Which roads lead to access? A global landscape of six COVID-19 vaccine innovation models.

BACKGROUND: Unequal and inequitable access to Covid-19 vaccines in low- and middle-income countries (L&MICs) was a major political, ethical and public health failure in the pandemic. However, vaccine developers' practices were not monolithic, but rather, took diverse approaches to supplying different countries, with important implications for global access. RESULTS: Using data on R&D investments, regulatory approvals, manufacturing and purchase agreements, and vaccine deliveries, we identified six distinct innovation models that apply across the 14 COVID-19 vaccines with more international presence from 2020-2022. "Western Early Arrivers" Pfizer/BioNTech and Moderna supplied the largest volumes quickly and prioritized high-income countries (HICs) from registration to vaccine delivery. "Western Latecomers" Janssen and Novavax supplied intermediate volumes later, also prioritizing HICs but with a greater proportion to L&MICs. "Major Chinese Developers" Sinopharm and Sinovac supplied intermediate volumes early, primarily to middle-income countries (MICs). "Russian Developer" Gamaleya completed development early but ultimately supplied small volumes, primarily to middle-income countries (MICs). "Cosmopolitan Developer" Oxford/AstraZeneca supplied large volumes early to HICs and MICs at the lowest prices. Finally, "Small MIC Developers" CanSino, Bharat Biotech, Medigen, Finlay Institute and the Center for Genetic Engineering and Biotechnology (CGEB), exported relatively small volumes to a few MICs. Low-income countries (LICs) were not targeted by any developer, and received far fewer doses, later, than any other income group. Almost all developers received public funding and other forms of support, but we found little evidence that such support was leveraged to expand global access. CONCLUSIONS: Each of the six innovation models has different implications for which countries get access to which vaccines, how quickly, and at which prices. Each offers different strengths and weaknesses for achieving equitable access. Our findings also suggest that Western firms had the greatest capacity to develop and deliver vaccines quickly during the pandemic, but such capacity is rapidly becoming more globally distributed with MICs playing a significant role, especially in supplying other MICs. Given the critical role of public support in enabling pandemic vaccine development and supply, governments have both the capacity and responsibility to craft international rules that will make responses to future pandemics more equitable and effective.

Do intraoral scanning technologies affect the trueness of dental arches with crowding, diastema, and edentulous spaces? A clinical perspective.

OBJECTIVES: To evaluate the trueness of dental arches digitised by two intraoral scanning (IOS) technologies from patients presenting crowding, diastema, and bilateral posterior edentulous space with tilted molar. METHODS: Conventional impressions and dental stone models were generated from three patients presenting the aforementioned dental arch conditions. These models were digitised on a desktop scanner, and the resulting mesh was used as reference. Subsequently, the patients were scanned using confocal based (CF; iTero Element 2) and blue laser-multiscan (BLM; Virtuo Vivo) imaging IOS technology, totalling thirty scans. The meshes from the scans were exported in Standard Tessellation Language format and analysed using Geomagic Control X software. Root mean square (RMS) indicated deviation magnitude. Differences in IOS technologies were evaluated with paired t-tests, and dental arch conditions compared using ANOVA and post-hoc Tukey tests (α=0.05). RESULTS: Digital dental arch from blue laser-multiscan technology showed lower trueness compared to confocal based technology for crowding (p = 0.0084) and edentulous spaces (p = 0.0025) conditions. When the types of oral condition were compared, discrepancies were significantly different for both IOS technologies, featuring the arch with diastema showing the lowest trueness, followed by edentulous spaces and crowding. CONCLUSION: Dental arches presenting crowding and edentulous spaces digitised by blue laser-multiscan technology exhibited greater discrepancies compared to confocal based imaging technology. Furthermore, trueness varied among the dental arch conditions. CLINICAL SIGNIFICANCE: The IOS technology and patient's dental arch condition can influence the trueness of dental arch digitisation. Being aware of these effects allows clinicians to take them into account during scanning procedures, digital planning and manufacturing.

Deliberately introduced dung beetles in Australia: 12 years of occurrence and abundance records from 2001 to 2022.

Since 1968, the Australian Dung Beetle Project has carried out field releases of 43 deliberately introduced dung beetle species for the biological control of livestock dung and dung-breeding pests. Of these, 23 species are known to have become established. For most of these species, sufficient time has elapsed for population expansion to fill the extent of their potential geographic range through both natural and human-assisted dispersal. Consequently, over the last 20 years, extensive efforts have been made to quantify the current distribution of these introduced dung beetles, as well as the seasonal and spatial variation in their activity levels. Much of these data and their associated metadata have remained unpublished, and they have not previously been synthesized into a cohesive dataset. Here, we collate and report data from the three largest dung beetle monitoring projects from 2001 to 2022. Together, these projects encompass data collected from across Australia, and include records for all 23 species of established dung beetles introduced for biocontrol purposes. In total, these data include 22,718 presence records and 213,538 absence records collected during 10,272 sampling events at 546 locations. Most presence records (97%) include abundance data. In total, 1,752,807 dung beetles were identified as part of these data. The distributional occurrence and abundance data can be used to explore questions such as factors influencing dung beetle species distributions, dung beetle biocontrol, and insect-mediated ecosystem services. These data are provided under a CC-BY-NC 4.0 license and users are encouraged to cite this data paper when using the data.

Pharmaceutical policy and innovation for rare diseases: A narrative review.

This article aims to synthesize the existing literature on the implementation of public policies to incentivize the development of treatments for rare diseases, (diseases with very low prevalence and therefore with low commercial interest) otherwise known as orphan drugs. The implementation of these incentives in the United States (US), Japan, and in the European Union (EU) seems to be related to a substantial increase in treatments for these diseases, and has influenced the way the pharmaceutical research & development (R&D) system operates beyond this policy area. Despite the success of the Orphan Drug model, the academic literature also highlights the negative implications that these public policies have on affordability and access to orphan drugs, as well as on the prioritization of certain disease rare areas over others. The synthesis focuses mostly on the United States' Orphan Drug Act (ODA) as a model for subsequent policies in other regions and countries. It starts with a historical overview of the creation of the term "rare diseases", continues with a summary of the evidence available on the US ODA's positive and negative impacts, and provides a summary of the different proposals to reform these incentives in light of the negative outcomes described. Finally, it describes some key aspects of the Japanese and European policies, as well as some of the challenges captured in the literature related to their impact in Low- and Middle-Income Countries (LMICs).

Finger-Prick Whole Blood Cryptococcal Antigen Lateral Flow Assay for the Diagnosis of Cryptococcosis in HIV-Negative Patients: A Case Series Study in Two Tertiary Centers in São Paulo, Brazil.

Cryptococcosis in HIV-negative patients can be an opportunistic or endemic disease. There are no published studies on the use of the finger-prick whole blood (point-of-care) cryptococcal antigen lateral flow assay (CrAg LFA) for diagnosing cryptococcosis in HIV-negative patients. We conducted a case series study of HIV-negative patients with cryptococcosis in two centers in São Paulo, Brazil. The objectives were to identify the sensitivity of a finger-prick whole blood CrAg LFA and to describe the main characteristics of this population. We identified 30 HIV-negative patients with cryptococcosis [19 (63%), male; median age, 47 years]. Ten (33%) patients were immunosuppressed, ten (33%) had other comorbidities, and ten (33%) were apparently immunocompetent and without comorbidities. The distribution of the sites of cryptococcosis was as follows: the central nervous system, 90% (n = 27); pulmonary, 43% (n = 13); and other extrapulmonary sites, 40% (n = 12). The sensitivity of the finger-prick whole blood CrAg LFA for the diagnosis of cryptococcosis was 97% (29/30). Among 26 participants with cryptococcal meningitis, the sensitivity of testing cerebrospinal fluid was as follows: CrAg latex agglutination, 77% (20/26); CrAg LFA, 96% (25/26); and culture, 81% (21/26). Culture speciation identified Cryptococcus gattii in 16 (62%) cases, and all had a positive finger-prick whole blood CrAg LFA. This test presented high sensitivity to the diagnosis of cryptococcosis in HIV-negative patients, including those caused by C. gattii.

Rising pharmaceutical innovation in the Global South: a landscape study.

BACKGROUND: There is growing interest in pharmaceutical innovation in low- and middle-income countries (LMICs), but information on existing activities, capacities, and outcomes is scarce. We mapped available data at the global level, and studied the national pharmaceutical innovation systems of Bangladesh and Colombia to shed light on pharmaceutical research and development (R&D) in the Global South, including challenges and prospects, to help fill existing knowledge gaps. METHODS: We gathered and analyzed data from three types of sources: literature, semi-structured interviews with key informants, and publicly available data on R&D funding, R&D scientific capacity measured by human resources, and clinical trial activities. RESULTS: Pharmaceutical R&D activities are occurring in many LMICs, but 16 countries have emerged as frontrunners. Investment in R&D in LMICs has increased in the past decade, particularly from middle-income countries (MICs). Capacity is also growing, with an increase in the number of research organizations and the amount of funding available from external sources. The total number of clinical trials and the proportion of trials in LMICs increased markedly, and there is also growing activity in the earlier, more innovative and riskier Phase 1 and 2 trials. Non-commercial entities comprise the majority of clinical trial funders and sponsors in LMICs. Finally, investments have borne fruit, as indicated by a number of innovative medicines developed in LMICs. The Bangladesh and Colombia country studies showed that there is still a need for both targeted R&D policies to strengthen capacities in the pharmaceutical sector, and more government support to overcome the challenges of a lack of funding and coordination among different actors. CONCLUSIONS: By triangulating between the data sources, it was possible to paint a broad picture of who was involved in pharmaceutical R&D in LMICs, in which particular countries, for which diseases, in which R&D phases, and with what results-as well as how these trends have changed over time. Prioritizing pharmaceutical R&D is an important strategy for better meeting health needs. The trendlines are promising, but focused attention is still needed to realize the potential for greater innovation in the Global South.

Non-commercial pharmaceutical R&D: what do neglected diseases suggest about costs and efficiency?

Background: The past two decades have witnessed significant growth in non-commercial research and development (R&D) initiatives, particularly for neglected diseases, but there is limited understanding of the ways in which they compare with commercial R&D. This study analyses costs, timelines, and attrition rates of non-commercial R&D across multiple initiatives and how they compare to commercial R&D. Methods: This is a mixed-method, observational, descriptive, and analytic study. We contacted 48 non-commercial R&D initiatives and received either quantitative and/or qualitative data from 13 organizations. We used the Portfolio to Impact (P2I) model's estimates of average costs, timelines, and attrition rates for commercial R&D, while noting that P2I cost estimates are far lower than some previous findings in the literature. Results: The quantitative data suggested that the costs and timelines per candidate per phase (from preclinical through Phase 3) of non-commercial R&D for new chemical entities are largely in line with commercial averages. The quantitative data was insufficient to compare attrition rates. The qualitative data identified more reasons why non-commercial R&D costs would be lower than commercial R&D, timelines would be longer, and attrition rates would be equivalent or higher, though the data does not allow for estimating the magnitude of these effects. Conclusions: The quantitative data suggest that costs and timelines per candidate per phase were largely in line with (lower-end estimates of) commercial averages. We were unable to draw conclusions on overall efficiency, however, due to insufficient data on attrition rates. Given that non-commercial R&D is a nascent area of research with limited data available, this study contributes to the literature by generating hypotheses for further testing against a larger sample of quantitative data. It also offers a range of explanatory factors for further exploration regarding how non-commercial and commercial R&D may differ in costs and efficiency.

Ointment of Ximenes americana promotes acceleration of wound healing in rats1.

PURPOSE: To evaluate the healing potential of the Ximenia americana hydroalcoholic extract in 10% cream in excisional wound models in rats. METHODS: Sixty male adults Wistar rats were submitted to skin and subcutaneous tissue surgery in the right and left thoracic regions, divided into three experimental groups: Standard submitted to treatment with only the base vehicle, Treated wounds treated with hydroalcoholic extract of X. americana applied on 10%, Lanette base and Control, untreated wounds. The treatment was performed daily and the wounds evaluated microscopically by the quantification of fibroblasts, collagen fibers and blood vessels. RESULTS: The histomorphometric analysis showed a significant increase in the number of fibroblasts, collagen fibers and blood vessels in the treated group. CONCLUSION: The topical action of the cream based on Ximenia americana shows angiogenic effects and improves the replacement of collagen, suggesting its use for the development of herbal remedy in the treatment of cutaneous wound healing.

Caloric restriction prevents the development of airway hyperresponsiveness in mice on a high fat diet.

We have previously shown that high fat diet (HFD) for 2 weeks increases airway hyperresponsiveness (AHR) to methacholine challenge in C57BL/6J mice in association with an increase in IL-1ß levels in lung tissue. We hypothesize that obesity increases AHR via the IL-1ß mechanism, which can be prevented by caloric restriction and IL-1ß blockade. In this study, we fed C57BL/6J mice for 8 weeks with several hypercaloric diets, including HFD, HFD supplemented with fructose, high trans-fat diet (HTFD) supplemented with fructose, either ad libitum or restricting their food intake to match body weight to the mice on a chow diet (CD). We also assessed the effect of the IL-1ß receptor blocker anakinra. All mice showed the same total respiratory resistance at baseline. All obese mice showed higher AHR at 30 mg/ml of methacholine compared to CD and food restricted groups, regardless of the diet. Obese mice showed significant increases in lung IL-1 ß mRNA expression, but not the protein, compared to CD and food restricted mice. Anakinra abolished an increase in AHR. We conclude that obesity leads to the airway hyperresponsiveness preventable by caloric restriction and IL-1ß blockade.

Civil society strategy for the compulsory licensing of lopinavir/ritonavir: the Brazilian case.

The flexibilities in the TRIPS Agreement (Trade Related Aspects of Intellectual Property) have been very useful in lowering the prices of antiretrovirals (ARVs) in Brazil. In this article, based on several presentations made at the conference, Marcela Fogaça Vieira et al describe recent developments in Brazil, including the granting of a compulsory licence for efavirenz.

Acesso e utilização dos serviços de saúde e raça/cor/etnia entre mulheres: uma metanálise / Access to and utilization of health services and race/color/ethnicity among women: a meta-analysis / Acceso y utilización de los servicios de salud y raza/color/etnia entre las mujeres: un metaanálisis

Diversas barreiras podem comprometer o acesso aos serviços de saúde no Brasil, especialmente entre as mulheres negras, evidenciando a urgência em discutir esse tema à luz das iniquidades raciais e de gênero. O objetivo deste estudo foi realizar uma revisão sistemática com metanálise para avaliar as evidências científicas da associação entre raça/cor de pele/etnia e acesso e utilização dos serviços de saúde entre mulheres. A busca dos estudos foi realizada em cinco bases eletrônicas, incluindo literatura cinzenta, até março de 2022 e, após a extração de dados, foi realizada a avaliação da qualidade dos artigos. A metanálise estimou a medida de associação global (odds ratio) e seu intervalo de confiança de 95%. Também foi avaliado o indicador de Higgins e Thompson (I2) para classificação da heterogeneidade estatística dos dados. Foram identificados 428 registros, mas apenas três estudos atenderam aos critérios de elegibilidade. A raça/cor de pele/etnia negra esteve associada a desfechos negativos relacionados ao acesso/utilização dos serviços de saúde no Brasil (OR = 1,49; IC95%: 1,26-1,76; I2 = 24,01%). Neste estudo, verificou-se que existem iniquidades raciais no acesso/utilização dos serviços de saúde entre mulheres. No entanto, destaca-se a necessidade de mais estudos rigorosos para elucidar a influência da raça/cor/etnia e de elaboração de políticas públicas.

Several barriers can compromise access to health services in Brazil, especially among black women, highlighting the urgency of discussing this topic in the light of racial and gender inequalities. This study aimed to carry out a systematic review with meta-analysis to assess the scientific evidence on the association between race/skin color/ethnicity and access and use of health services among women. The search for studies was carried out in five electronic databases, including the gray literature, until March 2022, and, after data extraction, the quality of the articles was evaluated. The meta-analysis estimated the global association measure (odds ratio) and its 95% confidence interval. The Higgins and Thompson indicator (I2) was also evaluated to classify the statistical heterogeneity of the data. A total of 428 records were identified, but only three studies met the eligibility criteria. Black race/skin color/ethnicity was associated with negative outcomes related to access/use of health services in Brazil (OR = 1.49; 95%CI: 1.26-1.76; I2 = 24.01%). This study showed the presence of racial inequalities in the access/use of health services among women. However, it highlights the need for more rigorous studies to elucidate the influence of race/color/ethnicity and the elaboration of public policies.

Diversos obstáculos pueden dificultar el acceso a los servicios de salud en Brasil, principalmente para las mujeres negras, lo que muestra la necesidad de discutir el tema de las inequidades racial y de género. Este estudio tiene por objetivo realizar una revisión sistemática con metaanálisis para evaluar la evidencia científica de la asociación entre raza/color/etnia y el acceso y uso de los servicios de salud por las mujeres. Se realizó una búsqueda en cinco bases de datos electrónicas, incluida la literatura gris, en el periodo hasta marzo de 2022; y tras evaluados los datos, se llevó a cabo una evaluación de la calidad de los artículos. El metaanálisis estimó la asociación global (Odds Ratio) y su intervalo de confianza del 95%. También se evaluó el indicador de Higgins y Thompson (I²) para clasificar la heterogeneidad estadística de los datos. Se identificaron 428 registros, de los cuales solo tres estudios cumplieron los criterios de elegibilidad. La raza/color de piel/etnia negra se asoció con desenlaces negativos relacionados al acceso/uso de los servicios de salud en Brasil (OR = 1,49; IC 95%: 1,26-1,76; I² = 24,01%). Estos hallazgos destacan las inequidades raciales en el acceso/uso de los servicios de salud entre mujeres brasileñas. Sin embargo, se necesitan investigaciones más rigurosas sobre la influencia de la raza/color/etnia y la implementación de políticas públicas efectivas.

High fat diet induces airway hyperresponsiveness in mice.

The experiment was conducted to examine the effect of a high fat diet (HFD) on airway hyperresponsiveness (AHR) in mice. Twenty-three adult male C57BL/6 J mice were fed with HFD or regular chow diet for two weeks. The total respiratory resistance was measured by forced oscillation technique at baseline and after methacholine aerosol challenge at 1, 3, 10 and 30 mg/mL. Bronchoalveolar lavage (BAL) was performed. Lipid levels and lipid peroxidation in lung tissue were measured along with gene expression of multiple cytokines. Lungs were digested, and IL-1ß secretion by pulmonary macrophages was determined. HFD feeding resulted in 11% higher body weight compared to chow. HFD did not affect respiratory resistance at baseline, but significantly augmented airway responses to methacholine compared to chow diet (40.5 ± 17.7% increase at 30 mg/ml methacholine, p < 0.05). HFD induced a 3.2 ± 0.6 fold increase in IL-1ß gene expression (p < 0.001) and a 38 fold increase in IL-1ß secretion in the lungs. There was no change in BAL and no change in any other cytokines, lipid levels or lipid peroxidation. Hence, HFD induced AHR in mice prior to the development of significant obesity which was associated with up-regulation of pulmonary IL-1ß.

Mast cell concentration and skin wound contraction in rats treated with Ximenia americana L.

PURPOSE: To evaluate wound contraction and the concentration of mast cells in skin wounds treated with wild plum (Ximenia americana) essential oil-based ointment in rats. METHODS: Sixty rats were submitted to two cutaneous wounds in the thoracic region, on the right and left antimeres. Thereon, they were divided into three groups: GX (wounds treated once a day with hydro alcoholic branch extract of Ximenia americana), GP (wounds that received vehicle), and GC (wounds without product application). Wounds were measured immediately after the injury as well as 4, 7, 14 and 21 days post-topical application of the extract. At these days, five rats from each group were euthanatized. Thereafter, samples were fixed in 10% formaldehyde and processed for paraffin embedding. Sections were stained with H.E, Masson's Trichrome and toluidine blue for morphological, morphometrical and histopathological analysis, under light microscopy. The degree of epithelial contraction was measured and mast cell concentrations were also evaluated with an image analyzer (Image Pro-plus®software) . RESULTS: The extract treated group showed lower mast cell concentrations in the 4th day of lesion, as compared to GP (GX GP = GC; p<0.05) . CONCLUSION: Ointment containing 10% X. americana induces a decrease in mast cell concentration, at the beginning of the healing process, and promotes early skin wound contraction in rats.

Ointment of Ximenes americana promotes acceleration of wound healing in rats

Abstract Purpose: To evaluate the healing potential of the Ximenia americana hydroalcoholic extract in 10% cream in excisional wound models in rats. Methods: Sixty male adults Wistar rats were submitted to skin and subcutaneous tissue surgery in the right and left thoracic regions, divided into three experimental groups: Standard submitted to treatment with only the base vehicle, Treated wounds treated with hydroalcoholic extract of X. americana applied on 10%, Lanette base and Control, untreated wounds. The treatment was performed daily and the wounds evaluated microscopically by the quantification of fibroblasts, collagen fibers and blood vessels. Results: The histomorphometric analysis showed a significant increase in the number of fibroblasts, collagen fibers and blood vessels in the treated group. Conclusion: The topical action of the cream based on Ximenia americana shows angiogenic effects and improves the replacement of collagen, suggesting its use for the development of herbal remedy in the treatment of cutaneous wound healing.

Functional capacity, independence and home affordances of premature children attending daycare centers / Capacidade funcional, independência e estimulação domiciliar de prematuros frequentadores de creches

Abstract Introduction: Child development is the result of the interaction between biological and environmental factors. Objective: The aim of this study is to evaluate and compare the Functional Capacity, Independence and Home Affordances Level of Stimulation of premature children between 18 and 42 months, attending or not daycare centers. Methods: Cross-sectional study with a convenience sample of 26 premature children between 18 and 42 months, paired and divided into two groups: attending (study group) and not attending daycare centers (control group). Data was collected from the questionnaires AHEMD-SR, PEDI and an identification questionnaire. Data analysis was performed by descriptive statistics, and Chi-square, Fisher, Mann-Whitney and Univariate Analysis tests, considering the level of significance of α = 0.05 and tendency of differentiation when α < 010. Results: There was a significant difference in the AHEMD-SR`s Variety of Stimulation (p = 0.036), higher in the control group, and tendency in the Gross Motor Toys (p = 0.086), more available in the study group. In PEDI, there was significant difference in Self-care (p = 0.045) and tendency of differentiation in Mobility (0.068), both of the Caregiver Assistance part (greater to the study). The sample showed low stimulation opportunities regarding Fine and Gross Motor Toys and high percentages of delay in Functional Skills (Mobility) and Independence (Self Care and Mobility), especially in the control group. Conclusion: Daycare centers seem to positively affect the Functional Capacity and Independence in premature children between 18 and 42 months.

Resumo Introdução: O desenvolvimento infantil é resultado da interação de fatores biológicos e ambientais. Objetivo: Verificar e comparar a Capacidade Funcional, a Independência e a Estimulação Presente no Ambiente Domiciliar de prematuros entre 18 e 42 meses, frequentadores e não frequentadores de creche. Métodos: Estudo transversal com amostra de conveniência de 26 prematuros entre 18 e 42 meses, pareados e divididos em frequentadores e não frequentadores de creche. Os dados foram coletados a partir do AHEMD-SR, do PEDI e de um questionário de identificação. A análise foi realizada por meio de estatística descritiva e testes Qui-quadrado, Fisher, Mann-Whitney e Análise Univariada, com nível de significância de α = 0,05 e tendência de diferenciação α < 0,1. Resultados: No AHEMD-SR, houve diferença significativa na Variedade de Estimulação (p = 0,036), maior para não frequentadores de creche, e tendência nos Materiais de Motricidade Grossa (p = 0,086), mais disponível para os frequentadores. No PEDI, na Assistência do Cuidador houve diferença significativa no Autocuidado (p = 0,045) e tendência de diferenciação na Mobilidade (0,068), melhor entre os frequentadores de creche. A amostra apresentou baixas oportunidades de estimulação no domicílio em relação a Materiais para Motricidade Fina e Grossa e altos percentuais de atraso nas Habilidades Funcionais (Mobilidade) e na Independência (Autocuidado e Mobilidade), principalmente nos que não frequentavam creche. Conclusão: A creche parece interferir positivamente na Capacidade Funcional e na Independência de nascidos prematuros entre 18 e 42 meses de idade.

Gray scale inversion in digital image for measurement of tooth length.

The aim of this study was to assess the applicability of gray scale inversion in performing digital linear endodontic measurements. Standardized digital images were taken of 40 extracted human permanent single-rooted teeth with K-files size 15 placed at different lengths in the root canal, using the CDR Wireless(®) digital system. All images were treated with Positive, a digital tool that inverts the grayscale value. Eight radiologists measured the distance between the lower limit of the rubber stop and the tip of the file on both original and positive images. After 15 days, they repeated this procedure in 50% of the image samples. The intra- and inter-examiner agreement was analyzed by intraclass correlation test, and the comparison between the two image groups and the actual lengths by the Student's t-test (α=0.05). Intra- and inter-examiner evaluation showed high reproducibility (r>0.95) of both original and positive images. No statistically significant differences (p>0.05) were found between measurements performed on original and positive images, but both differed significantly from the actual lengths (p<0.05). Gray scale inversion has low applicability in measuring endodontic files, since it did not improve the accuracy of measurements.

Mast cell concentration and skin wound contraction in rats treated with Ximenia americana L

Abstract Purpose: To evaluate wound contraction and the concentration of mast cells in skin wounds treated with wild plum (Ximenia americana) essential oil-based ointment in rats. Methods: Sixty rats were submitted to two cutaneous wounds in the thoracic region, on the right and left antimeres. Thereon, they were divided into three groups: GX (wounds treated once a day with hydro alcoholic branch extract of Ximenia americana), GP (wounds that received vehicle), and GC (wounds without product application). Wounds were measured immediately after the injury as well as 4, 7, 14 and 21 days post-topical application of the extract. At these days, five rats from each group were euthanatized. Thereafter, samples were fixed in 10% formaldehyde and processed for paraffin embedding. Sections were stained with H.E, Masson's Trichrome and toluidine blue for morphological, morphometrical and histopathological analysis, under light microscopy. The degree of epithelial contraction was measured and mast cell concentrations were also evaluated with an image analyzer (Image Pro-plus®software) . Results: The extract treated group showed lower mast cell concentrations in the 4th day of lesion, as compared to GP (GX<GP=GC, p=0.029), as well as with increased contraction at 7th and 14th days, respectively (7th and 14th days, GX > GP = GC; p<0.05) . Conclusion: Ointment containing 10% X. americana induces a decrease in mast cell concentration, at the beginning of the healing process, and promotes early skin wound contraction in rats.

Método Pilates versus Escola de Postura: análise comparativa de dois protocolos de tratamento para lombalgias / Pilates versus Back School: comparative analysis of two treatment protocols for low back pain

A dor lombar é uma disfunção que atinge a região baixa da coluna vertebral, podendo comprometer quadris e pernas. A Organização Mundial da Saúde estima que 80% dos sujeitos tem ou terão lombalgia e, em 40% dos casos, a dor inicial tende a se tornar crônica. O exercício é um dos poucos tratamentos baseados em evidências para a lombalgia crônica, mas a melhor forma de aplicar este tratamento é desconhecida. Este estudo teve como objetivo comparar dois protocolos de intervenção para o manejo da dor lombar crônica não-específica em mulheres de 25 a 50 anos quanto à dor, à funcionalidade e à qualidade de vida dos indivíduos. Um protocolo foi baseado em exercícios do método Pilates e o outro na Escola de Postura. Os instrumentos de avaliação foram o questionário de Roland Morris, O SF-36 e a Escala Visual Analógica para dor. A maior parte das mulheres apresentou diminuição da dor, melhora da funcionalidade e da qualidade de vida. O grupo tratado com a Escola de Postura obteve resultados melhores quando comparados com os resultados do grupo tratado com o método Pilates. Entretanto, devido ao pequeno número de voluntárias, não é possível afirmar as diferenças entre os dois grupos.