Self-Modulation of Gamma-Band Synchronization through EEG-Neurofeedback Training in the Elderly.

BACKGROUND: Electroencephalography (EEG) stands as a pivotal non-invasive tool, capturing brain signals with millisecond precision and enabling real-time monitoring of individuals' mental states. Using appropriate biomarkers extracted from these EEG signals and presenting them back in a neurofeedback loop offers a unique avenue for promoting neural compensation mechanisms. This approach empowers individuals to skillfully modulate their brain activity. Recent years have witnessed the identification of neural biomarkers associated with aging, underscoring the potential of neuromodulation to regulate brain activity in the elderly. METHODS AND OBJECTIVES: Within the framework of an EEG-based brain-computer interface, this study focused on three neural biomarkers that may be disturbed in the aging brain: Peak Alpha Frequency, Gamma-band synchronization, and Theta/Beta ratio. The primary objectives were twofold: (1) to investigate whether elderly individuals with subjective memory complaints can learn to modulate their brain activity, through EEG-neurofeedback training, in a rigorously designed double-blind, placebo-controlled study; and (2) to explore potential cognitive enhancements resulting from this neuromodulation. RESULTS: A significant self-modulation of the Gamma-band synchronization biomarker, critical for numerous higher cognitive functions and known to decline with age, and even more in Alzheimer's disease (AD), was exclusively observed in the group undergoing EEG-neurofeedback training. This effect starkly contrasted with subjects receiving sham feedback. While this neuromodulation did not directly impact cognitive abilities, as assessed by pre- versus post-training neuropsychological tests, the high baseline cognitive performance of all subjects at study entry likely contributed to this result. CONCLUSION: The findings of this double-blind study align with a key criterion for successful neuromodulation, highlighting the significant potential of Gamma-band synchronization in such a process. This important outcome encourages further exploration of EEG-neurofeedback on this specific neural biomarker as a promising intervention to counter the cognitive decline that often accompanies brain aging and, eventually, to modify the progression of AD.

The dual-path hypothesis for the emergence of anosognosia in Alzheimer's disease.

Although neurocognitive models have been proposed to explain anosognosia in Alzheimer's disease (AD), the neural cascade responsible for its origin in the human brain remains unknown. Here, we build on a mechanistic dual-path hypothesis that brings error-monitoring and emotional processing systems as key elements for self-awareness, with distinct impacts on the emergence of anosognosia in AD. Proceeding from the notion of anosognosia as a dimensional syndrome, varying between a lack of concern about one's own deficits (i.e., anosodiaphoria) and a complete lack of awareness of deficits, our hypothesis states that (i) unawareness of deficits would result from primary damage to the error-monitoring system, whereas (ii) anosodiaphoria would more likely result from an imbalance between emotional processing and error-monitoring. In the first case, a synaptic failure in the error-monitoring system, in which the anterior and posterior cingulate cortices play a major role, would have a negative impact on error (or deficits) awareness, preventing patients from becoming aware of their condition. In the second case, an impairment in the emotional processing system, in which the amygdala and the orbitofrontal cortex play a major role, would prevent patients from monitoring the internal milieu for relevant errors (or deficits) and assigning appropriate value to them, thus biasing their impact on the error-monitoring system. Our hypothesis stems on two scientific premises. One comes from preliminary results in AD patients showing a synaptic failure in the error-monitoring system along with a decline of awareness for cognitive difficulties at the time of diagnosis. Another comes from the somatic marker hypothesis, which proposes that emotional signals are critical to adaptive behavior. Further exploration of these premises will be of great interest to illuminate the foundations of self-awareness and improve our knowledge of the underlying paths of anosognosia in AD and other brain disorders.

Detecting Anosognosia from the Prodromal Stage of Alzheimer's Disease.

BACKGROUND: Though not originally developed for this purpose, the Healthy Aging Brain Care Monitor (HABC-M) seems a valuable instrument for assessing anosognosia in Alzheimer's disease (AD). OBJECTIVES: Our study aimed at 1) investigating the validity of the HABC-M (31 items), and its cognitive, psychological, and functional subscales, in discriminating AD patients from controls; 2) exploring whether the HABC-M discrepancy scores between the self-reports of patients/controls in these different domains and the respective ratings provided by their caregivers/informants correlate with an online measure of self-awareness; 3) determining whether the caregiver burden level, also derived from the HABC-M, could add additional support for detecting anosognosia. METHODS: The HABC-M was administered to 30 AD patients and 30 healthy controls, and to their caregivers/informants. A measure of online awareness was established from subjects' estimation of their performances in a computerized experiment. RESULTS: The HABC-M discrepancy scores distinguished AD patients from controls. The cognitive subscale discriminated the two groups from the prodromal AD stage, with an AUC of 0.88 [95% CI: 0.78;0.97]. Adding the caregiver burden level raised it to 0.94 [0.86;0.99]. Significant correlations between the HABC-M and online discrepancy scores were observed in the patients group, providing convergent validity of these methods. CONCLUSIONS: The cognitive HABC-M (six items) can detect anosognosia across the AD spectrum. The caregiver burden (four items) may corroborate the suspicion of anosognosia. The short-hybrid scale, built from these 10 items instead of the usual 31, showed the highest sensitivity for detecting anosognosia from the prodromal AD stage, which may further help with timely diagnosis.

Can a failure in the error-monitoring system explain unawareness of memory deficits in Alzheimer's disease?

Unawareness of memory deficits is an early manifestation in patients with Alzheimer's disease (AD), which often delays diagnosis. This intriguing behavior constitutes a form of anosognosia, whose neural mechanisms remain largely unknown. We hypothesized that anosognosia may depend on a critical synaptic failure in the error-monitoring system, which would prevent AD patients from being aware of their own memory impairment. To investigate, we measured event-related potentials (ERPs) evoked by erroneous responses during a word memory recognition task in two groups of amyloid positive individuals with only subjective memory complaints at study entry: those who progressed to AD within the five-year study period (PROG group), and those who remained cognitively normal (CTRL group). A significant reduction in the amplitude of the positivity error (Pe), an ERP related to error awareness, was observed in the PROG group at the time of AD diagnosis (vs study entry) in intra-group analysis, as well as when compared with the CTRL group in inter-group analysis, based on the last EEG acquisition for all subjects. Importantly, at the time of AD diagnosis, the PROG group exhibited clinical signs of anosognosia, overestimating their cognitive abilities, as evidenced by the discrepancy scores obtained from caregiver/informant vs participant reports on the cognitive subscale of the Healthy Aging Brain Care Monitor. To our knowledge, this is the first study to reveal the emergence of a failure in the error-monitoring system during a word memory recognition task at the early stages of AD. This finding, along with the decline of awareness for cognitive impairment observed in the PROG group, strongly suggests that a synaptic dysfunction in the error-monitoring system may be the critical neural mechanism at the origin of unawareness of deficits in AD.

Automatic dental biofilm detection based on deep learning.

AIM: To estimate the automated biofilm detection capacity of the U-Net neural network on tooth images. MATERIALS AND METHODS: Two datasets of intra-oral photographs taken in the frontal and lateral views of permanent and deciduous dentitions were employed. The first dataset consisted of 96 photographs taken before and after applying a disclosing agent and was used to validate the domain's expert biofilm annotation (intra-class correlation coefficient = .93). The second dataset comprised 480 photos, with or without orthodontic appliances, and without disclosing agents, and was used to train the neural network to segment the biofilm. Dental biofilm labelled by the dentist (without disclosing agents) was considered the ground truth. Segmentation performance was measured using accuracy, F1 score, sensitivity, and specificity. RESULTS: The U-Net model achieved an accuracy of 91.8%, F1 score of 60.6%, specificity of 94.4%, and sensitivity of 67.2%. The accuracy was higher in the presence of orthodontic appliances (92.6%). CONCLUSIONS: Visually segmenting dental biofilm employing a U-Net is feasible and can assist professionals and patients in identifying dental biofilm, thus improving oral hygiene and health.

Biopolymers as green-based food packaging materials: A focus on modified and unmodified starch-based films.

The ideal food packaging materials are recyclable, biodegradable, and compostable. Starch from plant sources, such as tubers, legumes, cereals, and agro-industrial plant residues, is considered one of the most suitable biopolymers for producing biodegradable films due to its natural abundance and low cost. The chemical modification of starch makes it possible to produce films with better technological properties by changing the functional groups into starch. Using biopolymers extracted from agro-industrial waste can add value to a raw material that would otherwise be discarded. The recent COVID-19 pandemic has driven a rise in demand for single-use plastics, intensifying pressure on this already out-of-control issue. This review provides an overview of biopolymers, with a particular focus on starch, to develop sustainable materials for food packaging. This study summarizes the methods and provides a potential approach to starch modification for improving the mechanical and barrier properties of starch-based films. This review also updates some trends pointed out by the food packaging sector in the last years, considering the impacts of the COVID-19 pandemic. Perspectives to achieve more sustainable food packaging toward a more circular economy are drawn.

Assessment of the relationship between tooth inclination and gingival and alveolar bone dimensions using computed tomography of the maxillary anterior teeth: a cross-sectional study.

OBJECTIVE: The present study aimed to investigate the relationship between tooth inclination and gingival and bone dimensions in maxillary anterior teeth. METHODS: This cross-sectional study included cone-beam computed tomography (CBCT) images of 160 maxillary anterior teeth (30 individuals). Tooth inclination, gingival and bone thickness, and distances from cementoenamel junction to alveolar bone crest and gingival margin were measured in the labial surface. The correlations were analyzed using Pearson and partial correlation tests (p≤0.05). RESULTS: In the central incisors, tooth inclination was positively and significantly related to apical bone thickness (R = 0.34, p= 0.001). In the canines, tooth inclination was negatively and significantly related to cervical bone thickness (R = - 0.34, p= 0.01) and positively associated to apical bone thickness (R = 0.36, p= 0.01) and to gingival margin-cementoenamel junction distance (R = 0.31, p= 0.03). In the lateral incisors, tooth inclination was not associated with gingival or bone dimensions. CONCLUSIONS: In the central incisors, the greater the labial tooth inclination, the greater is the apical bone thickness. In the canines, the greater the labial tooth inclination, the smallest is the cervical bone thickness, the greater is the apical bone thickness, and the greater is the gingival margin. Gingival and bone dimensions should be assessed when planning orthodontic treatment involving buccal movement of central incisors and canines.

Utilização indiscriminada de antitrombóticos e seus efeitos adversos no tratamento profilático em puérperas / Utilización indiscriminado de antitrombóticos y sus efectos secundarios en el tratamiento profiláctico en puérperas / Indiscriminate use of antithrombotics and their side effects in prophylactic treatment in postpartum women

Objetivo: Abordar os efeitos adversos relacionados a utilização indiscriminada de antitrombóticos no tratamento profilático em puérperas. Método: Revisão integrativa da literatura realizada entre fevereiro e abril de 2022 nas bases: Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Scientific Electronic Library Online (SciELO), SciVerse Scopus (SCOPUS) e Medical Literature Analysis and Retrievel System Online (MEDLINE/PubMed). Foram selecionados para essa revisão 10 artigos, publicadas entre 2012 e abril de 2022 (10 anos). Resultados: Os resultados evidenciar que a minimização de eventos tromboembólicos no puerpério é indispensável o acompanhamento desde a gestação, dessa forma se identificará precocemente os riscos e assim será possível tomar as devidas medidas preventivas eficazes na redução das consequências manifestadas pela doença. Conclusão: Evidencia-se que não há um procedimento específico com alto nível de evidência científica quando se trata de envolvimento do paciente sem risco iminente, em razão à escassez de estudos disponíveis acerca da temática.(AU)

Objective: To address the adverse effects related to the indiscriminate use of antithrombotics in the prophylactic treatment of postpartum women. Method: Integrative literature review carried out between February and April 2022 in the following databases: Latin American and Caribbean Literature in Health Sciences (LILACS), Scientific Electronic Library Online (SciELO), SciVerse Scopus (SCOPUS) and Medical Literature Analysis and Retrievel System Online (MEDLINE/PubMed). Ten articles were selected for this review, published between 2012 and April 2022 (10 years). Results: The results show that the minimization of thromboembolic events in the puerperium is essential to follow up since pregnancy, in this way the risks will be identified early and thus it will be possible to take the appropriate preventive measures effective in reducing the consequences manifested by the disease. Conclusion: It is evident that there is no specific procedure with a high level of scientific evidence when it comes to patient involvement without imminent risk, due to the scarcity of available studies on the subject.(AU)

Objetivo: Abordar los efectos adversos relacionados con el uso indiscriminado de antitrombóticos en el tratamiento profiláctico de la puérpera. Método: Revisión integrativa de la literatura realizada entre febrero y abril de 2022 en las siguientes bases de datos: Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS), Scientific Electronic Library Online (SciELO), SciVerse Scopus (SCOPUS) y Medical Literature Analysis and Retrievel System Online (MEDLINE/PubMed). Se seleccionaron diez artículos para esta revisión, publicados entre 2012 y abril de 2022 (10 años). Resultados: Los resultados muestran que la minimización de los eventos tromboembólicos en el puerperio es fundamental para el seguimiento desde el embarazo, de esta forma se identificarán tempranamente los riesgos y así se podrán tomar las medidas preventivas oportunas efectivas en la reducción de las consecuencias manifestadas por la enfermedad. Conclusión: Se evidencia que no existe un procedimiento específico con alto nivel de evidencia científica cuando se trata de involucramiento del paciente sin riesgo inminente, debido a la escasez de estudios disponibles sobre el tema.

Tomographic assessment of infrazygomatic crest bone depth for extra-alveolar miniscrew insertion in subjects with different vertical and sagittal skeletal patterns.

OBJECTIVE: To evaluate bone availability at the infrazygomatic crest for extra-alveolar bone miniscrew insertion in subjects with different vertical and sagittal skeletal patterns. SETTING AND SAMPLE POPULATION: Measurements of the infrazygomatic crest were performed on multislice computed tomography scans from 58 adults with different skeletal patterns. MATERIALS AND METHODS: Infrazygomatic crest bone depth was measured at 4, 5 and 6 mm from the cementoenamel junction (CEJ) of the maxillary first molar at three different angles (60°, 70° and 80°) in the first molar occlusal plane. The sagittal and vertical skeletal patterns were determined. Analysis of variance followed by Tukey's post hoc test was used (P ≤ .05). RESULTS: Bone depth was greater near the CEJ (8.7 ± 3.1 mm) and lower in the apical area (5.8 ± 2.7 mm). In Class II subjects, considering 6 mm from the CEJ, there was a significantly lower depth at the 80° angle (5.4 ± 2.5 mm) than at 60° (8.6 ± 3.5 mm; P = .007). In mesofacial subjects, considering 5 and 6 mm from the CEJ, bone depth was lower at 80° (5.7 ± 3.2 mm and 5.3 ± 2.5 mm) than at 60° considering 4 mm from the CEJ (P ≤ .019). CONCLUSION: Bone availability was lower at the apical level, especially in Class II and mesofacial subjects. Therefore, when the planned insertion site is located in the apical direction, it is recommended to choose shorter miniscrews (2.0 x 12mm) and a smaller insertion angle (60°) and/or to plan a miniscrew bone insertion deep enough to allow bicortical fixation.

Assessment of the relationship between tooth inclination and gingival and alveolar bone dimensions using computed tomography of the maxillary anterior teeth: a cross-sectional study

ABSTRACT Objective: The present study aimed to investigate the relationship between tooth inclination and gingival and bone dimensions in maxillary anterior teeth. Methods: This cross-sectional study included cone-beam computed tomography (CBCT) images of 160 maxillary anterior teeth (30 individuals). Tooth inclination, gingival and bone thickness, and distances from cementoenamel junction to alveolar bone crest and gingival margin were measured in the labial surface. The correlations were analyzed using Pearson and partial correlation tests (p≤0.05). Results: In the central incisors, tooth inclination was positively and significantly related to apical bone thickness (R = 0.34, p= 0.001). In the canines, tooth inclination was negatively and significantly related to cervical bone thickness (R = - 0.34, p= 0.01) and positively associated to apical bone thickness (R = 0.36, p= 0.01) and to gingival margin-cementoenamel junction distance (R = 0.31, p= 0.03). In the lateral incisors, tooth inclination was not associated with gingival or bone dimensions. Conclusions: In the central incisors, the greater the labial tooth inclination, the greater is the apical bone thickness. In the canines, the greater the labial tooth inclination, the smallest is the cervical bone thickness, the greater is the apical bone thickness, and the greater is the gingival margin. Gingival and bone dimensions should be assessed when planning orthodontic treatment involving buccal movement of central incisors and canines.

RESUMO Objetivo: O presente estudo teve como objetivo investigar a relação entre a inclinação dentária e as dimensões ósseas e gengivais em dentes anteriores superiores. Métodos: Esse estudo transversal incluiu imagens de tomografia computadorizada de feixe cônico (TCFC) de 160 dentes anteriores superiores divididos em três grupos (incisivo central, incisivo lateral e canino). Todos os pacientes tinham 18 anos ou mais, não tinham tratamento ortodôntico prévio nem história clínica que pudesse afetar as dimensões ósseas ou gengivais. A inclinação dentária, a espessura do osso e da gengiva e as distâncias da junção cemento-esmalte à crista óssea alveolar e à margem gengival foram medidas na face vestibular. As correlações foram analisadas por meio dos testes de Pearson e de correlação parcial (p≤0,05). Resultados: Nos incisivos centrais, a inclinação dentária foi positiva e significativamente relacionada à espessura do osso apical (R = 0,34, p= 0,001). Nos caninos, a inclinação dentária foi negativa e significativamente relacionada à espessura do osso cervical (R = - 0,34, p= 0,01) e positivamente associada à espessura do osso apical (R = 0,36, p= 0,01) e à distância entre a margem gengival e a junção cemento-esmalte (R = 0,31, p= 0,03). Nos incisivos laterais, a inclinação do dente não foi associada às dimensões do osso ou da gengiva. Conclusões: Nos incisivos centrais, quanto maior a inclinação vestibular do dente, maior a espessura do osso apical. Nos caninos, quanto maior a inclinação vestibular do dente, menor a espessura do osso cervical, maior a espessura do osso apical e maior a margem gengival. As dimensões ósseas e gengivais devem ser avaliadas ao se planejar o tratamento ortodôntico envolvendo a movimentação vestibular dos incisivos centrais e caninos.

Evaluation of alveolar process resorption after tooth extraction using the socket shield technique without immediate installation of implants: a randomised controlled clinical trial.

Our aim was to evaluate resorption of the alveolar ridge using the socket shield technique (SST) without immediate placement of dental implants. This randomised controlled clinical trial included 27 patients: 14 maxillary non-molar teeth were partially extracted using the SST (test group) and 13 were extracted using a minimally traumatic extraction approach (control group). Alterations in height and thickness of the alveolar ridge were evaluated by cone beam computed tomograms taken immediately after, and 100 days after, surgery. Minor resorption was observed in the height of the buccal and palatal plates, without intergroup difference (p ≥ 0.10). The test group showed significantly better preservation of the buccal-to-palatal crest dimension (p ≤ 0.05). In the control group, preservation of buccal plate thickness was significantly greater (p ≤ 0.05), but intragroup vertical resorption of the buccal plate and reduction in the buccal-to-palatal crest distance were greater (p ≤ 0.05). The SST without the immediate placement of implants showed greater preservation of the buccal-to-palatal crest dimension and lower preservation of buccal wall thickness compared with minimally traumatic extraction. In addition, it provided superior maintenance of the baseline buccal wall height. The modified SST is a promising approach, but factors that interfere with the results should be investigated.

Effects of Yoga Respiratory Practice (Bhastrika pranayama) on Anxiety, Affect, and Brain Functional Connectivity and Activity: A Randomized Controlled Trial.

Pranayama refers to a set of yoga breathing exercises. Recent evidence suggests that the practice of pranayama has positive effects on measures of clinical stress and anxiety. This study explored the impact of a Bhastrika pranayama training program on emotion processing, anxiety, and affect. We used a randomized controlled trial design with thirty healthy young adults assessed at baseline and after 4 weeks of pranayama practices. Two functional magnetic resonance imaging (MRI) protocols were used both at baseline and post-intervention: an emotion task as well as a resting-state acquisition. Our results suggest that pranayama significantly decreased states of anxiety and negative affect. The practice of pranayama also modulated the activity of brain regions involved in emotional processing, particularly the amygdala, anterior cingulate, anterior insula, and prefrontal cortex. Resting-state functional MRI (fMRI) showed significantly reduced functional connectivity involving the anterior insula and lateral portions of the prefrontal cortex. Correlation analysis revealed that changes in connectivity between the ventrolateral prefrontal cortex and the right anterior insula were associated with changes in anxiety. Although it should be noted that these analyses were preliminary and exploratory, it provides the first evidence that 4 weeks of B. pranayama significantly reduce the levels of anxiety and negative affect, and that these changes are associated with the modulation of activity and connectivity in brain areas involved in emotion processing, attention, and awareness. The study was registered at https://www.ensaiosclinicos.gov.br/rg/RBR-2gv5c2/(RBR-2gv5c2).

Dental health status and its indicators in adult Brazilian Indians without exposition to drinking water fluoridation: a cross-sectional study.

Water fluoridation is considered a cost-effective and practical method for controlling and preventing dental caries in the general population. The objective of this study was to evaluate the dental health status and risk indicators for dental caries in adult Brazilian Indians without exposition to dental caries-preventive effects of water fluoridation. Decayed (DT), missing (MT), and filled (FT) permanent teeth (DMFT), as well as plaque index, unstimulated salivary flow rate, salivary buffering capacity, and fasting blood glucose were examined in 225 adult Indians. Smoking habits and sociodemographic data were evaluated using a structured questionnaire. Drinking water samples from 10 Indian villages were analyzed for the natural fluoride concentration. The mean DMFT was 10.33 ± 6.91 (DT, 4.19 ± 3.99; MT, 4.99 ± 5.64; FT, 1.14 ± 1.75). DMFT index ≥ 9 was associated with age ≥ 35 years (p = 0.000), lower education (p = 0.03), and plaque index > 40% (p = 0.003). DT was associated only with plaque index (p = 0.03). MT was associated with age (p < 0.001) and plaque index (p = 0.01). FT was negatively associated with age (p = 0.02) and income (p = 0.02). Fluoride concentration varied from 0.01 to 0.07 mg/L and was not associated with dental health status (p ≥ 0.29). In conclusion, poorer dental health status was associated with older age, higher plaque index, and lower education and income levels. The fluoride level in the drinking water of Kiriri villages was lower than the level recommended for preventing dental caries. Water fluoridation may be recommended for this population.

Optimization of green PLE method applied for the recovery of antioxidant compounds from buriti (Mauritia flexuosa L.) shell.

Buriti fruit, with high content in carotenoids and antioxidant compounds, is well appreciated for its organoleptic characteristics. However, its shell, an agroindustrial residue, is mostly discarded. Therefore, to verify the technological potential of the buriti shells, the aim of this this study was to evaluated the antioxidant potential of the extracts from buriti shell obtained by pressurized liquid extraction (PLE) with ethanol/water mixtures. PLE optimization was performed by response surface methodology, with all results maximized at the conditions of 71.21 °C and with 91.58% of ethanol. The yields values varied from 16.82 to 25.16%, total carotenoids from 23.38 to 1056.59 µg ß-carotene equivalent g-1, total phenolic content from 143.37 to 172.02 mg Gallic acid equivalent g-1, DPPH from 31.04 to 48.62 µg.mL-1, and ABTS from 1.87 to 2.70 mmol TEAC. g-1. Therefore, considering the lack of studies about buriti shell, the present work provides valuable results that confirm the PLE relevance to enhance the value of this neglected material.

CDK2 and Bcl-xL inhibitory mechanisms by docking simulations and anti-tumor activity from piperine enriched supercritical extract.

Supercritical fluid technologies offer an innovative method for food industry and drug discovery from natural sources. The aim of the study is to investigate the anti-tumor activity of piperine rich extract by supercritical fluid (SFE) from black pepper (Piper nigrum). In silico docking simulations predicted anti-tumor molecular mechanism and protein-piperine hydrophobic interactions, showing hydrogen bonds between piperine and residue Ser5 inside the ATP binding site in CDK2. Moreover, piperine interacts with peptide substrate residue Lys8 inside its binding site in Cyclin A molecule. Other predicted interaction showed piperine inside the hydrophobic groove of Bcl-xL. Confirming the docking simulation, in vitro assays with SFE (40 °C/30 MPa) showed cytotoxicity to MCF-7 cells (IC50 = 27.8 ±â€¯6.8 µg/ml) correlated to increased apoptosis. Balb/c mice-bearing Ehrlich Ascites Carcinoma (EAC) group that received the SFE (100 mg/kg/day) showed tumor growth inhibition (60%) and increased mice survival (50%), probably related to cell cycle arrest (G2/M) and increased apoptosis. In vivo treatments with SFE increased the expression of pro-apoptotic proteins (p53 and Bax), inhibited cell cycle proteins (CDK2, Cyclin A) and anti-apoptotic protein (Bcl-xL). Thus, confirming in silico predicted inhibitory interactions. These results clearly showed promising performance of the piperine-rich fraction recovered from black pepper, drawing attention to its use as complementary therapy for cancer.

Rapid antidepressant effects of the psychedelic ayahuasca in treatment-resistant depression: a randomized placebo-controlled trial.

BACKGROUND: Recent open-label trials show that psychedelics, such as ayahuasca, hold promise as fast-onset antidepressants in treatment-resistant depression. METHODS: To test the antidepressant effects of ayahuasca, we conducted a parallel-arm, double-blind randomized placebo-controlled trial in 29 patients with treatment-resistant depression. Patients received a single dose of either ayahuasca or placebo. We assessed changes in depression severity with the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Hamilton Depression Rating scale at baseline, and at 1 (D1), 2 (D2), and 7 (D7) days after dosing. RESULTS: We observed significant antidepressant effects of ayahuasca when compared with placebo at all-time points. MADRS scores were significantly lower in the ayahuasca group compared with placebo at D1 and D2 (p = 0.04), and at D7 (p < 0.0001). Between-group effect sizes increased from D1 to D7 (D1: Cohen's d = 0.84; D2: Cohen's d = 0.84; D7: Cohen's d = 1.49). Response rates were high for both groups at D1 and D2, and significantly higher in the ayahuasca group at D7 (64% v. 27%; p = 0.04). Remission rate showed a trend toward significance at D7 (36% v. 7%, p = 0.054). CONCLUSIONS: To our knowledge, this is the first controlled trial to test a psychedelic substance in treatment-resistant depression. Overall, this study brings new evidence supporting the safety and therapeutic value of ayahuasca, dosed within an appropriate setting, to help treat depression. This study is registered at http://clinicaltrials.gov (NCT02914769).

Neurofunctional changes after a single mirror therapy intervention in chronic ischemic stroke.

BACKGROUND: Mirror therapy (MT) is becoming an alternative rehabilitation strategy for various conditions, including stroke. Although recent studies suggest the positive benefit of MT in chronic stroke motor recovery, little is known about its neural mechanisms. PURPOSE: To identify functional brain changes induced by a single MT intervention in ischemic stroke survivors, assessed by both transcranial magnetic stimulation (TMS) and functional magnetic resonance imaging (fMRI). MATERIALS AND METHODS: TMS and fMRI were used to investigate 15 stroke survivors immediately before and after a single 30-min MT session. RESULTS: We found statistically significant increase in post-MT motor evoked potential (MEP) amplitude (increased excitability) from the affected primary motor cortex (M1), when compared to pre-MT MEP. Post-MT fMRI maps were associated with a more organized and constrained pattern, with a more focal M1 activity within the affected hemisphere after MT, limited to the cortical area of hand representation. Furthermore, we find a change in the balance of M1 activity toward the affected hemisphere. In addition, significant correlation was found between decreased fMRI ß-values and increased MEP amplitude post-MT, in the affected hemisphere. CONCLUSION: Our study suggests that a single MT intervention in stroke survivors is related to increased MEP of the affected limb, and a more constrained activity of the affected M1, as if activity had become more constrained and limited to the affected hemisphere.

Responsiveness of the Early Childhood Oral Health Impact Scale (ECOHIS) is related to dental treatment complexity.

BACKGROUND: The responsiveness of the Early Childhood Oral Health Impact Scale (ECOHIS) has varied greatly across studies; hence, we hypothesized that this discrepancy could be related to the complexity of dental treatment received. Thus, we aimed to evaluate the responsiveness of the ECOHIS to changes in oral health-related quality of life (OHRQoL) following dental treatments of varying complexity in preschool children. METHODS: Preschool children aged 3 to 6 years were selected; their parents responded to the ECOHIS at baseline. The parents responded to the ECOHIS again and a global transition question 30 days after the children were treated. The type of treatment received by the children was categorized according to complexity, as follows: 1) non-operative treatment only, 2) restorative treatment, and 3) endodontic treatment and/or tooth extraction. Change scores and effect sizes (ES) were calculated for total scores, as well as considering the different treatment types and global transition question responses. RESULTS: Of the 152 children who completed the study, the ECOHIS yielded large ES for total scores (0.89). The children showed increasing ES values associated with better perception of improvement, assessed by the global transition question. The magnitude of ES after treatment was related to treatment complexity (0.53, 0.92 and 1.43, for children who received non-operative treatment only, restorative treatment, and endodontic treatment and/or tooth extraction, respectively). CONCLUSIONS: Parents whose children required more complex dental treatment are more likely to perceive treatment-related changes to OHRQoL assessed with the ECOHIS.

Dental health status in crack/cocaine-addicted men: a cross-sectional study.

The aim of this study was to evaluate the association between crack/cocaine addiction and dental health in men. Forty crack/cocaine-addicted patients and 120 nonaddicted patients (≥18 years) underwent full-mouth dental examinations. Decayed, missing, and filled teeth (DMFT) were identified using the criteria recommended by the World Health Organization. Crack/cocaine addiction was determined, based on the medical records and interviews of each patient. All drug-addicted patients used both crack and cocaine. The chi-square test and logistic regression analysis were used to assess the association between DMFT and crack/cocaine addiction (p ≤ 0.05). Decayed teeth showed a positive association with crack/cocaine addiction (odds ratio (OR) = 3.65; 95% confidence interval (CI), 1.68-7.92; p = 0.001), whereas filled and missing teeth showed a negative association (filled teeth: OR = 0.37; 95% CI, 0.18-0.76; p = 0.008; missing teeth: OR = 0.33; 95% CI, 0.13-0.81; p = 0.02). The DMFT was only associated with age (OR = 2.12; 95% CI, 1.11-4.08, p = 0.023). In the present population, crack/cocaine addiction was associated with a greater decayed teeth index and a lower filled and missing teeth index. Programs aimed to encourage self-esteem and encourage individuals to seek dental care are required for this population. Further studies using a larger sample size and studies with women are required to confirm the results.

Comunicação terapêutica: instrumento básico do cuidado em crianças hospitalizadas / Therapeutic communication: basic care instrument in hospitalized children / Comunicación terapéutica: instrumento básico del cuidado en niños hospitalizados

Objetivo: identificar a estratégia de comunicação terapêutica mais utilizada na assistência de enfermagem à criança hospitalizada. Método: estudo descritivo, observacional, com abordagem quantitativa, realizado entre os meses de março e abril de 2013, com 13 enfermeiros, 25 técnicos de enfermagem e todas as crianças atendidas na clínica pediátrica e no setor de observação pediátrica de um hospital público na Paraíba. Para o registro dos dados, utilizou-se checklist, em seguida, estes foram agrupados em tabelas e analisados a partir da literatura. O projeto de pesquisa foi aprovado pelo Comitê de Ética em Pesquisa, CAAE: 12950813.0.0000.5179. Resultados: evidencia a pouca utilização das técnicas de comunicação terapêutica pela equipe de enfermagem durante a assistência, sugerindo uma maior atenção desses profissionais sobre a temática. Conclusão: considera-se necessário trabalhar e desenvolver estratégias para efetivar e priorizar o processo de comunicação terapêutica como atividade de enfermagem relevante e essencial ao cuidado durante a hospitalização infantil.(AU)

Objective: to identify therapeutic communication strategy most commonly used in nursing care for hospitalized children. Method: a descriptive, observational study with a quantitative approach, performed between March and April 2013, with 13 nurses, 25 nursing technicians and all children assisted in pediatrics and pediatric observation unit of a public hospital in Paraíba. To record data a checklist was used, then, grouped in tables and analyzed from the literature. The research project was approved by the Research Ethics Committee, CAAE: 12950813.0.0000.5179. Results: it shows the low use of therapeutic communication techniques by the nursing team during the service, suggesting greater attention of these professionals about the subject. Conclusion: it is considered necessary to work and develop strategies to obtain and prioritize the process of therapeutic communication as relevant and critical care nursing activity during children´s hospitalization.(AU)

Objetivo: identificar la estrategia de comunicación terapéutica más utilizada en la asistencia de enfermería al niño hospitalizado. Método: estudio descriptivo, observacional con enfoque cuantitativo, realizado entre los meses de marzo y abril de 2013, con 13 enfermeros, 25 técnicos de enfermería y todos los niños atendidos en la clínica pediátrica y en el sector de observación pediátrica de un hospital público en Paraíba. Para el registro de los datos se utilizó un checklist, en seguida, fueron agrupados en tablas y analizados a partir de la literatura. El proyecto de investigación fue aprobado por el Comité de Ética en Investigación, CAAE: 12950813.0.0000.5179. Resultados: muestra la poca utilización de las técnicas de comunicación terapéutica por el equipo de enfermería durante la asistencia, sugiriendo una mayor atención de esos profesionales sobre el tema. Conclusión: se considera necesario trabajar y desarrollar estrategias para efectuar y priorizar el proceso de comunicación terapéutica como actividad de enfermería relevante y esencial al cuidado durante la hospitalización infantil.(AU)