Corrigendum: Safe and effective delivery of supplemental iron to healthy adults: a two-phase, randomized, double-blind trial - the safe iron study.

[This corrects the article DOI: 10.3389/fnut.2023.1230061.].

Study protocol for a zinc intervention in the elderly for prevention of pneumonia, a randomized, placebo-controlled, double-blind clinical pilot trial.

Pneumonia is a major public health problem for older adults, being one of the leading causes of hospitalization and death, particularly for elderly nursing home residents. We previously conducted a clinical trial in which we demonstrated that 29% of nursing home residents had low serum zinc levels coinciding with a two-fold increase in pneumonia incidence and duration in comparison to individuals with adequate serum zinc levels. However, causality could not be inferred and necessitates a double-blind clinical trial. To determine the appropriate supplementation dose for such a trial we are conducting a randomized, placebo-controlled, double-blind clinical pilot trial aimed at delineating the optimal dosage (30 and 60 mg/day elemental Zn) and establishing safety. The results from the pilot study will be leveraged to inform our larger randomized clinical trial designed to study the effect of zinc supplementation in nursing home elderly with low serum zinc levels on respiratory infections, antibiotic use, and duration of sick days with pneumonia. In tandem with dose optimization, we will evaluate the correlation between serum zinc and pan-T cell zinc levels, given that T cells and their zinc levels are important in the response and resolution of respiratory infections but whose correlation has only been extrapolated and not demonstrated. Herein we present the study rationale and protocol, as well as discuss specific challenges we encountered in securing a manufacturer for the study agents and when recruiting from nursing home populations during the COVID-19 pandemic. In light of these experiences, we provide recommendations for future clinical trials under circumstances where supply chains are disrupted, and recruitment pools are constrained or unavailable. Clinical trial registration: https://clinicaltrials.gov/, NCT05527899.

Alternative statistical modeling for radical prostatectomy data.

Several statistical models have been proposed in recent years, among them is the semiparametric regression. In medicine, there are several situations in which it is impracticable to consider a linear regression for statistical modeling, especially when the data contain explanatory variables that present a nonlinear relationship with the response variable. Another common situation is when the response variable does not have a unimodal shape, and it is not possible to adopt distributions belonging to the symmetric or asymmetric classes. In this context, a semiparametric heteroskedastic regression is proposed based on an extension of the normal distribution. Then, we show the usefulness of this model to analyze the cost of prostate cancer surgery. The predictor variables refer to two groups of patients such that one group receives a multimodal local anesthetic solution (Preemptive Target Anesthetic Solution) and the second group is treated with neuraxial blockade (spinal anesthesia/traditional standard). The other relevant predictor variables are also evaluated, thus allowing for the in-depth interpretation of the predictor variables with a nonlinear effect on the dependent variable cost. The penalized maximum likelihood method is adopted to estimate the model parameters. The new regression is a useful statistical tool for analyzing medical data.

Life-long consumption of high level of fruits and vegetables reduces tumor incidence and extends median lifespan in mice.

Objective: Epidemiological studies suggest that consumption of fruits and vegetables (FV) is negatively associated with the incidence of certain cancers and mortality. However, a causal relationship has not been demonstrated. Thus, we investigated the effect of life-long consumption of high level of FV on median lifespan, key biological functions, and pathologies in mice fed low-fat (LF) or high-fat (HF) diets and the underlying mechanisms. Methods: Using a 2 × 2 factorial design, 5 weeks-old male C57BL/6J mice were randomly assigned to one of four groups (n = 60/group): LF (LF-C, 10% kcal fat), HF (HF-C, 45% kcal fat) or each supplemented with 15% (w/w) of a unique FV mixture (LF + FV and HF + FV, respectively). Mice were euthanized when one group reached 50% mortality. Body weight and composition, tumor incidence, and death were monitored. Blood levels of lipids and pro-inflammatory cytokines were assessed. Results: After 21 months of feeding, HF-C group reached 50% mortality, at which time mice in all groups were terminated. HF-C had higher mortality (50.0%) compared to the LF-C group (18.3%, p = 0.0008). Notably, HF-FV had lower mortality (23.3%) compared to HF-C group (p = 0.008); there was no significant difference in mortality between HF-FV and LF-C groups. Tumors were found in all groups, and were predominantly present in the liver, followed by those of lung, intestine, and seminal vesicle. Tumor incidence in the HF-C group (73.3%) was higher than that in LF-C group (30.0%, p < 0.0001). HF + FV group had 23.3% lower tumor incidence compared to the HF-C group (p = 0.014). No significant difference in tumor incidence between the LF-C and LF + FV groups was observed. Long-term FV supplementation reduced systemic inflammation and blood lipids. Conclusion: We provide the first causal evidence that life-long intake of a diet, containing a high level and large variety of FV, decreases tumor incidence and extends median lifespan in mice fed a western-style high-fat diet. These effects of FV are at least in part due to reduced blood levels of pro-inflammatory cytokines and improved dyslipidemia.

Safe and effective delivery of supplemental iron to healthy adults: a two-phase, randomized, double-blind trial - the safe iron study.

Introduction: The safety of novel forms of iron in healthy, iron-replete adults as might occur if used in population-based iron supplementation programs was examined. We tested the hypotheses that supplementation with nanoparticulate iron hydroxide adipate tartrate (IHAT), an iron-enriched Aspergillus oryzae product (ASP), or ferrous sulphate heptahydrate (FS) are safe as indicated by erythrocyte susceptibility to malarial infection, bacterial proliferation, and gut inflammation. Responses to FS administered daily or weekly, and with or without other micronutrients were compared. Methods: Two phases of randomized, double-blinded trials were conducted in Boston, MA. Phase I randomized 160 volunteers to six treatments: placebo, IHAT, ASP, FS, and FS plus a micronutrient powder (MNP) administrated daily at 60 mg Fe/day; and FS administered as a single weekly dose of 420 mg Fe. Phase II randomized 86 volunteers to IHAT, ASP, or FS administered at 120 mg Fe/day. Completing these phases were 151 and 77 participants, respectively. The study was powered to detect effects on primary endpoints: susceptibility of participant erythrocytes to infection by Plasmodium falciparum, the proliferation potential of selected pathogenic bacteria in sera, and markers of gut inflammation. Secondary endpoints for which the study was not powered included indicators of iron status and gastrointestinal symptoms. Results: Supplementation with any form of iron did not affect any primary endpoint. In Phase I, the frequency of gastrointestinal symptoms associated with FS was unaffected by dosing with MNP or weekly administration; but participants taking IHAT more frequently reported abdominal pain (27%, p < 0.008) and nausea (4%, p = 0.009) than those taking FS, while those taking ASP more frequently reported nausea (8%, p = 0.009). Surprisingly, only 9% of participants taking IHAT at 120 mg Fe/day (Phase II) reported abdominal pain and no other group reported that symptom. Discussion: With respect to the primary endpoints, few differences were found when comparing these forms of iron, indicating that 28 days of 60 or 120 mg/day of IHAT, ASP, or FS may be safe for healthy, iron-replete adults. With respect to other endpoints, subjects receiving IHAT more frequently reported abdominal pain and nausea, suggesting the need for further study. Clinical Trial Registration: ClinicalTrials.gov, NCT03212677; registered: 11 July 2017.

A New Truncated Lindley-Generated Family of Distributions: Properties, Regression Analysis, and Applications.

We present the truncated Lindley-G (TLG) model, a novel class of probability distributions with an additional shape parameter, by composing a unit distribution called the truncated Lindley distribution with a parent distribution function G(x). The proposed model's characteristics including critical points, moments, generating function, quantile function, mean deviations, and entropy are discussed. Also, we introduce a regression model based on the truncated Lindley-Weibull distribution considering two systematic components. The model parameters are estimated using the maximum likelihood method. In order to investigate the behavior of the estimators, some simulations are run for various parameter settings, censoring percentages, and sample sizes. Four real datasets are used to demonstrate the new model's potential.

Nutrition, Immunosenescence, and Infectious Disease: An Overview of the Scientific Evidence on Micronutrients and on Modulation of the Gut Microbiota.

The immune system is key to host defense against pathogenic organisms. Aging is associated with changes in the immune system, with a decline in protective components (immunosenescence), increasing susceptibility to infectious disease, and a chronic elevation in low-grade inflammation (inflammaging), increasing the risk of multiple noncommunicable diseases. Nutrition is a determinant of immune cell function and of the gut microbiota. In turn, the gut microbiota shapes and controls the immune and inflammatory responses. Many older people show changes in the gut microbiota. Age-related changes in immune competence, low-grade inflammation, and gut dysbiosis may be interlinked and may relate, at least in part, to age-related changes in nutrition. A number of micronutrients (vitamins C, D, and E and zinc and selenium) play roles in supporting the function of many immune cell types. Some trials report that providing these micronutrients as individual supplements can reverse immune deficits in older people and/or in those with insufficient intakes. There is inconsistent evidence that this will reduce the risk or severity of infections including respiratory infections. Probiotic, prebiotic, or synbiotic strategies that modulate the gut microbiota, especially by promoting the colonization of lactobacilli and bifidobacteria, have been demonstrated to modulate some immune and inflammatory biomarkers in older people and, in some cases, to reduce the risk and severity of gastrointestinal and respiratory infections, although, again, the evidence is inconsistent. Further research with well-designed and well-powered trials in at-risk older populations is required to be more certain about the role of micronutrients and of strategies that modify the gut microbiota-host relationship in protecting against infection, especially respiratory infection.

The new Neyman type A generalized odd log-logistic-G-family with cure fraction.

The work proposes a new family of survival models called the Odd log-logistic generalized Neyman type A long-term. We consider different activation schemes in which the number of factors M has the Neyman type A distribution and the time of occurrence of an event follows the odd log-logistic generalized family. The parameters are estimated by the classical and Bayesian methods. We investigate the mean estimates, biases, and root mean square errors in different activation schemes using Monte Carlo simulations. The residual analysis via the frequentist approach is used to verify the model assumptions. We illustrate the applicability of the proposed model for patients with gastric adenocarcinoma. The choice of the adenocarcinoma data is because the disease is responsible for most cases of stomach tumors. The estimated cured proportion of patients under chemoradiotherapy is higher compared to patients undergoing only surgery. The estimated hazard function for the chemoradiotherapy level tends to decrease when the time increases. More information about the data is addressed in the application section.

A competitive family to the Beta and Kumaraswamy generators: Properties, Regressions and Applications.

We define two new flexible families of continuous distributions to fit real data by compoun-ding the Marshall-Olkin class and the power series distribution. These families are very competitive to the popular beta and Kumaraswamy generators. Their densities have linear representations of exponentiated densities. In fact, as the main properties of thirty five exponentiated distributions are well-known, we can easily obtain several properties of about three hundred fifty distributions using the references of this article and five special cases of the power series distribution. We provide a package implemented in R software that shows numerically the precision of one of the linear representations. This package is useful to calculate numerical values for some statistical measurements of the generated distributions. We estimate the parameters by maximum likelihood. We define a regression based on one of the two families. The usefulness of a generated distribution and the associated regression is proved empirically.

Red propolis effect analysis of dairy calves health based on Weibull regression model with long-term survivors.

Diarrhea is the most common cause of mortality and morbidity in dairy calves during the first weeks of life. It is responsible for the majority of costs related to animal death and treatments, as well as lower productivity due to reduced weight gain. Therefore, studies that focus on strategies to reduce diarrhea incidence and to improve animal welfare are very important for the dairy industry. For that reason, the beneficial effects of red propolis on the health status of preweaned dairy calves was studied. Animal disease data usually present incomplete observations of interest time, so-called censored observations and one of the statistical techniques for this modeling type is the survival analysis, hence it is a set of methods for analyzing data where the response variable is the time until the occurrence of an event of interest. We propose among some methods of survival data analysis, the long-term models. The motivation to study these models is the fact that part of the population is not susceptible to the event of interest during the period of the study, considered as immune or cured. In this paper, we studied the Weibull distribution in a structure of long-term model, including the covariates in the proportion of cured through the logistic link function. Besides, we used the residual analysis to check the assumptions of the model. The reason for the choice of the Weibull distribution was that this model is very flexibility to model a variety of data sets, among them animal science and long-term survival data. We illustrate its application with a case study from an animal experiment, which examined the time till the occurrence of diarrhea in Holstein calves, where a proportion of the animals were not susceptible to this health condition. This experiment aimed to verify the efficiency of red propolis in disease prevention and the influence of that on the proportion of animals that are not susceptible to diarrhea.

Dietary Fruit and Vegetable Supplementation Suppresses Diet-Induced Atherosclerosis in LDL Receptor Knockout Mice.

BACKGROUND: Epidemiologic studies suggest that fruit and vegetable (F&V) consumption is inversely associated with incidence of cardiovascular disease (CVD). However, evidence for causality is lacking, and the underlying mechanisms are not well understood. OBJECTIVES: We aimed to determine whether there is a causal relation between consuming high levels of F&V and prevention of atherosclerosis, the hallmark of CVD pathogenesis. Furthermore, the underlying mechanisms were determined. METHODS: Six-week-old male LDL receptor-knockout mice were randomly assigned to 3 diet groups (12 mice/group) for 20 wk: control (CON, 10% kcal fat, 0.20 g/kg cholesterol), atherogenic (Ath, 27% kcal fat, 0.55 g/kg cholesterol), and Ath supplemented with 15% F&V (Ath + FV) (equivalent to 8-9 servings/d in humans). F&V was added as a freeze-dried powder that was prepared from the 24 most commonly consumed F&Vs in the United States. Body weight, aortic atherosclerotic lesion area, hepatic steatosis area, serum lipid profile and proinflammatory cytokine TNF-α concentrations, gut microbiota, and liver TNF-α and fatty acid synthase (Fasn) mRNA concentrations were assessed. RESULTS: F&V supplementation did not affect weight gain. Mice fed the Ath + FV diet had a smaller aortic atherosclerotic lesion area (71.7% less) and hepatic steatosis area (80.7% less) than those fed the Ath diet (both P < 0.001) independent of impact on weight, whereas no difference was found between Ath + FV and CON groups in these 2 pathologic markers. Furthermore, F&V supplementation prevented Ath diet-induced dyslipidemia (high concentrations of serum TG and VLDL cholesterol and lower concentrations of HDL cholesterol), reduced serum TNF-α concentration (by 21.5%), suppressed mRNA expression of liver TNF-α and Fasn, and ameliorated Ath-induced gut microbiota dysbiosis. CONCLUSIONS: Our results indicate that consuming a large quantity and variety of F&Vs causally attenuates diet-induced atherosclerosis and hepatic steatosis in mice. These effects of F&Vs are associated with, and may be mediated through, improved atherogenic dyslipidemia, alleviated gut dysbiosis, and suppressed inflammation.

A new regression model for bimodal data and applications in agriculture.

We define the odd log-logistic exponential Gaussian regression with two systematic components, which extends the heteroscedastic Gaussian regression and it is suitable for bimodal data quite common in the agriculture area. We estimate the parameters by the method of maximum likelihood. Some simulations indicate that the maximum-likelihood estimators are accurate. The model assumptions are checked through case deletion and quantile residuals. The usefulness of the new regression model is illustrated by means of three real data sets in different areas of agriculture, where the data present bimodality.

Partial inclusion of bis(1,10-phenanthroline)silver(I) salicylate in ß-cyclodextrin: Spectroscopic characterization, in vitro and in silico antimicrobial evaluation.

Silver complexes containing 1,10-phenanthroline as a coordinated ligand have been of great interest due to their antibacterial and antifungal pharmacological properties. In this paper, we describe the synthesis of a new partial inclusion complex of bis(1,10-phenanthroline)silver(I) salicylate in ß-cyclodextrin (ß-CD) which was synthesized with a good yield. The compounds were characterized by FTIR, 1H, 13C NMR including 1H-1H COSY, TGA/DSC, elemental analysis (CHN), and X-ray powder diffraction. The results suggest the presence of non-covalent interactions such as hydrogen bonds, van der Waals forces, and hydrophobic interactions in the formation of the partial inclusion compound between ß-CD and bis(1,10-phenanthroline)silver(I) salicylate [Ag(phen)2]salH. Additionally, an in silico prediction of 1,10-phenanthroline biological activities was carried out and the acquired data suggests several potential targets associated with the antimicrobial activity of this compound and its silver complex. Most predicted targets are related to antimicrobial virulence and resistance that are a serious threat to global public health. The inclusion compound showed a higher inhibiting growth of Candida albicans than the free complex [Ag(phen)2]salH indicating that the formation of the inclusion complex with ß-CD increases the bioavailability of the antimicrobial active species [Ag(phen)2]+ of the new silver(I) compound.

A Novel Combination of Fruits and Vegetables Prevents Diet-Induced Hepatic Steatosis and Metabolic Dysfunction in Mice.

BACKGROUND: Epidemiological studies suggest that higher fruits and vegetables (F&V) consumption correlates with reduced risk of hepatic steatosis, yet evidence for causality and the underlying mechanisms is lacking. OBJECTIVES: We aimed to determine the causal relation between F&V consumption and improved metabolic disorders in mice fed high-fat (HF) (Experiment-1) or normal-fat (Experiment-2) diets and its underlying mechanisms. METHODS: Six-week-old male C57BL/6J mice were randomly grouped and fed diets supplemented at 0%-15% (wt:wt) with a freeze-dried powder composed of 24 commonly consumed F&V (human equivalent of 0-9 servings/d) for 20 wk. In Experiment-1, mice were fed an HF (45% kcal fat) diet with 0% (HF0), 5%, 10%, or 15% (HF15) F&V or a matched low-fat control diet (10% kcal fat). In Experiment-2, mice were fed an AIN-93 diet (basal) (B, 16% kcal fat) with 0% (B0), 5%, 10%, or 15% (B15) F&V supplementation. Body weight and composition, food intake, hepatic steatosis, inflammation, ceramide levels, sphingomyelinase activity, and gut microbiota were assessed. RESULTS: In Experiment-1, mice fed the HF15 diet had lower weight gain (17.9%), hepatic steatosis (48.4%), adipose tissue inflammation, blood (24.6%) and liver (33.9%) ceramide concentrations, and sphingomyelinase activity (38.8%) than HF0 mice (P < 0.05 for all). In Experiment-2, mice fed the B15 diet had no significant changes in weight gain but showed less hepatic steatosis (28.5%), blood and adipose tissue inflammation, and lower blood (30.0%) ceramide concentrations than B0 mice (P < 0.05 for all). These F&V effects were associated with favorable microbiota changes. CONCLUSIONS: These findings represent the first evidence for a causal role of high F&V intake in mitigating hepatic steatosis in mice. These beneficial effects may be mediated through changes in ceramide and/or gut microbiota, and suggest that higher than currently recommended servings of F&V may be needed to achieve maximum health benefits.

A new survival model with surviving fraction: An application to colorectal cancer data.

We propose a new survival model for lifetime data in the presence of surviving fraction and obtain some of its properties. Its genesis is based on extensions of the promotion time cure model, where an extra parameter controls the heterogeneity or dependence of an unobserved number of lifetimes. We construct a regression model to evaluate the effects of covariates in the cured fraction. We discuss inference aspects for the proposed model in a classical approach, where some maximum likelihood tools are explored. Further, an expectation maximization algorithm is developed to calculate the maximum likelihood estimates of the model parameters. We also perform an empirical study of the likelihood ratio test in order to compare the promotion time cure and the proposed models. We illustrate the usefulness of the new model by means of a colorectal cancer data set.

Predicting survival function and identifying associated factors in patients with renal insufficiency in the metropolitan area of Maringá, Paraná State, Brazil.

Renal insufficiency is a serious medical and public health problem worldwide. Recently, although many surveys have been developed to identify factors related to the lifetime of patients with renal insufficiency, controversial results from several studies suggest that researches should be conducted by region. Thus, in this study we aim to predict and identify factors associated with the lifetime of patients with chronic renal failure (CRF) in the metropolitan area of Maringá, Paraná State, Brazil, based on the generalized additive models for location, scale and shape (GAMLSS) framework. Data used in this study were collected from the Maringá Kidney Institute and comprehends 177 patients (classified with CRF and mostly being treated under the Brazilian Unified National Health System) enrolled in a hemodialysis program from 1978 up to 2010. By using this approach, we concluded that in other regions, gender, kidney transplant indicator, antibodies to hepatitis B and antibodies to hepatitis C are significant factors that affect the expected lifetime.

Predicting the cure rate of breast cancer using a new regression model with four regression structures.

Cure fraction models are useful to model lifetime data with long-term survivors. We propose a flexible four-parameter cure rate survival model called the log-sinh Cauchy promotion time model for predicting breast carcinoma survival in women who underwent mastectomy. The model can estimate simultaneously the effects of the explanatory variables on the timing acceleration/deceleration of a given event, the surviving fraction, the heterogeneity, and the possible existence of bimodality in the data. In order to examine the performance of the proposed model, simulations are presented to verify the robust aspects of this flexible class against outlying and influential observations. Furthermore, we determine some diagnostic measures and the one-step approximations of the estimates in the case-deletion model. The new model was implemented in the generalized additive model for location, scale and shape package of the R software, which is presented throughout the paper by way of a brief tutorial on its use. The potential of the new regression model to accurately predict breast carcinoma mortality is illustrated using a real data set.

Predicting survival function and identifying associated factors in patients with renal insufficiency in the metropolitan area of Maringá, Paraná State, Brazil / A predição da função de sobrevivência e identificação de fatores associados em pacientes renais crônicos na área metropolitana de Maringá, Paraná, Brasil / Prediciendo la esperanza de vida e identificando factores asociados en pacientes con insuficiencia renal en el área metropolitana de Maringá, Estado de Paraná, Brasil

Renal insufficiency is a serious medical and public health problem worldwide. Recently, although many surveys have been developed to identify factors related to the lifetime of patients with renal insufficiency, controversial results from several studies suggest that researches should be conducted by region. Thus, in this study we aim to predict and identify factors associated with the lifetime of patients with chronic renal failure (CRF) in the metropolitan area of Maringá, Paraná State, Brazil, based on the generalized additive models for location, scale and shape (GAMLSS) framework. Data used in this study were collected from the Maringá Kidney Institute and comprehends 177 patients (classified with CRF and mostly being treated under the Brazilian Unified National Health System) enrolled in a hemodialysis program from 1978 up to 2010. By using this approach, we concluded that in other regions, gender, kidney transplant indicator, antibodies to hepatitis B and antibodies to hepatitis C are significant factors that affect the expected lifetime.

A insuficiência renal crônica é um grave problema clínico e de saúde pública no mundo inteiro. Recentemente, apesar de muitas pesquisas já realizadas para identificar os fatores relacionados à evolução dos pacientes renais crônicos, os resultados conflitantes entre diversos estudos sugerem a necessidade de pesquisas por região. Portanto, o estudo busca predizer e identificar os fatores associados à evolução dos pacientes com insuficiência renal crônica (IRC) na área metropolitana de Maringá, Estado do Paraná, Brasil, com base nos modelos aditivos generalizados para localização, escala e forma (GAMLSS). Os dados utilizados neste estudo foram coletados no Instituto do Rim de Maringá e incluem 177 pacientes (classificados com IRC, a maioria tratada no Sistema Único de Saúde) inclusos no programa de hemodiálise entre 1978 e 2010. Através dessa abordagem, concluímos que em outras regiões, gênero, indicação para transplante renal e anticorpos aos vírus das hepatites B e C são fatores significativos que afetam a sobrevivência esperada.

La insuficiencia renal representa un problema médico y de salud pública serio en todo el mundo. Recientemente, pese a los muchos estudios que se han desarrollado para identificar factores relacionados con la esperanza de vida de los pacientes con insuficiencia renal, los resultados controvertidos de algunos estudios sugieren que las investigaciones deberían realizarse por regiones. No obstante, en este trabajo pretendemos predecir e identificar los factores asociados con la esperanza de vida de pacientes con fallo renal crónico (FRC) en el área metropolitana de Maringá, Estado de Paraná, Brasil, basado en el marco de modelos aditivos generalizados para ubicación, escala y forma (GAMLSS por sus siglas en inglés). Los datos usados en este estudio fueron recogidos del Instituto del riñón de Maringá y comprende a 177 pacientes (clasificados con FRC y en su mayoría siendo tratados en el Sistema Único de Salud), inscritos en un programa de hemodiálisis desde 1978 hasta 2010. Usando este enfoque, concluimos que en otras regiones, género, indicador de trasplante de riñón, anticuerpos a la hepatitis B y anticuerpos a la hepatitis C son factores significativos que afectan a la esperanza de vida.

Longitudinal impact of clinical and socioenvironmental variables on oral health-related quality of life in adolescents.

The aim of the present study was to investigate the impact of oral diseases, socioeconomic status, and family environmental factors on changes in the perception of oral health-related quality of life (OHRQoL) in adolescents. A prospective cohort study was conducted in Juiz de Fora, Minas Gerais, Brazil, with a sample of 286 twelve-year-old adolescents from public and private schools, selected by means of multistage random sampling. The adolescents were clinically examined for dental caries experience (number of decayed, missing, and filled teeth - DMFT index), presence of bleeding, and orthodontic treatment needs. They were asked to complete the Brazilian version of the Child Perceptions Questionnaire (CPQ11-14). In addition, parents answered a questionnaire about their socioeconomic status and family environmental characteristics. After 3 years, the adolescents were contacted again to participate in the research. Logistic regression models, with explanatory variables assessed both individually and jointly, were used to determine which independent variables impacted longitudinally on OHRQoL. The final result demonstrated that only DMFT explained part of the response variability in CPQ11-14 scores. In conclusion, caries experience was an important predictor of OHRQoL in adolescents followed up for 3 years.

The Impact of Molar-Incisor Hypomineralisation on Dental Caries in Permanent First Molars: A Prospective Cohort Study.

PURPOSE: To compare 2-year cumulative survival rates in first permanent molars (FPM) with and without MIH and to investigate risk factors associated with caries incidence. MATERIALS AND METHODS: A total of 142 children aged 5 to 6 years were recruited from all public schools in Botelhos, Minas Gerais, Brazil and 536 FPM were examined. A questionnaire was designed to collect sociodemographic background and behavioural information about children and their parents. Caries in FPM was recorded per surface in accordance with WHO methodology at baseline and once every 6 months over a period of two years. The survival analysis was conducted using the Weibull regression model with cure fraction. RESULTS: MIH was present in 16.19% of children. The 2-year cumulative survival rates for FPM with and without MIH showed statistically significant differences, and visible plaque on anterior teeth had an effect on the survival rates. CONCLUSION: Children with MIH and visible plaque on anterior teeth at baseline had a high risk for developing new caries lesions in their FPM over the course of two years. These variables should be considered in caries risk assessment in paediatric dental care.