Kisspeptin (Kp-10) inhibits in vitro osteogenic differentiation of multipotent mesenchymal stromal cells extracted from the bone marrow of adult rats.

Kisspeptin (Kp-10) is a neuropeptide that binds to GPR54 receptors, exerting several functions mainly in the nervous and reproductive systems of the body. However, its effects and mechanisms of action on the skeletal system remain poorly understood. This study evaluated the effects of different concentrations of Kp-10 on in vitro osteogenic differentiation of multipotent mesenchymal stromal cells (MSCs) extracted from the bone marrow (BM) of adult Wistar rats. Two-month-old female rats were euthanized to extract BM from long bones to obtain MSCs. Four experimental groups were established in vitro: a control and Kp-10 at concentrations of 0.01, 0.05 and, 0.1 µg/mL. After induction of osteogenic differentiation, cell viability was evaluated using the 3-(4,5-dimethylthiazol-2-yl)- 2,5-diphenyl tetrazolium bromide (MTT) assay, alkaline phosphatase activity, collagen synthesis, percentage of area covered by MSCs/field and mineralized nodules/field, and immunocytochemistry of the GPR54 receptor tests. Furthermore, evaluation of gene transcripts for type I collagen, Runx-2, Bmp-2, bone sialoprotein, osteocalcin and osteopontin was performed using real-time RT-qPCR. It was observed that MSCs expressed GPR54 receptor to which Kp-10 binds during osteogenic differentiation, promoting a negative effect on osteogenic differentiation. This effect was observed at all the Kp-10 concentrations in a concentration-dependent manner, characterized by a decrease in the activity of alkaline phosphatase, collagen synthesis, mineralized nodules, and decreased expression of gene transcripts for type I collagen, osteocalcin, osteopontin, and Runx-2. Thus, Kp-10 inhibits in vitro osteogenic differentiation of MSCs extracted from the BM of adult Wistar rats.

Mechanical stress distribution over the palate by different pacifiers assessed by finite element analysis and clinical data.

The mechanical behavior of each type of pacifier on rigid structures and their various impacts on orofacial growth have yet to be discovered. The study aimed to evaluate the stress distribution over a child's palate by three types of pacifiers using finite element analysis and clinical and laboratory data. Modulus of elasticity was obtained from 30 specimens comprising 10 of each conventional (A), orthodontic (B), and breast-shaped (C) pacifiers. Tongue strength was assessed in eight 3-year-old children (kPa). A hemi-maxilla model was obtained from 2- to 3-year-old skull tomography, and the images of pacifiers A, B, and C were captured using 3D scanning. The Hypermesh® program generated a mesh of 6-node tetrahedral elements for applying forces in the X, Y, and Z directions to enable a nonlinear analysis. Pacifier B exhibited the highest values for distributed stress on the palate, followed by pacifier A. Pacifier B stimulated the maxilla forward and sideways. In contrast, pacifier A promoted a forward and upward load, favoring a more atresic palate. Pacifiers A and B tended to rotate in the sagittal plane, generating tensions in the anterior incisors and favoring the open bite. Pacifier C exhibited lateral expansion by stress induction over the mid-palatal suture with less influence on incisor inclination. Pacifiers showed different detrimental stress distributions on the palate. This information can be helpful for improving recommendations given to parents.

Team sports as a protective factor against mental health problems and suicidal ideation in adolescents / El deporte colectivo como factor protector ante problemas de salud mental e ideación suicida en adolescentes

Abstract Introduction Adolescents who practice sports have better mental health indicators. Objective To analyze the association between different types of physical activity (systematized exercise, individual, and collective sports), mental health, and suicidal ideation in adolescents. Method We conducted a cross-sectional study with 666 Brazilian adolescents (14-19 y.o.) attending high schools and selected using random cluster sampling. The mental health indicators analyzed were evaluated through the Self Reporting Questionnaire and the Strengths and Difficulties Questionnaire, including suicidal ideation. We also obtained physical activity information through questionnaires. Results There was a higher prevalence related to mental disorders (54.2% vs. 32.5%), difficulties related to mental health (79.6% vs. 48.4%), and suicidal thoughts (22.9% vs. 11.4%) in girls than in boys (p < .001 for all). The boys engaged in more team sports (41.0 vs. 23.8), whereas girls performed more exercise (45.1 vs. 26.5; p < .001). Discussion and conclusion The practice of team sports helps develop the collective spirit, stimulates social interaction, and develops reasoning and emotional intelligence. Boys who play team sports have fewer symptoms of common mental disorders, lower mental health problems, and less suicidal ideation than physically inactive boys.

Resumen Introducción Los adolescentes que practican deportes tienen mejores indicadores de salud mental. Objetivo Analizar la asociación entre los diferentes tipos de actividad física (ejercicio sistematizado, deportes individuales y colectivos), la salud mental y la ideación suicida en adolescentes. Método Se realizó un estudio transversal realizado con 666 adolescentes brasileños (14-19 años) que asisten a escuelas secundarias y fueron seleccionados mediante muestreo aleatorio por conglomerados. Los indicadores de salud mental analizados fueron evaluados a través del Cuestionario de Autoinforme y el Cuestionario de Fortalezas y Dificultades, incluyendo la ideación suicida. También obtuvimos información de la actividad física a través de cuestionarios. Resultados Hubo una mayor prevalencia relacionada con trastornos mentales (54.2% contra 32.5%), dificultades relacionadas con la salud mental (79.6% contra 48.4%) y pensamientos suicidas (22.9% contra 11.4%) en niñas que en niños (p < .001 para todos). Los chicos practicaban más deportes de equipo (41.0 contra 23.8), mientras que las chicas hacían más ejercicio (45.1 contra 26.5; p < .001). Discusión y conclusión La práctica de deportes de equipo ayuda en el desarrollo del espíritu colectivo, estimula la interacción social, desarrolla el razonamiento y la inteligencia emocional. Los niños que practican deportes de equipo tienen menos síntomas de trastornos mentales comunes, menos problemas de salud mental y menos ideación suicida en comparación con los niños físicamente inactivos.

Factores sociodemográficos de las gestantes de un policlínico de Guantánamo, que interrumpieron voluntariamente el embarazo

Introducción: la interrupción voluntaria del embarazo -aborto inducido o provocado-, a pesar de ser una temática antigua, continúa siendo un problema social que afecta no solo a la mujer, sino también a la familia y la comunidad, en aspectos políticos, socioeconómicos, culturales y religiosos. Objetivo: caracterizar las interrupciones voluntarias del embarazo, según variables sociodemográficas en el Policlínico Universitario Hermanos Martínez Tamayo. Materiales y métodos: se realizó un estudio observacional, descriptivo, transversal en el Policlínico Universitario Hermanos Martínez Tamayo, del municipio Baracoa, provincia de Guantánamo, durante el año 2021. La muestra obtenida de 111 pacientes fue seleccionada por muestreo no probabilístico intencionado. El dato primario se obtuvo de la historia clínica individual y de encuestas realizadas a las pacientes. Resultados: se observó un predominio del grupo de edad de 20 a 24 años, con 36 pacientes (32,4 %). Las mujeres de zona urbana fueron la mayoría, con 79 (71,2 %). Respecto al estado civil, predominaron las solteras (56,7 %) y las divorciadas (19,8 %). El 36,9 % estaban en la universidad o contaban con nivel universitario y el 45,9 % eran de ocupación estudiante. Conclusiones: el tratamiento de algunos determinantes sociodemográficos en las características de las interrupciones voluntarias del embarazo, permite entender su variabilidad y su constitución como problema de salud en el Policlínico Universitario Hermanos Martínez Tamayo.

Introduction: the voluntary interruption of pregnancy -induced or provoked abortion- despite being an old issue, continues to be a social problem that affects not only women, but also family and community in political, socio-economic, cultural and religious aspects. Objective: to characterize the voluntary interruptions of pregnancy, according to socio-demographic variables in the University Polyclinic Hermanos Martinez Tamayo. Materials and methods: an observational, descriptive, cross-sectional study was carried out in the University Polyclinic Hermanos Martinez Tamayo, from the municipality of Baracoa, province of Guantanamo, during 2021. The sample obtained from 111 patients was selected by intentioned, non-probabilistic sampling. The primary data were obtained from the individual clinical records and from surveys carried out on the patients. Results: the age group between 20 and 24 years predominated with 36 patients (32.4%). Urban women were the majority 79 (71.2%). Regarding marital status single (56.7%) and divorced (19.8%) women predominated. 36.9% studied in the university or finished university studies, and 45.9% were students. Conclusions: the treatment of some socio-demographic determinants in the characteristics of pregnancy voluntary interruptions, allows us to understand its variability and its constitution as a health problem in the University Polyclinic Hermanos Martinez Tamayo.

Deep learning for automatic mandible segmentation on dental panoramic x-ray images.

Many studies in the last decades have correlated mandible bone structure with systemic diseases like osteoporosis. Mandible segmentation, as well as segmentation of other oral structures, is an essential step in studies that correlate oral structures' conditions with systemic diseases in general. However, manual mandible segmentation is a time-consuming and training-required task that suffers from inter and intra-user variability. Further, the dental panoramic x-ray image (PAN), the most used image in oral studies, contains overlapping of many structures and lacks contrast on structures' interface. Those facts make both manual and automatic mandible segmentation a challenge. In the present study, we propose a precise and robust set of deep learning-based algorithms for automatic mandible segmentation (AMS) on PAN images. Two datasets were considered. An in-house image dataset with 393 image/segmentation pairs was prepared using image data of 321 image patient data and the corresponding manual segmentation performed by an experienced specialist. Additionally, a publicly available third-party image dataset (TPD) composed of 116 image/segmentation pairs was used to train the models. Four deep learning models were trained using U-Net and HRNet architectures with and without data augmentation. An additional morphological refinement routine was proposed to enhance the models' prediction. An ensemble model was proposed combining the four best-trained segmentation models. The ensemble model with morphological refinement achieved the highest scores on the test set (98.27%, 97.60%, 97.18%, ACC, DICE, and IoU respectively), with the other models scoring above 95% in all performance metrics on the test set. The present study achieved the highest ranked performance considering all the previously published results on AMS for PAN images. Additionally, those are the most robust results achieved since it was performed over an image set with considerable gender representativeness, a wide age range, a large variety of oral conditions, and images from different imaging scans.

Oblique line contrast: A new radiomorphometric index for assessing bone quality in dental panoramic radiographs.

The present study was carried out to assess the possible changes in mandibular bone density according to age and gender through dental panoramic radiographs (PAN). More specifically, the region of the mandibular oblique line. Materials & methods: A group of 374 dental patients previously treated in the Ribeirão Preto Dental School (FORP/USP) was included in the study. The complete dental profiling of all the subjects (including PAN images) was previously available in the archive of the same institution. Those subjects were separated into four groups considering age and gender: Group 1-100 young adult men (21.48 ± 3.34 y. o.), Group 2-100 young adult women (20.66 ± 1.52 y. o.), Group 3-87 postmenopausal women (74.07 ± 9.82 y. o.), and Group 4-87 men over 70 years old (75.92 ± 8.71 y. o.). A new index called "W-index" (WI) was proposed for analyzing the possible difference in mandibular bone density. This new index is the ratio between the average pixel value of the image area of the mandibular ramus (AVMR) and the average pixel value of the image area of the mandibular oblique line (AVOL) (WI = AVMR/AVOL). WI was measured for each subject on each PAN and statistical analysis was performed to search how well WI can characterize each study group. Results: The largest difference in WI is observed when we compare older subjects (WI 0.73 ± 0.11) with younger subjects (0.89 ± 0.05). WI also varies significantly with gender but in a smaller amount. Mean WI for old women (0.68 ± 0.11) was found lower than for old men (0.77 ± 0.09), and mean WI for young women (0.89 ± 0.05) was also inferior to young men (0.91 ± 0.05). The differences in WI observed in the subject group were tested for a significance level of α = 0,01. We speculate that WI refers to an aspect of bone mineral density. First, the sharp contrast of the mandibular oblique line may signify the loss of mandibular bone mass. And second, it showed to vary significantly with gender and age, but with higher intensity with age. Clinical significance: WI might be used in the future for low bone mineral density risk assessment.

Mechanical and gas adsorption properties of graphene and graphynes under biaxial strain.

The exceptional properties of two-dimensional (2D) solids have motivated extensive research, which revealed the possibility of controlling many characteristics of these materials through strain. For instance, previous investigations demonstrated that compressive deformation could be used to direct the chemisorption of atomic hydrogen and oxygen. Still, to our knowledge, there is no work detailing how strain affects the adsorption isotherms of 2D materials and the adsorption properties of materials such as the graphynes, which are monolayers composed of sp and sp[Formula: see text] carbon atoms. In the present work, we analyze how biaxial tensile deformation changes the adsorption properties of four 2D materials (graphene, [Formula: see text]-graphyne, [Formula: see text]-graphyne, and [Formula: see text]-graphyne). To achieve this, we perform Monte Carlo Grand Canonical calculations to obtain the adsorption isotherms of H[Formula: see text], CO[Formula: see text], and CH[Formula: see text] on the monolayers with and without strain. And, to apply the deformation, we carry out Molecular Dynamics simulations. We find a substantial reduction in the amount of gas adsorbed on the monolayers for nearly all gas-solid combinations. This is particularly true for graphene, where 14.5% strain reduces the quantity of H[Formula: see text]/CO[Formula: see text]/CH[Formula: see text] by 44.7/64.1/41.7% at P [Formula: see text] 1 atm. To understand the results, we calculate adsorption enthalpies and analyze the gas distribution above the monolayers. We also characterize the mechanical properties of the considered solids under biaxial deformation. Finally, a comparison of pore sizes with the kinetic diameters of various gases suggests applications for the graphynes, with and without strain, in gas separation.

Morphometric magnetic resonance imaging study of the quadriceps tendon in hemodialysis patients: comparison with non-dialyzed controls.

Objective: To evaluate the knees of individuals with renal failure who are on hemodialysis, using magnetic resonance imaging (MRI), comparing them with those of a group of individuals with normal renal function. Materials and Methods: This was a cross-sectional, observational, controlled study conducted between August 2018 and February 2020. The cases consisted of 15 patients who had been on hemodialysis for ≥ 5 years and did not have a quadriceps tendon rupture. The controls consisted of 15 individuals with normal renal function who were matched (1:1) to the cases for sex, age, and physical activity level. The subjects in both groups underwent MRI of the right knee only. Results: The mean ages of the cases and controls were 50 ± 15 years and 49 ± 14 years, respectively. The median time on hemodialysis was 11 years (range, 10-14 years). Serum levels of parathyroid hormone, ferritin, alkaline phosphatase, phosphorus, and creatinine were higher among the cases than among the controls, whereas serum albumin and hemoglobin were lower (p < 0.05 for all). The MRI study showed a hyperintense signal in the quadriceps tendon in 11 of the cases and in three of the controls (p = 0.009). Knee joint effusion was observed in nine of the cases and in three of the controls (p < 0.05). The thickness, length, and width of the tendon did not differ between the groups. A hyperintense signal in the tendon was not associated with the time on hemodialysis; nor with the levels of intact parathyroid hormone, hemoglobin, or alkaline phosphatase. Conclusion: Patients on chronic hemodialysis, even those without a tendon rupture, show a hyperintense signal in the quadriceps tendon on MRI.

Objetivo: Avaliar joelhos de indivíduos com falência renal em hemodiálise por meio de ressonância magnética, em comparação com um grupo controle sem doença renal crônica. Materiais e Métodos: Estudo transversal, observacional, controlado, realizado entre agosto/2018 e fevereiro/2020. Os 15 casos consistiram de pacientes com cinco anos ou mais em hemodiálise, sem ruptura do tendão do quadríceps. Os 15 controles, sem doença renal crônica, foram pareados (1:1) por sexo, idade e nível de atividade física. Resultados: A média de idade dos casos foi 50 ± 15 anos e a dos controles, 49 ± 14 anos. A mediana do tempo em hemodiálise foi 11 anos (variação: 10-14 anos). Nos casos, os níveis séricos de paratormônio, ferritina, fosfatase alcalina, fósforo e creatinina estavam mais altos e os de albumina e hemoglobina, mais baixos (p < 0,05). Hipersinal no tendão foi demonstrado em 11 casos e três controles (p = 0,009). Derrame articular foi observado em nove casos e três controles (p < 0,05). A espessura, o comprimento e a largura do tendão não diferiram entre os grupos. Hipersinal no tendão do quadríceps não mostrou associação com o tempo em hemodiálise ou com os níveis de paratormônio intacto, hemoglobina e fosfatase alcalina. Conclusão: Pacientes em hemodiálise sem episódios de ruptura já apresentam hipersinal no tendão do quadríceps nas imagens de ressonância magnética.

Morphometric magnetic resonance imaging study of the quadriceps tendon in hemodialysis patients: comparison with non-dialyzed controls / Estudo morfométrico do tendão do quadríceps em pacientes em hemodiálise: avaliação por ressonância magnética e comparação com grupo controle

Abstract Objective: To evaluate the knees of individuals with renal failure who are on hemodialysis, using magnetic resonance imaging (MRI), comparing them with those of a group of individuals with normal renal function. Materials and Methods: This was a cross-sectional, observational, controlled study conducted between August 2018 and February 2020. The cases consisted of 15 patients who had been on hemodialysis for ≥ 5 years and did not have a quadriceps tendon rupture. The controls consisted of 15 individuals with normal renal function who were matched (1:1) to the cases for sex, age, and physical activity level. The subjects in both groups underwent MRI of the right knee only. Results: The mean ages of the cases and controls were 50 ± 15 years and 49 ± 14 years, respectively. The median time on hemodialysis was 11 years (range, 10-14 years). Serum levels of parathyroid hormone, ferritin, alkaline phosphatase, phosphorus, and creatinine were higher among the cases than among the controls, whereas serum albumin and hemoglobin were lower (p < 0.05 for all). The MRI study showed a hyperintense signal in the quadriceps tendon in 11 of the cases and in three of the controls (p = 0.009). Knee joint effusion was observed in nine of the cases and in three of the controls (p < 0.05). The thickness, length, and width of the tendon did not differ between the groups. A hyperintense signal in the tendon was not associated with the time on hemodialysis; nor with the levels of intact parathyroid hormone, hemoglobin, or alkaline phosphatase. Conclusion: Patients on chronic hemodialysis, even those without a tendon rupture, show a hyperintense signal in the quadriceps tendon on MRI.

Resumo Objetivo: Avaliar joelhos de indivíduos com falência renal em hemodiálise por meio de ressonância magnética, em comparação com um grupo controle sem doença renal crônica. Materiais e Métodos: Estudo transversal, observacional, controlado, realizado entre agosto/2018 e fevereiro/2020. Os 15 casos consistiram de pacientes com cinco anos ou mais em hemodiálise, sem ruptura do tendão do quadríceps. Os 15 controles, sem doença renal crônica, foram pareados (1:1) por sexo, idade e nível de atividade física. Resultados: A média de idade dos casos foi 50 ± 15 anos e a dos controles, 49 ± 14 anos. A mediana do tempo em hemodiálise foi 11 anos (variação: 10-14 anos). Nos casos, os níveis séricos de paratormônio, ferritina, fosfatase alcalina, fósforo e creatinina estavam mais altos e os de albumina e hemoglobina, mais baixos (p < 0,05). Hipersinal no tendão foi demonstrado em 11 casos e três controles (p = 0,009). Derrame articular foi observado em nove casos e três controles (p < 0,05). A espessura, o comprimento e a largura do tendão não diferiram entre os grupos. Hipersinal no tendão do quadríceps não mostrou associação com o tempo em hemodiálise ou com os níveis de paratormônio intacto, hemoglobina e fosfatase alcalina. Conclusão: Pacientes em hemodiálise sem episódios de ruptura já apresentam hipersinal no tendão do quadríceps nas imagens de ressonância magnética.

Are physicians aging well? Subjective successful aging, happiness, optimism, and resilience in a sample of Brazilian aging doctors

Background and objectives: The elderly physician population is increasing worldwide. Data on how doctors have aged are scarce. The purpose of this study is to evaluate subjective successful aging (SSA) and its correlations with resilience, happiness, and optimism in a sample of older physicians.MethodsA cross-sectional study was carried out with physicians over 65, through face-to-face interviews. All the volunteers answered the following: Self-rate successful aging; CD-RISC 10; Subjective Happiness Scale; LOT-R; SF-36; and a socio-demographic questionnaire.ResultsThe mean of self-rate successful aging in SSA was 8.65 (92.3% over or equal to 7), and significant and positive correlations were found between resilience (r = 0.33) and happiness (r = 0.68). No correlation was found between age subset (young-old x old) or physical limitations and evaluation of SSA.ConclusionPhysicians evaluated aging as successful regardless of health and limitations. SSA had a positive correlation with resilience and happiness. (AU)

Torqued and conventional cantilever for uprighting mesially impacted molars: A 3-dimensional finite element analysis.

INTRODUCTION: The objective of this study was to evaluate the effects of the torqued cantilever (TC) and conventional tip-back cantilever (CC) made of stainless steel (SS) and titanium-molybdenum alloy (TMA) on the uprighting of mesially impacted mandibular molars using three-dimensional finite element analysis. METHODS: The 3-dimensional mandibular model included part of the mandible with mesially tipped and impacted mandibular second molar, periodontal ligament (PDL), molar tube, mini-implant, and cantilevers. Four finite element method models (TC-SS, TC-TMA, CC-SS, and CC-TMA) were created to simulate different skeletally anchored uprighting mechanics. CC mechanics involved a known 0.019 × 0.025-in helical cantilever acting on a buccal molar tube. TC mechanics included a 0.019 × 0.025-in cantilever capable of producing mesial root torque by acting on a tube positioned on the molar disto-occlusal surface with the slot in a buccolingual direction. Three-dimensional molar displacement and stress distribution on the molar PDL were recorded. RESULTS: The SS cantilever produced almost twice as much molar displacement as the TMA. TC mechanics showed more evident mesial displacement of the molar root apexes. CC mechanics had greater molar rotation. TC uprighting moment produced greater molar mesial extrusion and greater intrusion of the distal root apex. The dual deflection system of the TC mechanics induced the lowest stress on the PDL, regardless of the metallic alloy. CONCLUSIONS: TC delivered a more efficient uprighting moment to the molar with less unwanted tooth movement and stress on the PDL and a more accessible site for bonding the molar tube.

TREATMENT OF QUADRICEPS TENDON RUPTURE IN HEMODIALYSIS PATIENTS: A 2020 UPDATE.

Quadriceps tendon tears are uncommon injuries often associated with chronic diseases, including end-stage renal disease (ESRD). The role of secondary hyperparathyroidism as a predisposing factor for tendon tears in this group of patients is well documented, and the weakening of the tendon-bone junction is part of this context. The treatment of choice for quadriceps tendon ruptures in patients with ESRD is surgery, which should be performed as soon as possible. There are several surgical techniques to be used, but the lack of comparative studies does not allow us to conclude which one is the best option. More recent publications have preferred the association of techniques, with emphasis on the use of autologous tendon grafts as a reinforcement tool, which is the author's procedure of choice. Recent studies reported the use of biological agents to stimulate healing and allografts, but the information seems preliminary to be routinely recommended. Level of evidence II; Obsevation of therapeutic studies.

As rupturas do tendão do quadríceps são lesões incomuns, frequentemente associadas a doenças crônicas, incluindo a doença renal em estágio de falência funcional. O papel do hiperparatireoidismo secundário como fator predisponente para rupturas tendinosas nesse grupo de pacientes está bem documentado, e o enfraquecimento da junção tendão-osso faz parte desse contexto. O tratamento de escolha para rupturas do tendão do quadríceps em pacientes com falência renal é a cirurgia, e deve ser realizado o mais rápido possível. Existem várias técnicas cirúrgicas a serem utilizadas, mas a falta de estudos comparativos não nos permite concluir qual é a melhor opção. Publicações mais recentes têm preferido a associação de técnicas, com destaque para o uso de enxerto tendíneo autólogo como ferramenta de reforço, procedimento de escolha do autor. Estudos recentes relatam o uso de agentes biológicos para estimular a cicatrização e aloenxertos, mas as informações parecem preliminares para serem rotineiramente recomendadas. Nível de Evidência II; Observação de estudos terapêuticos.

A Randomized Clinical Trial to Assess the Efficacy of Online-Treatment with Trial-Based Cognitive Therapy, Mindfulness-Based Health Promotion and Positive Psychotherapy for Post-Traumatic Stress Disorder during the COVID-19 Pandemic: A Study Protocol.

BACKGROUND: Research suggests the use of different forms of therapy as a way of decreasing dropout rates in the treatment of post-traumatic stress disorder (PTSD). The psychotherapies to be assessed in this study are trial-based cognitive therapy (TBCT), mindfulness-based health promotion (MBHP) and positive psychotherapy (PPT). OBJECTIVES: (1) to assess the online efficacy of TBCT compared to MBHP and PPT to reduce the symptoms of PTSD in the context of the Coronavirus Disease 2019 (COVID-19) pandemic; (2) to compare the efficacy of these psychotherapies in improving anxiety, depression, guilt and in promoting well-being; and (3) to describe how professionals perceive online treatment. METHODS: A randomized, multicenter, single-blind clinical trial will be conducted, with three separate arms. An estimated sample of 135 patients will receive either TBCT, MBHP or PPT and will be treated through online, individual, weekly visits, totaling 14 sessions. The primary outcome will be CAPS-5 and secondary outcomes will be HADS and WHO-5. The variables used to mediate these outcomes will be the Trauma-Related Guilt Inventory (TRGI), Negative Core Beliefs Inventory (NCBI) and the California Psychotherapy Alliance Scale (CALPAS-P). EXPECTED RESULTS: PTSD symptoms are expected to be reduced after TBCT, MBHP and PPT. No statistical difference is expected to be found among the three. DISCUSSION: The present study will evaluate and contribute towards the development of new psychotherapeutic options for patients with PTSD. The results of this study will allow the dissemination of new effective and adaptable interventions for patients with PTSD.

A New Proposal for Calibrated Gauges for Removable Partial Dentures: A Finite Element Analysis.

AIM: The aim of this study was to evaluate the stress distribution of a planned removable partial denture (RPD) using new proposals for calibrated gauges of 0.3 mm and 0.35 mm undercuts through the three-dimensional (3D) finite element methodology, and compare them with 0.25 mm and 0.5 mm gauges that are already existing in clinical practice. MATERIALS AND METHODS: Kennedy class-I edentulous 3D models and their respective RPDs (InVesalius software; Rhinoceros and SolidWorks CAD) were created and exported to the finite element program HyperMesh 2019 for mesh configuration. In the following steps, axial loading (0º) of 40 N per point was performed, with 3 points on the molars and 2 points on the premolars, totaling 280 N unilaterally. The model was processed by the OptiStruct 2019 software and imported into the HyperView 2019 software to obtain the stress maps (MPa). RESULTS: The use of 0.30 and 0.35 mm calibrated gauges presented tensions similar to those with the 0.25 mm gauge (gold standard) and caused no significant damage to biological structures. The use of a 0.5 mm undercut caused greater traction force in the periodontal ligament of the abutments. CONCLUSIONS: The 0.35 mm undercut seems promising as it presented more favorable results in this simulation, on the other hand, a 0.5 mm undercut is greater than that necessary for retainers made of CoCr. CLINICAL SIGNIFICANCE: This study aims to measure a new undercut gauge (0.35 mm) to increase the retention area in abutment teeth of removable partial dentures.

Pulp changes from rapid maxillary expansion: A systematic review.

INTRODUCTION: This study aimed to systematically review the current evidence on the occurrence of pulp changes as side effects from orthopaedic rapid maxillary expansion (ORME) or surgically assisted rapid maxillary expansion (SARME). METHODS: An electronic search was performed in eleven databases. The eligibility criteria included clinical studies assessing vitality, sensibility or dimensions of the pulp chamber of permanent teeth before and after ORME or SARME, without restrictions on publication year or language. The risk of bias was analysed with the NIH 'Quality Assessment Tool for Before-After (Pre-Post) Studies with No Control Group' and the 'JBI for quasi-experimental studies' tool. The GRADE tool was used to assess the certainty of evidence. RESULTS: The initial search resulted in 1,197 records, from which only seven before-after studies were included. There was a change in the pulpal blood flow (PBF) of maxillary incisors and canines up to 5 days after SARME, which gradually returned after 7 days to 3 months. After ORME, one study observed an increased PBF and one study observed a reduced PBF, which gradually returned after the end of expansion. Two studies observed that both ORME and SARME caused temporary changes in pulp sensibility. Three studies observed a significant reduction in the pulp chamber after ORME or SARME. The outcomes presented a very low certainty of evidence. CONCLUSIONS: Although limited, the evidence shows that ORME and SARME caused temporary changes in pulp vitality and sensibility, with the possibility of inducing a reduction in pulp chamber dimensions.

Treatment of quadriceps tendon rupture in hemodialysis patients: a 2020 update / Tratamento da ruptura do tendão do quadríceps em hemodialisados: uma atualização em 2020

ABSTRACT Quadriceps tendon tears are uncommon injuries often associated with chronic diseases, including end-stage renal disease (ESRD). The role of secondary hyperparathyroidism as a predisposing factor for tendon tears in this group of patients is well documented, and the weakening of the tendon-bone junction is part of this context. The treatment of choice for quadriceps tendon ruptures in patients with ESRD is surgery, which should be performed as soon as possible. There are several surgical techniques to be used, but the lack of comparative studies does not allow us to conclude which one is the best option. More recent publications have preferred the association of techniques, with emphasis on the use of autologous tendon grafts as a reinforcement tool, which is the author's procedure of choice. Recent studies reported the use of biological agents to stimulate healing and allografts, but the information seems preliminary to be routinely recommended. Level of evidence II; Obsevation of therapeutic studies.

RESUMO As rupturas do tendão do quadríceps são lesões incomuns, frequentemente associadas a doenças crônicas, incluindo a doença renal em estágio de falência funcional. O papel do hiperparatireoidismo secundário como fator predisponente para rupturas tendinosas nesse grupo de pacientes está bem documentado, e o enfraquecimento da junção tendão-osso faz parte desse contexto. O tratamento de escolha para rupturas do tendão do quadríceps em pacientes com falência renal é a cirurgia, e deve ser realizado o mais rápido possível. Existem várias técnicas cirúrgicas a serem utilizadas, mas a falta de estudos comparativos não nos permite concluir qual é a melhor opção. Publicações mais recentes têm preferido a associação de técnicas, com destaque para o uso de enxerto tendíneo autólogo como ferramenta de reforço, procedimento de escolha do autor. Estudos recentes relatam o uso de agentes biológicos para estimular a cicatrização e aloenxertos, mas as informações parecem preliminares para serem rotineiramente recomendadas. Nível de Evidência II; Observação de estudos terapêuticos.

Relationships, Decisions, and Physical Effort in the Marro Traditional Sporting Game: A Multimodal Approach.

The purpose of this study was to examine the players' decisions-making in Marro (a Traditional Sporting Game) through a multimodal approach. Each player's decision-making assumes specific accelerations and decelerations associated with different effort. The research objectives were: (i) to study the decision-making associated with the roles of Hunter and Hare; (ii) to know the physical effort by the roles (Hunters and Hares); (iii) to reveal T-Patterns in the multimodal strategic approach (integrated with decisions and different physical effort) with a direct incidence on the scoring by roles. The study was performed with 22 male and 2 female players aged 18 to 25 (M = 19.4; SD = 1.3). The Marro game was played by two groups for eight minutes. An observational methodology was used, through a type III design. The observational design was nomothetic, one-time, and multidimensional. An 'ad hoc' tool was built to ensure the data quality. Univariate analyses were performed using Crosstabs Command, with adjusted residuals (AR), Classification Trees (Chaid model) and T-Pattern Analysis (TPA). Significant differences were found between matches using the scoring (p < 0.001; ES = 0.26), role (p < 0.001; ES = 0.31), or the organic variables of the study, the speed (p < 0.001; ES = 0.73), the metabolic power and the acceleration/deceleration the speed (p = 0.023; ES = 0.43), while the predictive model pointed to the variable role (p < 0.001) as the main factor responsible for the model growth. TPA (p < 0.005) revealed differences attributable to internal logic in the yellow (first match) and orange (second match) teams, while organic variables were more changeable in the violet (first match) and green (second match) teams. This study advances the individualization of the decision-making process. These results may be useful to better understand the internal of functioning of the Marro game 360° since the use of various methodologies and variables (multimodal approach) provided original findings.

Improving the Room-Temperature Ferromagnetism in ZnO and Low-Doped ZnO:Ag Films Using GLAD Sputtering.

ZnO and doped ZnO films with non-ferromagnetic metal have been widely used as biosensor elements. In these studies, the electrochemical measurements are explored, though the electrical impedance of the system. In this sense, the ferromagnetic properties of the material can be used for multifunctionalization of the sensor element using external magnetic fields during the measurements. Within this context, we investigate the room-temperature ferromagnetism in pure ZnO and Ag-doped ZnO films presenting zigzag-like columnar geometry. Specifically, we focus on the films' structural and quasi-static magnetic properties and disclose that they evolve with the doping of low-Ag concentrations and the columnar geometry employed during the deposition. The magnetic characterization reveals ferromagnetic behavior at room temperature for all studied samples, including the pure ZnO one. By considering computational simulations, we address the origin of ferromagnetism in ZnO and Ag-doped ZnO and interpret our results in terms of the Zn vacancy dynamics, its substitution by an Ag atom in the site, and the influence of the columnar geometry on the magnetic properties of the films. Our findings bring to light an exciting way to induce/explore the room-temperature ferromagnetism of a non-ferromagnetic metal-doped semiconductor as a promising candidate for biosensor applications.