Rubric vs. numeric rating scale: agreement among evaluators on endodontic treatments performed by dental students.

BACKGROUND: Students´ assessment should be carried out in an effective and objective manner, which reduces the possibility of different evaluators giving different scores, thus influencing the qualification obtained and the consistency of education. The aim of the present study was to determine the agreement among four evaluators and compare the overall scores awarded when assessing portfolios of endodontic preclinical treatments performed by dental students by using an analytic rubric and a numeric rating scale. METHODS: A random sample of 42 portfolios performed by fourth-year dental students at preclinical endodontic practices were blindly assessed by four evaluators using two different evaluation methods: an analytic rubric specifically designed and a numeric rating scale. Six categories were analyzed: radiographic assessment, access preparation, shaping procedure, obturation, content of the portfolio, and presentation of the portfolio. The maximum global score was 10 points. The overall scores obtained with both methods from each evaluator were compared by Student's t, while agreement among evaluators was measured by Intraclass correlation coefficients (ICC). The influence of the difficulty of the endodontic treatment on the evaluators´ scores was analyzed by one-way ANOVA. Statistical tests were performed at a pre-set alpha of 0.05 using Stata 16. RESULTS: Difficulty of canal treatment did not influence the scores of evaluators, irrespective of the evaluation method used. When the analytic rubric was used, inter-evaluator agreement was substantial for radiographic assessment, access preparation, shaping procedure, obturation, and overall scores. Inter-evaluator agreement ranged from moderate to fair with the numeric rating scale. Mean higher overall scores were achieved when numeric rating scale was used. Presentation and content of the portfolio showed slight and fair agreement, respectively, among evaluators, regardless the evaluation method applied. CONCLUSIONS: Assessment guided by an analytic rubric allowed evaluators to reach higher levels of agreement than those obtained when using a numeric rating scale. However, the rubric negatively affected overall scores.

Influence of the adhesive strategy in the sealing ability of resin composite inlays after deep margin elevation.

BACKGROUND: The aim of this study was to determine the influence of the gingival margin position and the adhesive strategy selected to perform deep margin elevation (DME) in marginal sealing of resin composite inlays by a nanoleakage test. MATERIAL AND METHODS: 12 sound third molars were selected and expulsive MOD cavities for inlays were prepared. Experimental groups were established according to gingival margin location (enamel: 1 mm above cemento-enamel junction (CEJ), dentin: 1 mm below CEJ, or DME, and the adhesive strategy used to lute inlays and elevate the gingival margin. Therefore, the six experimental groups were: 1) Enamel + etch-and-rinse adhesive (ERA) Adper Scotchbond 1XT (SB1XT); 2) Dentin + SB1XT; 3) DME + SB1XT; 4) Enamel + self-etching adhesive (SEA) with enamel selective etching Clearfil SE Bond (CSE); 5) Dentin + CSE; 6) DME + CSE. Resin composite inlays were constructed (Gradia Indirect) and all luted with the same resin cement (RelyX ARC). Specimens were submitted to nanoleakage test. Results were analyzed by Kruskal-Wallis and Mann-Whitney U tests with Bonferroni correction (p<0.05). RESULTS: A perfect sealing ability was evidenced for experimental groups with gingival margins on enamel. Similar nanoleakage values were determined when CSE adhesive was applied regardless the gingival margin position. The highest silver nitrate infiltration was detected for elevated margins with the ERA SB1XT. CONCLUSIONS: The SEA Clearfil SE Bond showed higher sealing ability than the ERA Adper Scotchbond 1XT when margins were located on dentin, regardless margin elevation. Gingival margins on enamel together with enamel acid etching provided an excellent sealing with both adhesive systems. Key words:Adhesion, composite inlays, gingival margin, deep margin elevation, marginal seal, nanoleakage test.

Assessment of the strength and electrical activity of the pelvic floor muscles of male-to-female transgender patients submitted to gender-affirming surgery: A case series.

AIMS: To assess the strength and electrical activity of the pelvic floor muscles (PFMs) of male-to-female transgender individuals submitted to gender-affirming surgery (GAS). METHODS: A case series study was conducted from October 2016 to August 2018. Transgender women, who were scheduled for GAS, participated in the study. The volunteers were submitted to a clinical evaluation of the PFM followed by digital palpation (PERFECT method) and electromyography in the preoperative, 15, and 30 days after GAS. They responded to the International Consultation on Incontinence Questionnaire-Urinary Incontinence (UI)-Short Form to evaluate the effect of UI on quality of life and to questions related to the urinary, anorectal, and sexual symptoms. Fifteen days after the GAS, patients were instructed to perform perineal exercises at home, twice a day. RESULTS: The study sample consisted of 15 transgender women with an average age of 30.6 (SD = 6.7) years. There was a decline in median strength and sustained muscle contraction duration (PERFECT), in the electrical muscle activity (RMSmean and RMSmax) between pre-GAS and 15 days after GAS (p < 0.05). However, there was an increase in these parameters between 15 and 30 days after GAS (p < 0.05). Moreover, six patients exhibited pre-GAS UI, which continued after surgery, with a worsening of urgency symptoms and improvement in nocturia and postmicturition leakage. CONCLUSION: Strength, sustained muscle contraction duration, and PFM electrical activity may decline 15 days after GAS, returning to pre-GAS values in the first month after surgery.

Dietary zinc restriction promotes degeneration of the endocrine pancreas in mice.

Zinc is a key component of several proteins, interacting with the pancreatic hormones insulin and amylin. The role of zinc in insulin oligomerization and crystallinity is well established, although the effects of dietary zinc restriction on both energetic metabolism and ß-pancreatic hormonemia and morphology remain unexplored. Here we report the effects of dietary zinc restriction on the endocrine pancreas and metabolic phenotype of mice. Nontransgenic male Swiss mice were fed a low-zinc or control diet for 4 weeks after weanling. Growth, glycemia, insulinemia and amylinemia were lower and pancreatic islets were smaller in the intervention group despite the preserved insulin crystallinity in secretory granules. We found strong immunostaining for insulin, amylin and oligomers in apoptotic pancreatic islet. High production of ß-pancreatic hormones in zinc-restricted animals counteracted the reduced islet size caused by apoptosis. These data suggest that zinc deficiency is sufficient to promote islet ß-cell hormonal disruption and degeneration.

Aging and chromatoid body assembly: Are these two physiological events linked?

The chromatoid body is a cytoplasmic male germ cell structure that plays a role in the regulation of mRNA transcription during spermatogenesis. A proteomic analysis of this structure has identified the presence of its classic molecular markers (MVH and MIWI), as well as a significant number of transient proteins. Circadian locomotor output cycles protein kaput (CLOCK) and brain and muscle ARNT-like 1 (BMAL1), which are molecular components of the circadian clock, are likely located in the chromatoid body in a transient fashion. This study sought to determine whether aging produces morphological changes in the chromatoid bodies of round spermatids similar to those previously observed in BMAL1 knockout mice. A sample of 30 male mice was divided into three groups: juvenile mice (45 days old), adult mice (120 days old), and old mice (+180 days old). Aging was confirmed by viability and sperm count analyses and testosterone dosage. Squash slides prepared with fragments of seminiferous tubules were immunostained for MVH, MIWI, BMAL1, and CLOCK detection. In juvenile and adult specimens, single round chromatoid bodies were observed using MVH/BMAL1 and MIWI/CLOCK immunostaining. In old specimens, many chromatoid bodies displayed changes in number and morphology, as well as an increase in the interactions between MVH and BMAL1; MIWI and CLOCK. Changes in chromatoid body morphology increased interactions between the proteins analyzed herein, and decreased amounts of these proteins in seminiferous tubules of older mice may indicate that aging influences the assembly and physiology of chromatoid bodies, which may, in turn, affect fertility. Impact statement The results discussed in this paper indicate that aging compromises the structure and physiology of chromatoid bodies (CBs) in post-meiotic male cells. Since CB is a fundamental structure for the differentiation of the mature male germ cell it is possible that this imbalance in CB physiology may play a role in the reduction of fertility in older men. It is important to note that not only the classic CB markers (such as the MIWI and MVH proteins) were used to showcase the structural changes in the CBs but also the main components of circadian cycle control (the CLOCK and BMAL1 proteins), indicating that the reduction of circadian control in aged males may contribute to these changes in CBs as well. Therefore, it is intriguing to evaluate the hypothesis that controlling these physiological/structural changes in CBs may be a way of delaying the effects of aging in males.

Physico-chemical properties of co-formulated fast-acting insulin with pramlintide.

Since the discovery of amylin its use has been discouraged by the inadequacy of the protocol involving multiple injections in addition to insulin. We aimed here to develop a combined fixed-dose formulation of pramlintide with fast-acting insulin. We have investigated the compatibility of regular and fast-acting insulin analogues (Aspart, AspB28, and LisPro, LysB28ProB29) with the amylin analogue pramlintide by using electrospray ionization - ion mobility spectrometry-mass spectrometry (ESI-IMS-MS), kinetic aggregation assays monitored by thioflavin T, and transmission electron microscopy (TEM) in the evaluation of the aggregation product. Insulin interacts with pramlintide, forming heterodimers as probed by ESI-IMS-MS. While their interaction is likely to delay the amyloid aggregation of pramlintide in phosphate-buffered solution pH 7.0, they do not prevent aggregation at this condition. At acidic sodium acetate solution pH 5.0, combination of pramlintide and the fast-acting insulin analogues become stable against amyloid aggregation. The co-formulated product at high concentration of both pramlintide (600 µg/mL,150 µM) and LisPro insulin (50 IU/mL, 300 µM) showed also stability against amyloid aggregation. These data indicate the physico-chemical short-term stability of the co-formulated preparation of LisPro insulin with pramlintide, which could bring benefits for the combined therapy.

Amyloidogenesis of the amylin analogue pramlintide.

Amylin is a pancreatic peptide hormone co-secreted along with insulin by the ß-cells. It is found in amyloid deposits in both type 2 diabetic individuals and elder non-diabetic. The triple proline amylinomimetic compound (25,28,29-Pro-human amylin) named pramlintide was designed aiming to solve the solubility and amyloid characteristics of human amylin. We have found by using ion mobility spectrometry-based mass spectrometry that pramlintide is able to assembly into multimers. Pramlintide formed amyloid fibrils in vitro in a pH-dependent kinetic process within a few hours, as followed by thioflavin T, quantification of soluble peptide and further characterized by transmission electron microscopy, atomic force microscopy and X-ray diffraction. These data indicate that pramlintide can form amyloid fibers.

El entorno familiar y social de la madre como factor que promueve o dificulta la lactancia materna / The family and social environment of the mother as a factor that promotes or hinders breastfeeding

Antecedentes. Existe suficiente evidencia científica sobre las bondades de la práctica de la lactancia materna para el binomio madre-hijo. Se plantean diversas políticas y programas encaminados a promover, proteger y apoyar la lactancia materna, muchas veces, haciendo caso omiso de múltiples factores que la permean, como factores sociales, culturales, familiares y personales que pueden hacer que sea una experiencia exitosa o no. Objetivo. Identificar los factores determinantes de tipo social, cultural y familiar que inciden en el éxito o fracaso de la práctica de la lactancia materna. Materiales y métodos. Se realizó una búsqueda sistemática en bases de datos como: Scielo, Medigraphic, Redalyc, SINAB Universidad Nacional, Dial Net, ScienceDirect, MedLine, PubMed, Cochrane Database, Elsevier y EBSCOhost. Se revisaron estudios descriptivos, analíticos, de revisión de temas, de casos y controles realizados en los últimos diez años. Resultados. Entre los factores que protegen la lactancia materna se encuentran: el apoyo de la familia, el acompañamiento de la pareja y el haber tenido una experiencia previa positiva con otros hijos. El rol que ejerce la abuela es discordante en distintos estudios. La mayoría de estudios refieren que a mayor nivel de escolaridad hay mayor prevalencia de lactancia materna. Las madres trabajadoras lactan menos tiempo a sus hijos, aunque en entornos laborales donde la madre está protegida con políticas legales, la duración es mayor. Y las madres que permanecen en la casa lactan más. Conclusión. Tener presente el entorno materno es fundamental en la planeación de programas y proyectos que promuevan la lactancia.

Background. There is enough scientific evidence about the benefits of the practice of breastfeeding for mother and child. Various policies and programs to promote, protect and support breastfeeding are raised, often ignoring the many factors that pervade it, such as social, cultural, family and personal factors that can make it a successful experience or not . Objective. To identify the determinants of social, cultural and family type that affect the success or failure of the practice of breastfeeding. Materials and Methods. A systematic database search was conducted through Scielo, Medigraphic, Redalyc, SINAB National University, Dial Net, ScienceDirect, Medline, PubMed, Cochrane Database, Elsevier and EBSCOhost. There was a revision of descriptive, analytical and subject-review studies, as well as of cases and controls carried out during the past decade. Results. Among the factors that protect breastfeeding are family support, sentimental partner support and previous positive experience with other children. The role played by the grandmother is discordant in different studies. Most of the studies state that the higher the level of education, the greater the prevalence of breastfeeding. Working mothers breastfeed their children for a shorter period of time; however, the duration is longer when mothers are protected by legal policies in their workplaces. Mothers who stay at home breastfeed their children more. Conclusions. Keeping in mind the maternal environment is essential in the planning of programs and projects that promote breastfeeding.

Environmentally associated ticks (Acari: Ixodidae) in Campo Grande, Mato Grosso do Sul, Brazil.

Herein, we report tick species found on wild and domestic animals and in the environment during a one-year sampling period at the Brazilian Farming Research Company beef cattle unit (Embrapa Beef Cattle), which is located within the urban area of Campo Grande, Mato Grosso do Sul, Brazil. From 55 wild hosts including six different species (Nasua nasua, Cebus spp., Cerdocyon thous, Myrmecophaga tridactyla, Tamandua tetradactyla and Dasyprocta aguti), 323 ticks were collected. Amblyomma ovale ticks were found solely on coatis, and Amblyomma nodosum was identified solely on anteaters. No ticks were found on capuchin monkeys. However, Amblyomma cajennense was found on all parasitized host species with the exception of capuchin monkeys. Giant anteaters displayed the highest infestation abundance, with a mean of 53 ticks∕animal. Environmental sampling yielded 166 adult A. cajennense ticks. The tick species found on domestic animals (Rhipicephalus (Boophilus) microplus, R. sanguineus, Dermacentor nitens and A. cajennense) were those typically found on these hosts in Brazil. The most prevalent tick species, A. cajennense, was found on both wild and domestic animals and was also prevalent in the environment. Thus, this tick species is the primary vector that allows pathogens to bridge wild and domestic animals in the Cerrado.

Environmentally associated ticks (Acari: Ixodidae) in Campo Grande, Mato Grosso do Sul, Brazil / Carrapatos (Acari: Ixodidae) associados com o ambiente em Campo Grande, Mato Grosso do Sul, Brasil

Herein, we report tick species found on wild and domestic animals and in the environment during a one-year sampling period at the Brazilian Farming Research Company beef cattle unit (Embrapa Beef Cattle), which is located within the urban area of Campo Grande, Mato Grosso do Sul, Brazil. From 55 wild hosts including six different species (Nasua nasua, Cebus spp., Cerdocyon thous, Myrmecophaga tridactyla, Tamandua tetradactyla and Dasyprocta aguti), 323 ticks were collected. Amblyomma ovale ticks were found solely on coatis, and Amblyomma nodosum was identified solely on anteaters. No ticks were found on capuchin monkeys. However, Amblyomma cajennense was found on all parasitized host species with the exception of capuchin monkeys. Giant anteaters displayed the highest infestation abundance, with a mean of 53 ticks/animal. Environmental sampling yielded 166 adult A. cajennense ticks. The tick species found on domestic animals (Rhipicephalus (Boophilus) microplus, R. sanguineus, Dermacentor nitens and A. cajennense) were those typically found on these hosts in Brazil. The most prevalent tick species, A. cajennense, was found on both wild and domestic animals and was also prevalent in the environment. Thus, this tick species is the primary vector that allows pathogens to bridge wild and domestic animals in the Cerrado.

Neste trabalho são descritas as espécies de carrapatos de animais selvagens e domésticos e do ambiente coletados por um ano na EMBRAPA Gado de Corte localizado na área urbana de Campo Grande, Mato Grosso do Sul, Brasil. Dos 55 hospedeiros selvagens de seis espécies diferentes (Nasua nasua, Cebus spp.,Cerdocyon thous, Myrmecophaga tridactyla,Tamandua tetradactyla e Dasyprocta aguti) foram coletados 323 carrapatos. Amblyomma ovale foi encontrado apenas em quatis e Amblyomma nodosum apenas sobre tamanduás. Nenhum carrapato foi encontrado sobre macacos-prego. Por outro lado, Amblyomma cajennense foi encontrado em todos os hospedeiros com exceção dos macacos-pregos. A maior abundancia de infestação foi aquela em tamanduás-bandeira com média de 53 carrapatos/animal. No ambiente foram capturados 166 carrapatos, todos da espécie A. cajennense. As espécies de carrapatos em animais domésticos (Rhipicephalus (Boophilus) microplus, Rhipicephalus sanguineus, Dermacentor nitens e A. cajennense) foram aquelas características nestes hospedeiros no Brasil. De forma geral a espécie de carrapato A. cajennense foi a mais prevalente sendo encontrada em animais domésticos e selvagens bem como no ambiente. Portanto, esta é a principal espécie de vetor a estabelecer uma ponte para bioagentes patogênicos entre animais domésticos e selvagens.

Consenso médico de biopsia por aspiración con aguja fina de tiroides. reporte de citología tiroidea basado en el sistema de bethesda / Medical consensus of fine-needle aspiration biopsy of the thyroid. bethesda system for reporting thyroid cytopathology

En este artículo se presenta un consenso médico basado en el sistema de Bethesda del Instituto Nacionalde Cáncer (Estados Unidos) para el uso de la biopsia por aspiración con aguja fina en el manejo de nódulos tiroideos, realizado en conjunto con patólogos, radiólogos, endocrinólogos y otras especialidades médicas de Colombia, España, Chile, Venezuela, Estados Unidos y Panamá. En este trabajo se describen las indicaciones de la biopsia por aspiración con aguja fina de tiroides, requisitos previos, entrenamiento, acreditación, técnicas, terminología diagnóstica, pruebas complementarias y opciones de tratamiento. El objetivo del actual artículo es presentar ante la comunidad médica la clasificación de los reportes citológicos, el reporte de ecografía que propone usar el sistema de datos y el reporte de imágenes tiroideas (TIRADS, del inglés The Thyroid Imaging Reporting and Data System), el uso de la medición de tiroglobulina en biopsia por aspiración con aguja fina y técnicas de citología líquida;...

This article presents a medical consensus based on the Bethesda system of the National Cancer Institute (USA) for the use of fine needle aspiration biopsy in the management of thyroid nodules. This consensus was performed in conjunction with pathologists, radiologists, endocrinologists, and other medical specialties of Colombia, Spain, Chile, Venezuela, United States, and Panama. In this work was described the indications for fine needle aspiration biopsy of thyroid, prerequisites, training, accreditation, techniques, diagnostic terminology, additional tests and treatment options. The aim of this article is present to the medical community the classification of cytological report, ultrasound report using the data system, and the thyroid imaging reporting and data system (TIRADS); as well as, the use of thyroglobulin measurement in fine needle aspiration biopsy, and liquid-based cytology techniques...

Rotulagem de pizzas de mussarela: avaliação das informações obrigatórias e nutricionais / Labelling of mozzarella pizza: evaluation of information required and nutritional

A história da pizza começou há mais de 5000 anos. Nos dias atuais, por ser facilmente encontrada, pré-pronta ou congelada nos supermercados, ou pela grande expansão dos deliverys e pizzarias, a pizza se tornou um dos alimentos práticos e de consumo habitual na alimentação do brasileiro. Desta forma, foi objetivo deste estudo avaliar a rotulagem de pizzas de mussarela, considerando-se o estado de conservação e a limpeza do local, além do uso da refrigeração na exposição destes nos supermercados localizados na cidade do Rio de Janeiro, durante o ano de 2008...

Conhecimento de mulheres que fazem sexo com mulheres sobre o papiloma vírus / Knowledge of women who have sex with women about human papillomavirus

Estudo quantitativo e descritivo, que teve como objetivo verificar o conhecimento de mulheres que fazem sexo com mulheres sobre as formas de transmissão, prevenção e fatores de risco relacionados ao papiloma vírus humano (HPV). Foi realizado com 31 mulheres residentes no Município de São José do Rio Preto, Estado de São Paulo. Os dados foram coletados por meio de questionário estruturado com 17 questões, analisados com auxílio do programa estatístico Statistical Package of Social Sciences e estatística descritiva. Constatou-se que a média de idade das mulheres foi de 39,5 anos, e que 52% possuíam entre 9 e 11 anos de estudo. Em relação ao conhecimento, 68% das mulheres não sabiam o significado do HPV, 58% acreditavam que a camisinha protege totalmente, e 45% responderam que o Papanicolau deve ser realizado duas vezes ao ano. Concluiu-se que há vulnerabilidade para contaminação por HPV devido à exposição aos fatores de risco e falta de conhecimento.

Microbiota das mãos de mães e de profissionais de saúde de uma maternidade de Goiânia / Hand microbiota of mothers and healthcare workers of an obstetric hospital in Goiânia / Microbiota de las manos de madres y de profesionales de salud de una maternidad en Goiânia

Trata-se de um estudo descritivo realizado em uma maternidade de um Hospital Universitário de Goiânia-Goiás realizado de abril a outubro de 2003, cujo objetivo foi identificar a microbiota das mãos de mães e de profissionais da área da saúde que cuidam de recém-nascidos. A população do estudo foi composta por todos os trabalhadores da área da saúde que estavam em exercício ativo, e pelas mães que estavam em atendimento no serviço; durante o período do estudo. Das mãos de 31 sujeitos (15 mães e 16 profissionais de saúde) foram isolados cocos Gram-positivos, bastonetes Gram-negativos e leveduras, sendo que os microrganismos mais frequentemente isolados foram: Staphylococcus aureus, Staphylococcus e coagulase negativo, Escherichia coli, Klebsiella pneumoniae, Citrobacter freundii, Enterobacter sp, Hafnia alvei, Serratia sp e Arizona sp, os quais têm sido apontados na literatura como associados a surtos de infecção hospitalar em berçários e alojamento conjunto. Assim torna-se premente a elaboração de programas de educação permanente para profissionais e usuários dos serviços de saúde sobre a importância da higienização das mãos, como ferramenta para prevenir infecção e assegurar uma assistência de qualidade aos recém-nascidos.

This descriptive study was carried out at a maternity of a University Hospital in Goiânia-Goiás, Brazil, between April and October of 2003. It aimed to identify the hand microbiota of mothers and health professionals delivering care to newborns. The study population consisted of all active health workers and the mothers receiving care at the service during the study period. From the hands of 31 subjects (15 mothers and 16 health professionals), Gram-positive organisms, Gram-negative rods and yeasts were isolated. The most frequently isolated microorganisms were: Staphylococcus aureus, Staphylococcus e negative-coagulase, Escherichia coli, Klebsiella pneumoniae, Citrobacter freundii, Enterobacter sp, Hafnia alvei, Serratia sp and Arizona sp, which literature has appointed as being associated with outbreaks of hospital infection in child-care and rooming-in units. This reveals the urgent need to elaborate permanent education programs for professionals and health service users about the importance of hand washing as a tool to prevent infection and guarantee quality care to newborns.

Se trata de un estudio descriptivo realizado en una maternidad de un Hospital Universitario de Goiânia-Goiás, Brasil, entre abril y octubre de 2003, con objeto de identificar la microbiota de las manos de madres y de profesionales del área de la salud que cuidan de recién-nacidos. La población del estudio fue compuesta por todos los trabajadores del área de la salud que estaban en ejercicio activo, y por las madres que estaban recibiendo atención en el servicio durante el período del estudio. De las manos de 31 sujetos (15 madres y 16 profesionales de salud) fueron aislados cocos Gram-positivos, bastones Gram-negativos y levaduras, siendo que los microorganismos más frecuentemente aislados fueron: Staphylococcus aureus, Staphylococcus e coagulase negativo, Escherichia coli, Klebsiella pneumoniae, Citrobacter freundii, Enterobacter sp, Hafnia alvei, Serratia sp e Arizona sp, los cuales han sido indicados en la literatura como asociados a irrupciones de infección hospitalaria en nidos y alojamiento conjunto. Así, se vuelve urgente la elaboración de programas de educación permanente para profesionales y usuarios de los servicios de salud sobre la importancia de la higienización de las manos, como herramienta para prevenir infección y garantizar una atención de calidad a los recién-nacidos.