Effectiveness of Laser Acupuncture for Reducing Pain and Increasing Mouth Opening Range in Individuals with Temporomandibular Disorder: A Systematic Review and Network Meta-Analysis.

PURPOSE OF REVIEW: Laser acupuncture (LA) demonstrates promising results in the treatment of musculoskeletal disorders. However, its effects on temporomandibular disorder (TMD) are not yet fully understood. Thus, the aim of this systematic review and network meta-analysis was to assess the effectiveness of LA on pain intensity and maximum mouth opening range (MMO) related to TMD. A search was carried out in 11 electronic databases and references of included studies to locate randomized clinical trials (RCTs) that evaluated LA as a primary treatment for TMD. The risk of bias was assessed using the RoB 2 tool. Network meta-analysis was conducted on the MetaInsight platform, considering the pain intensity and counseling (C) as the outcome of reference. The GRADE system was used to assess the certainty of the evidence. RECENT FINDINGS: Five studies evaluated pain intensity, four with a high risk of bias and one with a low risk. Two studies evaluated pain intensity on palpation (one with high and one with low risk of bias), and one study with high risk of bias evaluated MMO. Laser parameters were: 690-810 nm, 40-150 mW, and 7.5-112.5 J/cm2. Occlusal splint (OS) [- 2.47; CI 95% - 3.64, - 1.30] and Physiotherapy (PT) [-2.64; CI 95% - 3.94, - 1.34] reduced pain intensity compared to C. The ranking of treatments in order of effectiveness was PT > OS > LA > C > CR (craniopuncture). The certainty of the evidence was very low or low. The data do not support the indication of LA for the treatment of TMDs and new placebo-controlled RCTs must be conducted to demonstrate its effectiveness more precisely.

Neuronal Population Encoding of Identity in Primate Prefrontal Cortex.

The ventrolateral prefrontal cortex (VLPFC) shows robust activation during the perception of faces and voices. However, little is known about what categorical features of social stimuli drive neural activity in this region. Since perception of identity and expression are critical social functions, we examined whether neural responses to naturalistic stimuli were driven by these two categorical features in the prefrontal cortex. We recorded single neurons in the VLPFC, while two male rhesus macaques (Macaca mulatta) viewed short audiovisual videos of unfamiliar conspecifics making expressions of aggressive, affiliative, and neutral valence. Of the 285 neurons responsive to the audiovisual stimuli, 111 neurons had a main effect (two-way ANOVA) of identity, expression, or their interaction in their stimulus-related firing rates; however, decoding of expression and identity using single-unit firing rates rendered poor accuracy. Interestingly, when decoding from pseudo-populations of recorded neurons, the accuracy for both expression and identity increased with population size, suggesting that the population transmitted information relevant to both variables. Principal components analysis of mean population activity across time revealed that population responses to the same identity followed similar trajectories in the response space, facilitating segregation from other identities. Our results suggest that identity is a critical feature of social stimuli that dictates the structure of population activity in the VLPFC, during the perception of vocalizations and their corresponding facial expressions. These findings enhance our understanding of the role of the VLPFC in social behavior.

Análise das urgências odontológicas durante a pandemia da covid-19 / Analysis of dental emergencies during the COVID-19 pandemic

Aim: to analyze, between 2019-2021, the quantitative changes in dental emergencies (DE) in Brazil and its regions. Materials and Methods: Data collected in the Primary Care Health Information System (SISAB) from 2019 to 2021. The DE represented by dentoalveolar abscess (DAA) and toothache (TA). 2019 was the control (non-pandemic), and 2020-21 the exposure year. Durbin-Conover's Friedman and Post-Hoc tests used a significance level of 5%. The data's organization used the percentage difference to facilitate analysis. Results: For Brazil in 2021, the percentage difference with 2019 suggests that DAA (-2.16%, p=1.0) and TA (+14.94%, p=0.064) returned to values after fall of 2020. The South region, in 2020, had no decrease in DAA (-5.48%, p=0.436) and TA (+3.7%, p<0.001) in 2020, and an increase in both in 2021 (DAA: +26.86%, p<0.001; TA: +51.06%, p<0.001). Discussion: In 2021, in Brazil, limited elective access and resumption of DAA and increase in TA suggest worsening the oral health and quality of life. The DAA and TA results in the South region do not provide plausible evidence to understand the unchanged values in 2020 and the considerable increase in 2021. Conclusion: Regardless of the pandemic, elective access still struggles to offer universal acessing, equitable, and the need of investments are essentials to prevent public services from becoming just gateways for relieving pain and suffering.

Objetivo: analisar, entre 2019-2021, as alterações quantitativas nas urgências odontológicas (UO) no Brasil e suas regiões. Materiais e Métodos: Dados coletados no Sistema de Informação em Saúde da Atenção Básica (SISAB) no período de 2019 a 2021. A representação das UO foi pelo abscesso dento-alveolar (ADA) e dor de dente (DD). O ano de 2019 foi o ano de controle (não pandêmico) e 2020-21 os de exposição. Os testes Friedman e Post-Hoc de Durbin-Conover utilizaram nível de significância de 5%. Os dados foram organizados pela diferença percentual para facilitar a análise. Resultados: Para o Brasil em 2021, a diferença percentual com 2019 sugerem que o ADA (-2,16%, p=1,0) e a DD (+14,94%, p=0,064) retomaram os valores, após a queda de 2020. A região Sul, em 2020, não teve queda em ADA (-5,48%, p=0,436) e DD (+3,7%, p<0,001) em 2020, e aumento em ambos em 2021 (ADA: +26,86%, p<0,001; DD: +51,06%, p<0,001). Discussão: Em 2021, no Brasil, o limitado acesso eletivo e a retomada da ADA e aumento da DD sugerem piora na saúde bucal e na qualidade de vida. Os resultados de ADA e DD na região Sul não apresentam evidências plausíveis para compreender a inalteração de valores em 2020 e o considerável aumento em 2021. Conclusão: Independentemente a pandemia, o acesso eletivo ainda luta para ser universal, equânime e os investimentos precisam ser retomados para evitar que os serviços públicos se tornem em apenas portas de entrada de alívio dor e sofrimento.

Technology transfer during the COVID-19 pandemic: report on the first face-to-face practical training course in Brazil.

MAIN RESULTS: Technology transfer can take place at large events, as long as safety protocols are strictly enforced. It is important to disseminate, at these events, the concepts of the Responsible Research and Innovation (RRI). Implications for services: Face-to-face training course is fundamental for training public health professionals. Technology transfer between research institutions and health services results in updating and improving health system performance. PERSPECTIVES: Based on the success of the reported technology transfer, a new module will be incorporated into the next edition of VEME (Panama 2022), entitled Virus Evolution to Public Health Policy Makers. The objective of this report was to describe the first face-to-face course aimed at training public health professionals in performing real-time genomic surveillance during the pandemic period. Experience report on a theoretical-practical course focusing on genomic research and surveillance, including mobile sequencing technologies, bioinformatics, phylogenetics and epidemiological modeling. There were 162 participants in the event and it was the first major face-to-face training course conducted during the COVID-19 epidemic in Brazil. No cases of SARS-CoV-2 infection was detected among the participants at the end of the event, suggesting the safety and effectiveness of all safety measures adopted. The results of this experience suggest that it is possible to conduct professional training safely during pandemics, as long as all safety protocols are followed.

BAROS PROTOCOL IN A UNIVERSITY HOSPITAL: WHAT IS THE IMPORTANCE IN THE POSTOPERATIVE RESULTS OF BARIATRIC SURGERY?

BACKGROUND: Although bariatric surgery is highly effective for the treatment of obesity and its comorbidities, preoperative weight loss has an impact on its results. AIMS: The aim of this study was to correlate preoperative weight loss with the outcome of bariatric surgery using the Bariatric Analysis and Reporting Outcome System scores. METHODS: This is a cross-sectional, observational study with 43 patients undergoing bariatric surgery that compared a group of 25 patients with a percentage of preoperative excess weight loss ³8% with a group of 18 patients with a percentage of preoperative excess weight loss <8% or with weight gain. The research took place at the bariatric surgery outpatient clinic of the Oswaldo Cruz University Hospital with patients 1 year after the surgery. RESULTS: Patients had a mean age of 40.8 years (42.7 percentage of preoperative excess weight loss ≥8% vs. 38.2 percentage of preoperative excess weight loss <8%, p=0.095). No significant difference was found between the two groups regarding preoperative comorbidities and body mass index at entry into the program. Higher preoperative body mass index (48.69 vs. 44.0; p=0.029) was observed in the group with percentage of preoperative excess weight loss <8%. No significant difference was found regarding the percentage of excess weight loss (71.4±15.4%; percentage of preoperative excess weight loss ≥8% vs. 69.47%±14.5 percentage of preoperative excess weight loss <8%; p=0.671), the result of the surgery according to the Bariatric Analysis and Reporting Outcome System scores protocol, the resolution of comorbidities, the quality of life, and the surgical complications between the two groups. CONCLUSIONS: Based on the available data, it is reasonable that bariatric surgery should not be denied to people who have not achieved pre-established weight loss before surgery.

Baros protocol in a university hospital: what is the importance in the postoperative results of bariatric surgery? / Protocolo baros em hospital universitário: qual a importância nos resultados pós-operatórios de cirurgia bariátrica?

ABSTRACT BACKGROUND: Although bariatric surgery is highly effective for the treatment of obesity and its comorbidities, preoperative weight loss has an impact on its results. AIMS: The aim of this study was to correlate preoperative weight loss with the outcome of bariatric surgery using the Bariatric Analysis and Reporting Outcome System scores. METHODS: This is a cross-sectional, observational study with 43 patients undergoing bariatric surgery that compared a group of 25 patients with a percentage of preoperative excess weight loss ³8% with a group of 18 patients with a percentage of preoperative excess weight loss <8% or with weight gain. The research took place at the bariatric surgery outpatient clinic of the Oswaldo Cruz University Hospital with patients 1 year after the surgery. RESULTS: Patients had a mean age of 40.8 years (42.7 percentage of preoperative excess weight loss ≥8% vs. 38.2 percentage of preoperative excess weight loss <8%, p=0.095). No significant difference was found between the two groups regarding preoperative comorbidities and body mass index at entry into the program. Higher preoperative body mass index (48.69 vs. 44.0; p=0.029) was observed in the group with percentage of preoperative excess weight loss <8%. No significant difference was found regarding the percentage of excess weight loss (71.4±15.4%; percentage of preoperative excess weight loss ≥8% vs. 69.47%±14.5 percentage of preoperative excess weight loss <8%; p=0.671), the result of the surgery according to the Bariatric Analysis and Reporting Outcome System scores protocol, the resolution of comorbidities, the quality of life, and the surgical complications between the two groups. CONCLUSIONS: Based on the available data, it is reasonable that bariatric surgery should not be denied to people who have not achieved pre-established weight loss before surgery.

RESUMO RACIONAL: Apesar da cirurgia bariátrica ser altamente eficaz para o tratamento da obesidade e suas comorbidades, ainda não está bem estabelecido o impacto da perda de peso pré-operatória em seus resultados. OBJETIVOS: Correlacionar a perda de peso pré-operatória com o resultado da cirurgia bariátrica pelos escores do método Bariatric Analysis and Reportig Outcome System. MÉTODOS: Estudo observacional transversal com 43 pacientes submetidos a cirurgia bariátrica que comparou um grupo de 25 pacientes com percentual de perda do excesso de peso pré-operatória igual ou maior a 8% com um grupo de 18 pacientes com percentual de perda do excesso de peso pré-operatória menor a 8% ou com ganho de peso. A pesquisa ocorreu no ambulatório de Cirurgia Bariátrica do Hospital Universitário Oswaldo Cruz com pacientes após um ano da cirurgia. RESULTADOS: Os pacientes tinham uma média de idade de 40,8 anos (42,7 percentual de perda do excesso de peso pré-operatória ≥8% vs 38,2 percentual de perda do excesso de peso pré-operatória <8%, p=0.095). Não foram encontradas diferenças significativas entre os dois grupos em relação às comorbidades pré-operatórias e o IMC na entrada do programa. Foi observado maior IMC pré-operatório (48,69 vs 44,0; p=0,029) no grupo com percentual de perda do excesso de peso pré-operatória <8%. Não foram encontradas diferenças significativas em relação ao percentual de perda do excesso de peso (71,4±15,4%; percentual de perda do excesso de peso pré-operatória ≥8% vs 69,47±14,5% percentual de perda do excesso de peso pré-operatória <8%, p=0,671), ao resultado da cirurgia pelo protocolo Bariatric Analysis and Reportig Outcome System, a resolução das comorbidades, a qualidade de vida e as complicações cirúrgicas entre os dois grupos. CONCLUSÕES: Com base nos dados disponíveis é condizente que a cirurgia bariátrica não seja negada a pessoas que não atingiram uma perda de peso pré-estabelecida antes da cirurgia.

Transferência tecnológica durante a pandemia de covid-19: relato do primeiro treinamento prático presencial no Brasil / Technology transfer during the COVID-19 pandemic: report on the first face-to-face practical training course in Brazil / Transferencia de tecnología durante la epidemia de COVID-19 en Brasil: informe de la primera formación práctica presencial

O relato descreveu o primeiro curso presencial visando capacitar profissionais de saúde pública na realização de vigilância genômica em tempo real, durante períodos pandêmicos. Relato de experiência sobre um curso teórico-prático com foco em pesquisa e vigilância genômica, incluindo tecnologias de sequenciamento móvel, bioinformática, filogenética e modelagem epidemiológica. O evento contou com 162 participantes e foi o primeiro grande treinamento presencial realizado durante a epidemia de covid-19 no Brasil. Não foi detectada infecção pelo SARS-CoV-2 ao final do evento em nenhum participante, sugerindo a segurança e efetividade de todas as medidas de segurança adotadas. Os resultados do evento sugerem que é possível executar capacitação profissional com segurança durante pandemias, desde que seguidos todos os protocolos de segurança.

The objective of this report was to describe the first face-to-face course aimed at training public health professionals in performing real-time genomic surveillance during the pandemic period. Experience report on a theoretical-practical course focusing on genomic research and surveillance, including mobile sequencing technologies, bioinformatics, phylogenetics and epidemiological modeling. There were 162 participants in the event and it was the first major face-to-face training course conducted during the COVID-19 epidemic in Brazil. No cases of SARS-CoV-2 infection was detected among the participants at the end of the event, suggesting the safety and effectiveness of all safety measures adopted. The results of this experience suggest that it is possible to conduct professional training safely during pandemics, as long as all safety protocols are followed.

Este estudio tuvo como objetivo describir el primer curso presencial para capacitar a los profesionales de la salud pública para llevar a cabo la vigilancia genómica en tiempo real durante los períodos de pandemia. Este es un informe de experiencia en un curso teórico-práctico centrado en la investigación y vigilancia genómica, que incluye secuenciación móvil, bioinformática, filogenética y tecnologías de modelado epidemiológico. Este evento contó con la asistencia de 162 participantes y fue la primera gran capacitación presencial realizada durante la epidemia de COVID-19 en Brasil. No se detectó infección por SARS-CoV-2 al final del evento en ningún participante, lo que sugiere la seguridad y efectividad de todas las medidas de seguridad adoptadas. Por lo tanto, los resultados del evento sugieren que es posible realizar entrenamientos profesionales de manera segura durante pandemias, siempre y cuando se sigan todos los protocolos de seguridad.

Blockade of the checkpoint PD-1 by its ligand PD-L1 and the immuno-oncological drugs pembrolizumab and nivolumab.

We investigate the interaction between the programmed cell death protein 1 (PD-1) and the programmed cell death ligand 1 (PD-L1), as well as the immuno-oncological drugs pembrolizumab (PEM), and nivolumab (NIV), through quantum chemistry methods based on the Density Functional Theory (DFT) and the molecular fractionation with conjugate caps (MFCC) scheme, in order to map their hot-spot regions. Our results showed that the total interaction energy order of the three complexes is in good agreement with the experimental binding affinity order: PD-1/PEM > PD-1/NIV > PD-1/PD-L1. Besides, a detailed investigation revealed the energetically most relevant residue-residue pairs-interaction for each complex. Our computational results give a better understanding of the interaction mechanism between the protein PD-1 and its ligands (natural and inhibitors), unleashing the immune surveillance to destroy the cancer cells by decreasing their immune evasion. They are also an efficient alternative towards the development of new small-molecules and antibody-based drugs, pointing out to new treatments for cancer therapy.

Saúde Mental dos Acadêmicos de Medicina na Quarentena ­ isolamento e enfrentamentos individuais / Mental Health of Medical Students in Quarantine ­ isolation and individual confrontations

O isolamento domiciliar e o distanciamento social têm sido sugeridos como estratégias a serem adotadas em estágios mais avançados de pandemias. Até recentemente tais medidas, geralmente, eram aplicadas somente para grupos de risco e/ou para contactantes de pessoas infectadas. A pandemia atual é a primeira experiência de implementação deste tipo de medida em larga escala. É fundamental avaliarmos as diferentes consequências que tanto a pandemia, como suas medidas de enfrentamento (isolamento domiciliar e distanciamento social), podem vir a ocasionar em territórios e estratos sociais distintos. Nesse estudo, buscou-se observar os efeitos da quarentena na saúde mental dos estudantes de medicina de uma faculdade particular, os fatores que influenciam, os recursos utilizados para lidar com essas dificuldades e quais as especificidades de ser estudante de medicina na quarentena. Para tanto, foram aplicados questionários semi-estruturados on-line analisados por meio de análise do conteúdo. Apresenta-se aqui os resultados preliminares e específicos quanto às estratégias utilizadas pelos acadêmicos para lidar com o sofrimento e os contratempos cotidianos. Os estudantes privilegiaram atividades de auto-cuidado e atividades de lazer experimentadas individualmente. Discutimos esses achados, considerando a carga do isolamento e seus efeitos para o processo de socialização dos acadêmicos.(AU)

Isolation and social distance have been suggested as strategies to be adopted in more advanced stages of pandemics. Until recently, such measures were generally applied only to groups at risk and / or to contact persons infected. The current pandemic is the first experience of implementing this type of measure on a large scale. It is essential to assess the different consequences that both the pandemic and its measures of coping (home isolation and social distance), may have in different territories and social strata. In this study, we sought to observe the effects of quarantine on the mental health of medical students from a particular college, the factors that influence it, the resources used to deal with these difficulties and what are the specifics of being a medical student in quarantine. For that, semi-structured questionnaires were applied online and analyzed through content analysis. Preliminary and specific results regarding the strategies used by academics to deal with daily suffering and setbacks are presented here. Students favored self-care activities and leisure activities experienced individually. We discussed these findings, considering the burden of isolation and its effects on the students socialization process.(AU)

Se ha sugerido que el aislamiento del hogar y la distancia social son estrategias a adoptar en las etapas más avanzadas de las pandemias. Hasta hace poco, estas medidas se aplicaban generalmente solo a grupos en riesgo y / o para contactar personas infectadas. La pandemia actual es la primera experiencia de implementación de este tipo de medidas a gran escala. Es fundamental evaluar las diferentes consecuencias que tanto la pandemia como sus medidas de afrontamiento (aislamiento domiciliario y distancia social), pueden tener en diferentes territorios y estratos sociales. En este estudio, buscamos observar los efectos de la cuarentena en la salud mental de los estudiantes de medicina de una universidad en particular, los factores que influyen en ella, los recursos utilizados para hacer frente a estas dificultades y cuáles son las particularidades de ser un estudiante de medicina en cuarentena. Para ello, se aplicaron cuestionarios semiestructurados online y se analizaron mediante análisis de contenido. A continuación se presentan resultados preliminares y específicos sobre las estrategias que utilizan los académicos para afrontar el sufrimiento y los retrocesos cotidianos. Los estudiantes favorecieron las actividades de cuidado personal y las actividades de ocio experimentadas individualmente. Discutimos estos hallazgos, considerando la carga del aislamiento y sus efectos en el proceso de socialización de los estudiantes.(AU)

Quantum binding energies of checkpoint CTLA-4 in complex with the immuno-oncological drug ipilimumab.

Inhibition of the checkpoint protein CTLA-4 by the US-FDA's approved monoclonal antibody ipilimumab has delivered breakthrough therapies against a wide range of cancers, being an important issue for clinical research. To date, many structural properties of this drug have been unveiled. However, the binding energy features of the receptor CTLA-4 in complex with its drug inhibitor, based on crystallographic data, need a deeper understanding. Within this context, by employing quantum chemistry we investigate in silico the binding energy features of the checkpoint protein CTLA-4 in complex with its drug inhibitor, highlighting the most relevant residue-residue interactions, looking for new insights into the mechanisms of pathway blockade to further engineer its affinity and selectivity. Our computational results not only give a better understanding of the binding mechanisms, but also point to an efficient alternative towards the development of antibody-based drugs, leading to new treatments for cancer therapy based upon immunotherapy.

A Magnetic Force Microscopy Study of Patterned T-Shaped Structures.

The study of patterned magnetic elements that can sustain more than one bit of the information is an important research line for developing new routes in magnetic storage and magnetic logic devices. Previous Monte Carlo studies of T-shaped magnetic nanostructures revealed the equilibrium and evolution of magnetic states that could be found as a result of the strong configurational anisotropy of these systems. In this work, for the first time, such behavior of T-shaped magnetic nanostructures is experimentally studied. In particular, T-shaped Co nanostructures have been produced by electron beam lithography using a single step lift-off process over Si substrates. The existence of four magnetic stable states has been proven by Magnetic Force Microscopy (MFM) and the analysis was complemented by Micromagnetic Simulations. The results confirmed that even for what can be considered large structures, with µm sizes, such four stable magnetic states can be achieved, and therefore two magnetic bits of information can be stored. We also addressed how to write and read those bits.

Is there evidence that periodontal diseases are risk factors for coronary arterial disease?-Scoping review.

AIM: To determine the scientific evidence regarding the condition of periodontal diseases (PDs) as risk factors of coronary artery diseases. MATERIALS AND METHODS: A scoping review was performed through the selection of articles from online databases (Medline via PubMed, LILACS, and Cochrane CENTRAL), using a search algorithm and eligibility criteria for data extraction and data synthesis of included papers. Four hundred forty-one studies from online databases and 1364 from reference lists were initially identified, and 34 articles were selected for inclusion. Articles had to be published between 2015 and 2020 and had to associate PDs to coronary arterial diseases. All studies comprised a sample of 446443 participants. Favorable opinions totaled 70.59%, and the cross-sectional observational study design was more frequently found (32.35%). Biochemical outcomes were showed more frequently, such as inflammatory biomarkers (58.82%). Despite a large advantage for favorable opinions, a statistically significant result was not found when extracted data were combined with studies opinions. CONCLUSION: The evidence was classified as level II-3, hence, still distant from the best ranks and can therefore be considered as unclear. Moreover, studies with the higher potential to generate evidence showed a high risk of bias.

The obscurance of the greatest sylvatic yellow fever epidemic and the cooperation of the Pan American Health Organization during the COVID-19 pandemic.

INTRODUCTION: Since 2016, Brazil has been in the midst of its largest sylvatic yellow fever epidemic ever, found predominantly outside the Amazon region. Cases originating from Brazil have been reported in France, the Netherlands, Romania, Switzerland, Argentina, and Chile. The epidemic began in the Central-West region of Brazil in 2014, spreading into the Southern region, with significant non-human primate transmission continuing towards Paraguay and Argentina. METHODS: This report is an integrative review of Pan American Health Organization cooperation during a sylvatic yellow fever epidemic. RESULTS: The Pan American Health Organization has played a central role in handling the yellow fever emergency, collaborating with the Ministry of Health and various research groups in supporting interventions of different response areas. The Pan American Health Organization's technical cooperation included: training and workshops to exchange experiences, carrying out technical cooperation in patient management and epidemiological, entomological, laboratory, and epizootic surveillance, organizing the assistance network, and acquiring strategic inputs. The Pan American Health Organization's technical cooperation supported the Ministry of Health's decision to adopt a single-dose vaccine and use fractional doses to support the vaccination needs of more than 39,000,000 people. The coronavirus disease 2019 pandemic contributed to the failure of reaching the yellow fever vaccination goals and made it difficult to integrate the yellow fever vaccine into recommended areas. CONCLUSIONS: Given the ongoing coronavirus disease 2019 pandemic, it is necessary to strengthen measures for the surveillance, prevention, and control of yellow fever with multilateral cooperation between countries.

A New Dual-cure Universal Simplified Adhesive: 18-month Randomized Multicenter Clinical Trial.

CLINICAL RELEVANCE: Non-carious cervical lesion restorations using a dual-cure universal adhesive in self-etch and etch-and-rinse mode showed satisfactory clinical performance after 18 months. SUMMARY: Objectives: The objective of this multicenter, double-blind, split-mouth randomized clinical trial was to evaluate the clinical performance of a new dual-cure universal adhesive system (Futurabond U, Voco GmBH) when applied using different strategies over a period of 18 months.Methods and Materials: Fifty patients participated in this study. Two hundred non-carious cervical lesions were restored using the adhesive Futurabond U according to four adhesive strategies (n=50 per group): only self-etch (SEE), selective enamel etching + self-etch (SET), etch-and-rinse with dry dentin (ERDry), and etch-and-rinse with wet dentin (ERWet). After the adhesive application, cavities were restored using Admira Fusion composite resin. These restorations were evaluated according to FDI World Dental Federation criteria for the following characteristics: retention/fracture, marginal adaptation, marginal staining, postoperative sensitivity, and caries recurrence.Results: After 18 months, only four patients (12 months: one patient, n=4 restorations; and 18 months: three patients, n=12 restorations) were not evaluated. Fourteen restorations were lost after 18 months of clinical evaluation (four for SEE, three for SET, three for ERDry, and four for ERWet). The retention rates for 18 months (95% confidence interval) were 92% (81%-97%) for SEE, 94% (83%-97%) for SET, 94% (83%-97%) for ERDry, and 92% (81%-97%) for ERWet (p>0.05). Thirty-eight restorations were considered to have minor discrepancies in marginal adaptation at the 18-month recall (13 for SEE, 13 for SET, six for ERDry, and six for ERWet; p>0.05). Fourteen restorations were detected as a minor marginal discoloration at the 18-month recall (six for SEE, six for SET, one for ERDry, and one for ERWet; p>0.05). However, all were considered clinically acceptable. No restorations showed postoperative sensitivity or caries recurrence at the time.Conclusion: The clinical performance of the Futurabond U did not depend on the bonding strategy used, and it was considered reliable after 18 months of clinical evaluation, although more marginal discrepancy was observed in the self-etch group.

Critical properties of the SIS model on the clustered homophilic network.

The spreading of epidemics in complex networks has been a subject of renewed interest of several scientific branches. In this regard, we have focused our attention on the study of the susceptible-infected-susceptible (SIS) model, within a Monte Carlo numerical simulation approach, representing the spreading of epidemics in a clustered homophilic network. The competition between infection and recovery that drives the system either to an absorbing or to an active phase is analyzed. We estimate the static critical exponents ß ∕ ν , 1 ∕ ν and γ ∕ ν , through finite-size scaling (FSS) analysis of the order parameter ρ and its fluctuations, showing that they differ from those associated with the contact process on a scale-free network, as well as those predicted by the heterogeneous mean-field theory.

Update on the treatment of musculoskeletal manifestations in chikungunya fever: a guideline.

Since the emergence of the chikungunya virus in Brazil in 2014, more than 700,000 cases have been reported throughout the country, corresponding to one-third of all cases reported in the Americas. In addition to its high attack rates, resulting in hundreds of thousands of cases, the disease has high chronicity rates with persistent joint manifestations for more than 3 months, which can spread to more than half of the patients affected in the acute phase. Pain associated with musculoskeletal manifestations, often disabling, has an effect on patients' quality of life at different stages of the disease. Currently, the challenge faced by specialists is identifying the best therapy to be instituted for symptom relief despite the limited number of published intervention studies. In 2016, a multidisciplinary group published pharmacological treatment protocols for pain in patients with chikungunya, which was incorporated into the guidelines for clinical management of the Brazilian Ministry of Health in 2017; in that same year, a consensus was published by the Brazilian Society of Rheumatology about diagnosis and treatment. After 5 years of experience with chikungunya epidemics, in 2019, specialists involved in the protocols of the Brazilian Society of Rheumatology and Brazilian Ministry of Health prepared an update with the main objective of developing flowcharts for the therapeutic approach of musculoskeletal manifestations in adult patients to enable specialists at different levels of healthcare to spread and apply this guideline in a systematic and simplified manner.

Phase-shift control of the exchange coupling between magnetic impurities.

The control of magnetic interactions is one of the most relevant topics in spintronics. In this work, we propose to use electric potential barriers for tuning or even suppressing the RKKY exchange coupling between magnetic impurities in a two-dimensional electron gas. Our results show that it is possible to manipulate both the magnitude and sign of the RKKY coupling. Systems with two and three impurities are studied. In the last case, the use of two potential barriers can be employed to decouple one of the impurities to the rest. The possibility to control the interactions between magnetic atoms individually may have applications in neuromorphic and quantum computing.

Persistence of chikungunya ECSA genotype and local outbreak in an upper medium class neighborhood in Northeast Brazil.

The chikungunya East/Central/South/Africa virus lineage (CHIKV-ECSA) was first detected in Brazil in the municipality of Feira de Santana (FS) by mid 2014. Following that, a large number of CHIKV cases have been notified in FS, which is the second-most populous city in Bahia state, northeastern Brazil, and plays an important role on the spread to other Brazilian states due to climate conditions and the abundance of competent vectors. To better understand CHIKV dynamics in Bahia state, we generated 5 complete genome sequences from a local outbreak raised in Serraria Brasil, a neighbourhood in FS, by next-generation sequencing using Illumina approach. Phylogenetic reconstructions revealed that the new FS genomes belongs to the ECSA genotype and falls within a single strongly supported monophyletic clade that includes other older CHIKV sequences from the same location, suggesting the persistence of the virus during distinct epidemic seasons. We also performed minor variants analysis and found a small number of SNPs per sample (b_29L and e_45SR = 16 SNPs, c_29SR = 29 and d_45PL and f_45FL = 21 SNPs). Out of the 93 SNPs found, 71 are synonymous, 21 are non-synonymous and one generated a stop codon. Although those mutations are not related to the increase of virus replication and/or infectivity, some SNPs were found in non-structural proteins which may have an effect on viral evasion from the mammal immunological system. These findings reinforce the needing of further studies on those variants and of continued genomic surveillance strategies to track viral adaptations and to monitor CHIKV epidemics for improved public health control.

Update on the treatment of musculoskeletal manifestations in chikungunya fever: a guideline

Abstract Since the emergence of the chikungunya virus in Brazil in 2014, more than 700,000 cases have been reported throughout the country, corresponding to one-third of all cases reported in the Americas. In addition to its high attack rates, resulting in hundreds of thousands of cases, the disease has high chronicity rates with persistent joint manifestations for more than 3 months, which can spread to more than half of the patients affected in the acute phase. Pain associated with musculoskeletal manifestations, often disabling, has an effect on patients' quality of life at different stages of the disease. Currently, the challenge faced by specialists is identifying the best therapy to be instituted for symptom relief despite the limited number of published intervention studies. In 2016, a multidisciplinary group published pharmacological treatment protocols for pain in patients with chikungunya, which was incorporated into the guidelines for clinical management of the Brazilian Ministry of Health in 2017; in that same year, a consensus was published by the Brazilian Society of Rheumatology about diagnosis and treatment. After 5 years of experience with chikungunya epidemics, in 2019, specialists involved in the protocols of the Brazilian Society of Rheumatology and Brazilian Ministry of Health prepared an update with the main objective of developing flowcharts for the therapeutic approach of musculoskeletal manifestations in adult patients to enable specialists at different levels of healthcare to spread and apply this guideline in a systematic and simplified manner.