Interrelationships among skeletal age, growth status and motor performances in female athletes 10-15 years.

BACKGROUND: Motor performances of youth are related to growth and maturity status, among other factors. AIM: To estimate the contribution of skeletal maturity status per se to the motor performances of female athletes aged 10-15 years and the mediation effects of growth status on the relationships. SUBJECTS AND METHODS: Skeletal age (TW3 RUS SA), body size, proportions, estimated fat-free mass (FFM), motor performances, training history and participation motivation were assessed in 80 non-skeletally mature female participants in several sports. Hierarchical and regression-based statistical mediation analyses were used. RESULTS: SA per se explained a maximum of 1.8% and 5.8% of the variance in motor performances of athletes aged 10-12 and 13-15 years, respectively, over and above that explained by covariates. Body size, proportions, and hours per week of training and participation motivation explained, respectively, a maximum of 40.7%, 18.8%, and 22.6% of the variance in performances. Mediation analysis indicated specific indirect effects of SA through stature and body mass, alone or in conjunction with FFM on performances. CONCLUSION: SA per se accounted for small and non-significant amounts of variance in several motor performances of female youth athletes; rather, SA influenced performances indirectly through effects on stature, body mass and estimated FFM.

Genetic regulation of body size and morphology in children: a twin study of 22 anthropometric traits.

BACKGROUND: Anthropometric measures show high heritability, and genetic correlations have been found between obesity-related traits. However, we lack a comprehensive analysis of the genetic background of human body morphology using detailed anthropometric measures. METHODS: Height, weight, 7 skinfold thicknesses, 7 body circumferences and 4 body diameters (skeletal breaths) were measured in 214 pairs of twin children aged 3-18 years (87 monozygotic pairs) in the Autonomous Region of Madeira, Portugal. Factor analysis (Varimax rotation) was used to analyze the underlying structure of body physique. Genetic twin modeling was used to estimate genetic and environmental contributions to the variation and co-variation of the anthropometric traits. RESULTS: Together, two factors explained 80% of the variation of all 22 anthropometric traits in boys and 73% in girls. Obesity measures (body mass index, skinfold thickness measures, as well as waist and hip circumferences) and limb circumferences loaded most strongly on the first factor, whereas height and body diameters loaded especially on the second factor. These factors as well as all anthropometric measures showed high heritability (80% or more for most of the traits), whereas the rest of the variation was explained by environmental factors not shared by co-twins. Obesity measures showed high genetic correlations (0.75-0.98). Height showed the highest genetic correlations with body diameter measures (0.58-0.76). Correlations between environmental factors not shared by co-twins were weaker than the genetic correlations but still substantial. The correlation patterns were roughly similar in boys and girls. CONCLUSIONS: Our results show high genetic correlations underlying the human body physique, suggesting that there are sets of genes widely affecting anthropometric traits. Better knowledge of these genetic variants can help to understand the development of obesity and other features of the human physique.

Coupled Minimal Conformal Field Theory Models Revisited.

We study coupled unitary Virasoro minimal models in the large rank (m→∞) limit. In large m perturbation theory, we find two nontrivial IR fixed points which exhibit irrational coefficients in several anomalous dimensions and the central charge. For N>4 copies, we show that the IR theory breaks all possible currents that would otherwise enhance the Virasoro algebra, up to spin 10. This provides strong evidence that the IR fixed points are examples of compact, unitary, irrational conformal field theories with the minimal amount of chiral symmetry. We also analyze anomalous dimension matrices for a family of degenerate operators with increasing spin. These display further evidence of irrationality and begin to reveal the form of the leading quantum Regge trajectory.

Comparison of different waste bin monitoring approaches: An exploratory study.

Waste bin monitoring solutions are an essential step towards smart cities. This study presents an exploratory analysis of two waste bin monitoring approaches: (1) ultrasonic sensors installed in the bins and (2) visual observations (VO) of the waste collection truck drivers. Bin fill level data was collected from a Portuguese waste management company. A comparative statistical analysis of the two datasets (VO and sensor observations) was performed and a predictive model based on Gaussian processes was applied to enable a trade-off analysis of the number of collections versus the number of overflows for each monitoring approach. The results demonstrate that the VO are valuable and reveal that significant improvements can be achieved for either of the monitoring approaches in relation to the current situation. A monitoring approach based on VO combined with a predictive model is shown to be viable and leads to a considerable reduction in the number of collections and overflows. This approach can enable waste collection companies to improve their collection operations with minimal investment costs during their transition to fully sensorized bins.

Genetics of somatotype and physical fitness in children and adolescents.

OBJECTIVES: To analyze the influence of genetic and environmental factors on the variation in somatotype, physical fitness, and their mutual associations. METHODS: Twins from 214 pairs (87 monozygotic) of the Autonomous Region of Madeira, Portugal, from 3 to 18 years of age (51% girls) were assessed in anthropometry and physical fitness tests. We estimated endomorphy, mesomorphy, and ectomorphy based on anthropometric measures and physical fitness using the Eurofit test battery. Two age categories were analyzed: children (3-11 years) and adolescents (12-18 years). Genetic and environmental variations were estimated using quantitative genetic twin modeling. RESULTS: No genetic sex differences were found, thus boys and girls were pooled in all genetic analyses. Heritability estimates were high for somatotype (a2  = 0.80-0.93), physical fitness traits (a2  = 0.67-0.83), and largely similar in children and adolescents. Positive correlations were found for ectomorphy with motor ability and cardiorespiratory endurance as well as for endomorphy and mesomorphy with muscular strength (r = 0.25-0.37). In contrast, negative associations were found for ectomorphy with muscular strength, as well as for endomorphy and mesomorphy with motor ability and cardiorespiratory endurance (-0.46 to -0.26). Twin modeling indicated that these associations were explained mostly by genetic factors in common to the two associated traits (84% or more). CONCLUSIONS: Associations between somatotype and physical fitness tests are mainly explained by common genetic background in children and adolescents. Therefore, interventions in youth should consider that a child's performance in physical fitness tests partly reflects their inherited physique.

Do Type of Helmet and Alcohol Use Increase Facial Trauma Severity?

PURPOSE: Facial trauma caused by motorcycle accidents has become a major issue because of its high prevalence and morbidity, causing death and esthetic and functional sequelae in many individuals. This work evaluated helmet and alcohol use and severity of facial fractures in motorcyclists treated at public hospitals in Pernambuco, Brazil. PATIENTS AND METHODS: This prospective study was conducted from December 2016 to December 2018 and submitted to statistical and descriptive analysis. Variables such as gender, age, helmet use and type, previous accidents, and duration of hospitalization were collected. The Facial Injury Severity Scale was used to classify the facial fractures. The Alcohol Use Disorders Identification Test was used to verify alcohol dependence. RESULTS: The sample was composed of 455 patients. Most were male patients (90.8%) and were aged 18 to 29 years (54.5%). Of the patients, 36.5% reported no helmet use and 31.6% reported wearing an open helmet. Alcohol use was reported in 38.7% of the group. In 79.8% of the sample, alcohol use was classified as low risk. There was a greater likelihood of having severe facial trauma if patients were aged between 30 and 39 years and had harmful or at-risk alcohol use. These patients also tended to remain hospitalized for more than 10 days. No statistically significant relationship was found with the type of helmet. CONCLUSIONS: The individuals most affected by facial trauma were young male patients (aged 18 to 29 years). Patients aged 30 to 39 years with high-risk use and dependence on alcohol were more likely to have more complex facial trauma. The type of helmet used was not effective in reducing the severity of facial fractures.

Motor performance, body fatness and environmental factors in preschool children.

The first aim of this study was to investigate the relationship between motor performance and body fatness among 3- to 5-year-old children. The second aim was to assess whether this relationship works similarly for boys and girls. We also investigated whether socioeconomic status (SES) and geographical area when children are aged 3 years old predicts the motor performance of 4 and 5-yr-old children. Motor performance was assessed through the Preschool Test Battery, while body fatness was estimated through body mass index (BMI). SES and geographical area were assessed via parent proxy-report questionnaires. BMI was negatively associated with standing long jump. The association of BMI and motor performance was not statistically different for boys and girls. Children from low SES performed better than high SES peers in tennis ball throw for distance. Rural children were better performers than urban peers in standing long jump. Rural area at baseline was also predictor of standing long jump and tennis ball throw for distance at time 1 and 2. In conclusion, BMI had a negative association with standing long jump and the relationship of BMI with all motor tests was similar for boys and girls. SES and rural area were predictors of motor performance.

Sequential morphometric evaluation at UnicCa® and DCD® implant surfaces. An experimental study in the dog.

AIM: To study tissue components adjacent to implants with nanotechnologically modified surfaces at different periods of healing. MATERIAL & METHODS: In 12 beagle dogs, two different implant systems with different surface configurations were randomly installed in the edentulous premolar regions of the mandible. One surface was first acid-etched and subsequently, nanotechnologically modified with calcium ions (UnicCa® ), while the other was first sandblasted and acid-etched, and then additionally treated with a nanometer calcium phosphate deposition (discrete crystalline deposition; DCD® ). The implants were fully submerged; surgeries and sacrifices were planned to harvest biopsies after 1, 2, 4 and 8 weeks of healing (n = 6 per period). A morphometric evaluation of percentages of new and old bone, bone debris/particles and clot, new soft tissues (provisional matrix and immature marrow), mature bone marrow and vessels was performed in the spongiosa compartment adjacent to the implant surface up to a distance of about 0.4 mm from the surface. RESULTS: After 2 weeks of healing, the soft tissues were represented by 41.0% at the UnicCa® and 37.9% at the DCD® surfaces, in both cases mainly being composed of provisional matrix. These percentages decreased over time, being composed of greater amounts of immature bone marrow, and disappeared after 8 weeks. New bone increased progressively between 1 and 8 weeks of healing from 9.7 ± 6.3% to 70.0 ± 8.4% and from 8.2 ± 3.5% to 67.0 ± 6.1% at the UnicCa® and DCD® surfaces, respectively. Pristine bone was progressively resorbed. CONCLUSIONS: Throughout the periods of healing observed, the formation of a provisional matrix followed by the formation of new bone and marrow was revealed in a similar fashion as for other modified surface configurations.

Biological and environmental determinants of 12-minute run performance in youth.

BACKGROUND: The 12-minute run is a commonly used indicator of cardiorespiratory fitness in youth. Variation in growth and maturity status as potential correlates of test performance has not been systematically addressed. AIM: To evaluate biological and environmental determinants of 12-minute run performance in Portuguese youth aged 7-17 years. SUBJECTS AND METHODS: Mixed-longitudinal samples of 187 boys and 142 girls were surveyed in 1996, 1997 and 1998. The 12-minute run was the indicator of cardiorespiratory fitness. Height, body mass and five skinfolds were measured and skeletal maturity was assessed. Physical activity, socioeconomic status and area of residence were obtained with a questionnaire. Multi-level modelling was used for the analysis. RESULTS: Chronological age and sum of five skinfolds were significant predictors of 12-minute run performance. Older boys and girls ran longer distances than younger peers, while high levels of subcutaneous fat were associated with shorter running distances. Rural boys were more proficient in the 12-minute run than urban peers. Skeletal maturity, height, body mass index, physical activity and socioeconomic status were not significant predictors of 12-minute run performances. CONCLUSIONS: Age and sum of skinfolds in both sexes and rural residence in boys are significant predictors of 12-minute run performance in Portuguese youth.

Change, stability and prediction of gross motor co-ordination in Portuguese children.

BACKGROUND: The knowledge about intra- and inter-individual variation can stimulate attempts at description, interpretation and prediction of motor co-ordination (MC). AIM: To analyse change, stability and prediction of motor co-ordination (MC) in children. SUBJECTS AND METHODS: A total of 158 children, 83 boys and 75 girls, aged 6, 7 and 8 years, were evaluated in 2006 and re-evaluated in 2012 at 12, 13 and 14 years of age. MC was assessed through the Kiphard-Schilling's body co-ordination test and growth, skeletal maturity, physical fitness, fundamental motor skills (FMS), physical activity and socioeconomic status (SES) were measured and/or estimated. RESULTS: Repeated-measures MANOVA indicated that there was a significant effect of group, sex and time on a linear combination of the MC tests. Univariate tests revealed that group 3 (8-14 years) scored significantly better than group 1 (6-12 years) in all MC tests and boys performed better than girls in hopping for height and moving sideways. Scores in MC were also higher at follow-up than at baseline. Inter-age correlations for MC were between 0.15-0.74. Childhood predictors of MC were growth, physical fitness, FMS, physical activity and SES. Biological maturation did not contribute to prediction of MC. CONCLUSION: MC seemed moderately stable from childhood through adolescence and, additionally, inter-individual predictors at adolescence were growth, FMS, physical fitness, physical activity and SES.

Integrated modelling approach for the evaluation of low emission zones.

Low emission zones (LEZ) are areas where the most polluting vehicles are restricted or deterred from entering. In recent years, LEZ became a popular option to reduce traffic-related air pollution and have been implemented in many cities worldwide, notably in Europe. However, the evidence about their effectiveness is inconsistent. This calls for the development of tools to evaluate ex-ante the air quality impacts of a LEZ. The integrated modelling approach we propose in this paper aims to respond to this call. It links a transportation model with an emissions model and an air quality model operating over a GIS-based platform. Through the application of the approach, it is possible to estimate the changes induced by the creation of a LEZ applied to private cars with respect to air pollution levels not only inside the LEZ, but also, more generally, in the city where it is located. The usefulness of the proposed approach was demonstrated for a case study involving the city of Coimbra (Portugal), where the creation of a LEZ is being sought to mitigate the air quality problems that its historic centre currently faces. The main result of this study was that PM10 and NO2 emissions from private cars would decrease significantly inside the LEZ (63% and 52%, respectively) but the improvement in air quality would be small and exceedances to the air pollution limits adopted in the European Union would not be fully avoided. In contrast, at city level, total emissions increase and a deterioration of air quality is expected to occur.

Gross motor coordination and weight status of Portuguese children aged 6-14 years.

OBJECTIVES: To construct age- and gender-specific percentiles for gross motor coordination (MC) tests and to explore differences in gross MC in normal-weight, overweight and obese children. METHODS: Data are from the "Healthy Growth of Madeira Study," a cross-sectional study carried out in children, aged 6-14 years. All 1,276 participants, 619 boys and 657 girls, were assessed for gross MC (Körperkoordinations Test für Kinder, KTK), anthropometry (height and body mass), physical activity (Baecke questionnaire) and socioeconomic status (SES). Centile curves for gross MC were obtained for boys and girls separately using generalized additive models for location, scale and shape. RESULTS: A significant main effect for age was found in walking backwards and moving sideways. Boys performed significantly better than girls on moving sideways. At the upper limit of the distributions, interindividual variability was higher in hopping on one leg (girls) and jumping and moving sideways (boys and girls). One-way ANCOVA, controlling for age, physical activity and SES, indicated that normal-weight children scored significantly better than their obese peers in all gross MC tests. Overweight boys and girls also scored significantly better than their obese colleagues in some MC tests. CONCLUSIONS: These centile curves can be used as reference data in Portuguese children and youth, aged 6-14 years. Being overweight or obese was a major limitation in MC tests and, therefore, of the children's health- and performance-related physical fitness.

Skeletal maturation, fundamental motor skills and motor coordination in children 7-10 years.

Relationships between skeletal maturation and fundamental motor skills and gross motor coordination were evaluated in 429 children (213 boys and 216 girls) 7-10 years. Skeletal age was assessed (Tanner-Whitehouse 2 method), and stature, body mass, motor coordination (Körperkoordinations Test für Kinder, KTK) and fundamental motor skills (Test of Gross Motor Development, TGMD-2) were measured. Relationships among chronological age, skeletal age (expressed as the standardised residual of skeletal age on chronological age) and body size and fundamental motor skills and motor coordination were analysed with hierarchical multiple regression. Standardised residual of skeletal age on chronological age interacting with stature and body mass explained a maximum of 7.0% of the variance in fundamental motor skills and motor coordination over that attributed to body size per se. Standardised residual of skeletal age on chronological age alone accounted for a maximum of 9.0% of variance in fundamental motor skills, and motor coordination over that attributed to body size per se and interactions between standardised residual of skeletal age on chronological age and body size. In conclusion, skeletal age alone or interacting with body size has a negligible influence on fundamental motor skills and motor coordination in children 7-10 years.

Short-term evaluation of grafts fixed with either N-butyl-2-cyanocrylate or screws.

PURPOSE: N-butyl-2-cyanoacrylate (NB-Cn) is an alternative method for onlay graft fixation and might be efficient for preserving the graft volume. Our aim was to analyze the gene expression and mineralized tissue variations of calvarial bone grafting fixed in the mandible with either NB-Cn or a titanium screw (TiS). MATERIALS AND METHODS: New Zealand rabbits had bilateral calvarial grafts fixed at both sides of the mandible with either NB-Cn or a TiS. The rabbits were sacrificed at 4 and 8 days, and micro-computed tomography analysis was performed. For molecular analysis, the gene expression of interleukin-6, interleukin-10, and tumor necrosis factor-α was assessed. Quantification using real-time polymerase chain reaction was performed. Statistical analysis was performed using the paired Student t test (P < .05). RESULTS: Bone graft fixation with NB-Cn promoted superior volume and density preservation. The percentage of mineralized tissue at the center portion and border of the graft was very similar (NB-Cn, 50.6% ± 8.3% and 50.3% ± 10.6%, respectively) and superior than in the TiS group (32.5% ± 3.5% and 33.8% ± 6%, respectively). Genes from the NB-Cn group were upregulated compared with those in the TiS group at the initial phases of bone healing (4 days), with the profile reversed at the 8-day point. At day 8, the osteoclastogenesis-related genes were upregulated in the TiS group. CONCLUSIONS: Onlay bone grafts fixed with screws induced more inflammation during the initial remodeling process than did NB-Cn. The differences in the incorporation into the host bed suggest that the use of adhesives for graft fixation will promote superior volume and density preservation.

Genetic Regulation of Physical Fitness in Children: A Twin Study of 15 Tests from Eurofit and Fitnessgram Test Batteries.

PURPOSE: To analyze the shared genetic background of physical fitness tests in children. METHODS: Physical fitness was assessed in 198 Portuguese twin pairs (6-18 years old, 40% monozygotic) through 15 tests from the Eurofit and Fitnessgram test batteries. Genetic twin modeling was used to estimate the heritability of each test and the genetic correlations between them. RESULTS: Girls performed better than boys in flexibility, while boys performed better than girls in cardiorespiratory endurance and muscular strength. No sex differences were found in the influence of genetic factors on the physical fitness tests or their mutual correlations. Genetic factors explained 52% (standing long jump) to 79% (sit and reach) of the individual variation in motor performance, whereas individual-specific environmental factors explained the remaining variation. Most of the tests showed modest to moderate genetic correlations. Out of all 105 genetic correlations, 65% ranged from 0.2 to 0.6 indicating that they shared from 4% to 36% of genetic variation. The correlations between individual-specific environmental factors were mostly negligible. CONCLUSIONS: Tests measuring the strength of different muscle groups showed only modest correlations, but moderate correlations were found between tests measuring explosive strength, running speed/agility, and cardiorespiratory endurance. Genetic factors explained a major portion of the variation in tests included in the Eurofit and Fitnessgram test batteries and explained the correlations between them. The modest to moderate genetic correlations indicated that there is little redundancy of tests in either Eurofit or Fitnessgram test batteries.

Comparisons between Bio-Oss(®) and Straumann(®) Bone Ceramic in immediate and staged implant placement in dogs mandible bone defects.

OBJECTIVE: To compare immediate and staged approach implant placement in circumferential defects treated with deproteinized bovine bone mineral (DBBM); hidroxyapatite/tricalcium phosphate (HA/TP); autogenous bone (Ab); and coagulum (Cg); upon implant stability, osseointegration and alveolar crest maintenance. MATERIALS AND METHODS: Six dogs underwent extractions of lower premolars, bilaterally. Twelve weeks later four bone defects (6 mm wide/4 mm long) were drilled at one side and randomly filled with DBBM; HA/TP; Ab; and Cg, respectively, and left to heal (staged approach). Eight weeks later one implant (Osseospeed(™) , AstraTech) was placed in experimental sites. At the same session four defects were drilled on contra-lateral side and implants were inserted immediately after biomaterials grafting (immediate approach). Animals were euthanized 8 weeks later. Implant stability was measured by resonance frequency analysis (RFA) at installation and after sacrifice. Ground sections were prepared for bone contact (BIC); bone area (BA); distance implant shoulder-bone crest (IS-C); distance implant shoulder first bone contact (IS-B); and areas occupied by soft tissue. RESULTS: The BA and BIC were superior in the staged approach. The Cg exhibited higher BIC and BA as compared with other materials at the total implant body (P = 0.004 and 0.012, respectively). The DBBM, HA/TP and Ab groups rendered similar BA and BIC. The immediate approach resulted in less crest resorption compared to staged approach. The biomaterials did not affect the IS-C and IS-B measurements. Particles area tended to be higher in DBBM group than HA/TP (P = 0.15), while soft tissue infiltrate was higher in DBBM group when used in the immediate approach (P = 0.04). The RFA indicated gain in stability in the staged approach (P = 0.002). The correlation test between RFA vs. BIC and BA demonstrated inferior stability for DBBM group in immediate approach (P = 0.01). CONCLUSIONS: Implants placed in healed defects resulted in better stability as a consequence of higher BIC and BA. The Cg alone rendered increased BIC compared to other materials in both approaches. Immediate approach should be preferable to staged approach in terms of alveolar crest maintenance. The BIC and BA values did not vary between micro and macro-threads in this experimental model. Implants installed in sites filled with DBBM in immediate approach were less stable.

Immunohistochemical, tomographic, and histological study on onlay bone graft remodeling. Part III: allografts.

OBJECTIVE: In the last decades aroused the interest for bone tissue bank as an alternative to autogenous grafting, avoiding donor sites morbidity, surgical time, and costs reduction. The purpose of the study was to compare allografts (ALg) with autografts (AUg) using histology, immunochemistry, and tomographic analysis. MATERIAL AND METHODS: Fifty-six New Zealand White rabbits were submitted to surgical procedures. Twenty animals were donors and 36 were actually submitted to onlay grafting with ALg (experimental group) and AUg (control group) randomly placed bilaterally in the mandible. Six animals of each group were sacrificed at 3, 5, 7, 10, 20, and 60 postoperative days. Immunolabeling was accomplished with osteoprotegerin (OPG); receptor activator of nuclear factor-k ligand (RANKL); alkaline phosphatase (ALP); osteopontin (OPN); vascular endothelial growth factor (VEGF); tartrate-resistant acid phosphatase (TRAP); collagen type I (COL I); and osteocalcin (OC). Density and volume of the grafts was evaluated on tomography obtained at the surgery and sacrifice. RESULTS: The ALg and AUg exhibited similar patterns of density and volume throughout the experiments. The intra-group data showed statistical differences at days 7 and 60 in comparison with other time points (P = 0.001), in both groups. A slight graft expansion from fixation until day 20 (P = 0.532) was observed in the AUg group and then resorbed significantly at the day 60 (P = 0.015). ALg volume remained stable until day 7 and decreased at day 10 (P = 0.045). The light microscopy analysis showed more efficient incorporation of AUg onto the recipient bed if compared with the ALg group. The immunohistochemical labeling picked: at days 10 and 20 with OPG in the AUg group and at day 7 with TRAP in the ALg group (P = 0.001 and P = 0.002, respectively). CONCLUSIONS: ALg and AUg were not differing in patterns of volume and density during entire experiment. Histological data exhibit more efficient AUg incorporation into recipient bed compared with the ALg group. Immunohistochemistry outcomes demonstrated similar pattern for both ALg and AUg groups, except for an increasing resorption activity in the ALg group mediated by TRAP and in the AUg group by higher OPG labeling. However, this latter observation does not seem to influence clinical outcomes.

Cytotoxicity testing of methyl and ethyl 2-cyanoacrylate using direct contact assay on osteoblast cell cultures.

PURPOSE: Cyanoacrylate has been used as a commercial tissue adhesive. Recently, ethyl 2-cyanoacrylate has been suggested for the fixation of onlay autogenous bone graft. However, ethyl 2-cyanoacrylate must be biocompatible with bone tissue. This study evaluated the cytotoxicity of cyanoacrylate adhesives using a direct contact assay on human oral osteoblast cells. MATERIALS AND METHODS: Osteoblastic cells derived from human alveolar bone of the mandible were cultured with or without cyanoacrylate. The CA1 group contained methyl 2-cyanoacrylate, the CA2 group contained ethyl 2-cyanoacrylate, and the CA3 group did not contain cyanoacrylate (control). This study investigated cell morphology, which included the inhibition zone, and cytotoxicity was evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, which was measured as optical density. Data from the MTT assay were tested statistically using SigmaStat 3.5. RESULTS: Dead cells found around the CA1- and CA2-treated cells constituted inhibitory zones that varied from 200 to 500 µm. There was no inhibitory zone in the CA3 group. Cell viability evaluated by the MTT assay showed that the CA2 and CA3 optical densities were not significantly different. The CA1 optical densities differed significantly from the CA3 optical densities. CONCLUSIONS: Within the limits of this study, the MTT method supported the conclusion that ethyl 2-cyanoacrylate is biocompatible according to a direct contact assay on human osteoblast cell cultures and suggests its usefulness in bone graft fixation.

Extensive cervical necrotizing fasciitis of odontogenic origin.

Necrotizing fasciitis (NF) is an uncommon infection, but potentially lethal, especially when associated with systemic disorders such as diabetes. The authors report a case of necrotizing fasciitis from odontogenic origin in a patient with uncontrolled diabetes mellitus. The initial diagnosis was based on clinical information, in which multiple necrosis areas in cervical and thoracic regions were observed. Wide antibiotic therapy was applied, followed by surgical drain age and debridement. Culture was positive for methicillin-resistant Staphylococcus aureus. Although the treatment is established, the patient dies after sepsis and failure of vital organs. Clearly, the morbidity associated to this infection, even in diabetic patients, can be minimized if an early diagnosis and effective debridement are done.

PRO-Act: a healthcare provider workshop outlining the added value of implementing PROs in routine HIV practice.

Patient Reported Outcomes (PROs) are an evidenced way of adding value to routine clinical care. As a source of unique information on the effect of a medical condition and its treatment from the patients' perspective (Mercieca-Bebber et al. in Patient Relat Outcome Meas 9: 353-367, https://doi.org/10.2147/PROM.S156279 , 2018), PROs allow for an improved assessment in routine clinical care of symptoms, side effects, functional outcomes (physical, sexual, social, emotional, cognitive functioning), and health-related quality of life (HRQoL). By helping to align healthcare providers' interventions with what matters most to the patient, PROs contribute to the individualized choice of Anti-Retroviral Therapy (Carfora et al. in PLoS ONE 17(4): e0267030, https://doi.org/10.1371/journal.pone.0267030 , 2022) as a paramount component of tailored and person-centred care management, in routine clinical practice. This article outlines a practical framework and process tested in Portugal to raise awareness of PROs' added value, and to help guide first steps in the implementation and seamless integration of PROs, in routine HIV care.