Mechanical properties of dual-polymerizing resin-core material, dual-polymerizing resin cement, and bulk-fill composite resin used for restoring endodontically treated teeth.

STATEMENT OF PROBLEM: How resin-based material and a light-activation protocol influence the mechanical properties of materials used to cement glass fiber post-and-cores in endodontically treated teeth is unclear. PURPOSE: The purpose of this in vitro study was to evaluate the influence of immediate or 5-minute delayed light activation on the mechanical properties of dual-polymerizing resin cements and dual-polymerizing resin-core materials compared with bulk-fill composite resins. MATERIAL AND METHODS: Nine resin-based materials were tested: 4 dual-polymerizing resin-core materials, (Allcem Core; FGM, LuxaCore Z; DMG, Rebilda DC; VOCO, and (Clearfil DC Core Plus; KURARAY), 3 dual-polymerizing resin cements, (RelyX Universal; 3M ESPE, RelyX U200; 3M ESPE, and Allcem Dual; FGM), and 2 bulk-fill composite resins, (Opus Bulk Fill APS; FGM, and Filtek One Bulk Fill; 3M ESPE). The dual-polymerizing materials were light activated using both protocols. The postgel shrinkage (Shr), flexural strength (FS), elastic modulus (E), Knoop hardness (KH), degree of conversion (DC), and depth of polymerization (DoP) were measured (n=10). The data for Shr, FS, E, and DoP were analyzed using 2-way ANOVA, and for KH and DC using 2-way repeated measurement ANOVA and the Tukey HSD test (α=.05). RESULTS: A 5-minute delay before light-activation significantly reduced Shr for all materials (P<.001). Increasing the depth significantly reduced the KH for all materials (P<.001). Bulk-fill composite resins and dual-polymerizing resin-core had higher KH values than dual-polymerizing resin cements (P<.001). CONCLUSIONS: Delayed 5-minute light-activation reduced postgel shrinkage and had no negative effect on mechanical properties. Dual-polymerizing resin-core materials exhibited higher KH values than dual-polymerizing resin cement and mechanical properties similar to those of bulk-fill composite resin.

Impact of adenotonsillectomy and palatal expansion on the apnea-hypopnea index and minimum oxygen saturation in nonobese pediatric obstructive sleep apnea with balanced maxillomandibular relationship: A cross-over randomized controlled trial.

OBJECTIVE: To determine the impact and best management sequence between adenotonsillectomy (AT) and rapid palatal expansion (RPE) on the apnea-hypopnea index (AHI) and minimum oxygen saturation (MinSaO2) in nonobese pediatric obstructive sleep apnea (OSA) patients presenting balanced maxillomandibular relationship. STUDY DESIGN/METHODS: Thirty-two nonobese children with balanced maxillomandibular relationship and a mean age of 8.8 years, with a graded III/IV tonsillar hypertrophy and maxillary constriction, participated in a cross-over randomized controlled trial. As the first intervention, one group underwent AT while the other underwent RPE. After 6 months, interventions were switched in those groups, but only to participants with an AHI > 1 after the first intervention. OSA medical diagnosis with the support of Polysomnography (PSG) was conducted before (T0), 6 months after the first (T1) and the second (T2) intervention. The influence of sex, adenotonsillar hypertrophy degree, initial AHI and MinSaO2 severity, and intervention sequence were evaluated using linear regression analysis. Intra- and intergroup comparisons for AHI and MinSaO2 were performed using ANOVA and Tukey's test. RESULTS: The initial AHI severity and intervention sequence (AT first) explained 94.9% of AHI improvement. The initial MinSaO2 severity accounted for 83.1% of MinSaO2 improvement changes. Most AHI reductions and MinSaO2 improvements were due to AT. CONCLUSIONS: Initial AHI severity and AT as the first intervention accounted for most of the AHI improvement. The initial MinSaO2 severity alone accounted for the most changes in MinSaO2 increase. In most cases, RPE had a marginal effect on AHI and MinSaO2 when adjusted for confounders.

Adaptation and Biomechanical Performance of Custom-Fit Mouthguards Produced Using Conventional and Digital Workflows: A Comparative In Vitro Strain Analysis.

BACKGROUND/OBJECTIVES: The use of different models for the fabrication of custom-fit mouthguards (MTGs) can affect their final thickness, adaptation, and shock-absorption properties. This study aimed to evaluate the adaptation, thickness, and shock absorption of ethylene-vinyl acetate (EVA) thermoplastic MTGs produced using conventional plaster or three-dimensional (3D) printed models. MATERIALS AND METHODS: A typical model with simulated soft gum tissue was used as the reference model to produce MTGs with the following two different protocols: plast-MTG using a conventional impression and plaster model (n = 10) and 3DPr-MTG using a digital scanning and 3D printed model (n = 10). A custom-fit MTG was fabricated using EVA sheets (Bioart) plasticized over different models. The MTG thickness (mm), internal adaptation (mm) to the typodontic model, and voids in the area (mm2) between the two EVA layers were measured using cone-beam computed tomography images and Mimics software (Materialize). The shock absorption of the MTG was measured using a strain-gauge test with a pendulum impact at 30° with a steel ball over the typodont model with and without MTGs. Data were analyzed using one-way analysis of variance with repeated measurements, followed by Tukey's post hoc tests. RESULTS: The 3DPr-MTG showed better adaptation than that of the Plast-MTG at the incisal/occlusal and lingual tooth surfaces (p < 0.001). The 3DPr-MTG showed a thickness similar to that of the Plast-MTG, irrespective of the measured location. MTGs produced using both model types significantly reduced the strain values during horizontal impact (3DPr-MTG 86.2% and Plast-MTG 87.0%) compared with the control group without MTG (p < 0.001). CONCLUSION: The MTGs showed the required standards regarding thickness, adaptation, and biomechanical performance, suggesting that the number and volume of voids had no significant impact on their functionality. Three-dimensional printed models are a viable alternative for MTG production, providing better adaptation than the Plast-MTG at the incisal/occlusal and lingual tooth surfaces and similar performance as the MTG produced with the conventional protocol.

The effects of different types of exercises on cognition in older persons with mild cognitive impairment: A systematic review and meta-analysis.

PURPOSE: This systematic review with meta-analysis aims to analyze the effects of different types of exercise on cognition, neuroprotective and neuroinflammatory blood markers in older adults with mild cognitive impairment (MCI). METHODS: Relevant studies were identified using PubMED, SPORTDiscuss, Web of Science, Scopus, and PsycInfo databases. Methodological quality assessment of the studies was done with modified Downs and Black checklist. Data obtained from the included studies was analyzed using Comprehensive Meta-Analysis 4.0 software and results were reported using the random effects method. RESULTS: A total of twenty-three studies were identified. The findings were summarized as change in cognitive function after the exercise interventions in general and after each type of exercise. On average, the exercise intervention revealed an effect size (ES): 1.165; 0.741 to 1.589 (95% Confidence Interval (CI); p < 0.001); aerobic exercise ES: 1.442; 0.624 to 2.260 (95 %CI); p = 0.001; Multimodal ES: 0,856; 0.366 to 1.346 (95 % CI); p = 0.001 and resistance exercise ES: 1.229; 0.339 to 2.120 (95 % CI); p = 0.007. In addition, we observed significant small ES: -0.475; -0.817 to -0.134 (95 %CI); p = 0.006, I2= 0 %; τ2 = 0 of exercise effects on Tumor Necrosis Factor-α (TNF-α) and non-significant large ES:0.952; -0.238 to 2.142 (95 %CI); p = 0.117 on Brain Derived Neurotrophic Factor (BDNF) in persons with MCI. CONCLUSION: The present study revealed the existence of a large positive effect of overall exercise intervention on cognitive function and a small effect on TNF-α in old people with MCI. Additionally, this study demonstrates that aerobic and resistance exercises had similar larger positive effects and were better than multimodal exercise on increasing cognition in older persons with MCI.

Left Gastric Vein Direct Anastomosis as Alternative to Portal Flow Reconstruction in Liver Transplantation.

Introduction: The most relevant limiting factor for performing end-to-end anastomosis is portal vein thrombosis (PVT), which leads to challenging vascular reconstructions. This study aimed to analyze a single center's experience using the left gastric vein (LGV) for portal flow reconstruction in liver transplantation (LT). Methods: This retrospective observational study reviewed laboratory and imaging tests, a description of the surgical technique, and outpatient follow-up of patients with portal system thrombosis undergoing LT with portal flow reconstruction using the LGV. This study was conducted at a single transplant reference center in the northeast region of Brazil from January 2016 to December 2021. Results: Between January 2016 and December 2021, 848 transplants were performed at our center. Eighty-two patients (9.7%) presented with PVT, most of whom were treated with thrombectomy. Nine patients (1.1% with PVT) had extensive thrombosis of the portal system (Yerdel III or IV), which required end-to-side anastomosis between the portal vein and the LGV without graft, and had no intraoperative complications. All patients had successful portal flow in Doppler ultrasound control evaluations. Discussion: The goal was to reestablish physiological flow to the graft. A surgical strategy includes using the LGV graft. According to our reports, using LGV fulfilled the requirements for excellent vascular anastomosis and even allowed the dispensing of venous grafts. This is the largest case series in a single center of reconstruction of portal flow with direct anastomosis with the LGV without needing a vascular graft.

Changes in Metabolic and Inflammatory Markers after a Combined Exercise Program in Workers: A Randomized Controlled Trial.

PURPOSE: We investigated the effects of a 16-week combined exercise training on body composition, metabolic and inflammatory markers in sedentary middle-aged workers. We also assessed whether significant alterations in metabolic markers were associated with changes in health-related outcomes. METHODS: This randomized controlled trial involved 46 participants randomly allocated into control and exercise groups. The exercise group performed 16-week combined aerobic and resistance training for 75 min/session, 3 times/week. Fasting blood samples were collected at baseline and after 16-week intervention to determine lipid profile, metabolic and inflammatory markers as primary outcomes. RESULTS: A total of 36 participants completed the intervention (53.70 ± 6.92 years old) (n = 18 in each group). Waist circumference (interaction effect: F = 7.423, p = 0.002), fat mass (interaction effect: F = 5.070, p = 0.011), and muscle mass (interaction effect: F = 5.420, p = 0.007) were improved in the exercise group compared to the control group. Fasting glucose increased after the 16-week follow-up (time effect: F = 73.253, p < 0.001), without an intergroup difference. Insulin levels were greater in the control compared to exercise group (group effect: F = 6.509, p = 0.015). The control group tended to increase the HOMA-IR index (interaction effect: F = 3.493, p = 0.070) and to decrease the QUICKI index (interaction effect: F = 3.364, p = 0.075) to a greater extent compared to the exercise group. Exercise group reduced leptin (interaction effect: F = 11.175, p = 0.002) and adiponectin (interaction effect: F = 4.437, p = 0.043) concentrations in a greater magnitude than control group. IL-6 (time effect: F = 17.767, p < 0.001) and TNF-α (time effect: F = 9.781, p = 0.004) concentrations decreased after the intervention, without an intergroup difference. IL-17A levels increased in the control compared to exercise group (interaction effect: F = 5.010, p = 0.033). Effects on adiponectin, IL-6 and IL-17A levels seem to depend on baseline BMI, age, and sex. Percentage changes in leptin correlated positively with changes in HOMA-IR index in the exercise (r = 0.565, p = 0.015) and control (r = 0.670, p = 0.002) groups. CONCLUSIONS: A combined training program can be an effective strategy to improve body composition and inflammatory markers and prevent marked reductions in insulin sensitivity among middle-aged workers.

Mobile Robot + IoT: Project of Sustainable Technology for Sanitizing Broiler Poultry Litter.

The traditional aviary decontamination process involves farmers applying pesticides to the aviary's ground. These agricultural defenses are easily dispersed in the air, making the farmers susceptible to chronic diseases related to recurrent exposure. Industry 5.0 raises new pillars of research and innovation in transitioning to more sustainable, human-centric, and resilient companies. Based on these concepts, this paper presents a new aviary decontamination process that uses IoT and a robotic platform coupled with ozonizer (O3) and ultraviolet light (UVL). These clean technologies can successfully decontaminate poultry farms against pathogenic microorganisms, insects, and mites. Also, they can degrade toxic compounds used to control living organisms. This new decontamination process uses physicochemical information from the poultry litter through sensors installed in the environment, which allows accurate and safe disinfection. Different experimental tests were conducted to construct the system. First, tests related to measuring soil moisture, temperature, and pH were carried out, establishing the range of use and the confidence interval of the measurements. The robot's navigation uses a back-and-forth motion that parallels the aviary's longest side because it reduces the number of turns, reducing energy consumption. This task becomes more accessible because of the aviaries' standardized geometry. Furthermore, the prototype was tested in a real aviary to confirm the innovation, safety, and effectiveness of the proposal. Tests have shown that the UV + ozone combination is sufficient to disinfect this environment.

Pancreaticopleural fistula as the inaugural presentation of chronic pancreatitis: A case report.

INTRODUCTION: Pancreaticopleural fistula is a rare complication most associated with alcohol-induced chronic pancreatitis. This usually presents with chest symptoms instead of abdominal ones. Diagnosis requires a high index of suspicion in patients with pancreatitis and persistent pleural effusions. PRESENTATION OF CASE: We present a case of an 81-years-old man admitted in the emergency department with a one week complaints of productive cough, fever, dyspnea and left-side chest pain. The chest X-ray revealed a moderated-volume left-side pleural effusion. The pleural fluid analysis was consistent with an exsudative pleural effusion with high levels of amylase. The thoracoabdominal CT raised the suspicion of a pancreaticopleural fistula, confirmed by ERCP. A pancreatic main duct stenting was performed with good results. The patient was discharged asymptomatic after 18 days of hospitalization. DISCUSSION: Because of PPF insidious presentation it poses a great number of differential diagnosis, so pleural fluid analysis is of paramount importance with high levels of amylase confirming the diagnosis. MRCP and ERCP may establish the fistulous tract between the pancreatic duct and the pleural cavity, with the latter being also therapeutic. CONCLUSION: The rarity of this complication related to pancreatitis and the seldomly presence of abdominal pain in contrast with chest symptoms poses a diagnostic challenge.

The Pattern of GH Action in the Mouse Brain.

GH acts in numerous organs expressing the GH receptor (GHR), including the brain. However, the mechanisms behind the brain's permeability to GH and how this hormone accesses different brain regions remain unclear. It is well-known that an acute GH administration induces phosphorylation of the signal transducer and activator of transcription 5 (pSTAT5) in the mouse brain. Thus, the pattern of pSTAT5 immunoreactive cells was analyzed at different time points after IP or intracerebroventricular GH injections. After a systemic GH injection, the first cells expressing pSTAT5 were those near circumventricular organs, such as arcuate nucleus neurons adjacent to the median eminence. Both systemic and central GH injections induced a medial-to-lateral pattern of pSTAT5 immunoreactivity over time because GH-responsive cells were initially observed in periventricular areas and were progressively detected in lateral brain structures. Very few choroid plexus cells exhibited GH-induced pSTAT5. Additionally, Ghr mRNA was poorly expressed in the mouse choroid plexus. In contrast, some tanycytes lining the floor of the third ventricle expressed Ghr mRNA and exhibited GH-induced pSTAT5. The transport of radiolabeled GH into the hypothalamus did not differ between wild-type and dwarf Ghr knockout mice, indicating that GH transport into the mouse brain is GHR independent. Also, single-photon emission computed tomography confirmed that radiolabeled GH rapidly reaches the ventral part of the tuberal hypothalamus. In conclusion, our study provides novel and valuable information about the pattern and mechanisms behind GH transport into the mouse brain.

Biomechanical behavior of three maxillary expanders in cleft lip and palate: a finite element study.

This study evaluated the stress distribution in the dentoalveolar and palatal bone structures during maxillary expansion in a 17-year-old male patient with bilateral cleft lip and palate (BCLP) using expanders with dental (HYRAX) and skeletal anchorage (MARPE). For the generation of the specific finite element models, cone-beam computed tomography was used, and the DICOM files were exported to Mimics 3-Matic (Materialise) and Patran (MSC Software) software. Three specific three-dimensional models were generated: A) HYRAX: conventional four-banded hyrax screw (9 mm); B) MARPE-DS: 3 miniscrews (1.8 mm diameter - 5.4 mm length) and four-banded dental anchorage; and C) MARPE-NoDS: 3 miniscrews without dental anchorage. Maxillary expansion was simulated by activating the expanders transversely 1 mm on the "X" axis. HYRAX resulted in higher levels of deformation predominantly in the dentoalveolar region. MARPE-DS showed stress in the dentoalveolar region and mainly in the center of the palatal region, at approximately 4,000 µÎµ. MARPE-NoDS exhibited evident stress only in the palatal region. High stress levels in the root anchoring teeth were observed for HYRAX and MARPE-DS. In contrast, MARPE-NoDS cause stress on the tooth structure. The stress distribution from the expanders used in the BLCP showed asymmetric expansive behavior. During the initial activation phase of expansion, the HYRAX and MARPE-DS models produced similarly high strain at the dentoalveolar structures and upper posterior teeth displacement. The MARPE-NoDS model showed restricted strain on the palate.

Ciliate diversity in rodrigo de freitas lagoon (Rio de Janeiro, Brazil) from an integrative standpoint.

The Rodrigo de Freitas Lagoon is a highly eutrophic lacustrine system and has one of the longest histories of exploration and anthropic alteration in Brazil. Despite its relevance, limited studies explored the diversity of micro-eukaryotes in the lagoon. Ciliates (Alveolata, Ciliophora) are overlooked in environmental microbiology, especially in tropical and subtropical ecosystems, resulting in limited knowledge about their diversity and functional relevance in South American habitats, particularly in coastal lagoons. To fill this gap, here we investigated the diversity of ciliates in a brackish coastal lagoon in an urban area of Rio de Janeiro, Brazil, applying and comparing the performance of morphological and metabarcoding approaches. The metabarcoding analysis, based on high-throughput sequencing of the hipervariable region V4 of the 18S rRNA genes detected 37 molecular operational taxonomic units (MOTUs) assigned to Ciliophora, representing only about a half (56.9%) of the diversity detected by microscopy, which counted 65 ciliate morphotypes. The most representative classes in both approaches were Spirotrichea and Oligohymenophorea. The metabarcoding analysis revealed that 35.3% of the ciliate MOTUs had less than 97% similarity to available sequences in the NCBI database, indicating that more than one-third of these MOTUs potentially represents still not represented or undescribed ciliate species in current databases. Our findings indicate that metabarcoding techniques can significantly enhance the comprehension of ciliate diversity in tropical environments, but the scarcity of reference sequences of brackish ciliates in molecular databases represents a challenge to the taxonomic assignment of the MOTUs. This study provides new insights into the diversity of ciliates in a threatened coastal lagoon, revealing a vast array of still unknown and rare ciliate taxonomic units in tropical environments.

Development of a tool to calculate the probability of hypocalcemia after total thyroidectomy: a prospective study.

PURPOSE: This study aimed to evaluate the ability of the percentage of decrease in serum PTH level in the first 8 h after total thyroidectomy (TT) to predict hypocalcemia requiring Ca supplementation and develop a tool to predict it. METHODS: 97 patients who underwent TT with measurement of preoperative parathyroid hormone (PTH) levels were prospectively evaluated 1 and 8 h after TT; postoperative magnesium (Mg2PO) and phosphorus levels were evaluated on the 2nd day after surgery. The percentage of decrease in PTH level 1 h (%dPTH1h) and 8 h (%dPTH8h) postoperatively and predictors of hypocalcemia requiring Ca supplementation were evaluated and an equation was developed to predict this outcome. RESULTS: %dPTH1h (p = 0.002), %dPTH8h (p = 0.001) and (Mg2PO) (p < 0.01) were isolated predictors of postoperative hypocalcemia requiring Ca supplementation. The data obtained led to the development of two tools to predict this complication. CONCLUSIONS: The percentage of decrease in PTH level 1 h and 8 h postoperatively and the magnesium level on the 2nd day after surgery were predictors of more severe hypocalcemia, and an auxiliary tool for predicting this complication was developed.

The effects of combined exercise training on glucose metabolism and inflammatory markers in sedentary adults: a systematic review and meta-analysis.

This systematic review and meta-analysis aimed to determine the magnitude of the effect of combined exercise training on glucose metabolism markers, adipokines, and inflammatory cytokines in non-diabetic sedentary adults. PubMed, Web of Science, Scopus, Cochrane Library electronic databases and reference lists of included studies were explored for randomized controlled trials (RCTs) that included physically inactive adults and provided combined training interventions (aerobic plus resistance exercise). Effects on fasting glucose and insulin, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), HbA1c, adiponectin, leptin, IL-6, TNF-α, and C-reactive protein (CRP) in exercise vs control groups were analyzed using random effects meta-analysis. The Cochrane Risk of Bias Tool for Randomized Trials 2.0 (RoB 2) was used to assess the risk of bias. A total of 24 RCTs were included in the quantitative analysis. Combined exercise training significantly decrease fasting glucose (standardized mean difference, SMD: - 0.474, 95% CI [- 0.829, - 0.120], p = 0.009, 35 study arms), fasting insulin (SMD: - 1.024, 95% CI [- 1.502, - 0.545], p < 0.001, 27 study arms), HOMA-IR (SMD: - 0.946, 95% CI [- 1.450, - 0.442], p < 0.001, 23 study arms), TNF-α (SMD: - 0.972, 95% CI [- 1.361, - 0.582], p < 0.001, 10 study arms), and CRP (SMD: - 0.507, 95% CI [- 0.818, - 0.196], p = 0.001, 14 study arms). No significant effects were observed for HbA1c, adiponectin, leptin, and IL-6 levels. Random effects meta-regression models by age, sex, and intervention length were not able to explain any of the variation in the effect size of HOMA-IR. Findings from this systematic review and meta-analysis suggest that combined exercise training improves some glucose metabolism markers and inflammatory parameters in sedentary adults without diabetes.

Effect of four different mono and multi-wave light-curing units on the Knoop hardness of veneer resin composites.

OBJECTIVES: To evaluate the effect of mono and multi-wave light-curing units (LCUs) on the Knoop hardness of resin-based composites (RBC) that use different photoinitiators. METHODS: Central incisor-shaped specimens 12 mm long, 9 mm wide, and 1.5 mm thick were made from 2 RBCs that use different photoinitiators: Tetric N-Ceram (Ivoclar Vivadent) - and Vittra APS (FGM), both A2E shade. They were light-cured with 4 different LCUs: two claimed to be multi-wave - VALO Grand (Ultradent) and Emitter Now Duo (Schuster); and two were monowave - Radii Xpert (SDI) and Elipar DeepCure-L (3 M Oral Care) using 2 different light exposure protocols: one 40 s exposure centered over the specimen; and two 20 s light exposures that delivered light from two positions to better cover the entire tooth. 16 groups with 10 specimens in each group were made. The Knoop hardness (KH, kg/mm2) was measured at the top and bottom of the specimen in the center and at the cervical, incisal, mesial, and distal peripheral regions. The active tip diameters (mm) and spectral radiant powers (mW/nm) of the LCUs were measured with and without the interposition of the RBC, as well as the radiant exposure beam profiles (J/cm²) delivered to the top of the RBCs. The data was analyzed using Three-way ANOVA and Tukey's tests (α = 0.05). RESULTS: The VALO Grand (1029 mW) emitted twice the power of the Radii Xpert (500 mW). The KH values of VI and TN resin composite specimens were significantly affected by the LCU used (p < .001), the measurement location (p < .001), and the surface of the specimen (p < .001). LCUs with wider tip diameters produced greater Knoop hardness values at the peripheries of the 12 mm of long, 9 mm wide specimens. In general, the VALO Grand produced the highest KH values, followed by Elipar DeepCure-L, then by Radii Xpert. The Emitter Now Duo LCU produced the lowest values. Exposing the veneers from two locations reduced the differences between the LCUs and the effect of the measurement location. Only the VALO Grand could fully cover the composite veneer with light when the two locations were used. SIGNIFICANCE: The light tip must cover the entire restoration to photocure the RBC beneath the light tip.

Radiotherapy in the head and neck region influences the chemical and mechanical properties of intraradicular dentin.

OBJECTIVES: To investigate the chemical and mechanical properties of intraradicular dentin submitted to radiotherapy. MATERIALS AND METHODS: Sixteen mandibular incisors were divided into two groups (n = 8): non-irradiated and irradiated. The irradiated teeth were obtained from head and neck radiotherapy patients, with a total dose ranging from 70.2 to 72 Gy divided into 1.8 Gy daily. After sample preparation, intraradicular dentin slices of each root third were evaluated by Raman spectroscopy, energy dispersive spectroscopy and Knoop microhardness test. Data were analyzed by Two-way ANOVA and Tukey's test (α = 0.05). RESULTS: In Raman spectroscopy, carbonate and amide III showed a significant difference for irradiation and third (carbonate p = 0.021 and p < 0.001; amide III p < 0.001 and p = 0.001, respectively). For amide I, there was a significant difference for third (p < 0.001). For carbonate/mineral ratio, there was a significant difference for irradiation (p = 0.0016) and third (p < 0.001), with the irradiated middle third showing the lowest values. For amide I/amide III ratio, there was a significant difference for irradiation (p = 0.005) in the cervical third. In energy dispersive spectroscopy, carbon (p = 0.004; p = 0.020), phosphorus (p < 0.001; p = 0.009) and calcium (p = 0.008; p = 0.007) showed differences for irradiation and third, with the irradiated groups presenting lower values in cervical and middle thirds. For calcium/phosphorus ratio, there was a significant difference for irradiation (p < 0.001) in cervical and middle thirds. Regarding microhardness, there was a significant difference for irradiation (p < 0.001), with all irradiated groups showing lower microhardness values. CONCLUSIONS: The radiotherapy altered the chemical and mechanical properties of intraradicular dentin, mainly in the cervical and middle root thirds.

Basal or stimulated thyroglobulin in evaluating response to treatment in papillary thyroid carcinoma? A retrospective cohort study.

OBJECTIVE: It is not clear whether response to initial treatment in papillary thyroid carcinoma (PTC) patients is best evaluated by measuring thyroglobulin (Tg) in the presence of levothyroxine (BTg) or when stimulated by elevated TSH (STg). The aim of this study was to evaluate whether response to therapy 1 year after initial treatment changes with the use of STg in relation to BTg in PTC patients treated with total thyroidectomy (TT) and radioiodine (131I), and, if observed, to assess which response is better associated with clinical course. SUBJECTS AND METHODS: This is a retrospective study of 148 PTC patients submitted to TT and 131I. We analyzed the response to therapy (excellent, biochemical incomplete, or indeterminate) at 1 year after initial treatment, using BTg or STg, and compared which method was better associated with "excellent response at final evaluation." RESULTS: Twenty-eight patients (20.4%) presented change in response to therapy, with 17 of these (60.7%) presenting a worse response. Response using STg was 1.6 times better associated with proposed outcome [odds ratio (OR) = 4.61; confidence interval 95% (IC95%): 2.13-9.98] than with BTg (OR = 2.84; IC95%: 1.33-6.06). CONCLUSION: Response to therapy at 1 year using STg was altered in approximately 20% of cases and therefore proved to be a better predictor of excellent response in the last evaluation.

Biomechanical behavior of three maxillary expanders in cleft lip and palate: a finite element study

Abstract: This study evaluated the stress distribution in the dentoalveolar and palatal bone structures during maxillary expansion in a 17-year-old male patient with bilateral cleft lip and palate (BCLP) using expanders with dental (HYRAX) and skeletal anchorage (MARPE). For the generation of the specific finite element models, cone-beam computed tomography was used, and the DICOM files were exported to Mimics 3-Matic (Materialise) and Patran (MSC Software) software. Three specific three-dimensional models were generated: A) HYRAX: conventional four-banded hyrax screw (9 mm); B) MARPE-DS: 3 miniscrews (1.8 mm diameter - 5.4 mm length) and four-banded dental anchorage; and C) MARPE-NoDS: 3 miniscrews without dental anchorage. Maxillary expansion was simulated by activating the expanders transversely 1 mm on the "X" axis. HYRAX resulted in higher levels of deformation predominantly in the dentoalveolar region. MARPE-DS showed stress in the dentoalveolar region and mainly in the center of the palatal region, at approximately 4,000 με. MARPE-NoDS exhibited evident stress only in the palatal region. High stress levels in the root anchoring teeth were observed for HYRAX and MARPE-DS. In contrast, MARPE-NoDS cause stress on the tooth structure. The stress distribution from the expanders used in the BLCP showed asymmetric expansive behavior. During the initial activation phase of expansion, the HYRAX and MARPE-DS models produced similarly high strain at the dentoalveolar structures and upper posterior teeth displacement. The MARPE-NoDS model showed restricted strain on the palate.

Orofacial Deformities in 3 Related Rhesus Monkeys (Macaca mulatta) Resembling Human Binder's Syndrome.

Binder's syndrome is a rare congenital deformity characterized by midface hypoplasia, particularly around the nasomaxillary area. Genetic etiology or developmental failure caused by prenatal exposure to teratological agents has been considered. In this article, we present 3 related rhesus monkeys born with orofacial deformities similar to those found in infants with the Binder phenotype. For the first time, a primate biomodel for this condition is presented. The clinical description and association with management and environmental factors are discussed. These findings reinforce the knowledge about the relationship between possible vitamin K metabolism interference and Binder's syndrome.

Vigilância da fluoretação da água no município de São Paulo, Brasil, no período 1990-2021: dos relatórios aos dados abertos / Health surveillance of community water fluoridation in the municipality of Sao Paulo, Brazil, in the period 1990-2021: from reports to open data

Introdução: A vigilância da qualidade da água para consumo humano requer verificação contínua dos padrões de potabilidade, entre os quais a concentração de fluoreto. Sistemas de vigilância lidam com informações de interesse público, nos marcos legais definidos pelo Estado. No mundo contemporâneo, implicam equilibrar o direito de acesso à informação e a garantia de privacidade. Objetivo: Caracterizar a evolução do sistema de vigilância da fluoretação da água no município de São Paulo e avaliar se a população esteve exposta a concentrações adequadas e seguras do parâmetro fluoreto nas águas de abastecimento público, no período 1990-2021. Método: O estudo é ecológico, com dados secundários de 49.515 registros, geocodificados e classificados conforme a Resolução SS-250 e o intervalo ótimo de concentração recomendada pelo Centro Colaborador do Ministério da Saúde em Vigilância da Saúde Bucal (0,545-0,944 mgF/L). Adicionalmente, realizou-se revisão do marco legal brasileiro que trata da Lei de Acesso à Informação e da Lei Geral de Proteção de Dados Pessoais, tendo em vista a publicação dos parâmetros de qualidade da água em portais de dados abertos governamentais. Resultados: A média das temperaturas máximas diárias foi estimada em 25,7ºC. Foi possível geocodificar 98,43% dos registros. Obteve-se a concentração média de 0,663 mgF/L, com desvio-padrão de 0,167. De acordo com a Resolução SS-250, 48.118 (97,18%) das amostras estiveram adequadas. Considerando o Documento de Consenso Técnico, 29.823 (60,23%) das amostras apresentaram máximo benefício na prevenção da cárie e 48.786 (98,53%) indicaram baixo risco para fluorose dentária. O período analisado apresenta ampliação do acesso a dados abertos governamentais de qualidade da água para consumo humano, com potencial para ampliar as possibilidades de controle social sobre as políticas públicas. Entretanto, impõe desafios à garantia da privacidade. Conclusão: A utilização de técnicas de geocodificação possibilitou a recuperação de uma série histórica sem precedentes na literatura científica. Os resultados indicam que a população paulistana esteve exposta a concentrações adequadas e seguras do parâmetro fluoreto nas águas de abastecimento público no período 1990-2021.

Introduction: The surveillance of water quality for human consumption requires continuous verification of potability standards, among which is fluoride concentration. Surveillance systems deal with public interest information within the legal frameworks defined by the State. In the contemporary world, this implies balancing the right to access information and the guarantee of privacy. Objective: To characterize the evolution of the water fluoridation surveillance system in the municipality of São Paulo and evaluate whether the population has been exposed to adequate and safe concentrations of the fluoride in public water supplies during the period 1990-2021. Method: The study is ecological, utilizing secondary data from 49,515 records, geocoded and classified according to Resolution SS-250 and the optimal concentration range recommended by the Collaborating Center of the Ministry of Health in Oral Health Surveillance (0.545-0.944 mgF/L). Additionally, a review of the Brazilian legal framework addressing the Access to Information Law and the General Data Protection Law was conducted, considering the publication of water quality parameters on open government data websites. Results: The average daily maximum temperatures was estimated at 25.7ºC. It was possible to geocode 98.43% of the records. The average fluoride concentration was 0.663 mgF/L, with a standard deviation of 0.167. According to Resolution SS-250, 48,118 (97.18%) of the samples were adequate. Considering the Technical Consensus Document, 29,823 (60.23%) of the samples showed maximum benefit in caries prevention, and 48,786 (98.53%) presented a low risk for dental fluorosis. The period analyzed shows an expansion of access to open government data on water quality for human consumption, with potential to broaden the possibilities for social control over public policies. However, it imposes challenges to the guarantee of privacy. Conclusion: The use of geocoding techniques enabled the recovery of an unprecedented historical series in the scientific literature. The results indicate that the São Paulo population was exposed to adequate and safe concentrations of the fluoride parameter in public water supplies during the period 1990-2021.

Multiple GISTand pheochromocytoma -A rare associationin neurofibromatosis type 1 / GIST múltipley feocromocitoma -Una asociación raraen neurofibromatosis tipo 1

We describe a case of coexistence of multiple gastrointestinal stromal tumors (GIST) and pheochromocytoma in a 32-year-old patient with neurofibromatosis type 1. The coexistence of these two conditions in patients with this syndrome is extremely rare.(AU)