A Global Systematic Literature Review of Ecosystem Services in Reef Environments.

Ecosystem services (ES) embrace contributions of nature to human livelihood and well-being. Reef environments provide a range of ES with direct and indirect contributions to people. However, the health of reef environments is declining globally due to local and large-scale threats, affecting ES delivery in different ways. Mapping scientific knowledge and identifying research gaps on reefs' ES is critical to guide their management and conservation. We conducted a systematic assessment of peer-reviewed articles published between 2007 and 2022 to build an overview of ES research on reef environments. We analyzed the geographical distribution, reef types, approaches used to assess ES, and the potential drivers of change in ES delivery reported across these studies. Based on 115 articles, our results revealed that coral and oyster reefs are the most studied reef ecosystems. Cultural ES (e.g., subcategories recreation and tourism) was the most studied ES in high-income countries, while regulating and maintenance ES (e.g., subcategory life cycle maintenance) prevailed in low and middle-income countries. Research efforts on reef ES are biased toward the Global North, mainly North America and Oceania. Studies predominantly used observational approaches to assess ES, with a marked increase in the number of studies using statistical modeling during 2021 and 2022. The scale of studies was mostly local and regional, and the studies addressed mainly one or two subcategories of reefs' ES. Overexploitation, reef degradation, and pollution were the most commonly cited drivers affecting the delivery of provisioning, regulating and maintenance, and cultural ES. With increasing threats to reef environments, the growing demand for assessing the contributions to humans provided by reefs will benefit the projections on how these ES will be impacted by anthropogenic pressures. The incorporation of multiple and synergistic ecosystem mechanisms is paramount to providing a comprehensive ES assessment, and improving the understanding of functions, services, and benefits.

Impact of substage and histologic type in stage I ovarian carcinoma survival: a multicenter retrospective observational study.

OBJECTIVE: This international study aimed to investigate the impact of substage, histological type and other prognostic factors on long-term survival for stage I ovarian carcinoma. METHODS: Our study was a retrospective multicenter cohort study that included patients with the International Federation of Gynecology and Obstetrics (FIGO) stage I (IA-IC3) ovarian carcinoma treated at four European referral centers in Germany and Italy. Using Kaplan-Meier survival curves we compared overall and disease-free survival between the different stage I groups. RESULTS: A total of 1115 patients were included. Of these, 48.4% (n=540) were in stage IA, 6.6% (n=73) stage IB, and 45% (n=502) stage IC, of the latter substage IC1, 54% (n=271), substage IC2, 31.5% (n=158), and substage IC3, 14.5% (n=73). Five-year overall and disease-free survival rates for the entire cohort were 94% and 86%, respectively, with no difference between stage IA and IB. However, there was a significantly better overall and disease-free survival for stage IA as compared with stage IC (p=0.007 and p<0.001, respectively). Multivariate analysis revealed incomplete/fertility-sparing staging (HR 1.95; 95% CI 1.27 to 2.99, and HR 3.54; 95% CI 1.83 to 6.86, respectively), and stage IC (HR 2.47; 95% CI 1.63 to 3.75) as independent risk factors for inferior disease-free survival, while low-grade endometrioid (HR 0.42; 95% CI 0.25 to 0.72) and low-grade mucinous (HR 0.17; 95% CI 0.06 to 0.44) histology had superior disease-free survival. Considering overall survival, stage IC (HR 2.41; 95% CI 1.45 to 4.01) and older age (HR 2.41; 95% CI 1.46 to 3.95) were independent risk factors. CONCLUSION: Although stage I ovarian carcinoma exhibited excellent outcomes, the prognosis of patients with stage IA differs significantly compared with stage IC. Sub-optimal staging as an indicator for quality of care, and tumor biology defined by histology (low-grade endometrioid/mucinous) independently impact disease-free survival.

Anatomical distribution of sentinel lymph nodes in patients with endometrial cancer: a multicenter study.

OBJECTIVE: Sentinel lymph node (SLN) mapping represents the standard approach in uterine confined endometrial cancer patients. The aim of this study was to evaluate the anatomical distribution of SLNs and the most frequent locations of nodal metastasis. METHODS: This was an observational retrospective multicenter study involving eight high volume gynecologic cancer centers in Italy. We reviewed 1576 patients with a histologically confirmed diagnosis of endometrial cancer from September 2015 to June 2020. All patients underwent total hysterectomy with salpingo-ophorectomy and SLN mapping. RESULTS: A total of 3105 SLNs were mapped and removed, 2809 (90.5%) of these were bilateral and 296 (9.5%) unilateral. The overall detection rate was 93.4% (77.9% bilateral and 15.5% unilateral). The majority of SLNs (80%) and positive SLNs (77.8%) were found at the external iliac and obturator level in both endometrioid and non-endometrioid endometrial cancer. Negative SLNs were more frequent in patients with endometrioid compared with non-endometrioid cancer (91.9% vs 86.1%, p<0.0001). Older patients, a higher body mass index, and non-endometrioid histology were more likely to have 'no mapping' (p<0.0001). Univariate and multivariate analysis showed that higher body mass index and age at surgery were independent predictive factors of empty node packet and fat tissue (p=0.029 and p<0.01, respectively). CONCLUSION: The most frequent sites of SLNs and metastases were located in the pelvic area below the iliac vessel bifurcation. Our findings showed that older age, a higher body mass index, and non-endometrioid histology had a negative impact on mapping.

Is there any therapeutic role of pelvic and para-aortic lymphadenectomy in apparent early stage epithelial ovarian cancer?

OBJECTIVE: The therapeutic role of pelvic and para-aortic lymphadenectomy in surgical staging of apparent early-stage epithelial ovarian cancer (eEOC) is still under debate. The aim of this study was to evaluate the potential therapeutic role of systematic lymphadenectomy in patients with eEOC. METHODS: Multi-center retrospective cohort study, comparing women with apparent eEOC who underwent comprehensive bilateral pelvic and para-aortic lymphadenectomy (defined as ≥20 lymph nodes) versus patients receiving no lymphadenectomy or lymph node sampling, from 05/1985 to 12/2016. Patients with bulky nodes at CT-scan and those without complete intra-peritoneal surgical staging were excluded. Only patients who received at least 3 cycles of platinum-based adjuvant chemotherapy were included. RESULTS: Out of 2559 patients with FIGO stage IA-IIIA1 ovarian cancer, 639 (25.0%) met inclusion criteria. 360 (56.3%) underwent comprehensive lymphadenectomy, 150 (23.5%) lymph node sampling and 129 (20.2%) no lymphadenectomy. Patients who underwent comprehensive lymphadenectomy were younger (p < 0.001), experienced a higher number of severe post-operative complications (p = 0.008) and had a longer time to start chemotherapy (p = 0.034). There was no difference in intra-operative complications. Median follow-up was 63 months (range, 5-342). The 5-year disease-free survival (DFS) was 79.7% vs. 76.5% vs. 68.3% (p = 0.006), and 5-year overall survival (OS) was 92.3% vs. 94.5% vs. 89.8% (p = 0.165) in women who received comprehensive lymphadenectomy vs. lymph node sampling vs. no lymphadenectomy, respectively. Lymphadenectomy represented an independent factor for DFS improvement, HR 0.52 (95%CI 0.37-0.73) (p < 0.001). CONCLUSION: Pelvic and para-aortic lymphadenectomy in surgical staging of eEOC improves DFS for the price of increasing post-operative complications and time to chemotherapy but does not affect OS. Better understanding of tumor biology may help to identify those patients in whom lymphadenectomy should still play a role.

Sentinel node mapping vs. sentinel node mapping plus back-up lymphadenectomy in high-risk endometrial cancer patients: Results from a multi-institutional study.

OBJECTIVE: Sentinel node mapping (SLN) has replaced lymphadenectomy for staging surgery in apparent early-stage low and intermediate risk endometrial cancer (EC). Only limited data about the adoption of SNM in high risk EC is still available. Here, we evaluate the outcomes of high-risk EC undergoing SNM (with or without back-up lymphadenectomy). METHODS: This is a multi-institutional international retrospective study, evaluating data of high-risk (FIGO grade 3 endometrioid EC with myometrial invasion >50% and non-endometrioid histology) EC patients undergoing SNM followed by back-up lymphadenectomy and SNM alone. RESULTS: Chart of consecutive 196 patients were evaluated. The study population included 83 and 113 patients with endometrioid and non-endometrioid EC, respectively. SNM alone and SNM followed by back-up lymphadenectomy were performed in 50 and 146 patients, respectively. Among patients having SNM alone, 14 (28%) were diagnosed with nodal disease. In the group of patients undergoing SNM plus back-up lymphadenectomy 34 (23.2%) were diagnosed with nodal disease via SNM. Back-up lymphadenectomy identified 2 (1%) additional patients with nodal disease (in the para-aortic area). Back-up lymphadenectomy allowed to remove adjunctive positive nodes in 16 (11%) patients. After the adoption of propensity-matched algorithm, we observed that patients undergoing SNM plus back-up lymphadenectomy experienced similar disease-free survival (p = 0.416, log-rank test) and overall survival (p = 0.940, log-rank test) than patients undergoing SLN alone. CONCLUSIONS: Although the small sample size, and the retrospective study design this study highlighted that type of nodal assessment did not impact survival outcomes in high-risk EC. Theoretically, back-up lymphadenectomy would be useful in improving the removal of positive nodes, but its therapeutic value remains controversial. Further prospective evidence is needed.

Standard ultra-staging compared to one-step nucleic acid amplification for the detection of sentinel lymph node metastasis in endometrial cancer patients: a retrospective cohort comparison.

INTRODUCTION: The objective of this study was to compared standard ultra-staging (SU) with one-step nucleic acid amplification (OSNA) for the detection of sentinel lymph node (SLN) metastasis in women with apparent uterine-confined endometrial cancer. METHODS: All women underwent SLN identification with complete surgical staging. All SLNs were cut perpendicular to the long axis and two adjacent 5 µm sections were cut at each of two levels 50 µm apart. At each level, one slide was stained with hematoxylin and eosin and the other with immunohistochemistry using the AE1/AE3 anti-cytokeratin antibody, as well as one negative control slide for a total of five slides per block. For OSNA analysis, the 2 mm sections of the lymph nodes were homogenized to form a lysate. The lysate was then centrifuged and inserted into the RD 100i instrument where the isothermal amplification of CK19 mRNA was executed. RESULTS: Of the 396 patients included in the retrospective analysis, 214 were in the SU group, and 182 in the OSNA group. Overall 869 SLNs were identified (490 SU, 379 OSNA). Sixty patients exhibited SLN metastasis (34 SU, 26 OSNA). Macrometastasis, micrometastases, and isolated tumor cells (ITC) were 5.1%, 4.1%, and 0.2%, respectively, in the US group, and 2.4%, 6.3%, and 0.1%, respectively, in the OSNA group (p=0.022). CONCLUSIONS: The OSNA assay detected a higher rate of micrometastasis and a lower rate of macrometastasis and ITC when compared with SU. The clinical and prognostic impact of ITC is debatable and controversial. Further studies are needed to clarify the respective roles of the OSNA and SU methods, and the possible role of ITC in the prognosis of patients with apparent early-stage endometrial cancer.

Processing of metacaspase 2 from Trypanosoma brucei (TbMCA2) broadens its substrate specificity.

Metacaspases are members of the cysteine peptidase family and may be implicated in programmed cell death in plants and lower eukaryotes. These proteases exhibit calcium-dependent activity and specificity for arginine residues at P1. In contrast to caspases, they do not require processing or dimerization for activity. Indeed, unprocessed metacaspase-2 of Trypanosoma brucei (TbMCA2) is active; however, it has been shown that cleavages at Lys55 and Lys268 increase TbMCA2 hydrolytic activity on synthetic substrates. The processed TbMCA2 comprises 3 polypeptide chains that remain attached by non-covalent bonds. Replacement of Lys55 and Lys268 with Gly via site-directed mutagenesis results in non-processed but enzymatically active mutant, TbMCA2 K55/268G. To investigate the importance of this processing for the activity and specificity of TbMCA2, we performed activity assays comparing the non-processed mutant (TbMCA2 K55/268G) with the processed TbMCA2 form. Significant differences between TbMCA2 WT (processed form) and TbMCA2 K55/268G (non-processed form) were observed. Specifically, we verified that although non-processed TbMCA2 is active when assayed with small synthetic substrates, the TbMCA2 form does not exhibit hydrolytic activity on large substrates such as azocasein, while processed TbMCA2 is able to readily digest this protein. Such differences can be relevant for understanding the physiological regulation and function of TbMCA2.

Thermal tolerance as a driver of reef fish community structure at the isolated tropical Mid-Atlantic Ridge Islands.

Reef fish communities are shaped by historical and ecological factors, including abiotic and biotic mechanisms at different spatial scales, determining species composition, abundance and biomass. The oceanic islands in the Mid-Atlantic Ridge (St. Peter and St. Paul's Archipelago - SPSPA, Ascension, and St. Helena), exhibiting differences in community structure along a 14-degree latitudinal and a 10 °C thermal gradient. We investigate the influence of sea surface temperature, area, age, isolation and phosphate on reef fish community structures. Reef fish trophic structure varies significantly across the islands, with planktivores and herbivore-detritivores showing the highest abundances in SPSPA and Ascension, while less abundant in St. Helena, aligning with the thermal gradient. Variations in reef fish community structures were predominantly influenced by thermal regimes, corroborating the expansion of species' thermal niche breadth at higher latitudes and lower temperatures. This study highlights that in addition to biogeographic factors, temperature is pivotal on shaping oceanic island reef fish community structure.

TimeFISH: Long-term assessment of reef fish assemblages in a transition zone in the Southwestern Atlantic.

The TimeFISH database provides the first public time-series dataset on reef fish assemblages in the southwestern Atlantic (SWA), comprising 15 years of data (2007-2022) based on standardized Underwater Visual Censuses (UVCs). The rocky reefs covered by our dataset are influenced by pronounced seasonal cycles of ocean temperatures with warm tropical waters from the Brazil Current in the summer (~27°C) and colder waters from the La Plata River Plume discharge and upwelling from the South Atlantic Central Water in the winter (~18°C). These oceanographic conditions characterize this area as the southernmost tropical-subtropical climatic transition zone in the Atlantic Ocean. As a result, reef fish assemblages are comprised of both tropical and subtropical species. All records included in TimeFISH were collected using UVCs, a nondestructive method that allows the estimation of fish species richness, abundance, and body size distributions. UVCs were performed through 40 m2 belt transects by scuba diving in nine locations along the southern Brazilian coast (25-29°S). Four of these locations lie within the boundaries of the no-entry Arvoredo Marine Biological Reserve, where fishing and recreational activities are forbidden, and the remaining locations are unprotected from these activities. During each belt transect, a diver swam at a constant depth above and parallel to the reef, identifying fish species, counting the number of individuals, and estimating the total body length (Lt in cm) of all detected individuals. All fish individuals in the water column (up to 2 m above the substratum) and at the bottom were targeted. In total, 202,965 individuals belonging to 163 reef fish species and 53 families were recorded across 1857 UVCs. All survey campaigns were funded by either public or mixed capital (private-public) sources, including seven grants from the Brazilian federal and Santa Catarina state governments. Part of the data has already been used in multiple MS.c. and Ph.D. theses and scientific articles. TimeFISH represents an important contribution for future studies aiming to examine temporal and spatial variations of reef fish assemblages in transition zones. No copyright restrictions apply to the use of this data set, other than citing this publication.

Lymph node staging in grade 1-2 endometrioid ovarian carcinoma apparently confined to the ovary: Is it worth?

OBJECTIVE: The aim of this study was to assess the disease-free survival (DFS) and overall survival (OS) of patients with grade 1-2 endometrioid ovarian carcinoma apparently confined to the ovary, according to surgical staging. METHODS: Multicenter, retrospective, observational cohort study. Patients with endometrioid ovarian carcinoma, surgical procedure performed between May 1985 and December 2019, stage pT1 N0/N1/Nx, grade 1-2 were included. Patients were stratified according to lymphadenectomy (defined as removal of any lymph node versus no lymph node assessment), and subgroup analyses according to tumor grade were performed. Kaplan-Meier curves and cox regression analyses were used to perform survival analyses. RESULTS: 298 patients were included. 199 (66.8 %) patients underwent lymph node assessment. Of these, 166 (83.4 %) had unilateral/bilateral pelvic and para-aortic/caval lymphadenectomy. Eleven (5.5 %) patients of those who underwent lymph node assessment showed pathologic metastatic lymph nodes (FIGO stage IIIA1). Twenty-seven patients (9.1 %) had synchronous endometrioid endometrial cancer. After a median follow up of 45 months (95 %CI:37.5-52.5), 5-year DFS and OS of the entire cohort were 89.8 % and 96.2 %, respectively. Age ≤ 51 years (HR=0.24, 95 %CI:0.06-0.91; p = 0.036) and performance of lymphadenectomy (HR=0.25, 95 %CI: 0.07-0.82; p = 0.022) represented independent protective factors toward risk of death. Patients undergoing lymphadenectomy had better 5-year DFS and OS compared to those not receiving lymphadenectomy, 92.0 % versus 85.6 % (p = 0.016) and 97.7 % versus 92.8 % (p = 0.013), respectively. This result was confirmed after exclusion of node-positive patients. When stratifying according to tumor grade (node-positive excluded), patients with grade 2 who underwent lymphadenectomy had better 5-year DFS and OS than those without lymphadenectomy (93.0 % versus 83.1 %, p = 0.040 % and 96.5 % versus 90.6 %, p = 0.037, respectively). CONCLUSION: Staging lymphadenectomy in grade 2 endometrioid ovarian carcinoma patients was associated with improved DFS and OS. Grade 1 and grade 2 might be considered as two different entities, which could benefit from different approach in terms of surgical staging. Prospective studies, including molecular profiles are needed to confirm the survival drivers in this rare setting.

Low-Pressure Laparoscopy Using the AirSeal System versus Standard Insufflation in Early-Stage Endometrial Cancer: A Multicenter, Retrospective Study (ARIEL Study).

The aim of our study was to evaluate the benefits of a low-pressure insufflation system (AirSeal) vs. a standard insufflation system in terms of anesthesiologists' parameters and postoperative pain in patients undergoing laparoscopic surgery for early-stage endometrial cancer. This retrospective study involved five tertiary centers and included 152 patients with apparent early-stage disease who underwent laparoscopic surgical staging with either the low-pressure AirSeal system (8−10 mmHg, n = 84) or standard laparoscopic insufflation (10−12 mmHg, n = 68). All the intraoperative anesthesia variables evaluated (systolic blood pressure, end-tidal CO2, peak airway pressure) were significantly lower in the AirSeal group. We recorded a statistically significant difference between the two groups in the median NRS scores for global pain recorded at 4, 8, and 24 h, and for overall shoulder pain after surgery. Significantly more women in the AirSeal group were also discharged on day one compared to the standard group. All such results were confirmed when analyzing the subgroup of women with a BMI >30 kg/m2. In conclusion, according to our preliminary study, low-pressure laparoscopy represents a valid alternative to standard laparoscopy and could facilitate the development of outpatient surgery.

Childbirth experience and practice changing during COVID-19 pandemic: A cross-sectional study.

AIM: To evaluate mothers' satisfaction with childbirth experience in a cohort of women who delivered during COVID pandemia and to compare them to a pre-COVID cohort. DESIGN: We performed a cross-sectional study in a low-risk Maternity Unit. METHODS: Women who delivered during COVID-19 pandemic were compared to a pre-COVID cohort recruited in 2018 in the same setting. Italian version of the Birth Satisfaction Scale-Revised (I-BSS-R) was used. RESULTS: Three hundred and seventy-seven women were included (277 pre-COVID and 100 during COVID pandemic). No differences in terms of satisfaction at birth were reported (I-BSS-R mean 27.0, SD 5.3 versus mean 27.6, SD 6.1, p 0.34), despite an increased rate of active intrapartum interventions. Intrapartum variables that significantly reduced satisfaction were the same in the two groups: epidural analgesia (p < .0001 in both groups), prolonged active phases (p < .0001 in both), oxytocin administration (p < .0001 in both) and operative delivery (p 0.0009 versus p 0.0019).

Dose-dense Neoadjuvant Chemotherapy With Paclitaxel and Carboplatin in Cervical Cancer: Efficacy on Pathological Response.

BACKGROUND/AIM: The role of neoadjuvant chemotherapy (NACT) is under investigation in locally advanced cervical cancer (LACC). PATIENTS AND METHODS: A total of 49 patients with FIGO stage IB1-IIB cervical cancer who underwent two different regimens of weekly dose-dense NACT were included. The objective was to evaluate clinical/pathological response and toxicity profile. RESULTS: A clinical complete response and partial response were obtained in 43 patients with a clinical overall response rate of 88%. Among the 42 surgically treated patients, 7 (17%) and 35 (83%) achieved a pathological overall optimal response and a suboptimal pathological response, respectively. G3-G4 neutropenia occurred in 16% of patients, whereas no cases of G3 thrombocytopenia, G3 anemia and febrile neutropenia were observed. CONCLUSION: Dose-dense NACT is safe, has acceptable toxicity, and obtains good clinical response, but is less effective in terms of pathological overall optimal response rates compared to other regimens.

Life-history traits, geographical range, and conservation aspects of reef fishes from the Atlantic and Eastern Pacific.

Reef fish represent one of the most diverse vertebrate groups on Earth, with over 7,000 species distributed around the globe. This richness is not evenly distributed geographically. The Atlantic (AT) and the Eastern Pacific (EP) encompass 30% of the global fish fauna. These areas have been considered the most isolated from the marine biodiversity hotspot in the Indo-Pacific due to distinct physical barriers, such as the Tethyan closure and the distance between the EP and the western Pacific. Despite their comparatively lower species richness, these realms host unique fish assemblages characterized by a remarkable proportion of regional endemics and species with large body size. Here, we present the largest database of life-history traits and biogeographical and conservation aspects presently available for the reef fish fauna of the AT and the EP realms. The database includes 21 traits distributed into behavioral (home range, diel activity, group size, level in the water column, three measures of preferred temperature), morphological (maximum body size, size class, body shape, aspect ratio, caudal fin, mouth position), and ecological (trophic level, diet, spawning strategy, depth of occurrence, two allometric constants, pelagic larval duration, and life span), as well as biogeographical (geographic range index, range extension, species distribution in 20 marine provinces, latitude north and south of occurrence, total number of provinces where species occur, occurrence in the AT and EP), and conservation aspects (IUCN status, vulnerability and global market price). We compiled these data through a careful review of 104 local checklists published between 1982 and 2020, online repositories, local reports, books, and monographs on specific families or genera. We limited our database to localities situated between latitudes 51°N and 45°S that including shallow and upper mesophotic biogenic and/or rocky reefs habitats. Our database covers 2,198 species belonging to 146 families and 655 reef fish genera distributed in two marine realms (1,458 in the AT, 829 in the EP, and 89 in both realms) and 20 marine provinces. This database of reef fish offers the opportunity to explore novel ecological and evolutionary questions at different scales and provides tools for species conservation based on these traits. There are no copyright or proprietary restrictions for research or teaching purposes.

The impact of low-volume metastasis on disease-free survival of women with early-stage cervical cancer.

PURPOSE: We aimed to assess the impact of low-volume metastasis (micrometastasis and isolated tumor cells) on disease-free survival (DFS) of women with early-stage cervical cancer. METHODS: Women with clinically suspected stage 1A-IB2 (FIGO 2018 classification) disease who underwent retroperitoneal nodal staging between October 2010 and April 2018, were retrospectively analyzed. The group of women who had undergone lymphadenectomy and standard node pathologic analysis (H&E group), were compared to the group undergoing sentinel node mapping (SLN) and ultrastaging with or without lymphadenectomy (ultrastaging group). At a median follow-up of 45 months, the DFS curves were analyzed. RESULTS: Overall, 573 patients were revised (272 in the H&E group and 302 in the ultrastaging group). Eighty-five patients presented lymph node metastasis (32 in H&E, 53 in ultrastaging). Ultrastaging protocol increased the rate of low-volume metastasis by 5.6%. Twenty patients showed exclusive micrometastasis or ITC's. Seventy-three recurrences occurred (35 in H&E, 38 in ultrastaging). Only 1 out of 53 patients in the ultrastaging group (1.9%) presented with micrometastasis recurred. The 3-year disease-free survival was 89% for the H&E group, and 88% for the ultrastaging group, respectively (p = 0.175). CONCLUSION: Ultrastaging analysis allowed increasing the detection of low volume metastasis in women with early-stage cervical cancer. However, the type of nodal staging did not have an impact on patients' 3-year disease-free survival.

Hydroalcoholic Extract of Eugenia uniflora as Denture Disinfectant: Antimicrobial Activity and Effect on the Physical Properties of Polymethylmethacrylate

Abstract To the moment, there is no ideal substance for home-based denture disinfection. This study assessed in vitro the antimicrobial effect of the hydroalcoholic extract of Eugenia uniflora and the effect on the physical properties of denture polymethylmethacrylate (PMMA). Candida albicans, Staphylococcus aureus, and Klebsiella oxytoca were isolated from samples of saliva collected from denture wearers. The extracts were produced in three concentrations, according to the Brazilian Pharmacopeia. One hundred eighty-eight disc-shaped specimens of thermopolymerizable PMMA were prepared and randomly allocated to five treatment groups: sterile saline solution (0.85%; control); chlorhexidine digluconate (0.2%); and hydroalcoholic extract of E. uniflora (0.2%, 0.8%, and 1.16%). The specimens were disinfected for 8 hours/day for 30 days. Adherence of microorganisms to the surface, PMMA surface roughness, and color stability were assessed. Inferential statistics were performed with one- and two-way ANOVA/Tukey test, and Kruskal Wallis, Mann-Whitney U, and paired t-tests, at α=0.05. The extract of E. uniflora at 0.2% and 1.16% reduced the microbial load of K. oxytoca, while chlorhexidine digluconate significantly reduced microbial load of all microrganisms. Microbial adherence at day 10 was reduced by all experimental substances (p<0.001). Surface roughness was not affected by the disinfecting substances (p>0.05). Nevertheless, all experimental groups produced unacceptable color change at the end of the disinfection protocol (p<0.001). The non-adherent potential against microorganisms isolated from the oral cavity confirm the potential of use of the hydroalcoholic extract of E. uniflora as a denture disinfectant. Yet, unacceptable color changes may occur, regardless of extract concentration.

Denture disinfection using Salvia officinalis L: microbial load and selected properties of PMMA

Denture use may aggravate the occurrence of oral infections, considering it enhances microbial adherence. Aim: This study assessed the reduction of microbial loads of Candida albicans, Staphylococcus aureus, and Klebsiella oxytoca by disinfecting the polymethylmethacrylate (PMMA) of complete dentures with hydroalcoholic extract of Salvia officinalis. Additionally, the effect of such extract on the properties of PMMA was examined. Methods: Microorganisms were isolated from saliva samples collected from complete denture wearers. The hydroalcoholic extract of S. officinalis was produced according to the Brazilian Pharmacopoeia 5. The PMMA specimens (n=188) were immersed in microbial inoculum and incubated at 37°C for 16 hours per day. Then, they were subjected to a disinfection protocol for 30 days. The specimens were divided into five treatment groups: sterile saline solution (0.85%; control), 0.2% chlorhexidine digluconate, and hydroalcoholic extract of S. officinalis (0.2%, 0.8%, and 1.16%). Microorganism adherence to the PMMA surface was also assessed, as well as surface roughness (Ra in µm) and color stability of the PMMA (mean ΔE). Changes in microbial load and surface roughness after the disinfection protocol were verified with paired t-test. Substances at day 10, adherence, and color stability were compared by the Kruskall-Wallis and Mann-Whitney tests, and one-way ANOVA was used to compare substances at the beginning and end of the experiment (α=0.05). Results: The 1.16% S. officinalis extract significantly reduced the microbial load of all the microorganisms after 30 days of disinfection (p<0.05). The microbial load of K. oxytoca was also reduced at lower concentrations of the S. officinalis extract (0.2% and 0.8%) (p<0.02). Antimicrobial and anti-adherent effects against microorganisms isolated from the oral cavity were observed. There was no significant change in surface roughness (p>0.05) and color stability was significantly higher in the control group (p<0.0001). Conclusions: The hydroalcoholic extract of S. officinalis may be used as a disinfectant solution for dentures

Comparison: real and simulated ear insertion gain.

UNLABELLED: The development of hearing aid (HA) software programming does not replace the analysis of real ears with probe microphones. AIM: To compare simulated insertion gain in HA software programming and real ear insertion gain. METHOD: A prospective study of 62 patients (aged from 29 to 93 years; 30 male and 32 female). All patients presented unilateral (n=14) or bilateral (n=48) and mild to profound sensorineural hearing impairment. 110 ears assessed. Data was gathered from medical records and the insertion gain was obtained in real ears for comparison with the simulated insertion gain in HA software programming. Statistical tests were applied to analyze the correlation of data - difference of real ear and simulated insertion gain. RESULTS: HA software programming simulated insertion gain was higher than real ear insertion gain obtained with probe microphone measures. There were statistically significant frequency differences. Age did not correlate with the difference of real ear and simulated measures. CONCLUSION: The use of real ear measures is important during verification of HA.

Comparison: real and simulated ear insertion gain / Comparação: ganho de inserção obtido em orelha real e simulado

The development of hearing aid (HA) software programming does not replace the analysis of real ears with probe microphones. AIM: To compare simulated insertion gain in HA software programming and real ear insertion gain. METHOD: A prospective study of 62 patients (aged from 29 to 93 years; 30 male and 32 female). All patients presented unilateral (n=14) or bilateral (n=48) and mild to profound sensorineural hearing impairment. 110 ears assessed. Data was gathered from medical records and the insertion gain was obtained in real ears for comparison with the simulated insertion gain in HA software programming. Statistical tests were applied to analyze the correlation of data - difference of real ear and simulated insertion gain. RESULTS: HA software programming simulated insertion gain was higher than real ear insertion gain obtained with probe microphone measures. There were statistically significant frequency differences. Age did not correlate with the difference of real ear and simulated measures. CONCLUSION: The use of real ear measures is important during verification of HA.

Profissionais vêm utilizando as simulações dos softwares de programação de Aparelhos de Amplificação Sonora Individuais (AASI) em substituição à verificação do desempenho medido em ouvido real. OBJETIVO: Comparar o ganho de inserção simulado nos softwares de programação dos AASI com as medidas reais do ganho de inserção. MATERIAL E MÉTODO: Estudo retrospectivo com 62 pacientes (idade entre 29 e 93 anos; 30 homens e 32 mulheres) com deficiência auditiva neurossensorial unilateral (n=14) ou bilateral (n=48) de grau leve a profundo, totalizando 110 orelhas avaliadas. As simulações e medidas em ouvido real foram comparadas por meio do teste t pareado. Foi analisada a correlação entre a diferença do ganho real e o ganho simulado e a idade. RESULTADOS: O ganho simulado no software de programação foi significativamente maior do que o ganho de inserção real. Não houve correlação entre a idade e a diferença entre estas medidas. CONCLUSÃO: A despeito da maior sofisticação dos softwares de programação do AASI, os dados de simulação não substituem a realização da verificação com as medidas com microfone sonda.