Are images worth a thousand words? A preliminary study testing a video for owner education in canine atopic dermatitis.

BACKGROUND: Successful management of canine atopic dermatitis (cAD) is challenging and effective pet owner education is crucial to successful outcomes. However, there are limited proven educational strategies in this area. Our goal was to create an effective and engaging educational tool for owners of dogs with cAD. HYPOTHESIS: Video-based education efficacy would be comparable to traditional verbal delivery. Secondary objectives included assessing client perception of the intervention, and determining if there were clinical benefits for the dogs and improved client adherence to treatment. SUBJECTS: Twenty-nine dogs with cAD and their owners were recruited from a teaching hospital of a European veterinary medicine faculty. MATERIALS AND METHODS: In this 8 week, prospective, randomised controlled study, clients in the control group (CG, n = 13) received verbal education and those in the intervention group (IG, n = 16) watched a video. Client knowledge was assessed at Day (D)0 and D56. Treatment adherence and perceived utility and appeal ratings were measured at D56. Clinical progress was assessed at D0 and D56 using CADESI-04 and PVAS10. RESULTS: The differences found in the means of cAD knowledge score, clinical outcomes, utility and appeal ratings and owners' adherence score between groups were not statistically significant. A significant association between the outcome and the intervention group concerning education success [CG, six of 13 (46.15%); IG, 15 of 16 (93.75%)] was found (p = 0.01). CONCLUSIONS AND CLINICAL RELEVANCE: Video-based instructions positively impacted owners' education and demonstrated their potential as a valuable tool. The authors believe that video-based education could be a time-efficient alternative for initial cAD education in veterinary clinics.

Beyond Basics: Can a Driving Simulator Reliably Reproduce Real Vehicle Dynamics?

Despite constant technological innovation, road transport remains a significant source of pollutant emissions, and effective driver-behaviour changes can be considered as solutions that can increase the sustainability of road traffic in a short period. Thus, understanding driver behaviour plays a key role in assessing traffic-related impacts. Since real-world experiments entail some risks and are often not flexible, simulator-based experiments can be relevant to studying vehicle dynamics and driver behaviour. However, the reliability of the simulation results' accuracy must be ensured. The primary objective of this paper is to present an exploratory analysis focused on the study of the reliability of a driving simulator to reproduce driving parameters that can then be used for emission estimation. For that purpose, tests were conducted by two drivers for urban and highway scenarios performed on a driving simulator and in real-world environments. Different road singularities composed events that were microscopically analysed. Second-by-second vehicle dynamic variables were recorded, and the pollutant emissions were estimated using the vehicle specific power (VSP) methodology. The results of this exploratory validation analysis showed that the total average emissions of all events were not significantly different (958.39 g for simulated and 998.06 g for empirical tests). Overall, the driving simulator can replicate vehicle dynamics from a microscopic perspective, especially for the urban scenario. This may be due to the more complex traffic conditions and road specificities that require more restrained driving behaviour. Nevertheless, VSP mode distributions did not follow the same pattern in 4 out of 10 events, meaning that the drivers displayed different behaviours in the simulated and empirical tests for those events. The relative errors range between 4 and 29% for carbon dioxide emissions and between 2 and 33% for nitrogen oxides emissions.

Quality and sensory milk traits of goats grazing Caatinga or confined receiving either corn or spineless cactus-based diets in the Brazilian semiarid environment.

This study aimed to evaluate the yield, physical-chemical properties, fatty acid (FA) profile, and sensory traits of goat milk under different nutritional strategies in a Brazilian semiarid environment. Eighteen lactating crossbred dairy goats were distributed in a completely randomized design with three nutritional strategies: Caatinga strategy (1.5% of body weight with a concentrate supplementation), Corn-based confined strategy, and Spineless Cactus confined strategy. Daily milk yield was recorded, and milk samples were collected from all animals. Goats fed the spineless cactus-based diet presented a higher milk yield than goats feed the other strategies. Moreover, milk from goats fed with a spineless Cactus confined strategy presented higher saturated FA (SFA), and a lower proportion of cis- monounsaturated FA, trans-monounsaturated FA, and c9,t11-18:2 than milk from goats feed the other strategies. Milk from goats in the pasture system presented the highest proportions of 18:2n-6, 18:3n-3, and thus of polyunsaturated FA, when compared with milk from confined goats. We assume that milk from goats grazing in Caatinga pastures presents more benefits to human health due to the positive effects of this diet on the milk's fat content and FA profile, and this feeding strategy also results in a better sensory evaluation that may increase the acceptability of goat milk by consumers. All nutritional strategies evaluated herein and adopted in the semiarid region of Brazil are recommended for maintaining the yield, physical-chemical properties, and acceptability of milk goats.

Effects of antidepressant drug therapy with or without physical exercise on inflammatory biomarkers in major depressive disorder: a systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: To conduct a systematic review and meta-analysis of the effects of antidepressant drug therapy (with or without physical exercise) on peripheral inflammatory markers in patients with major depressive disorder (MDD). METHODS: MEDLINE, PyscINFO, Embase, and Google Scholar databases were searched until May 2020. Randomized trials that measured at least one inflammatory biomarker and included adult outpatients with MDD under antidepressant drug therapy (any drug) with or without physical exercise (any modality) were eligible. Results were summarized using the standardized mean difference (SMD) with 95% confidence intervals (95% CI) under a random-effects model. The Cochrane risk of bias tool (2010) was used to evaluate the risk of bias in the included trials. RESULTS: Sixty-three trials were identified, encompassing data from 3482 patients, and 20 investigated biomarkers. Trials had biases across multiple domains, rising concerns primarily to selection bias/performance bias/detection bias/attrition bias. SMDs between pre- and post-results indicated a significant reduction in the levels of IL-2 (SMD, - 0.25; 95% CI, - 0.41 to - 0.09, P = 0.002), IL-6 (SMD, - 0.19; 95% CI, - 0.35 to - 0.025, P = 0.024), IL-10 (SMD, - 0.32; 95% CI, - 0.57 to - 0.07, P = 0.011), and serum cortisol (SMD, - 0.35; 95% CI, - 0.58 to - 0.12, P = 0.002). Evidence supporting the influence of physical exercise combined with antidepressant drugs on peripheral inflammatory markers in MDD is sparse and heterogeneous. CONCLUSION: There is some evidence that antidepressant drug therapy is associated with an overall positive reduction in inflammatory markers, but the evidence is heterogeneous. Further research linking how inflammatory biomarkers modulate physiology related to antidepressant response is required. TRIAL REGISTRATION: CRD42020220735.

Lambs fed diets containing by-product from coconut processing: histomorphometry characteristics in the digestive and renal systems.

This study aimed to evaluate the histological characteristics in the digestive and renal systems of lambs fed diets containing coconut by-product (CB). A total of 35 male lambs with an initial weight of 16.9 ± 2.93 kg were distributed in a completely randomized design with five levels of CB in the diet (0; 4.8; 9.6; 14.4 and 19.2% in total dry matter). Samples of the liver, kidney, rumen, and intestine were histomorphometrically evaluated, and the data were submitted to regression analysis, at a 5% error probability. The inclusion of CB linearly decreased the dry matter intake and caused a quadratic effect for the height of ruminal papillae, absorption area, epithelium thickness, as well as for average daily gain. The inclusion of CB linearly increased the mucous layer and reduced the submucosal layer, as well as promoted a decrease in goblet cells in the small intestine. The inclusion of CB did not influence hepatic glycogen; additionally, the histopathological examination did not reveal liver damage or congestion, vacuolization, and necrosis of the renal tissue. Therefore, our results indicate that CB can be included in lambs diet up to the level of 7.2% without causing changes in the histomorphometry characteristics of the gastrointestinal tract and changes in liver and kidney tissue that compromise animal performance.

Coconut fruit pulp by-product in the diet of sheep.

This study aimed to evaluate the effect of the inclusion of coconut fruit pulp by-product (CPB) on the intake, apparent digestibility, nitrogen balance, and ruminal parameters of sheep. Five intact, male, non-descript lambs with a mean initial body weight of 25.5 ± 1.68 kg were assigned to a Latin square design (5 × 5) of five treatments consisting of CPB inclusion levels, in five proportions of 0%, 5%, 10%, 15%, and 20% dry matter (DM), in diets consisting of sugarcane bagasse as forage, with corn and soybean meal. Each period lasted 15 days for adaptation followed by 6 days for data collection. The inclusion of CPB linearly decreased (P < 0.05) the intake of DM, crude protein, non-fibre carbohydrates, neutral detergent fibre (NDF), and DM digestibility. The inclusion of CPB linearly increased (P < 0.05) the ether extract digestibility, but did not influence (P > 0.05) the NDF digestibility. There was a linear reduction (P < 0.05) in the absorbed nitrogen (N) and retained N (g/day); however, a quadratic increase (P < 0.05) for N absorbed (% consumed) as well as ammonia nitrogen was observed. There was a quadratic increase (P < 0.05) for propionate (mMol/L and %) and the ratio of acetate, propionate and butyrate (mMol/L and %) with the inclusion of CPB in the diet. Based on these findings, it was recommended to incorporate CPB up to the level of 5% in the diet of sheep.

Morphological factors associated with giant vacuoles with I-pores in Schlemm's canal endothelial cells of human eyes: A serial block-face scanning electron microscopy study.

Increased intraocular pressure (IOP) is the main risk factor for primary open-angle glaucoma and results from impaired drainage of aqueous humor (AH) through the trabecular outflow pathway. AH must pass the inner wall (IW) endothelium of Schlemm's canal (SC), which is a monolayer held together by tight junctions, to exit the eye. One route across the IW is through giant vacuoles (GVs) with their basal openings and intracellular pores (I-pores). AH drainage through the trabecular outflow pathway is segmental. Whether more GVs with both basal openings and I-pores are present in the active flow areas and factors that may influence formation of GVs with I-pores have not been fully elucidated due to limitations in imaging methods. In this study, we applied a relatively new technique, serial block-face scanning electron microscopy (SBF-SEM), to investigate morphological factors associated with GVs with I-pores in different flow areas. Two normal human donor eyes were perfused at 15 mmHg with fluorescent tracers to label the outflow pattern followed by perfusion-fixation. Six radial wedges of trabecular meshwork including SC (2 each from high-, low-, and non-flow areas) were imaged using SBF-SEM (total: 9802 images). Total GVs, I-pores, basal openings, and four types of GVs were identified. Percentages of GVs with I-pores and basal openings and number of I-pores/GV were determined. Overall, 14.4% (477/3302) of GVs had I-pores. Overall percentage of GVs with both I-pores and basal openings was higher in high- (15.7%), than low- (12.6%) or non-flow (7.3%) areas. Of GVs with I-pores, 83.2% had a single I-pore; 16.8% had multiple I-pores (range: 2-6). Additionally, 180 GVs (90 with I-pores and 90 without I-pores) were randomly selected, manually segmented, and three-dimensionally (3D) reconstructed to determine size, shape, and thickness of the cellular lining. Size of GVs (including median volume, surface area, and maximal cross-sectional area) with I-pores (n = 90) was significantly larger than GVs without I-pores (n = 90) using 3D-reconstructed GVs (P ≤ 0.01). Most I-pores (73.3%; 66/90) were located on or close to GV's maximal cross-sectional area with significant thinning of the cellular lining. Our results suggest that larger size and thinner cellular lining of GVs may contribute to formation of GVs with I-pores. More GVs with I-pores and basal openings were observed in high-flow areas, suggesting these GVs do provide a channel through which AH passes into SC and that increasing this type of GV may be a potential strategy to increase aqueous outflow for glaucoma treatment.

Laser Nd:YAG patterning enhance human osteoblast behavior on zirconia implants.

Zirconia has been regarded as a promising material for dental implants, and Nd:YAG laser treatment has been proposed as a potential strategy to improve its bioactivity. The main aim of the present study was to evaluate the in vitro behavior of human fetal osteoblasts in contact with laser-textured zirconia implant surfaces assessing the effect of different texture patterns, spacing between laser passes and number of laser passes. Zirconia discs were produced and treated with Nd:YAG laser according to test group variables: texture (microgrooves and micropillar array), distance between surface features (25 µm, 30 µm and 35 µm), and laser passes [1, 2, 4, and 8]. Untextured sandblasted and acid-etched zirconia discs (SBAE) were used as controls. Human osteoblasts (hFOB 1.19) were cultured for 14 days on test and control samples. Morphology and cellular adhesion were observed using scanning electron microscopy (SEM). Cell viability and proliferation were evaluated at 1, 3, 7, and 14 days using a commercial resazurin-based method. Collagen type I was evaluated at 3 days using ELISA. Alkaline phosphatase (ALP) activity was evaluated at 7 days using a colorimetric enzymatic technique. Group comparisons were tested using ANOVA or Mann-Whitney test (Tukey's post hoc) using statistical software, and significance was set at p < 0.05. Cell viability and proliferation increased over time for all groups with statistically higher values for laser-textured groups when compared with control at 7 and 14 days in culture (p < 0.05). Collagen type I levels were higher for study groups (p < 0.05) when compared with control group. No statistically differences were detected for ALP activity levels between texture and control groups (p > 0.05). The results suggest that laser-machined zirconia implant surfaces may benefit biological osteoblast response. However, the type of texture, spacing at the range of 25-35 µm, and number of laser passes did not seem to be relevant variables.

Prevalence of subclinical hypocalcemia in dairy cows in the Sousa city micro-region, Paraíba state.

Subclinical hypocalcemia is a metabolic disorder characterised by a decrease in serum calcium (Ca) levels, with no clinical symptoms. The aim of this study was to determine the punctual prevalence of subclinical hypocalcemia in dairy cows, in the Sousa city micro-region, Paraíba state. Samples were collected from 29 dairy farms, consisting of 153 and 296 blood samples in the pre- and postpartum period respectively. In relation to the mineral supplementation profile, 89.25% of the properties use a commercial supplement. On average, 40.53% of lactating cows presented total serum Ca levels under the lower limit of 8.0 mg/dL, with an exclusive supplement of NaCl resulting in a higher percentage of cows, 61.11%, with the condition of subclinical hypocalcemia. For ionized Ca, the average prevalence of subclinical hypocalcemia was 21.16%. The prevalence of subclinical hypocalcemia for total serum Ca was 37.25 and 42.23% of cows in the pre- and postpartum period respectively. The type of mineral supplement did not influence (P > .05) total and ionized serum Ca levels in lactating cows. There was no significant difference (P > .05) for total and ionized serum Ca levels as a function of the reproductive period in lactating cows. Subclinical hypocalcemia was evident in the dairy cows under evaluation and occurred with an average punctual prevalence of 40.34%. Commercial supplement is the most common form of mineral mixture used; however, it was not able to promote an increase in the levels of total and ionized serum Ca levels due to errors in managing the supply.

[Epidemiological research of the maternal deaths and compliance with the fifth millennium development goal]. / Pesquisa epidemiológica dos óbitos maternos e o cumprimento do quinto objetivo de desenvolvimento do milênio.

OBJECTIVE: To identify and describe the epidemiological characteristics of maternal deaths that occured between 2000-2012 in a reference hospital in the state of São Paulo in order to contribute to the analysis of compliance with the fifth Millennium Development Goal. METHOD: Epidemiological, retrospective and cross-sectional study with a population of 58 maternal deaths. Data were collected in the second half of 2013, through medical records and death certificates, and analyzed by SPSS version 13.0. RESULTS: An average age of 29.11 years was identified, 56.9% with 1-3 previous pregnancies, 56.9% cesarean deliveries, 84.5% of maternal complications occurred during pregnancy and the postpartum period, 81% of deaths occurred in postpartum, 56.9% of deaths were classified as direct causes, with 44.8% of deaths being attributed to high blood pressure. CONCLUSION: There is a need for investment in obstetric care to optimize the reduction of complications during the gestation and puerperal period, thereby influencing the reduction of maternal mortality.

Cell Biological and Antibacterial Evaluation of a New Approach to Zirconia Implant Surfaces Modified with MTA.

Peri-implantitis continues to be one of the major reasons for implant failure. We propose a new approach to the incorporation of MTA into zirconia implant surfaces with Nd:YAG laser and investigate the biological and the microbiological responses of peri-implant cells. Discs of zirconia stabilized with yttria and titanium were produced according to the following four study groups: Nd:YAG laser-textured zirconia coated with MTA (Zr MTA), Nd:YAG laser-textured zirconia (Zr textured), polished zirconia discs, and polished titanium discs (Zr and Ti). Surface roughness was evaluated by contact profilometry. Human osteoblasts (hFOB), gingival fibroblasts (HGF hTERT) and S. oralis were cultured on discs. Cell adhesion and morphology, cell differentiation markers and bacterial growth were evaluated. Zr textured roughness was significantly higher than all other groups. SEM images reveal cellular adhesion at 1 day in all samples in both cell lines. Osteoblasts viability was lower in the Zr MTA group, unlike fibroblasts viability, which was shown to be higher in the Zr MTA group compared with the Zr textured group at 3 and 7 days. Osteocalcin and IL-8 secretion by osteoblasts were higher in Zr MTA. The Zr textured group showed higher IL-8 values released by fibroblasts. No differences in S. oralis CFUs were observed between groups. The present study suggests that zirconia implant surfaces coated with MTA induced fibroblast proliferation and osteoblast differentiation; however, they did not present antibacterial properties.

Effect of coconut processing by-product graded feeding on carcass traits and meat quality of lambs.

The inclusion of by-product coconut mesocarp skins (CMS) in diets was evaluated in feedlot lambs. The objective of this study was to evaluate CMS levels effects on carcass traits and meat quality of lambs. Thirty-five male lambs with an initial body weight of 16.9 ± 2.93 kg were distributed in a completely randomized design with five CMS levels in total dry matter (0; 4.8; 9.6; 14.4 and 19.2%) and fed during 71 d until slaughter. High levels of CMS decreased the intake of dry matter and negatively affected the performance of lambs. Fat and protein contents of Longissimus lumborum muscle (P < 0.05) and the saturated fatty acid (FA) decreased (P < 0.001) whereas polyunsaturated FA increased (P < 0.01) with the inclusion of CMS. The ratio t10/t11-18:1 increased with the inclusion of CMS (P < 0.001). The instrumental color descriptors were unaffected by CMS levels. According to the effects on the investigated meat quality traits we recommend up to 4.8% CMS in diets of confined lambs.

Cicatrization of oncological wounds by autologous fibrin biopolymer dressing treatment: a case series.

INTRODUCTION: Traditional therapies used to treat chronic wounds are often expensive and, in general, are not adequate to support healing. A promising alternative to conventional dressings is the autologous biopolymer FM, full of cytokines and growth factors that accelerate the healing process of wounds of various etiologies. MATERIALS AND METHODS: The authors report 3 cases in which FM was used to treat chronic oncological wounds that had been conventionally treated for more than 6 months with no sign of healing. RESULTS: Among the 3 reported cases, there was complete healing of 2 wounds. The other lesion did not heal, mainly due to the location (at the base of the skull). However, it significantly reduced its area, extension, and depth. No adverse effects or hypertrophic scar formation were recorded, and the patients reported an absence of pain from the second week of FM application. CONCLUSIONS: The proposed FM dressing approach was effective in healing and speeding up tissue regeneration. It can also be considered one of the most versatile delivery systems to the wound bed, as it is an excellent carrier of growth factors and leukocytes.

Satisfaction of Health Professionals Regarding the Short Binasal Prong Used as a Non-Invasive Ventilation Interface in Neonatology.

Purpose: To evaluate the health professionals' satisfaction regarding the short binasal prong used in Neonatal Intensive Care Units (NICU), evaluate the difficulties related to its use, and present possible improvements in the design of this device. Patients and Methods: Observational, cross-sectional study with prospective data collection carried out in the NICU of a public hospital in southern Brazil. This research was presented into two stages. In the first stage, the Quebec User Evaluation of Satisfaction with Assistive Technology was applied with 90 health professionals to evaluate the satisfaction regarding the short binasal prong. In the second stage, the health professional's experiences and difficulties in using the binasal prongs in 14 newborns (NBs) that required non-invasive ventilation was collected. The short binasal prongs used was the Fanem® brand and the CPAP circuit was Gabisa Medical International (GMI®). Finally, improvements and recommendations were presented to optimize the device's design. Results: The mean score of the health professionals' satisfaction with short binasal prongs was 3.8 ± 0.6. Ease of adjustment (3.27) and dimensions (3.62) variables had the worst scores. The main difficulties pointed out by health professionals were: circuit disconnection (57.1%), the size of the prong did not correspond to NBs' anatomical characteristics (35.7%), air leakage (21.4%), and difficulty in fixing and positioning the prong in the NB (14.28%). The improvements suggested were: appropriate prong sizes based on the anatomical characteristics of the NBs; adjustable distance between insertion and base catheters; manufactured with malleable material, however not easily foldable; curved and adjustable insertion catheters and functional system of tracheas' connection. Conclusion: The dissatisfaction of health professionals with the dimensions and prongs adjustments and the difficulties faced in clinical practice indicate the need for improvements in these interfaces. The recommendations presented in this study may contribute to optimizing the design of the binasal prong in the future.

Ecotoxicological relevance of glyphosate and flazasulfuron to soil habitat and retention functions - Single vs combined exposures.

Glyphosate (GLY) and flazasulfuron (FLA) are two non-selective herbicides commonly applied together. However, research focused on their single and combined ecotoxicological impacts towards non-target organisms is still inconclusive. Therefore, this study aimed to test their single effects on soil's habitat and retention functions, and to unravel their combined impacts to earthworms and terrestrial plants. For this, ecotoxicological assays were performed with plants (Medicago sativa), oligochaetes (Eisenia fetida) and collembola (Folsomia candida). Soil elutriates were also prepared and tested in macrophytes (Lemna minor) and microalgae (Raphidocelis subcapitata). FLA (82-413 µg kg-1) reduced earthworms' and collembola's reproduction and severely impaired M. sativa growth, being much more toxic than GLY (up to 30 mg kg-1). In fact, the latter only affected plant growth (≥ 9 mg kg-1) and earthworms (≥ 13 mg kg-1), especially at high concentrations, with no effects on collembola. Moreover, only elutriates from FLA-contaminated soils significantly impacted L. minor and R. sucapitata. The experiments revealed that the co-exposure to GLY and FLA enhanced the toxic effects of contaminated soils not only on plants but also on earthworms'. However, such increase in toxicity was dependent on GLY residual concentrations in soils. Overall, this work underpins that herbicides risk assessment should consider herbicides co-exposures, since the evaluation of single exposures is not representative of current phytosanitary practices and of the potential effects under field conditions, where residues of different compounds may persist in soils.

Advances in tissue engineering of cancer microenvironment-from three-dimensional culture to three-dimensional printing.

Cancer treatment development is a complex process, with tumor heterogeneity and inter-patient variations limiting the success of therapeutic intervention. Traditional two-dimensional cell culture has been used to study cancer metabolism, but it fails to capture physiologically relevant cell-cell and cell-environment interactions required to mimic tumor-specific architecture. Over the past three decades, research efforts in the field of 3D cancer model fabrication using tissue engineering have addressed this unmet need. The self-organized and scaffold-based model has shown potential to study the cancer microenvironment and eventually bridge the gap between 2D cell culture and animal models. Recently, three-dimensional (3D) bioprinting has emerged as an exciting and novel biofabrication strategy aimed at developing a 3D compartmentalized hierarchical organization with the precise positioning of biomolecules, including living cells. In this review, we discuss the advancements in 3D culture techniques for the fabrication of cancer models, as well as their benefits and limitations. We also highlight future directions associated with technological advances, detailed applicative research, patient compliance, and regulatory challenges to achieve a successful bed-to-bench transition.

Primary Prevention of Canine Atopic Dermatitis: Breaking the Cycle-A Narrative Review.

Canine atopic dermatitis (cAD) is a common and distressing skin condition in dogs, affecting up to 30% of the canine population. It not only impacts their quality of life but also that of their owners. Like human atopic dermatitis (hAD), cAD has a complex pathogenesis, including genetic and environmental factors. Current treatments focus on managing clinical signs, but they can be costly and have limitations. This article emphasizes the importance of preventing cAD from developing in the first place. Understanding the role of the skin's protective barrier is crucial, as its dysfunction plays a vital role in both hAD and cAD. hAD prevention studies have shown promising results in enhancing the skin barrier, but more research is needed to support more robust conclusions. While hAD primary prevention is currently a focal point of intensive investigation in human medicine, research on cAD primary prevention remains under-researched and almost non-existent. Pioneering effective prevention strategies for cAD holds immense potential to enhance the quality of life for both dogs and their owners. Additionally, it bears the promise of a translational impact on human research. Hence, further exploration of this crucial topic is not only relevant but also timely and imperative, warranting support and encouragement.

Bio-Piezoelectric Ceramic Composites for Electroactive Implants-Biological Performance.

Barium titanate (BaTiO3) piezoelectric ceramic may be a potential alternative for promoting osseointegration due to its piezoelectric properties similar to bone electric potentials generated in loading function. In this sense, the aim of this in vitro study was to evaluate the cellular response of human osteoblasts and gingival fibroblasts as well as the impact on S. oralis when in contact with BaTiO3 functionalized zirconia implant surfaces with piezoelectric properties. Zirconia discs with BaTiO3 were produced and contact poling (piezo activation) was performed. Osteoblasts (hFOB 1.19), fibroblasts (HGF hTERT) and S. oralis were culture on discs. Cell viability and morphology, cell differentiation markers, bacterial adhesion and growth were evaluated. The present study suggests that zirconia composite surfaces with the addition of piezoelectric BaTiO3 are not cytotoxic to peri-implant cells. Also, they seem to promote a faster initial osteoblast differentiation. Moreover, these surfaces may inhibit the growth of S. oralis by acting as a bacteriostatic agent over time. Although the piezoelectric properties do not affect the cellular inflammatory profile, they appear to enable the initial adhesion of bacteria, however this is not significant over the entire testing period. Furthermore, the addition of non-poled BaTiO3 to zirconia may have a potential reduction effect on IL-6 mediated-inflammatory activity in fibroblasts.

Oral Hygiene in Patients with Stroke: A Best Practice Implementation Project Protocol.

Oral hygiene has been shown to reduce adverse events and promote the quality of life of patients with stroke. However, a stroke can result in the impairment of physical, sensory, and cognitive abilities, and comprise self-care. Although nurses recognize its benefits, there are areas for improvement in the implementation of the best evidence-based recommendations. The aim is to promote compliance with the best evidence-based recommendations on oral hygiene in patients with stroke. This project will follow the JBI Evidence Implementation approach. The JBI Practical Application of Clinical Evidence System (JBI PACES) and the Getting Research into Practice (GRiP) audit and feedback tool will be used. The implementation process will be divided into three phases: (i) establishing a project team and undertaking the baseline audit; (ii) providing feedback to the healthcare team, identifying barriers to the implementation of best practices, and co-designing and implementing strategies using GRIP, and (iii) undertaking a follow-up audit to assess the outcomes and plan for sustainability. So, the successful adoption of the best evidence-based recommendations on oral hygiene in patients with stroke will reduce the adverse events related to poor oral care and may improve patients' quality of care. This implementation project has great transferability potential to other contexts.