Role of ultrasound in detection of lymph-node metastasis in gynecological cancer: systematic review and meta-analysis.

OBJECTIVE: To assess the diagnostic performance of transvaginal sonography (TVS) for the preoperative evaluation of lymph-node metastasis in gynecological cancer. METHODS: This was a systematic review and meta-analysis of studies published between January 1990 and May 2023 evaluating the role of ultrasound in detecting pelvic lymph-node metastasis (index test) in gynecological cancer, using histopathological analysis as the reference standard. The quality of included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Pooled sensitivity, specificity and diagnostic odds ratio were estimated. RESULTS: The literature search identified 2638 citations. Eight studies reporting on a total of 967 women were included. The mean prevalence of pelvic lymph-node metastasis was 24.2% (range, 14.0-65.6%). The risk of bias was low for most domains assessed. Pooled sensitivity, specificity and diagnostic odds ratio of TVS were 41% (95% CI, 26-58%), 98% (95% CI, 93-99%) and 32 (95% CI, 14-72), respectively. High heterogeneity was found between studies for both sensitivity and specificity. CONCLUSION: TVS showed a high pooled specificity for the detection of pelvic lymph-node metastasis in gynecological cancer, but pooled sensitivity was low. © 2024 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Prospective external validation of IOTA methods for classifying adnexal masses and retrospective assessment of two-step strategy using benign descriptors and ADNEX: a Portuguese multicenter study.

OBJECTIVE: This study aimed to externally and prospectively validate the International Ovarian Tumor Analysis (IOTA) Simple Rules (SRs), Logistic Regression model 2 (LR2) and Assessment of Different NEoplasias in the adneXa (ADNEX) in a Portuguese population, comparing them with operator subjective assessment (SA), Risk-of-Malignancy Index (RMI), as well as with each other. This study also aimed to retrospectively validate IOTA two-step strategy, using modified benign descriptors (MBDs) followed by the application of ADNEX in cases where MBDs were not applicable (MBDs + ADNEX). METHODS: In this multicenter diagnostic accuracy study, conducted between January 2016 and December 2021, three tertiary referral centers prospectively included consecutive patients with ultrasound diagnosis of at least one adnexal tumor who underwent surgery. All ultrasound assessments were performed by level II or III sonologists with IOTA certification. Patient clinical data and serum cancer antigen (CA125) levels were collected from the hospital databases. Each adnexal mass was classified as benign or malignant using SA, RMI, IOTA SRs, LR2 and ADNEX (with and without CA125). The reference standard was histopathological diagnosis. In the second phase, all adnexal tumors were retrospectively classified using the two-step strategy (MBDs + ADNEX). The sensitivity, specificity, positive (PPV) and negative predictive value (NPV), positive (LR+) and negative likelihood ratio (LR-) as well as overall accuracy were determined for SA, RMI, IOTA SRs, LR2, ADNEX and two-step strategy (MBDs + ADNEX). Receiver-operator characteristic curves were constructed and corresponding areas under the curve (AUC) determined for RMI, LR2 and ADNEX and two-step strategy (MBDs + ADNEX). The ADNEX calibration plots were constructed and estimated by LOESS smoother. RESULTS: Of the 571 included patients, 428 had benign disease, 42 borderline ovarian tumors, 93 primary invasive adnexal cancers and 8 metastatic tumors in adnexa (malignancy prevalence: 25.0%). The operator SA had an overall sensitivity of 97.9% and a specificity of 83.6% for distinguishing between benign and malignant lesions. RMI showed high specificity (95.6%) but very low sensitivity (58.7%), with an AUC of 0.913. The IOTA SRs were applicable in 80.0% of patients, with a sensitivity of 94.8% and a specificity of 98.6%. LR2 revealed a sensitivity of 84.6%, a specificity of 86.9% and an AUC of 0.939, at the malignancy risk cut-off of 10%. At the same cut-off, ADNEX with and without CA125 had a sensitivity of 95.8% and 98.6%, respectively, and a specificity of 82.5% and 79.7%, respectively. The AUC of ADNEX with vs. without CA125 was 0.962 vs. 0.960. The ADNEX model provided heterogeneous results in distinguishing between benign and different subtypes of malignancy, with the highest AUC (0.991) for discriminating benign masses from primary adnexal cancer stage II-IV, and the lowest AUC (0.696) for distinguishing primary adnexal cancer stage I and metastatic lesion in adnexa. The ADNEX calibration plots suggested an underestimation of the predicted risk in relation with the observed proportion of malignancies. The MBDs were applicable in 26.3% of cases (150/571 tumors, none of which were malignant). Similar to the ADNEX model applied in all patients, the two-step strategy using ADNEX in the second step only, with and without CA125, had an AUC of 0.964 and 0.961, respectively. CONCLUSIONS: Our results showed a good to excellent performance of the IOTA methods in the studied Portuguese population, outperforming RMI. ADNEX was superior in accuracy, but interpretation of its ability to distinguish malignant subtypes was fundamentally limited not only by sample size but also by large differences in the prevalence of tumor subtypes. The IOTA MBDs have been shown to be reliable in identifying benign disease. The two-step strategy based on the application of MBDs, followed by the ADNEX model if MBDs are not applicable, has proven to be suitable for daily practice circumventing the need to use electronic support in all patients. This article is protected by copyright. All rights reserved.

Effect of whitening products on sound enamel and on artificial caries lesions during a cariogenic challenge.

OBJECTIVE: To investigate the effect of fluoride-containing whitening products on sound enamel and on artificial caries lesions during a cariogenic challenge. MATERIALS AND METHODS: Bovine enamel specimens (n = 120) with three areas [non-treated sound enamel (NSE), treated sound enamel (TSE), and treated artificial caries lesion (TACL)] were randomly assigned to the four groups: whitening mouthrinse (WM: 2.5% hydrogen peroxide-100 ppm F-), placebo mouthrinse (PM: 0% hydrogen peroxide-100 ppm F-), whitening gel (WG: 10% carbamide peroxide-1130 ppm F-), and deionized water (negative control; NC). The treatments (2 min for WM, PM, and NC, and 2 h for WG) were carried out during a 28-day pH-cycling model (6 × 60 min demineralization/day). Relative surface reflection intensity (rSRI) and transversal microradiography (TMR) analyses were performed. Fluoride uptake (surface and subsurface) was measured in additional enamel specimens. RESULTS: For TSE, a higher value of rSRI was observed in WM (89.99% ± 6.94), and a greater decrease in rSRI was observed for WG and NC, and no sign of mineral loss was verified for all groups (p > 0.05). For TACL, rSRI significantly decreased after pH-cycling for all experimental groups with no difference between them (p < 0.05). Higher amounts of fluoride were found in WG. WG and WM exhibited intermediate values of mineral loss, similar to PM. CONCLUSIONS: The whitening products did not potentialize the enamel demineralization under a severe cariogenic challenge, and they did not exacerbate mineral loss of the artificial caries lesions. CLINICAL RELEVANCE: Low concentrated hydrogen peroxide whitening gel and mouthrinse containing fluoride do not intensify the progression of caries lesions.

Biofilm formation under high shear stress increases resilience to chemical and mechanical challenges.

The effect that the hydrodynamic conditions under which biofilms are formed has on their persistence is still unknown. This study assessed the behaviour of Pseudomonas fluorescens biofilms, formed on stainless steel under different shear stress (τw) conditions (1, 2 and 4 Pa), to chemical (benzalkonium chloride - BAC, glutaraldehyde - GLUT and sodium hypochlorite - SHC) and mechanical (20 Pa) treatments (alone and combined). The biofilms formed under different τw  showed different structural characteristics. Those formed under a higher τw were invariably more tolerant to chemical and mechanical stresses. SHC was the biocide which caused the highest biofilm killing and removal, followed by BAC. The sequential exposure to biocides and mechanical stress was found to be insufficient for effective biofilm control. A basal layer containing biofilm cells mostly in a viable state remained on the surface of the cylinders, particularly for the 2 and 4 Pa-generated biofilms.

Cryopreservation of Collared Peccary (Pecari tajacu Linnaeus, 1758) Somatic Cells is Improved by Sucrose and High Concentrations of Fetal Bovine Serum.

BACKGROUND: The formation of somatic cell banks is affected by, amongst other factors, the cryoprotectant solution used. The selection of an effective solution, therefore, is a primary parameter. OBJECTIVE: We optimized the cryoprotectant used for collared peccary somatic cell cryopreservation. MATERIALS AND METHODS: We categorized cells into different groups based on their cryopreservation and evaluated the morphology, viability, proliferative activity, metabolism, and oxidative stress. One group was cryopreserved in 10% DMSO with 10% fetal bovine serum (DMSO-10FBS), and another with 50% FBS (DMSO-50FBS). The cryopreservation of both groups included the presence of 0.2 M sucrose (DMSO-SUC-10FBS and DMSO-SUC-50FBS). Non-cryopreserved cells and cells cryopreserved with 10% DMSO (DMSO) supplemented with 0.2 M sucrose (DMSO-SUC) were used as controls. RESULTS: There was no difference observed in morphology or viability among the groups. Proliferative activity was reduced in DMSO-10FBS when compared to controls. Although cryopreservation reduced metabolism, no difference was observed among solutions. A lower level of reactive oxygen species was observed in cells of DMSO-SUC-50FBS when compared to other cryoprotectants. Only cells of DMSO-SUC-50FBS had mitochondrial potential similar to non-cryopreserved cells. CONCLUSION: 10% DMSO supplemented with 50% FBS and 0.2 M SUC was observed to be the most efficient cryoprotectant for preserving collared peccary somatic cells.

Digital Image Correlation and Finite Element Analysis of Bone Strain Generated by Implant-Retained Cantilever Fixed Prosthesis.

PURPOSE: The present study evaluated the displacement and strain generated in an implant- supported fixed prosthesis under axial and non-axial loads using two methods. MATERIALS AND METHODS: Three implants were inserted in a resin block. The Digital Image Correlation (DIC) was used to measure displacement and strain generated on the surface of the resin blocks for the different load applications (500N, 1 image/second). A 3-dimensional model was constructed and a load of 500 N was applied at an axial point and a non-axial point through finite element analysis (FEA). RESULTS: Both methods gave similar trends for the strains, and both gave slightly higher strains with non-axial loading. FEA predicted higher strain magnitude (±11%) in comparison with DIC, but with the same mechanical behavior. According to ANOVA, the loading influenced the strain concentration. Higher strain was generated for non-axial loading around the implant nearest to the loading. CONCLUSIONS: For implant-retained cantilever fixed prosthesis, the same load applied in the lever arm induces higher strain in the cervical area of the last implant, which suggests more damaging potential than a load applied at the center of the prosthesis.

Histopathological, histoenzymological, immunohistochemical and immunofluorescence analysis of tissue response to sealing materials after furcation perforation.

AIM: To evaluate in vivo tissue responses after sealing furcation perforations in dog's teeth with either Biodentine™, mineral trioxide aggregate (MTA) or gutta-percha, by means of histopathological, histoenzymological, immunohistochemical and immunofluorescence analysis. METHODOLOGY: After root canal treatment, perforations were created in the central region of the pulp chamber floor using a round diamond bur and filled with one or other of the materials. The animals were euthanized after 120 days, and the teeth (n = 30) were processed for histopathological analysis of new mineralized tissue formation and collagen fibre reinsertion, immunohistochemical analysis of osteopontin (OPN) and alkaline phosphatase (ALP) and immunofluorescence analysis for bone morphogenetic protein (BMP-2), cementum attachment protein (CAP), bone sialoprotein (BSP), osteocalcin (OCN) and cementum protein1 (CEMP1). Histoenzymology was performed for TRAP activity and osteoclast count. Data were analysed statistically (α = 0.05) using chi-square and Kruskal-Wallis tests. RESULTS: Gutta-percha did not induce mineralized tissue formation. MTA and BiodentineTM formed mineralized tissue in 88% and 92% of specimens, respectively, with no significant difference (P > 0.05). Gutta-percha was associated with scattered collagen fibres parallel to the perforations. Groups treated with MTA or BiodentineTM had partial fibre reinsertion perpendicular to the newly formed mineralized tissue. All materials induced OPN and ALP expression, weakest for gutta-percha and strongest for MTA (P < 0.05). Only MTA induced BMP-2, BSP, OCN, CAP and CEMP1 expression. Osteoclast counts were similar in all groups (P = 0.97). CONCLUSIONS: Mineral trioxide aggregate and BiodentineTM were biocompatible, with formation of mineralized tissue and partial reinsertion of collagen fibres. In addition, the participation of several molecules by which calcium silicate-based materials induce the formation of mineralized tissue were noted, with expression of ALP and OPN mineralization markers, without interference in the number of osteoclasts. Only MTA stimulated the expression of proteins associated with the formation of a cementum-like mineralized tissue.

Influence of Ceramic Materials on Biomechanical Behavior of Implant Supported Fixed Prosthesis with Hybrid Abutment.

PURPOSE: This study evaluated the stress distribution in different cement-retained implant-supported prostheses with a hybrid abutment. MATERIALS AND METHODS: Two factors were evaluated: restorative material for the crown and hybrid abutment - zirconia, lithium disilicate and hybrid ceramic, yielding 9 combinations. For finite element analysis, a monolithic crown cemented on a hybrid abutment was modeled and cemented on a titanium base (Ti base). An oblique load (45°, 300 N) was applied to the fossa bottom and system fixation occurred on the bone's base. RESULTS: Each structure was evaluated separately to find the possible weaknesses in geometry and failure criteria. In this context, results demonstrated a significant decrease of maximum principal and von-Mises stresses concentration when crowns with high elastic modulus are cemented onto a hybrid abutment with lower elastic modulus. CONCLUSIONS: Considering this theoretical study for a Morse taper implant, the association of a rigid crown with a more resilient hybrid abutment reduces the tensile stress concentration in the restoration cervical region.

HIV infection is independently associated with a higher concentration of alpha-1 antitrypsin.

OBJECTIVES: Alpha-1 antitrypsin (AAT) deficiency is associated with an increased risk of chronic obstructive pulmonary disease and has been related to CD4 T-cell count decline in people living with HIV (PLWH). We determined whether HIV status is associated with AAT concentrations and assessed associations between AAT concentration, pulmonary function and immunological status. METHODS: Alpha-1 antitrypsin was measured and spirometry performed in 1011 PLWH from the Copenhagen Comorbidity in HIV Infection (COCOMO) study and in 11 962 age- and sex-matched uninfected controls. We studied associations between AAT concentration, HIV status, pulmonary function, and current and nadir CD4 T-cell counts using multivariate linear regression analyses. RESULTS: The mean age of PLWH was 50.7 [standard deviation (SD) 11.3] years and 98.6% were receiving combination antiretroviral therapy (cART). The mean current CD4 T-cell count was 718 (SD 284) cells/µL. PLWH had a higher median AAT concentration than uninfected controls [1.4 (interquartile range (IQR) 1.3-1.6) versus 1.3 (IQR 1.2-1.4) g/L; P < 0.0001] and HIV infection was independently associated with higher AAT concentration [adjusted ß = 0.10 g/L; 95% confidence interval (CI) 0.08; 0.11 g/L; P < 0.001]. Low AAT concentration (< 1.0 g/L) was not more common in PLWH with airflow limitation (defined as forced expiratory volume in 1 second/forced vital capacity (FEV1 /FVC) < 0.7 with FEV1 -predicted < 80%) compared with uninfected controls with airflow limitation, and the effect of AAT on FEV1 %-predicted was comparable to that in uninfected controls (P-interaction = 0.66). AAT concentration was not associated with current or nadir CD4 T-cell count. CONCLUSIONS: HIV infection was independently associated with a higher concentration of AAT through unknown mechanisms. However, AAT does not seem to contribute to lower pulmonary function or to low CD4 T-cell counts in PLWH.

The extent of B-cell activation and dysfunction preceding lymphoma development in HIV-positive people.

OBJECTIVES: B-cell dysfunction and activation are thought to contribute to lymphoma development in HIV-positive people; however, the mechanisms are not well understood. We investigated levels of several markers of B-cell dysfunction [free light chain (FLC)-κ, FLC-λ, immunoglobulin G (IgG), IgA, IgM and IgD] prior to lymphoma diagnosis in HIV-positive people. METHODS: A nested matched case-control study was carried out within the EuroSIDA cohort, including 73 HIV-positive people with lymphoma and 143 HIV-positive lymphoma-free controls. Markers of B-cell dysfunction were measured in prospectively stored serial plasma samples collected before the diagnosis of lymphoma (or selection date in controls). Marker levels ≤ 2 and > 2 years prior to diagnosis were investigated. RESULTS: Two-fold higher levels of FLC-κ [odds ratio (OR) 1.84; 95% confidence interval (CI) 1.19, 2.84], FLC-λ (OR 2.15; 95% CI 1.34, 3.46), IgG (OR 3.05; 95% CI 1.41, 6.59) and IgM (OR 1.46; 95% CI 1.01, 2.11) were associated with increased risk of lymphoma > 2 years prior to diagnosis, but not ≤ 2 years prior. Despite significant associations > 2 years prior to diagnosis, the predictive accuracy of each marker was poor, with FLC-λ emerging as the strongest candidate with a c-statistic of 0.67 (95% CI 0.58, 0.76). CONCLUSIONS: FLC-κ, FLC-λ and IgG levels were higher > 2 years before lymphoma diagnosis, suggesting that B-cell dysfunction occurs many years prior to lymphoma development. However, the predictive value of each marker was low and they are unlikely candidates for risk assessment for targeted intervention.

Spatial distribution and risk factors for equine infectious anaemia in the state of Mato Grosso, Brazil.

The prevalence of equine infectious anaemia (EIA) in the three biomes of the state of Mato Grosso (Amazon, Cerrado and Pantanal) was estimated. Serum samples were collected from 3,858 equines in 1,067 herds between Septemberand December 2014. The agar gel immunodiffusion (AGID) assay was used to detect EIA virus antibodies, and if a herd contained a seropositive animal itwas classified as a focus. The prevalence rates were 17.2% (95% confidence interval [CI]: 14.9-19.8%) for herds and 6.6% (95% CI: 5.8-7.5%) for animals. The Pantanal region showed the highest prevalence rates: 36.1% (95% CI: 30.8-41.7%) for herds and 17.0% (95% CI: 14.7-19.6%) for animals. The spatial distribution of relative risk was calculated according to the kernel density, which revealed three major clusters with the highest prevalence rates occurring in the north-western(Amazon biome), north-eastern (Cerrado biome) and southern (Pantanal biome)regions. A high spatial correlation was found among ranches, with high intra-herd prevalence rates located in the Amazon and Cerrado biomes, but the highest spatial correlation with EIA foci was found in the Pantanal biome. Variables related to ranch management, reflecting human influence, were associated with positive equines. Based on the results, it can be concluded that EIA is present in all biomes of the state, and that the risk factors are associated with human interference in the transmission process. Given this situation, the EIA control programme should be re-evaluated and more prophylactic measures should be adopted to control the disease.

Les auteurs présentent les résultats d'une estimation de la prévalence de l'anémie infectieuse des équidés (AIE) dans les trois biomes de l'état du Mato Grosso (l'Amazonie, le Cerrado et le Pantanal) réalisée de septembre à décembre2014 à partir d'échantillons de sérum collectés chez 3 858 équidés dans1 067 troupeaux. La méthode d'immunodiffusion sur gélose était utilisée pour détecter les anticorps anti-AIE. En cas de test positif chez un individu, le troupeau était classé comme un foyer. La prévalence par troupeau était de 17,2 % (intervalle de confiance à 95 % [IC 95 %] de 14,9 à 19,8) tandis que la prévalence individuelle était de 6,6 % (IC 95 % de 5,8 à 7,5). La prévalence la plus élevée était enregistrée dans la région du Pantanal : 36,1 % (IC 95 % de 30,8 à 41,7) par troupeaux et17,0 (IC 95 % de 14,7 à 19,6) à l'échelle des individus. La distribution spatiale du risque relatif estimée par noyau montre trois grappes de prévalence élevée dans le nord-ouest (biome de l'Amazonie), le nord-est (biome du Cerrado) et le sud (biome du Pantanal). Si une corrélation spatiale forte est observée dans les élevages des biomes de l'Amazonie et du Cerrado où la prévalence intra-troupeau est élevée, la corrélation spatiale la plus élevée avec les foyers d'AIE se trouve dans le biome du Pantanal. Une association a été constatée entre les équidés testés positifs et les variables descriptives liées aux pratiques d'élevage, ce qui traduit l'importance de l'influence humaine. À partir de ces résultats, on peut conclure que l'AIE est présente dans l'ensemble des biomes de l'état et que les facteurs de risque sont associés à l'interférence humaine dans le processus de transmission. Ainsi, une réévaluation du programme de lutte contre l'AIE serait indiquée avec plus de mesures prophylactiques afin de contrôler la maladie.

Los autores describen el proceso seguido para estimar la prevalencia de anemia infecciosa equina en los tres biomas presentes en el estado de Mato Grosso (Amazonia, Cerrado y Pantanal). Entre septiembre y diciembre de 2014 se extrajeron muestras a 3.858 equinos de 1.067 rebaños, a las que se aplicó la técnica de inmunodifusión en gel de agar para detectar anticuerpos contra el virus de la anemia infecciosa equina: todo rebaño en el que hubiera un animal seropositivo era considerado un foco. La tasa de prevalencia de rebaños infectados resultó del 17,2% (intervalo de confianza [IC] al 95%: 14,9­19,8) y la de individuos infectados del 6,6% (IC 95%: 5,8­7,5). Las tasas más elevadas se observaron en la región de Pantanal: un 36,1% (IC 95%: 30,8­41,7) de prevalencia de rebaño y un 17,0% (IC 95%: 14,7­19,6) de prevalencia individual. La distribución espacial del riesgo relativo se determinó con arreglo a la densidad kernel, proceso que reveló la presencia de tres grandes conglomerados: las mayores tasas de prevalencia se situaban en las regiones del noroeste (en el caso del bioma amazónico), el noreste (biomade Cerrado) y el sur (bioma de Pantanal). Se observó que existía una estrecha correlación espacial entre explotaciones, y aunque en los biomas de la Amazonia y Cerrado había elevadas tasas de prevalencia intrarrebaño, fue en el bioma de Pantanal donde se observó la correlación espacial más estrecha con los focos de anemia infecciosa equina. La presencia de equinos seropositivos venía asociada a variables relacionadas con la gestión de las explotaciones, hecho que pone de relieve la influencia humana en la cuestión. A tenor de los resultados, cabe concluir que la anemia infecciosa equina está presente en todos los biomas del estado y que los factores de riesgo guardan relación con la interferencia humana en el proceso de transmisión. Ante tal situación, convendría evaluar de nuevo el programa de lucha contra la anemia infecciosa y poner mayor acento en las medidas profilácticas para combatir la enfermedad.

Can different stages of leprosy treatment influence the profile of oral health? Oral status in leprosy.

BACKGROUND: The aim of study was to evaluate the oral health status, salivary flow and halitosis among individuals diagnosed with leprosy as compared with healthy subjects. MATERIAL AND METHODS: A sample of 160 individuals was allocated into four groups, as follows: (G1) individuals with complete leprosy treatment; (G2) individuals diagnosed with leprosy and under multi-drug therapy; (G3) individuals diagnosed with leprosy not yet under treatment; and (G4) healthy individuals. Then individuals were submitted to periodontal clinical examination (visible plaque index, bleeding index, depth of probing and clinical attachment level); DMFT index (decayed-missing-filled teeth index); evaluation of salivary flow and halitosis using a halimeter equipment (Interscan Corp, Chatsworth, CA, USA). RESULTS: The data were analyzed using Kruskal-Wallis and chi-square tests. The mean DMFT was found to be higher than 6.6, which is considered very high, with no significant difference between groups (P>0.05). As for salivary flow, 76.2% of the subjects presented normal flow rates, while 10% and 13.7% showed low and very low salivary flow rates, respectively, with hyposalivation being mostly observed in Groups 1 and 2. The highest prevalence of noticeable odor was found in healthy individuals (G4), and the most prevalent periodontal diagnosis was gingivitis (63.1%) in Group 3 (individuals with leprosy not yet under multi-drug therapy) followed by periodontitis (25%) in Group 1 (individuals who had completed leprosy treatment). CONCLUSIONS: It was observed that individuals with a history of leprosy present poor oral health similar to that of systemically healthy individuals.

Prevention, removal and inactivation of Escherichia coli and Staphylococcus aureus biofilms using selected monoterpenes of essential oils.

AIMS: The aim of this study was to investigate the antibiofilm potential of five essential oil (EO) components with cyclic (sabinene-SAB, carveol-C1, carvone-C2) and acyclic (citronellol-C3 and citronellal-C4) structures against Escherichia coli and Staphylococcus aureus. METHODS AND RESULTS: The selected EO components prevented biofilm set-up, with C3 and C4 causing remarkable effects. When applied against pre-established biofilms, they promoted high biomass removal and inactivation of biofilm cells. Moreover, no viable E. coli biofilm cells were detected after exposure to SAB at 5 × MIC and 10 × MIC, and a significant viability decrease was observed for both bacteria with the other EO components. SAB, C3 and C4 caused the most prominent effects apparently due to their octanol-water partition coefficient (Po/w), the number of rotatable bonds (n-ROTB) and the free hydroxyl groups. CONCLUSIONS: The overall results demonstrated that the selected EO components, particularly SAB, C3 and C4 are of interest as new lead molecules to both prevent biofilm set-up and to control pre-established biofilms of E. coli and S. aureus. SIGNIFICANCE AND IMPACT OF THE STUDY: The tested EO components exhibited prominent antibiofilm properties against E. coli and S. aureus providing a novel and effective alternative/complementary approach to counteract chronic infections and the transmission of diseases in clinical settings.

Correlates of children's compliance with moderate-to-vigorous physical activity recommendations: a multilevel analysis.

This study aimed to investigate the association between individual and school characteristics associated with the number of school days children comply with moderate-to-vigorous physical activity (MVPA) recommendations. Sample comprises 612 Portuguese children, aged 9-11 years, from 23 schools. Time spent in MVPA was measured by accelerometry, while individual-level correlates were obtained by anthropometry and questionnaires. School-level variables were collected by questionnaire, and accelerometer wear time and season were also considered. Maximum likelihood estimates of model parameters were obtained via a multilevel analysis with children as level-1, and school as level-2. Children who spent more time in sedentary activities and girls were less likely to comply with MVPA/daily. More mature children and those who use active transportation to school were more likely to attain the PA recommendation. Furthermore, greater accelerometer wear time and spring season increased the chance to achieve the recommended MVPA. In terms of school-level correlates, a greater number of available facilities was negatively associated with children MVPA compliance. Given the set of variables, our results showed that individual characteristics seem to be more relevant for children's compliance rates with PA/day than school context variables, which should be taken into account in the implementation of school policies and practices.

Nd:YAG laser irradiation associated with fluoridated gels containing photo absorbers in the prevention of enamel erosion.

This study evaluated the combined effect of Nd:YAG laser irradiation and fluoridated gels containing photo absorbers against enamel erosion. Enamel specimens from bovine teeth were polished, eroded (10 min, with 1% citric acid, pH = 2.6), and randomly allocated into the experimental groups (n = 8), according to the different surface treatments: fluoridated gels (F: 9047 ppm F and F + Sn: 9047 ppm F and 3000 ppm Sn), with or without photo absorbers (E: erythrosine and MB: methylene blue), and associated or not with Nd:YAG laser irradiation (in contact; 0.5 W; 50 mJ; ~41.66 J/cm2; 10 Hz; 40 s; pulse duration of 120 µs). A placebo gel (PLA) associated or not with laser was used as control. All gels had pH = 4.5 and were applied for 2 min. Laser irradiation was performed during gel application. The specimens were then submitted to a 5-day erosion-remineralization cycling model using 0.3% citric acid (pH = 2.6), 4×/day. Enamel surface loss (SL) was analyzed by optical profilometry in the end of the cycling (in µm). Data were analyzed by ANOVA and Tukey tests (α = 0.05). Means (SD) of SL for the groups were the following (different superscript letters imply significant difference among groups): PLA (21.02 ± 1.28)a, PLA + laser (19.20 ± 0.96)ab, laser (17.47 ± 1.50)b, F + Sn + E + laser (13.69 ± 0.62)c, F + E + laser (13.52 ± 1.16)c, F (13.10 ± 1.08)c, F + laser (11.94 ± 1.44)cd, F + Sn + MB + laser (11.90 ± 4.02)cd, F + MB + laser (11.42 ± 1.42)cd, F + Sn (11.12 ± 1.20)cd, and F + Sn + laser (10.35 ± 0.89)d. In conclusion, all fluoridated gels and the Nd:YAG laser irradiation reduced erosion development, but the combination of treatments did not promote further protection. The addition of photo absorbers to the fluoridated gels did not influence the anti-erosive effect of the combination of laser plus fluoridated gels.

Chromosomal evolution in large pelagic oceanic apex predators, the barracudas (Sphyraenidae, Percomorpha).

Sphyraena (barracudas) represents the only genus of the Sphyraenidae family and includes 27 species distributed into the tropical and subtropical oceanic regions. These pelagic predators can reach large sizes and, thus, attracting significant interest from commercial and sport fishing. Evolutionary data for this fish group, as well its chromosomal patterns, are very incipient. In the present study, the species Sphyraena guachancho, S. barracuda, and S. picudilla were analyzed under conventional (Giemsa staining, C-banding, and Ag-NOR) and molecular (CMA3 banding, and in situ hybridization with 18S rDNA, 5S rDNA, and telomeric probes) cytogenetic methods. The karyotypic patterns contrast with the current phylogenetic relationships proposed for this group, showing by themselves to be distinct among closely related species, and similar among less related ones. This indicates homoplasic characteristics, with similar karyotype patterns originating at least twice, independently. Although still cytogenetically poor investigated, our data were enough to put in evidence a variety of ancient conserved traits and evolutionary novelties for the Sphyraena genus. In this sense, it is fundamental that a larger number of Sphyraenidae species, as well as of other phylogenetically related families, be also investigated. This will solidify the knowledge of their karyotypic patterns, and the evolutionary path followed by the species of this particular fish family.

Interregional cytogenetic comparisons in Halichoeres and Thalassoma wrasses (Labridae) of coastal and insular regions of the southwestern Atlantic.

The distribution patterns of marine biodiversity are complex, resulting from vicariant events and species dispersion, as well as local ecological and adaptive conditions. Furthermore, the wide geographic distribution of some species may be hindered by biogeographical barriers that can interfere in the gene flow. Cytogenetic analyses in marine fishes, especially those involving populations in small remote insular environments, remain scarce. In the Western Atlantic, species of wrasses from the genera Halichoeres and Thalassoma occur in biogeographic arrangements that make it possible to analyze cytogenetic patterns between coastal and widely separated island populations. Species of these genera were punctually analyzed in some Atlantic regions. In this study, we compared several chromosomal features, such as karyotype macrostructure, heterochromatic patterns, patterns of base-specific fluorochromes, Ag-NORs, and 18S and 5S ribosomal sites in Thalassoma noronhanum, Halichoeres poeyi, and Halichoeres radiatus individuals from distinct coastal or insular regions of Atlantic. Notably, all of them are characterized by multiple 18S and 5S rDNA sites with syntenic arrangements in some chromosome pairs. Individuals of T. noronhanum (between the insular regions of Rocas Atoll and Fernando de Noronha Archipelago - FNA) and H. poeyi (coastal areas from Northeastern Brazil) show no detectable differences among their cytogenetic patterns. On the other hand, H. radiatus from FNA and São Pedro and São Paulo Archipelago exhibit differences in the frequency of rDNA sites that could suggest some level of population structuring between these insular regions. Interregional cytogenetic inventories of marine species with wide geographic distribution need to be rapidly expanded. These data will allow a better understanding of the level of chromosomal stability between vast oceanic spaces, which may be less than previously thought.

Willingness to pay for other individuals' healthcare expenditures.

OBJECTIVES: The need to improve the sustainability of public health expenditure, in a climate of growing pressure on national budgets, inevitably leads to a discussion about resource rationing, and the extent of society's responsibility for those expenditures. To contribute to this discussion empirically, this study evaluated the willingness of Portuguese respondents to pay for other individuals' healthcare expenditures through out-of-pocket payments. STUDY DESIGN: A questionnaire addressed to the general public was developed, with 296 respondents. The survey was divided into three sections: (i) sociodemographic characteristics of the respondents; (ii) health-related habits; and (iii) willingness to pay other individuals' healthcare expenditures and, if so, how much. METHODS: Logit and ordered logit models were applied. RESULTS: Respondents were divided fairly even between those who were willing to pay for other individuals' healthcare expenditures and those who were not. Respondents with health insurance contracts were more willing to contribute, and the contribution value was higher. Having a degree-level education was associated with reduced willingness to pay for other individuals' healthcare expenditures, and reduced probability of paying a larger amount, which may be associated with holding individuals accountable for their choices. Considering self-reported risky behaviours, the respondents who consumed alcohol were more likely to be willing to pay for other individuals' healthcare expenditures, and to a greater extent, whereas smokers were less likely to pay larger amounts. These effects suggest that respondents with different unhealthy behaviours are not equally altruistic. CONCLUSIONS: These findings highlight the need to combine health policy and social beliefs. The respondents seem to be interested to discuss healthcare funding, given that they agreed to reveal their willingness to pay for other individuals' healthcare expenditures. Moreover, respondents' sociodemographic characteristics and health-related behaviours play a role in their willingness to contribute to social well-being through healthcare expenditures. The differences observed denote that no agreement exists regarding the extent of society's responsibility.

Oral and endotracheal tubes colonization by periodontal bacteria: a case-control ICU study.

Periodontal infection is a possible risk factor for respiratory disorders; however, no studies have assessed the colonization of periodontal pathogens in endotracheal tubes (ET). This case-control study analyzed whether periodontal pathogens are able to colonize ET of dentate and edentulous patients in intensive care units (ICU) and whether oral and ET periodontal pathogen profiles have any correlation between these patients. We selected 18 dentate and 18 edentulous patients from 78 eligible ICU patients. Oral clinical examination including probing depth, clinical attachment level, gingival index , and plaque index was performed by a single examiner, followed by oral and ET sampling and processing by quantitative polymerase chain reaction (total bacterial load, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Tannerella forsythia). Data were statistically analyzed by Mann-Whitney U, two-way analysis of variance (p < 0.05). Among dentate, there was no correlation between clinical parameters and ET bacterial levels. Both dentate and edentulous patients showed similar ET bacterial levels. Dentate patients showed no correlation between oral and ET bacterial levels, while edentulous patients showed positive correlations between oral and ET levels of A. actinomycetemcomitans, P. gingivalis, and T. forsythia. Periodontal pathogens can colonize ET and the oral cavity of ICU patients. Periodontal pathogen profiles tend to be similar between dentate and edentulous ICU patients. In ICU patients, oral cavity represents a source of ET contamination. Although accompanied by higher oral bacterial levels, teeth do not seem to influence ET bacterial profiles.

An approach to develop chemical intuition for atomistic electron transport calculations using basis set rotations.

Single molecule conductance measurements are often interpreted through computational modeling, but the complexity of these calculations makes it difficult to directly link them to simpler concepts and models. Previous work has attempted to make this connection using maximally localized Wannier functions and symmetry adapted basis sets, but their use can be ambiguous and non-trivial. Starting from a Hamiltonian and overlap matrix written in a hydrogen-like basis set, we demonstrate a simple approach to obtain a new basis set that is chemically more intuitive and allows interpretation in terms of simple concepts and models. By diagonalizing the Hamiltonians corresponding to each atom in the molecule, we obtain a basis set that can be partitioned into pseudo-σ and -π and allows partitioning of the Landuaer-Büttiker transmission as well as create simple Hückel models that reproduce the key features of the full calculation. This method provides a link between complex calculations and simple concepts and models to provide intuition or extract parameters for more complex model systems.