single matrix, acting as a spatial multiplier that amplifies local forest disturbances. This matrix holds practical implications for policymakers as they can use it to easily map where the damage of an initial forest disturbance is amplified and propagated to. We identify regions that are likely to cause the largest impact throughout the basin and those that are the most vulnerable to shocks caused by remote deforestation. On average, the presence of cascading effects mediated by winds in the Amazon doubles the impact of an initial damage. However, there is heterogeneity in this impact. While damage in some regions does not propagate, in others, amplification can reach 250%. Since we only account for spillovers mediated by winds, our multiplier of 2 should be seen as a lower bound.

Advancing electrocatalytic reactions through mapping key intermediates to active sites via descriptors.

Descriptors play a crucial role in electrocatalysis as they can provide valuable insights into the electrochemical performance of energy conversion and storage processes. They allow for the understanding of different catalytic activities and enable the prediction of better catalysts without relying on the time-consuming trial-and-error approaches. Hence, this comprehensive review focuses on highlighting the significant advancements in commonly used descriptors for critical electrocatalytic reactions. First, the fundamental reaction processes and key intermediates involved in several electrocatalytic reactions are summarized. Subsequently, three types of descriptors are classified and introduced based on different reactions and catalysts. These include d-band center descriptors, readily accessible intrinsic property descriptors, and spin-related descriptors, all of which contribute to a profound understanding of catalytic behavior. Furthermore, multi-type descriptors that collectively determine the catalytic performance are also summarized. Finally, we discuss the future of descriptors, envisioning their potential to integrate multiple factors, broaden application scopes, and synergize with artificial intelligence for more efficient catalyst design and discovery.

Clearing Up Discrepancies in 2D and 3D Nickel Molybdate Hydrate Structures.

When electrocatalysts are prepared, modification of the morphology is a common strategy to enhance their electrocatalytic performance. In this work, we have examined and characterized nanorods (3D) and nanosheets (2D) of nickel molybdate hydrates, which previously have been treated as the same material with just a variation in morphology. We thoroughly investigated the materials and report that they contain fundamentally different compounds with different crystal structures, chemical compositions, and chemical stabilities. The 3D nanorod structure exhibits the chemical formula NiMoO4·0.6H2O and crystallizes in a triclinic system, whereas the 2D nanosheet structures can be rationalized with Ni3MoO5-0.5x(OH)x·(2.3 - 0.5x)H2O, with a mixed valence of both Ni and Mo, which enables a layered crystal structure. The difference in structure and composition is supported by X-ray photoelectron spectroscopy, ion beam analysis, thermogravimetric analysis, X-ray diffraction, electron diffraction, infrared spectroscopy, Raman spectroscopy, and magnetic measurements. The previously proposed crystal structure for the nickel molybdate hydrate nanorods from the literature needs to be reconsidered and is here refined by ab initio molecular dynamics on a quantum mechanical level using density functional theory calculations to reproduce the experimental findings. Because the material is frequently studied as an electrocatalyst or catalyst precursor and both structures can appear in the same synthesis, a clear distinction between the two compounds is necessary to assess the underlying structure-to-function relationship and targeted electrocatalytic properties.

Exploring the Feasibility of a Cancer Awareness Program for High School Students in a Brazilian School: A Pilot Study.

Cancer is a leading cause of mortality globally and is projected to be the primary cause of death in Brazil by 2030. Yet, for high school students, information and understanding about cancer are primarily offered through standard biology lessons. This study aimed to assess the feasibility of a brief educational intervention related to cancer among high school students in a Brazilian private school. Participants attended a 1-h online session regarding different aspects of cancer. A self-reported questionnaire about the main topics addressed in the session was filled out before [pre] and after [post] the educational intervention and the results were compared by McNemar's chi-square test. From 900 parents invited, 44 (4.9%) responded to the invitation and agreed with their children's participation, and 24 students attended the activity. The questionnaire was easy to fill out for the students and allowed us to measure differences after the educational intervention. The high school students considered the most interesting topics cancer myths and protective/risk factors. The project was feasible and showed easy application and better knowledge after the educational intervention. The main challenge is related to the access to parents to authorize their children's participation. Designing interventions that focus on cancer education might be a viable way to increase prevention and early diagnosis with implications for students, their families, and the community.

Essential oils and capsaicin in the diet of Jersey cows at early lactation and their positive impact on anti-inflammatory, antioxidant and immunological responses.

The objective of this work was to determine whether the addition of phytogenic compounds based on essential oils (carvacrol, eugenol, cinnamaldehyde) and resinous pepper oil (capsaicin) to the diet of Jersey cows at the beginning of lactation affects anti-inflammatory, antioxidant and immunomodulatory responses, as well as whether there are effects of EO on blood metabolites, ruminal fermentation, digestibility and milk production and composition. Six primiparous cows (370.00 ± 17 kg body weight (BW); 13.02 kg dry matter intake (DMI); 21 days of lactation and average milk production of 20 ± 2 L per day) were allocated to crossed experimental design (2 × 2) with two experimental periods of 28 days and two treatments. Blood, milk and rumen fluid were collected and, at the end of each period, feed and feces samples were collected to evaluate the apparent digestibility of nutrients. The groups were control (CLT) without supplementation and treated (BEO) with the addition of 150 mg/kg of dry matter of the phytogenic to the concentrated portion of the diet. Cows in the BEO group had lower numbers of leukocytes (P ≤ 0.05) and lymphocytes (P ≤ 0.02), but total protein and globulin levels were higher on days 21 and 28 (P ≤ 0.01). In the BEO group, the levels of immunoglobulin A, immunoglobulin heavy chain and transferrin were higher (P ≤ 0.05). The levels of ceruloplasmin, haptoglobin and C-reactive protein were lower in the BEO group (P ≤ 0.05). Lipid peroxidation levels and protein carbonyl content were lower in the BEO group. The total antioxidant capacity (P ≤ 0.09) and the activity of glutathione S-transferase (P ≤ 0.03) and glutathione peroxidase (P ≤ 0.05) were higher in the BEO group. Cows in the BEO group had lower pH (P ≤ 0.05), acetic acid concentrations (P ≤ 0.01) and higher protozoa counts (P ≤ 0.01). Our results suggest that phytogenic supplementation has positive effects on the health of Jersey cows in early lactation, characterized by immunostimulant, antioxidant and anti-inflammatory effects.

Environmental concerns and bioaccumulation of psychiatric drugs in water bodies - Conventional versus biocatalytic systems of mitigation.

The COVID-19 pandemic has brought increments in market sales and prescription of medicines commonly used to treat mental health disorders, such as depression, anxiety, stress, and related problems. The increasing use of these drugs, named psychiatric drugs, has led to their persistence in aquatic systems (bioaccumulation), since they are recalcitrant to conventional physical and chemical treatments typically used in wastewater treatment plants. An emerging environmental concern caused by the bioaccumulation of psychiatric drugs has been attributed to the potential ecological and toxicological risk that these medicines might have over human health, animals, and plants. Thus, by the application of biocatalysis-assisted techniques, it is possible to efficiently remove psychiatric drugs from water. Biocatalysis, is a widely employed and highly efficient process implemented in the biotransformation of a wide range of contaminants, since it has important differences in terms of catalytic behavior, compared to common treatment techniques, including photodegradation, Fenton, and thermal treatments, among others. Moreover, it is noticed the importance to monitor transformation products of degradation and biodegradation, since according to the applied removal technique, different toxic transformation products have been reported to appear after the application of physical and chemical procedures. In addition, this work deals with the discussion of differences existing between high- and low-income countries, according to their environmental regulations regarding waste management policies, especially waste of the drug industry.

Individual and combined toxicity of imidacloprid and two seed dressing insecticides on collembolans Folsomia candida.

The aim of this study was to examine the chronic toxicity of imidacloprid (IMI), clothianidin (CLO) and fipronil (FIP) as a single exposure, as well as binary mixtures of IMI with CLO or FIP toward collembolans Folsomia candida, which are fauna present in the soil. Chronic toxicity assays were performed following an ISO guideline in a Tropical Artificial Soil (TAS), and the influence on the number and growth of the juveniles produced were determined. The range of nominal concentrations used in the tests with the individual compounds was 0.08-1.28 mg/kg (IMI), 0.079-1.264 mg/kg (FIP) and 0.007-0.112 mg/kg (CLO), whereas the mixture assays were performed with half the value used in the tests with individual compounds. Based upon single exposures, IMI produced a similar impact of reducing reproduction by 50% (EC50 ranging from 0.74 to 0.85 mg/kg) compared to FIP (EC50 = 0.78 mg/kg), whereas CLO was the most toxic to F. candida (EC50 = 0.08 mg/kg). Their mixtures generally resulted in a diminished effect on reproduction, as evidenced by the higher EC50 values. In contrast, in the case of the IMI+FIP combination at high concentrations at the EC50 level, a synergistic effect on toxicity was observed. The single exposure to the three insecticides and the mixture of IMI-FIP also decreased the size of generated juveniles, which was evidenced by the reduction in the proportion of large juveniles and increased proportion of small juveniles. However, both binary mixtures (IMI-FIP and IMI-CLO) presented antagonistic effects as evidenced by less than expected reductions in growth. Data on the toxic effects of IMI in a mixture with other seed dressing insecticides to collembolans provides useful information to environmental risk assessors by diminishing the uncertainties on the ecological risk of exposure to pesticides, enabling soil management degradation by utilizing multiple insecticides.

Suicidal Behavior and Early Maladaptive Schemas and Schema Domains.

ABSTRACT: Suicidal behavior is a risk factor for suicide attempts. Identifying the factors that increase suicidal behavior risk is paramount for overall suicide prevention efforts. One model that may contribute to our understanding of the relationship between early life experiences and suicidal behavior is the schema theory. This study aimed to examine suicidal behavior, early maladaptive schemas (EMSs), and schema domains using a large Brazilian nonclinical sample. The study included 19,060 individuals. We assessed sociodemographic variables, suicidal behavior (Suicidal Behavior Questionnaire), and EMSs (Young Schema Questionnaire) using an online, Web-based survey. Our results showed that, when comparing participants with no ideation with those with serious suicide attempts, we found significant statistical differences in all EMSs (all p 's < 0.05), with higher scores in those with serious suicide attempts. Our results suggest that specific unmet emotional needs during childhood can affect mental health and result in serious suicide attempts in adulthood.

Microalgae-Based Biotechnology as Alternative Biofertilizers for Soil Enhancement and Carbon Footprint Reduction: Advantages and Implications.

Due to the constant growth of the human population and anthropological activity, it has become necessary to use sustainable and affordable technologies that satisfy the current and future demand for agricultural products. Since the nutrients available to plants in the soil are limited and the need to increase the yields of the crops is desirable, the use of chemical (inorganic or NPK) fertilizers has been widespread over the last decades, causing a nutrient shortage due to their misuse and exploitation, and because of the uncontrolled use of these products, there has been a latent environmental and health problem globally. For this reason, green biotechnology based on the use of microalgae biomass is proposed as a sustainable alternative for development and use as soil improvers for crop cultivation and phytoremediation. This review explores the long-term risks of using chemical fertilizers for both human health (cancer and hypoxia) and the environment (eutrophication and erosion), as well as the potential of microalgae biomass to substitute current fertilizer using different treatments on the biomass and their application methods for the implementation on the soil; additionally, the biomass can be a source of carbon mitigation and wastewater treatment in agro-industrial processes.

Low Quality of Life, Falls, and Pre-Frailty are Associated with Depressive Symptoms in Virologically Suppressed PLWHIV in Salvador, Brazil.

Depression is the leading cause of years lived with disability worldwide and PLWHIV present a higher risk of developing depressive symptoms. We aimed to evaluate depressive symptoms and their predictors in virologically suppressed PLWHIV. We conducted a cross-sectional study with 200 PLWHIV. Depressive symptoms were defined as scoring ≥ 14 points in the Beck Depression Inventory II. Most of the participants (58.5%) were men, with a median age of 54 years (IQR: 46.25-59.00). Depressive symptoms' prevalence was 19.5% and they were associated with being divorced/widowed (aOR: 2.93, CI 95%: 1.17-7.37), recurrent falls (aOR: 4.24, CI 95%: 1.07-16.85), pre-frailty (aOR: 3.55, CI 95%: 1.47-8.57), and lower scores in all HRQoL dimensions. Although virologically suppressed PLWHIV presented lower prevalence of depressive symptoms than reported in previous studies in Brazil and South America, they were associated with falls and frailty, highlighting the need for screening.

RESUMEN: La depresión es la principal causa de años vividos con discapacidad en todo el mundo y las PVVIH presentan un mayor riesgo de desarrollar síntomas depresivos. Nuestro objetivo fue evaluar los síntomas depresivos y sus predictores en PVVIH que tienen supresión viral. Fue realizado un estudio de corte transversal incluyendo 200 PVVIH. La presencia de síntomas depresivos fue definida con una puntuación ≥ 14 puntos en el Inventario de Depresión de Beck II. La mayoría de los participantes (58.5%) fueron hombres, la mediana de edad fue de 54 años (RIQ: 46.25­59.00), y la prevalencia de síntomas depresivos fue de 19.5%. La depresión estuvo asociada con ser divorciado/viudo (ORa: 2.93, IC 95%: 1.17­7.37), caídas recurrentes (ORa: 4.24, IC 95%: 1.07­16.85) y prefragilidad (ORa: 3.55, IC 95%: 1.47­8.57). Los pacientes con síntomas depresivos tuvieron puntuaciones más bajas en todas las dimensiones de la escala de calidad de vida. Aunque encontramos una baja prevalencia de síntomas depresivos en PVVIH con supresión virológica en comparación con estudios previos en Brasil y Sudamérica, los factores asociados resaltan la importancia de la identificación temprana de caídas y fragilidad en esta población.

Revalorization of Microalgae Biomass for Synergistic Interaction and Sustainable Applications: Bioplastic Generation.

Microalgae and cyanobacteria are photosynthetic microorganisms' sources of renewable biomass that can be used for bioplastic production. These microorganisms have high growth rates, and contrary to other feedstocks, such as land crops, they do not require arable land. In addition, they can be used as feedstock for bioplastic production while not competing with food sources (e.g., corn, wheat, and soy protein). In this study, we review the macromolecules from microalgae and cyanobacteria that can serve for the production of bioplastics, including starch and glycogen, polyhydroxyalkanoates (PHAs), cellulose, polylactic acid (PLA), and triacylglycerols (TAGs). In addition, we focus on the cultivation of microalgae and cyanobacteria for wastewater treatment. This approach would allow reducing nutrient supply for biomass production while treating wastewater. Thus, the combination of wastewater treatment and the production of biomass that can serve as feedstock for bioplastic production is discussed. The comprehensive information provided in this communication would expand the scope of interdisciplinary and translational research.

Correlating blast vibrations and geomechanical properties to determine damage profiles and improve wall conditions in open pit mining.

Slope stability is one of the biggest concerns for mining practices and to consider the rock mass response over blasting is fundamental to achieve pit geometry. This study consists in developing a methodology which connects the dynamic behavior of one lithological domain to blast designs applied at a copper mine. The central element of this study was the construction of vibration attenuation and seed wave model which, in conjunction with geomechanical properties, has allowed the characterization of this particular rock mass and the vibration attenuation phenomena. The new blast design was developed from the model simulations, once it was possible to recognize which parameters of the blast design affect most of the damage induced by blasting. To guarantee model representativeness, two blast tests were conducted: one with the usual blast design and another using the new one. Furthermore, holes were drilled behind the blasts, which were inspected before and after each blast to compare the produced fracturing with the fracturing expected by the model. The results obtained in these blast tests show a strong correlation between the modeled and the real. The modeling proved to be a useful tool providing manners to stablish a blast design, which generates stable walls.

Encapsulated nitrate replacing soybean meal in diets with and without monensin on in vitro ruminal fermentation.

This study assessed the association between encapsulated nitrate product (ENP) and monensin (MON) to mitigate enteric methane (CH4) in vitro and possible effects on ruminal degradability, enteric fermentation characteristics, and microbial populations. Six treatments were used in randomized complete design in a 2×3 factorial arrangement with two levels of MON (0 and 2.08 mg/mL of buffered rumen fluid) and three levels of ENP (0, 1.5 and 3.0%). The substrate consisted of 50% Tifton-85 hay and 50% concentrate mixture (ground corn and soybean meal). ENP replaced soybean meal to achieve isonitrogenous diets (15% CP). No ENP×MON interaction was observed for any measured variable (P > 0.05) except for the relative abundance of F. succinogenes (P = 0.02) that linearly increased in diets with MON when ENP was added. The ENP addition decreased CH4 production (P < 0.01) without affecting (P > 0.05) truly degraded organic matter nor the relative abundance of methanogens. Hydrogen production was reduced with MON (P = 0.04) and linearly decreased with ENP inclusion (P = 0.02). We concluded that use of nitrate is a viable strategy for CH4 reduction, however, no additive effect of ENP and MON was observed for mitigating CH4 production.

Effects of UV and UV-vis Irradiation on the Production of Microalgae and Macroalgae: New Alternatives to Produce Photobioprotectors and Biomedical Compounds.

In the last decade, algae applications have generated considerable interest among research organizations and industrial sectors. Bioactive compounds, such as carotenoids, and Mycosporine-like amino acids (MAAs) derived from microalgae may play a vital role in the bio and non-bio sectors. Currently, commercial sunscreens contain chemicals such as oxybenzone and octinoxate, which have harmful effects on the environment and human health; while microalgae-based sunscreens emerge as an eco-friendly alternative to provide photo protector agents against solar radiation. Algae-based exploration ranges from staple foods to pharmaceuticals, cosmetics, and biomedical applications. This review aims to identify the effects of UV and UV-vis irradiation on the production of microalgae bioactive compounds through the assistance of different techniques and extraction methods for biomass characterization. The efficiency and results focus on the production of a blocking agent that does not damage the aquifer, being beneficial for health and possible biomedical applications.

Fungal Proteins from Sargassum spp. Using Solid-State Fermentation as a Green Bioprocess Strategy.

The development of green technologies and bioprocesses such as solid-state fermentation (SSF) is important for the processing of macroalgae biomass and to reduce the negative effect of Sargassum spp. on marine ecosystems, as well as the production of compounds with high added value such as fungal proteins. In the present study, Sargassum spp. biomass was subjected to hydrothermal pretreatments at different operating temperatures (150, 170, and 190 °C) and pressures (3.75, 6.91, and 11.54 bar) for 50 min, obtaining a glucan-rich substrate (17.99, 23.86, and 25.38 g/100 g d.w., respectively). The results indicate that Sargassum pretreated at a pretreatment temperature of 170 °C was suitable for fungal growth. SSF was performed in packed-bed bioreactors, obtaining the highest protein content at 96 h (6.6%) and the lowest content at 72 h (4.6%). In contrast, it was observed that the production of fungal proteins is related to the concentration of sugars. Furthermore, fermentation results in a reduction in antinutritional elements, such as heavy metals (As, Cd, Pb, Hg, and Sn), and there is a decrease in ash content during fermentation kinetics. Finally, this work shows that Aspergillus oryzae can assimilate nutrients found in the pretreated Sargassum spp. to produce fungal proteins as a strategy for the food industry.

Recent Advances in Prodigiosin as a Bioactive Compound in Nanocomposite Applications.

Bionanocomposites based on natural bioactive entities have gained importance due to their abundance; renewable and environmentally benign nature; and outstanding properties with applied perspective. Additionally, their formulation with biological molecules with antimicrobial, antioxidant, and anticancer activities has been produced nowadays. The present review details the state of the art and the importance of this pyrrolic compound produced by microorganisms, with interest towards Serratia marcescens, including production strategies at a laboratory level and scale-up to bioreactors. Promising results of its biological activity have been reported to date, and the advances and applications in bionanocomposites are the most recent strategy to potentiate and to obtain new carriers for the transport and controlled release of prodigiosin. Prodigiosin, a bioactive secondary metabolite, produced by Serratia marcescens, is an effective proapoptotic agent against bacterial and fungal strains as well as cancer cell lines. Furthermore, this molecule presents antioxidant activity, which makes it ideal for treating wounds and promoting the general improvement of the immune system. Likewise, some of the characteristics of prodigiosin, such as hydrophobicity, limit its use for medical and biotechnological applications; however, this can be overcome by using it as a component of a bionanocomposite. This review focuses on the chemistry and the structure of the bionanocomposites currently developed using biorenewable resources. Moreover, the work illuminates recent developments in pyrrole-based bionanocomposites, with special insight to its application in the medical area.

Trace metal dynamics in an industrialized Brazilian river: A combined application of Zn isotopes, geochemical partitioning, and multivariate statistics.

The Paraiba do Sul (PSR) and Guandu Rivers (GR) water diversion system (120 km long) is located in the main industrial pole of Brazil and supplies drinking water for 9.4 million people in the metropolitan region of Rio de Janeiro. This study aims to discern the trace metals dynamics in this complex aquatic system. We used a combined approach of geochemical tools such as geochemical partitioning, Zn isotopes signatures, and multivariate statistics. Zinc and Pb concentrations in Suspended Particulate Matter (SPM) and sediments were considerably higher in some sites. The sediment partition of As, Cr, and Cu revealed the residual fraction (F4) as the main fraction for these elements, indicating low mobility. Zinc and Pb were mostly associated with the exchangeable/carbonate (F1) and the reducible (F2) fractions, respectively, implying a higher susceptibility of these elements to being released from sediments. Zinc isotopic compositions of sediments and SPM fell in a binary mixing source process between lithogenic (δ66/64ZnJMC ≈ + 0.30‰) and anthropogenic (δ66/64ZnJMC ≈ + 0.15‰) end members. The lighter δ66/64ZnJMC values accompanied by high Zn concentrations in exchangeable/carbonate fraction (ZnF1) enable the tracking of Zn anthropogenic sources in the studied rivers. Overall, the results indicated that Hg, Pb, and Zn had a dominant anthropogenic origin linked to the industrial activities, while As, Cr, and Cu were mainly associated with lithogenic sources. This work demonstrates how integrating geochemical tools is valuable for assessing geochemical processes and mixing source effects in anthropized river watersheds.

Impact of quadrivalent influenza vaccines in Brazil: a cost-effectiveness analysis using an influenza transmission model.

BACKGROUND: Influenza epidemics significantly weight on the Brazilian healthcare system and its society. Public health authorities have progressively expanded recommendations for vaccination against influenza, particularly to the pediatric population. However, the potential mismatch between the trivalent influenza vaccine (TIV) strains and those circulating during the season remains an issue. Quadrivalent vaccines improves vaccines effectiveness by preventing any potential mismatch on influenza B lineages. METHODS: We evaluate the public health and economic benefits of the switch from TIV to QIV for the pediatric influenza recommendation (6mo-5yo) by using a dynamic epidemiological model able to consider the indirect impact of vaccination. Results of the epidemiological model are then imputed in a health-economic model adapted to the Brazilian context. We perform deterministic and probabilistic sensitivity analysis to account for both epidemiological and economical sources of uncertainty. RESULTS: Our results show that switching from TIV to QIV in the Brazilian pediatric population would prevent 406,600 symptomatic cases, 11,300 hospitalizations and almost 400 deaths by influenza season. This strategy would save 3400 life-years yearly for an incremental direct cost of R$169 million per year, down to R$86 million from a societal perspective. Incremental cost-effectiveness ratios for the switch would be R$49,700 per life-year saved and R$26,800 per quality-adjusted life-year gained from a public payer perspective, and even more cost-effective from a societal perspective. Our results are qualitatively similar in our sensitivity analysis. CONCLUSIONS: Our analysis shows that switching from TIV to QIV to protect children aged 6mo to 5yo in the Brazilian influenza epidemiological context could have a strong public health impact and represent a cost-effective strategy from a public payer perspective, and a highly cost-effective one from a societal perspective.

Effects of Water-Circulating Cooling Mask on Postoperative Outcomes in Orthognathic Surgery and Facial Trauma.

The purpose of this study was to perform a systematic review and meta-analysis of randomized clinical trials (RCTs) investigating the efficacy of hilotherapy on postoperative pain, swelling, neurosensory impairment and patient satisfaction. The authors analyzed RCTs comparing the use of hilotherapy versus conventional cryotherapy or no cold treatment for orthognathic surgery and repair of facial trauma. The authors assessed the risk of bias and strength of evidence according to the Cochrane guidelines and GRADE rating system, respectively. Treatment effects were defined as weighted or standardized mean difference using the inverse variance method. Five RCTs were included. Postoperative pain and swelling in patients using hilotherapy were lower comparing to the control group in the postoperative day 2 (Pain: MD -1.75, CI 95% -2.69 to -0.81; Swelling: MD -21.16 mL, CI 95% -38.91 to -3.41) and in the final evaluation (Pain: MD -0.31, CI 95% -0.44 to -0.18; MD -4.45 mL, CI 95% -7.87 to -1.03). Patients reported higher satisfaction with hilotherapy, but no differences were found for neurosensory impairment. Current evidence suggests that hilotherapy is effective in reducing postoperative pain and swelling in orthognathic surgery and repair of facial fractures and may lead to improvements in patient satisfaction in the recovery phase.

Migration and surgical retrieval of a broken dental needle: a literature review and case report.

Although the incidence of broken needles in dental practice is minimal, needle breakage can occur as a result of manufacturing defects, inadequate patient management, or poor practitioner technique. Retrieval of a broken needle is justified not only because of the potential for needle migration but also because of psychological and medicolegal considerations. This case report describes the surgical removal of a dental needle that fractured during an attempt at local anesthesia. Identifying the precise location of the broken needle fragment and its relationship with the surrounding bones, vessels, and nerves is essential to designing an adequate treatment plan. If surgical retrieval is indicated, it should be performed immediately, especially in cases in which the needle fragment has not been bent or deformed. In the present case, the use of C-arm fluoroscopy aided the surgical removal while saving time and reducing the cost of treatment.