Resmetirom for treatment of MASH.

Resmetirom is an oral selective THR-ß agonist conditionally approved for the treatment of patients with noncirrhotic MASH with moderate to advanced fibrosis. Resmetirom restores mitochondrial and hepatic metabolic function; reduces atherogenic lipids; improves hepatic steatosis, inflammation, and fibrosis; and has no significant effect on THR-α. To view this Bench to Bedside, open or download the PDF.

Integrative oncology: Addressing the global challenges of cancer prevention and treatment.

The increase in cancer incidence and mortality is challenging current cancer care delivery globally, disproportionally affecting low- and middle-income countries (LMICs) when it comes to receiving evidence-based cancer prevention, treatment, and palliative and survivorship care. Patients in LMICs often rely on traditional, complementary, and integrative medicine (TCIM) that is more familiar, less costly, and widely available. However, spheres of influence and tensions between conventional medicine and TCIM can further disrupt efforts in evidence-based cancer care. Integrative oncology provides a framework to research and integrate safe, effective TCIM alongside conventional cancer treatment and can help bridge health care gaps in delivering evidence-informed, patient-centered care. This growing field uses lifestyle modifications, mind and body therapies (eg, acupuncture, massage, meditation, and yoga), and natural products to improve symptom management and quality of life among patients with cancer. On the basis of this review of the global challenges of cancer control and the current status of integrative oncology, the authors recommend: 1) educating and integrating TCIM providers into the cancer control workforce to promote risk reduction and culturally salient healthy life styles; 2) developing and testing TCIM interventions to address cancer symptoms or treatment-related adverse effects (eg, pain, insomnia, fatigue); and 3) disseminating and implementing evidence-based TCIM interventions as part of comprehensive palliative and survivorship care so patients from all cultures can live with or beyond cancer with respect, dignity, and vitality. With conventional medicine and TCIM united under a cohesive framework, integrative oncology may provide citizens of the world with access to safe, effective, evidence-informed, and culturally sensitive cancer care.

Patterns of mosaicism for sequence and copy-number variants discovered through clinical deep sequencing of disease-related genes in one million individuals.

DNA variants that arise after conception can show mosaicism, varying in presence and extent among tissues. Mosaic variants have been reported in Mendelian diseases, but further investigation is necessary to broadly understand their incidence, transmission, and clinical impact. A mosaic pathogenic variant in a disease-related gene may cause an atypical phenotype in terms of severity, clinical features, or timing of disease onset. Using high-depth sequencing, we studied results from one million unrelated individuals referred for genetic testing for almost 1,900 disease-related genes. We observed 5,939 mosaic sequence or intragenic copy number variants distributed across 509 genes in nearly 5,700 individuals, constituting approximately 2% of molecular diagnoses in the cohort. Cancer-related genes had the most mosaic variants and showed age-specific enrichment, in part reflecting clonal hematopoiesis in older individuals. We also observed many mosaic variants in genes related to early-onset conditions. Additional mosaic variants were observed in genes analyzed for reproductive carrier screening or associated with dominant disorders with low penetrance, posing challenges for interpreting their clinical significance. When we controlled for the potential involvement of clonal hematopoiesis, most mosaic variants were enriched in younger individuals and were present at higher levels than in older individuals. Furthermore, individuals with mosaicism showed later disease onset or milder phenotypes than individuals with non-mosaic variants in the same genes. Collectively, the large compendium of variants, disease correlations, and age-specific results identified in this study expand our understanding of the implications of mosaic DNA variation for diagnosis and genetic counseling.

In situ interaction between the hormone 17α-ethynylestradiol and the liquid-ordered phase composed of the lipid rafts sphingomyelin and cholesterol.

Hormone treatments are frequently associated with cardiovascular diseases and cancers in women. Additionally, the detrimental effects of their presence as contaminants in water remain a concern. The transport of hormones through cell membranes is essential for their biological action, but investigating cell permeability is challenging owing to the experimental difficulty in dealing with whole cells. In this paper, we study the interaction of the synthetic hormone 17α-ethynylestradiol (EE2) with membrane models containing the key raft components sphingomyelin (SM) and cholesterol (Chol). The models consisted of Langmuir monolayers and giant unilamellar vesicles (GUVs) that represent bilayers. EE2 induced expansion of SM monolayers upon interacting with the non-hydrated amide group of SM head, but it had practically no effect on SM GUVs because these group are not available for interaction in bilayers. In contrast, EE2 interacted with hydrated phosphate group (PO2-) and amide group of SM/Chol mixture monolayer, which could explain the loss in phase contrast of liquid-ordered GUVs suggesting pore formation. A comparison with reported EE2 effects on GUVs in the fluid phase, for which no loss in phase contrast was observed, indicates that the liquid-ordered phase consisting of lipid rafts is relevant to be associated with the changes on cell permeability caused by the hormones.

Cytotoxic, antioxidant, and antiglycation activities, and tyrosinase inhibition using silver nanoparticles synthesized by leaf extract of Solanum aculeatissimum Jacq.

The present study aimed to determine the biological properties of an extract of Solanum aculeatissimum aqueous extract (SaCE) alone as well as silver nanoparticles (AgNPs) generated by green synthesis utilizing S. aculeatissimum aqueous extract (SaCE). These synthesized SaCE AgNPs were characterized using UV-VIS spectrophotometry, scanning transmission electron microscopy (TEM), energy dispersive spectroscopy (EDS), zeta potential (ZP), dynamic light scattering (DLS). Determination of total polyphenols, flavonoids, saponins content was conducted. In addition, high performance liquid chromatography-mass spectrometry (HPLC-MS) was employed to identify constituents in this extract. Antioxidant activity was determined by DPPH radical scavenging and ferric ion reducing power (FRAP) methods. Antiglycation activity was demonstrated through relative mobility in electrophoresis (RME) and determination of free amino groups. The inhibitory activity on tyrosinase was also examined. Molecular docking analyses were performed to assess the molecular interactions with DNA and tyrosinase. The antitumor activity SaCE was also measured. Phytochemical analysis of SaCE and AgNPs showed presence polyphenols (1000.41 and 293.37 mg gallic acid equivalent/g), flavonoids (954.87 and 479.87 mg rutin equivalent/g), saponins (37.89 and 23.01% total saponins), in particular steroidal saponins (aculeatiside A and B). Both SaCE and AgNPs exhibited significant antioxidant (respectively, 73.97%, 56.27% in DPPH test, 874.67 and 837.67 µM Trolox Equivalent/g in FRAP test) and antiglycation activities (72.81 and 67.98% free amino groups, results observed in RME). SaCE and AgNPs presented 33.2, 36.1% inhibitory activity on tyrosinase, respectively. In silico assay demonstrated interaction between steroidal saponins, DNA or tyrosinase. SaCE exhibited antitumor action against various human tumor cells. Data demonstrated that extracts SaCE alone and AgNPs synthesized from SaCE presented biological properties of interest for application in new therapeutic formulations in medicine.

Ecological risk of mercury in bottom sediments and spatial correlation with land use in Neotropical savanna floodplain lakes, Araguaia River, Central Brazil.

The Araguaia River floodplain is an important biogeographic boundary between the two largest South American biomes: the Cerrado (Brazilian Savanna) and the Amazon rainforest. The large-scale degradation due to land use conversion experienced in the Araguaia River watershed represents a potential source of mercury (Hg) transport to aquatic ecosystems. However, more information is needed about the dynamics of Hg distribution in savanna floodplains, including the Araguaia River floodplain. We analyzed total mercury (THg) concentrations in the bottom sediments of 30 lakes connected to the Araguaia River and four tributaries, aiming to evaluate the environment's integrity based on the geoaccumulation index (Igeo) and the ecological risk index (ERI). The principal component analysis was applied to examine associations between Hg concentrations, environmental conditions, and land use intensity among lakes associated with different river systems. We used indicator cokriging to identify areas with a greater probability of Hg pollution and ecological risk associated with land use intensity. The land use data showed the predominance of areas used for pasture in the Araguaia River basin. THg concentrations in the sediments varied between 22.6 and 81.9 ng g-1 (mean: 46.5 ± 17.7 ng g-1). Sediments showed no significant pollution (Igeo: 1.35 - 0.50; Classes 1 and 2) and low to considerable ecological risks (ERI: 23.5-85.1; Classes 1 to 3). THg in bottom sediments was associated with land use, water turbidity and electrical conductivity, and sediment organic matter. The indicator cokriging indicates a moderate to strong spatial dependence between land use intensity and Hg, confirming the contribution of anthropic sources to the increment of ecological risk but also the influence of extrinsic factors (such as environmental conditions, geology, and hydrology). Integrating sediment assessment and land use indices with geostatistical methods proved a valuable tool for identifying priority areas for Hg accumulation at a regional scale.

Effectiveness of intravesical ozone in interstitial cystitis by the O'Leary-Sant symptom index.

INTRODUCTION AND HYPOTHESIS: A prospective clinical, preliminary study was performed in patients with interstitial cystitis/bladder pain syndrome (IC/BPS) who were nonresponders to conventional treatment and received intravesical ozone as a therapeutic alternative. METHODS: Sixteen patients received six applications of intravesical ozone at a concentration of 41 µg/mL. We evaluated therapeutic efficacy by the percentage reduction of Interstitial Cystitis Symptom and Problem Index scores (ICSI/ICPI-the O'Leary-Sant symptom index), recurrence rate, nonresponse, and side effects in scores collected on admission (pre-treatment), at the end of the therapeutic protocol (post-treatment), and 180 days (follow-up) after the last ozone application. RESULTS: The mean age of women was 52.9 years (SD: 15.5), and the duration of symptoms was 5.7 years (SD: 7.1). The median ICSI on admission was 17 (IQR: 14.25-19.5) and at follow-up was 0.5 (IQR: 0-2), with a reduction of 97.5% (CI: 85.7-100). The median ICSI/ICPI on admission was 31.5 (IQR: 29-35.2) and at follow-up was 2.0 (IQR: 0-3.75), with a reduction of 92.3% (CI: 88.8-100). The recurrence rate was only 6.25%, and no patients were nonresponders to the treatment. CONCLUSIONS: The application of intravesical ozone was effective in the treatment of patients with IC/BPS who were nonresponders to conventional therapy, showing a progressive and safe effect, at least in the short term.

Intimate Partner Violence-Related Brain Injury Among Colombian Women.

OBJECTIVE: The aim of this study was to assess the prevalence of brain injury (BI) and its relationship to cognitive and psychological outcomes in women survivors of intimate partner violence (IPV) in Colombia, South America. SETTING: Women's shelters and organizations in Barranquilla, Colombia. PARTICIPANTS: Seventy women from the city of Barranquilla, Colombia, who experienced any form of IPV. DESIGN: Cross-sectional, retrospective. MAIN MEASURES: Participants were administered the computerized EMBRACED neuropsychological battery to assess learning, working and long-term memory, cognitive flexibility, and processing speed. Participants also completed measures of psychological symptoms. Partner violence severity was assessed with a semistructured interview for survivors of domestic violence. Presence and severity of IPV-related BI were assessed using the Brain Injury Severity Assessment (BISA). RESULTS: Thirty-one percent of women sustained at least one BI during an abusive relationship, and 10% sustained repetitive BIs. Furthermore, BI was negatively associated with measures of long-term and working memory, cognitive flexibility, as well as a trending ( P = .05) positive association with depression. With the exception of the relationship between BI and cognitive flexibility, which was substantially reduced and no longer significant, all of these relationships were nearly identical in strength when controlling for abuse severity, socioeconomic status, and educational level. CONCLUSION: These data are the first to specifically examine IPV-related BI in relation to cognitive and psychological functioning in a sample of Colombian women. These data add cross-cultural knowledge to the limited work in this area that has largely focused on women in North America.

Platelet-Rich Fibrin Progressive Protocol: Third Generation of Blood Concentrates.

PURPOSE: Platelet-rich fibrin (PRF) has been used in several fields of dentistry to improve tissue healing. However, PRF from glass tubes results in a limited number of small membranes, increasing clinical difficulty and work time. The aim of this study was to evaluate cell and platelet amounts and biomechanical strength of PRF-giant membranes produced from plastic tubes without additives. MATERIAL AND METHODS: The investigators designed an ex vivo study, to compare 3 different centrifugation protocols for obtaining PRF: 700 × g/12 minutes (leukocyte and PRF [L-PRF]), 350 × g/14 minutes (GM350), and 60-700 × g more than 15 minutes total (progressive PRF [PRO-PRF]). We collected blood samples from 5 volunteers aged 25-54 years, over 3 different time periods (triplicate and paired study). From each venipuncture, 4 mL of blood was collected in vacutainers with ethylenediamine tetraacetic acid (EDTA) and approximately 104 mL in 12 plastic tubes without additives, which were separated into 3 groups, as per the centrifugation protocols (n = 5): L-PRF, GM350, and PRO-PRF. The PRF from the tubes of the same protocol was aspirated and 9 mL were placed in polylactic acid (PLA) forms and 3 mL were placed in a glass receptacle. The membranes from PLA forms were tested for tensile strength and the membranes from glass receptacles were evaluated by histomorphometry, while platelets and leukocytes were counted for those in tubes with EDTA. Statistical analyses were performed using Shapiro-Wilk normality test and then a one-way repeated measures analysis followed by Tukey multiple comparisons test (α < 0.05). RESULTS: In tensile analyses, PRO-PRF (0.85 ± 0.23 N) showed a significantly higher maximum breaking strength than L-PRF (0.61 ± 0.26 N, P = .01) and GM350 (0.58 ± 0.23 N, P < .01). The histomorphometry revealed no significant statistical difference in cell counts between the groups (P = .52). Furthermore, there was no significant difference between the leukocyte (P = .25) and platelet counts (P = .59) in whole blood between the groups. CONCLUSION: The progressive protocol (PRO-PRF) enabled the production of PRF giant membranes with greater tensile strength and adequate cell distribution. Moreover, it allows biomaterial incorporation during production and enables clinical control of membrane thickness and size as per the surgical procedure.

Variations in clinical course and surgical outcomes of acute appendicitis during COVID-19 Pandemic: a multicenter cohort study.

BACKGROUND: COVID-19 pandemic has led to changes in the presentation and treatment of surgical pathologies. Therefore, we aim to describe the influence of the COVID-19 pandemic on the clinical presentation and management of acute appendicitis (AAp) and its surgical outcomes. STUDY DESIGN: A multicenter cohort study with prospectively collected databases. Three high-volume centers were included and all patients over 18 years of age who underwent appendectomy for AAp were included. Multiple logistic regression and multinomial logistic regression were performed, and odds ratio, relative risk, and B-coefficient were reported when appropriate, statistical significance was reached with p-values < 0.05. RESULTS: 1.468 patients were included (709 in the pre-pandemic group and 759 in the COVID-19 group). Female patients constituted 51.84%. Mean age was 38.13 ± 16.96 years. Mean Alvarado's score was 7.01 ± 1.59 points. Open surgical approach was preferred in 90.12%. Conversion rate of 1.29%. Mortality rate was 0.75%. There was an increase of perforated and localized peritonitis (p 0.01) in the COVID-19 group. Presence of any postoperative complication (p 0.00), requirement of right colectomy and ileostomy (p 0.00), and mortality (p 0.04) were higher in the COVID-19 group. Patients in the pre-pandemic group have a lesser risk of mortality (OR 0.14, p 0.02, 95% CI 0.02-0.81) and a lesser relative risk of having complicated appendicitis (RR 0.68, p 0.00, 95% CI 0.54-0.86). CONCLUSION: Complicated appendicitis was an unexpected consequence of the COVID-19 pandemic, due to surgical consultation delay, increased rates of morbidity, associated procedures, and mortality, influencing the clinical course and surgical outcomes of patients with AAp.

Effects of different doses of ionizing radiation on alveolar bone repair in post-extraction tooth socket: an experimental study in rats.

OBJECTIVE: This study aimed to evaluate the dose-response effects of ionizing radiation (IR) on alveolar bone repair and bone strength after tooth extraction. MATERIALS AND METHODS: A total of 32 male Wistar rats were used in the study, 28 animals were included in the final analysis, and n = 7 for each experimental group. Mandibular first molars were extracted. After 7 days, the animals were randomly divided into four groups according to single-dose irradiation: NIr, control group; Ir15, irradiated at 15 Gy; Ir20, irradiated at 20 Gy; and Ir30, irradiated at 30 Gy. The tooth extraction sites were subjected to micro-computed tomography (micro-CT), histological, histomorphometric, and biomechanical analyses 14 days after extraction. Data were analyzed using one-way ANOVA followed by Tukey's post hoc test (α = 0.05). RESULTS: Micro-CT analysis revealed that IR led to lower values of bone volume (BV, in mm3) (0.68 ± 0.08, P < 0.001) and bone volume fraction, ratio of the segmented bone volume to the total volume of the region of interest (BV/TV, in %) (44.1 ± 8.3, P < 0.001) for the Ir30 group compared to the control group. A significantly lower amount of newly formed bone was observed in the Ir30 (P = 0.005) than in the Ir15 group. The histomorphometric results of quantification of bone matrix neoformation and the micro-CT were in agreement, demonstrating greater damage to the Ir30 group. IR30 cells showed a lower percentage of densely packed collagen than control cells. No significant differences were found in the biomechanical parameters. CONCLUSION: IR affects alveolar bone repair. A dose of 30 Gy reduced the bone healing process owing to a smaller amount of newly formed bone and a lower percentage of densely packed collagen. Therefore, a dose of 30 Gy can be used to successfully establish an animal model of an irradiated mandible that mimics the irradiated clinical conditions. CLINICAL RELEVANCE: Radiotherapy can lead to severe side effects and tooth extraction is a major risk factor. A proper understanding of the pathological mechanisms of radiation in alveolar bone repair requires the establishment of a suitable animal model of clinical conditions.

Biomechanical effects of a hard insert and air space in mouthguards on the shock absorption and protection against fractures of direct resin composite veneers from trauma.

BACKGROUND/AIM: Mouthguards (MTG) are used to prevent dental trauma. However, their protective effect on esthetic restorations and whether modified MTGs are beneficial is uncertain. The aim of this study was to evaluate the effect of hard inserts and air spaces in MTGs in protecting direct resin composite veneers during impact. MATERIALS AND METHODS: Twenty resin composite veneers (1.0 mm) were prepared on upper right central incisors on printed maxilla models using polyether. The effect of the MTGs was evaluated in four groups (n = 5): Con-MTG, conventional custom-fit MTGs made with two layers of ethylene vinyl acetate (EVA); Air-MTG, MTGs with the insertion of 2.0 mm air space between the two layers of EVA and tooth surface; PETG-MTG, MTGs with 1.0 mm of polyethylene terephthalate glycol-modified (PETG) inserted between the EVA layers; and No-MTG, comprising resin composite veneers without MTG. The printed models were fixed in a pendulum device, and the impact was performed at 30°. The strain (µS) and shock absorption (%) of the MTG were recorded using strain gauges. Failure modes and cracks were evaluated using macro photography and transillumination and analyzed using the chi-square test. Strain and shock absorption data were analyzed using the one-way analysis of variance followed by Tukey's test (α = 0.05). RESULTS: Mouthguards reduced strain and enhanced shock absorption, regardless of the MTG type (p < .001). Con-MTG, Air-MTG, and PETG-MTG had shock absorption rates of 76.1%, 72.3%, and 33.4%, respectively (p < .001). The single No-MTG model had a root fracture, while all the others had superficial damage. None of the MTG models had cracks or fractures. CONCLUSIONS: Mouthguards protected the resin composite veneers. The Con-MTG and Air-MTG groups had lower strain and greater shock absorption than the PETG-MTG. Resin veneers had no cracks or damage following MTG use. However, 80% of the veneers had surface damage when no MTG was used.

Fluorescence-aided identification technique using a low-cost violet flashlight and rotatory instruments for dental trauma splint removal.

BACKGROUND/AIM: Removing resin composites used for bonding dental trauma splints may result in irreversible damage to the enamel. This in vitro study evaluated the influence of additional violet illumination and different bur types on damage caused to tooth enamel. MATERIALS AND METHODS: Fifteen maxillary models with four bovine incisor teeth were prepared. All models were scanned using a laboratory scanning system (s600 ARTI; Zirkonzahn). Six experimental groups (n = 10) were generated by two study factors: lighting type (three levels), (1) low-cost (5-7 US$) violet LED flashlight (LUATEK, LT 408); (2) VALO Cordless light curing unit (Ultradent) with black lens; or (3) without additional illumination; and rotatory instrument (two levels), (1) diamond bur or (2) multifluted tungsten-carbide bur. New scanning was performed after splint removal, and the generated files were superimposed on the initial scans using Cumulus software. The light emitted by both violet light sources was characterized by using integrating sphere and beam profile. A qualitative and quantitative analysis of enamel damage and two-way ANOVA followed by Tukey's post hoc was used at an α = 0.05. RESULTS: The use of low-cost violet flashlight that emitted the violet peak light at 385 nm and VALO Cordless with black lens at 396 nm resulted in significantly lower damage to the enamel surface than those in the groups without additional violet light (p < .001). An interaction between rotatory instruments and lighting was found. When no additional violet lighting was used, the diamond bur presented higher mean and maximum depth values. CONCLUSIONS: Fluorescence lighting facilitated the removal of remnant resin composite dental trauma splints, leading to less invasive treatment. The diamond bur resulted in higher enamel damage than that affected by the multifluted bur when no violet lighting was used. A low-cost violet flashlight is a useful fluorescence-aided identification technique for removing resin composite dental trauma splints.

Effect of different materials for conventional and 3D-printed models on the mechanical properties of ethylene-vinyl acetate utilized for fabricating custom-fit mouthguards.

BACKGROUND/AIM: The interaction between the ethylene-vinyl acetate (EVA) with distinct materials utilized for obtaining dental models can affect the performance of resulting mouthguards. This study attempted to evaluate the effect of different materials for conventional (dental stone) or 3D-printed (resin) models on EVA's physical and mechanical properties and surface characteristics. MATERIAL AND METHODS: EVA sheets (Bioart) were laminated over four model types: GIV, conventional Type IV dental stone model (Zhermak); ReG, resin-reinforced Type IV dental stone model (Zero Stone); 3DnT, 3D resin printed model (Anycubic) without surface treatment; 3DT, 3D-printed model (Anycubic) with water-soluble gel (KY Jelly Lubricant, Johnson & Johnson) coating during post-curing process. The EVA specimens were cut following the ISO 37-II standard (n = 30). Shore A hardness was measured before and after plasticization on the contact (internal) or opposite (external) surfaces with the model. The breaking force (F, N), elongation (EL, mm), and ultimate tensile strength (UTS, MPa) were measured using a universal testing machine. Macro-photography and scanning electron microscopy were adopted for classifying the EVA surface alteration. Data were analyzed by one-way ANOVA with repeated measures, followed by Tukey's test (α = .05). RESULTS: Plasticization significantly decreased Shore A values for the tested EVA regardless of the model type (p < .001). Higher F, El, and UTS values were verified for the EVA with 3DT and GIV models compared to ReG and 3DnT (p < .001). 3DnT models resulted in severe surface alteration and a greater reduction of the mechanical properties of the EVA. CONCLUSION: The interaction of EVA with 3D resin-printed models without surface treatment or resin-reinforced Type IV dental stone models significantly affected the physical and mechanical properties of this material. The utilization of water-soluble gel coating during the post-curing process of 3D resin printed models improved the mechanical properties of the EVA, similarly when this material was plasticized over conventional Type IV dental stone model.

Effect of surface treatment of ethylene vinyl acetate on the delamination of custom-fitted mouthguards.

BACKGROUND/AIM: Contamination of ethylene vinyl acetate (EVA) during mouthguard fabrication can cause delamination. The study evaluated the effects of different EVA surface treatments on the contact angle, laminate bond strength, and elongation capacity. MATERIALS AND METHODS: Specimens of two bonded EVA plates were prepared (n = 30). The Shore A hardness of standardized EVA plate specimens was measured before and after thermo-plasticization. The EVA plates were randomly allocated to one of five different surface treatment groups: no treatment (control); isopropyl alcohol, 100%; chloroform, 99.8%; self-cure acrylic resin monomer (methacrylate, ethylene glycol dimethacrylate, and chemical initiator-amine type); and ethyl alcohol, 70%. The maximum breaking force and elongation at the site of fracture were recorded using a universal testing machine. The contact angle surface was measured using ImageJ software. Scanning electron microscopy of the EVA surface was performed. The laminate bond strength was obtained by dividing the maximum breaking force by the bonding area between the two EVA plates. The laminate bond strength and maximum elongation data were analyzed by one-way ANOVA, followed by the Tukey's and the Dunnet test. The failure mode data was analyzed using the chi-square test (α = .05). RESULTS: EVA surface treatment significantly influenced the laminate bond strength and maximum elongation (p < .001). The control group had a higher contact angle and significantly lower laminate bond strength and maximum elongation than the other groups (p < .001). The acrylic resin monomer and chloroform-treated specimens had similar laminate bond strength and maximum elongation. The acrylic resin monomer group had a significantly lower contact angle (p < .001). CONCLUSIONS: All treatments had a significantly higher laminate bond strength and maximum elongation than the control group. The acrylic resin monomer and chloroform groups had a significantly higher laminate bond strength and maximum elongation and the acrylic resin monomer group had a lower contact angle than the other groups. The chloroform should be avoided due its hazardous effects.

Effect of excise tax on sugar-sweetened beverages in Catalonia, Spain, three and a half years after its introduction.

BACKGROUND: The World Health Organisation urges countries to levy specific excise taxes on SSBs. Currently, more than 50 countries have introduced some type of tax on SSBs. In March 2017, the Autonomous Region of Catalonia approved the introduction of a tiered excise tax on SSBs for public health reasons. To evaluate the effect of the Catalonian excise tax on the price and purchase of sugar-sweetened beverages (SSBs) and their possible substitutes, i.e., non-sugar-sweetened beverages (NSSBs) and bottled water, three and half years after its introduction, and 1 year after the outbreak of the COVID-19 pandemic. METHODS: We analysed purchase data on soft drinks, fruit drinks and water, sourced from the Ministry of Agriculture food-consumption panel, in a random sample of 12,500 households across Spain. We applied the synthetic control method to infer the causal impact of the intervention, based on a Bayesian structural time-series model which predicts the counterfactual response that would have occurred in Catalonia, had no intervention taken place. RESULTS: As compared to the predicted (counterfactual) response, per capita purchases of SSBs fell by 0.17 l three and a half years after implementing the SSB tax in Catalonia, a 16.7% decline (95% CI: - 23.18, - 8.74). The mean SSB price rose by 0.11 €/L, an 11% increase (95% CI: 9.0, 14.1). Although there were no changes in mean NSSB prices, NSSB consumption rose by 0.19 l per capita, a 21.7% increase (95% CI: 18.25, 25.54). There were no variations in the price or consumption of bottled water. The effects were progressively greater over time, with SSB purchases decreasing by 10.4% at 1 year, 12.3% at 2 years, 15.3% at 3 years, and 16.7% at three and a half years of the tax's introduction. CONCLUSIONS: The Catalonian SSB excise tax had a sustained and progressive impact over time, with a fall in consumption of as much as 16.7% three and half years after its introduction. The observed NSSB substitution effect should be borne in mind when considering the application of this type of tax to the rest of Spain.

Phenotypes of mutations related to voltage-dependent sodium channels on children and adolescents.

Cardiac channelopathies are a heterogeneous group of inherited cardiac diseases that are associated with mutations in the genes that encode the expression of cardiac ion channels. In view of this, it can be mentioned that the main hereditary arrhythmias in children and adolescents, caused by dysfunction of the ion channels, are Brugada Syndrome (BrS) and Long QT Syndrome (LQTS). However, few studies address the physiological effects of these conditions on children and adolescents. Thus, the aim of this study is to describe the mutation phenotype related to voltage-gated sodium channels in children and adolescents. A search was performed in the literature of PubMed, Scielo, and Google scholar. The search was limited to articles written in the last 5 years, so articles published between 2014 and 2019 were included. Among 2196 studies identified through a systematic literature review, 30 studies related to the theme were identified for a complete review and after applying exclusion criteria, 4 articles were included in the results of this study. As the most frequently observed channelopathy, BrS was also more identified in children and adolescents, characterized by episodes of syncope or sudden cardiac death. LQTS shows clinical manifestations with a mild phenotype and good prognosis, although it is necessary to monitor and correct serum electrolyte disturbances to prevent ventricular arrhythmias and, consequently, sudden death in patients with the pathology. The aim of this study is to find the general phenotypes related to genetic mutations of voltage-gated sodium channels, in a population aged from 7- to 14-year-old.

Lean mass and strength profile of women submitted to bariatric surgery: comparison of the EWGSOP2 and FNIH classification for sarcopenia - ASBS program phase II.

Aim: To assess the effect of bariatric surgery on the lean mass of women after one year of the procedure, comparing its outcomes upon the classification from both the Foundation of the National Institutes of Health (FNIH) and the European Working Group on Sarcopenia in the Elderly People (EWGSOP). Material and methods: Twenty-eight obese women aged 40.5 ± 9.8 yrs who underwent Roux-en-Y gastric bypass (RYGB) were included. 27 of them were reassessed after 6 months of surgery, and 16 completed the one-year follow-up. Pre-sarcopenia condition was assessed through a handgrip strength test and body composition by dual-energy X-ray absorptiometry (DXA). Total body mass, body mass index, and lean mass (LM) were collected prior to, 6 and 12 months after RYGB surgery. Results: All subjects reassessed after 12 months were diagnosed with pre-sarcopenia according to the FNIH classification criteria, while according to the EWGSOP2 Consensus they presented normal values. LM represented 14% of the influence on handgrip strength (p = .049) after 6 months of surgery; however, its influence on strength after 12 months increased to 30% (p = .028). Conclusion: The FNIH classification is the most effective criteria since it uses LM content as the first test, considering that strength capacity needs more time to be affected by the surgical procedure. On the other hand, the EWGSOP2 classification should not be applied to determine the loss of LM in younger populations regardless of what may have caused such changes.

Analysis of pain relief and functional recovery in patients with rotator cuff tendinopathy through therapeutic ultrasound and photobiomodulation therapy: a comparative study.

This study aimed to compare shoulder tendinopathy treatment with therapeutic ultrasound combined with LED photobiomodulation therapy using LED-infrared (850 nm) or LED-red (640 nm). The study assessed 75 patients, aged 45 to 70 years, distributed into five experimental groups (15 patients each): therapeutic ultrasound (US), infrared light irradiation (IR), visible red light irradiation (VR), infrared light and ultrasound combined (IR-US), and red light in conjunction with ultrasound (VR-US). The ultrasound parameters are 1 MHz, 0.5 W/cm2 (SATA), and 100 Hz repetition rate, applied for 4 min each session. LED irradiation protocols were as follows: 3 points, 7.5 J per point, IR-LED 750 mW, 10 s, VR-LED 250 mW, 30 s. LED irradiation is followed by ultrasound in the combined therapies. The efficiency of the five therapies was evaluated assessing 12 parameters: quality of life (Health Assessment Questionnaire, HAQ), pain intensity (Visual Analog Scale, VAS), articular amplitude of shoulder movement (flexion, extension, abduction, adduction, medial rotation, lateral rotation), muscle strength (abduction, lateral rotation), and electromyography (lateral rotation, abduction). Treatments comprised 12 sessions for 4 weeks. Intra-group analysis showed that the five therapies significantly improved the recovery of all parameters after treatment. Regarding the comparison of irradiated therapies and ultrasound, statistical analysis showed that IR-US was a better treatment than US for all 12 parameters. IR treatment exceeded US on 9 items, whereas that VR and VR-US therapies exceeded US in 7 and 10 parameters, respectively (p < 0.05). Because of that, IR-US shows to be the best treatment for rotator cuff tendinopathy. In conclusion, improvements in quality of life, pain intensity relief, shoulder amplitude motion, and muscle strength force obtained with ultrasound therapy are enhanced by adding infrared LED irradiation to ultrasound for patients suffering from rotator cuff tendinopathy. This study was registered with the Brazilian Registry of Clinical Trials (ReBEC) under Universal Trial Number (UTN) U1111-1219-3594 (2018/22/08).

Photobiomodulation effect of red LED (630 nm) on the free radical levels produced by pulp cells under stress conditions.

The aim of this study was to assess the ability of red light emitting diodes (LED) to modulate oxidative stress in human dental pulp fibroblasts (HDPFs) when different irradiation parameters are employed. Cells from primary teeth were seeded (100,000 cells/well) in 24-well plates in culture medium (DMEM). At 24 h after incubation, the culture medium was replaced with DMEM containing 10 µg/mL lipopolysaccharide (LPS). Thereafter, the cells were irradiated (LED 630 nm, 0.04 W/cm2 and 0.08 W/cm2) at 0 J/cm2 (control group), 4 J/cm2, 15 J/cm2, and 30 J/cm2; and their viability (MTT assay), number (Trypan Blue), synthesis of nitric oxide (NO) (Griess reagent), and reactive oxygen species (ROS) (fluorescence probe, DCFH-DA) were assessed. The Kruskal-Wallis and Mann-Whitney statistical tests using Bonferroni correction were employed (significance level of 5%). Compared to that in control fibroblasts, increased viability was observed in HDPFs exposed to LPS and irradiated with 15 J/cm2 and 30 J/cm2 at 0.04 W/cm2 and 4 J/cm2 and 15 J/cm2 at 0.08 W/cm2 (p < 0.05). Exposure to 4 J/cm2 at 0.04 W/cm2 and 15 J/cm2 and 30 J/cm2 at 0.08 W/cm2 modulated the oxidative stress in cells relative to that observed in non-irradiated LPS-treated pulp cells (p < 0.05). It was concluded that the irradiation strategies of using red LED with radiant exposures of 15 J/cm2 and 30 J/cm2 at 0.04 W/cm2 and 15 J/cm2 at 0.08 W/cm2 were the best parameters to decrease NO and ROS concentration and to stimulate viability of HDPFs exposed to LPS challenge.