Spatial patterns of prematurity and its determinants in the metropolitan region of São Paulo, Brazil, 2010-2019.

OBJECTIVE: To analyze spatial distribution of preterm births and their association with maternal, social, and health services indicators in the metropolitan region of São Paulo, Brazil, 2010-2019. METHODS: Ecological study using data on preterm newborns from 39 municipalities in the metropolitan region of São Paulo. Univariate global Moran's index (Im) was used to evaluate spatial association of prematurity, and univariate local Moran's index by using the cluster map (LISA) to identify spatial patterns and clusters. Bivariate global Moran's index was also used to analyze spatial autocorrelation with maternal, social, and health services indicators. RESULTS: A total of 3,103,898 live births were registered in period 2010-2019, of which 331,174 (10.7%) were preterm. The global Moran's index showed spatial independence (Im=0.05; p-value=0.233) of the proportion of preterm births between municipalities. However, in the local spatial analysis it was possible to identify a statistically significant spatial cluster between the municipalities of Biritiba Mirim, Guararema and Salesópolis, with high proportions of preterm births. In the bivariate analysis, a significant positive spatial association was identified with proportions of mothers under 20 years old (Im=0.17; p-value=0.024) and mothers with low schooling (Im=0.17; p-value=0.020), and a significant negative spatial association with HDI (Im=-0.14; p-value=0.039). CONCLUSIONS: The local spatial approach identified a spatial cluster located in the far east of the metropolitan region of São Paulo, where actions by health managers are needed to minimize occurrence of preterm births.

Spatial patterns of prematurity and its determinants in the metropolitan region of São Paulo, Brazil, 2010-2019 / Padrões espaciais da prematuridade e seus determinantes na região metropolitana de São Paulo, Brasil, 2010-2019

ABSTRACT Objective: To analyze spatial distribution of preterm births and their association with maternal, social, and health services indicators in the metropolitan region of São Paulo, Brazil, 2010-2019. Methods: Ecological study using data on preterm newborns from 39 municipalities in the metropolitan region of São Paulo. Univariate global Moran's index (Im) was used to evaluate spatial association of prematurity, and univariate local Moran's index by using the cluster map (LISA) to identify spatial patterns and clusters. Bivariate global Moran's index was also used to analyze spatial autocorrelation with maternal, social, and health services indicators. Results: A total of 3,103,898 live births were registered in period 2010-2019, of which 331,174 (10.7%) were preterm. The global Moran's index showed spatial independence (Im=0.05; p-value=0.233) of the proportion of preterm births between municipalities. However, in the local spatial analysis it was possible to identify a statistically significant spatial cluster between the municipalities of Biritiba Mirim, Guararema and Salesópolis, with high proportions of preterm births. In the bivariate analysis, a significant positive spatial association was identified with proportions of mothers under 20 years old (Im=0.17; p-value=0.024) and mothers with low schooling (Im=0.17; p-value=0.020), and a significant negative spatial association with HDI (Im=-0.14; p-value=0.039). Conclusions: The local spatial approach identified a spatial cluster located in the far east of the metropolitan region of São Paulo, where actions by health managers are needed to minimize occurrence of preterm births.

RESUMO Objetivo: Analisar a distribuição espacial dos nascimentos prematuros e sua associação com indicadores maternos, sociais e de serviços de saúde na região metropolitana de São Paulo, Brasil, 2010-2019. Métodos: Estudo ecológico utilizando dados sobre recém-nascidos pré-termo dos 39 municípios da região metropolitana de São Paulo. Utilizou-se o índice de Moran (Im) global univariado para avaliar a associação espacial da prematuridade, e o índice de Moran local univariado por meio do mapa de clusters (LISA) para a identificação de padrões e aglomerados espaciais. Também foi utilizado o índice de Moran global bivariado para analisar a autocorrelação espacial com os indicadores maternos, sociais e de serviços de saúde. Resultados: Foram registrados 3.103.898 nascidos vivos no período 2010-2019, dos quais 331.174 (10,7%) foram prematuros. O índice de Moran global mostrou independência espacial (Im=0,05; p-valor=0,233) da proporção dos nascimentos prematuros entre municípios. No entanto, na análise espacial local foi possível identificar aglomerado espacial estatisticamente significativo entre os municípios de Biritiba Mirim, Guararema e Salesópolis, com proporções altas de nascimentos pré-termo. Na análise bivariada, identificou-se associação espacial significativa positiva com proporções de mães menores de 20 anos (Im=0,17; p-valor=0,024) e mães com baixa escolaridade (Im=0,17; p-valor=0,020), e associação espacial significativa negativa com IDH (Im=-0,14; p-valor=0,039). Conclusão: A abordagem espacial local identificou agrupamento espacial situado no extremo leste da região metropolitana de São Paulo, onde ações dos gestores de saúde são necessárias para minimizar a ocorrência de partos prematuros.

Fluoride-modified implant surfaces improves osseointegration in the tibias of rats with induced diabetes.

This study evaluated the influence of a fluoride-modified titanium surface on osseointegration in rats with induced diabetes. One hundred and eighty rats were randomly allocated into 3 groups with 60 animals each: Control group (C): Animals without diabetes; Diabetes Group (D): Animals with uncontrolled induced diabetes; Controlled Diabetes Group (CD): Animals with diabetes induced controlled by the insulin administration. Diabetes was induced by streptozotocin injection. Each animal received 2 implants in the proximal tibial metaphysis, one with the machined surface (M) and the other one with a fluoride-modified titanium surface (F), after 4 weeks of induction of diabetes. The animals were submitted to euthanasia 2, 4, and 6 weeks after the implant placement (n = 20 animals/group). The osseointegration was evaluated by the implant removal torque test and the histometric analysis of the non-decalcified histological sections: 1) Contact bone/implant (%BIC); 2) Bone tissue area between implant threads (%BBT). Implants with F surface showed a higher removal torque than implants with surface M in all groups. There was no difference in %BIC between the groups regardless of the surface used. The F surface showed a tendency to present higher %BBT values for the 3 evaluation periods in the D group. The fluoride-modified implant surface has no impact on the %BIC and %BBT. However, the fluoride-modified implant surface increases the locking of the implants with the bone. The hyperglycemia was associated with lower removal torque values despite the surfaces of the implant used.

Fluoride-modified implant surfaces improves osseointegration in the tibias of rats with induced diabetes

Abstract This study evaluated the influence of a fluoride-modified titanium surface on osseointegration in rats with induced diabetes. One hundred and eighty rats were randomly allocated into 3 groups with 60 animals each: Control group (C): Animals without diabetes; Diabetes Group (D): Animals with uncontrolled induced diabetes; Controlled Diabetes Group (CD): Animals with diabetes induced controlled by the insulin administration. Diabetes was induced by streptozotocin injection. Each animal received 2 implants in the proximal tibial metaphysis, one with the machined surface (M) and the other one with a fluoride-modified titanium surface (F), after 4 weeks of induction of diabetes. The animals were submitted to euthanasia 2, 4, and 6 weeks after the implant placement (n = 20 animals/group). The osseointegration was evaluated by the implant removal torque test and the histometric analysis of the non-decalcified histological sections: 1) Contact bone/implant (%BIC); 2) Bone tissue area between implant threads (%BBT). Implants with F surface showed a higher removal torque than implants with surface M in all groups. There was no difference in %BIC between the groups regardless of the surface used. The F surface showed a tendency to present higher %BBT values for the 3 evaluation periods in the D group. The fluoride-modified implant surface has no impact on the %BIC and %BBT. However, the fluoride-modified implant surface increases the locking of the implants with the bone. The hyperglycemia was associated with lower removal torque values despite the surfaces of the implant used.

Resumo Este estudo avaliou a influência de uma superfície de titânio modificada com flúor na osseointegração em ratos com diabetes induzida. Cento e oitenta ratos foram distribuídos aleatoriamente em 3 grupos com 60 animais cada: Grupo controle (C): Animais sem diabetes; Grupo Diabetes (D): Animais com diabetes induzida descompensada; Grupo Diabetes Controlado (CD): Animais com diabetes induzido controlado pela administração de insulina. O diabetes foi induzido por injeção de estreptozotocina. Cada animal recebeu 2 implantes na metáfise proximal da tíbia, um com superfície usinada (M) e outro com superfície de titânio modificado com flúor (F), após 4 semanas de indução do diabetes. Os animais foram submetidos à eutanásia 2, 4 e 6 semanas após a colocação do implante (n = 20 animais/grupo). A osseointegração foi avaliada pelo teste de torque de remoção do implante e pela análise histométrica dos cortes histológicos não descalcificados: 1) Contato osso-implante (%BIC); 2) Área de tecido ósseo entre as roscas do implante (%BBT). Os implantes com superfície F apresentaram maior torque de remoção do que os implantes com superfície M em todos os grupos. Não houve diferença no %BIC entre os grupos independente da superfície utilizada. A superfície F mostrou tendência a apresentar maiores valores de %BBT para os 3 períodos de avaliação no grupo D. As superfícies de implantes modificadas com flúor não influenciaram nos dados de %BIC e %BBT. Entretanto, essas superfícies aumentaram o travamento dos implantes no tecido ósseo. A hiperglicemia foi associada a menores torques de remoção dos implantes independentemente do tipo de superfície de implante utilizada.

Surface topography of resorbable porcine collagen membranes, and their effect on early osteogenesis: An in vitro study.

OBJECTIVE: Guided tissue regeneration (GTR) is based on the use of different membranes that function as sealants and barriers in specific clinical situations. Among the several tissue production methods and origins, resorbable porcine-derived membranes are the most commonly used. Because these membranes are so diverse, and have several different clinical applications, doubts linger as to their effect in stimulating osteogenesis. The objective of this study was to make an in vitro evaluation of the viability and differentiation of osteoblastic cells cultured on the surface of the following collagen membranes: Jason® (Botiss Biomaterials), Collprotect® (Botiss Biomaterials), and Bio-Gide® (Geistlich). MATERIAL AND METHODS: Fragments of the 3 resorbable collagen membranes (5 × 5 mm) were used, and pre-osteoblastic SAOS-2 cells (ATCC, USA) were plated on their porous surfaces. Evaluation of the membranes was performed at 3, 5 and 7 days, considering the following parameters: (1) topographic analysis of the different surfaces by scanning electron microscope; (2) cellular viability by MTT, (3) quantification of type I collagen and osteopontin by Elisa. The quantitative analyses were carried out using a significance level of 5%. RESULTS: Collprotect® and Jason® membranes presented a rough surface with an irregular aspect on both sides, while double-layered Bio-Gide® had one layer with a smooth surface and the other with a rough surface along each respective length. The viability assays revealed that the cells cultured the cells grown on Collprotect® showed higher viability than those grown in Bio-Gide® or Jason®, especially after 5 and 7 days. After 3 and 5 days, evaluation of type I collagen showed that the cells plated on the Jason® and Collprotect® surfaces had greater collagen secretion than those plated on BioGide®. After 7 days, an increase in osteopontin levels was observed when the cells were plated on all the experimental membranes, compared with the control group. CONCLUSION: All the tested membranes were suitable for use in GTR clinical procedures. Their indication in specific regenerative cases depends on the mechanical and biological properties of their originating tissues, thus enabling better results and assertive choices by dental professionals.

Spatial patterns of mortality in low birth weight infants at term and its determinants in the State of São Paulo, Brazil.

OBJECTIVE: Low birth weight (LBW) is a public health problem strongly associated with infant mortality. This study aimed to identify the spatial distribution of infant mortality in newborns with LBW (750-2,500 g) at term (≥37 weeks of gestation), due to their being small for gestational age, analyzing its association with mother-related determinants, as well as to identify priority areas of mortality in the State of São Paulo, 2010-2019. METHODS: Infant mortality rate was analyzed in the division of neonatal mortality and postneonatal mortality of newborns with LBW at term. The empirical Bayesian method smoothed the rates, the univariate Moran index was used to measure the degree of spatial association between the municipalities, and the bivariate Moran index was employed to identify the existence of a spatial association between the rates and the selected determinants. Thematic maps of excess risk and local Moran were prepared to identify spatial clusters, adopting 5% as a significance level. RESULTS: The excess risk map showed that more than 30% of the municipalities had rates above the state rate. High-risk clusters were identified in the southwest, southeast, and east regions, mainly among more developed municipalities. The determinants of adolescent mothers, mothers over 34 years of age, low education, human development index, social vulnerability index, gross domestic product, physicians, and pediatric beds showed a significant association with the rates evaluated. CONCLUSIONS: Priority areas and significant determinants associated with reduced mortality in newborns with LBW were identified, suggesting the need for intervention measures to achieve the Sustainable Development Goal.

Analysis of bone stress and primary stability of a dental implant using strain and torque measurements.

Introduction: The consensus among researchers is that early failure of dental implants is due to the lack of primary stability and compressive stress on the peri-implant bone that exceeds the physiological tolerance. Objective: The objective of this work is to propose a new methodology to quantify bone stress during dental implant insertion and to correlate it with primary stability. Materials and Methods: Titanium dental implants with a diameter of 3.75 mm were inserted in a 3.35 mm hole of a synthetic bone of polyurethane (PU) foam with a density of 20 PCF (0.32 g/cm3). During insertion, the insertion torque was measured with a digital torque meter and the bone strain was measured with strain gages located at 2, 4, 6, 8, and 10 mm from the coronal region. Results: The tests showed that the compressive strain is maximum in the third coronal region and decreases in the apical direction. The data also showed that there is a relationship between strain, insertion torque, and the primary stability of dental implants. Conclusion: The stress and strain on the bone progressively decreased from the coronal to the apical third. The maximum compressive stress (0.42 MPa) during insertion of the implant did not exceed bone strength. Insertion of 3.75 mm implants in type D2 bone with a 3.35 mm hole provides adequate primary stability without excessive compression of the bone. Clinical Significance: For the implant-bone combination used in the present study, the compressive stress generated during implant insertion did not exceed the physiological limit of cortical and medullary bone to the point of impairing osseointegration.

Populism, cyberdemocracy and disinformation: analysis of the social media strategies of the French extreme right in the 2014 and 2019 European elections.

Since the European elections in 2014, the populist formations had been increasing the shares of power that their masses finally claimed in the May 2019 elections. In the case of France, this rise of the Rassemblement National has even given rise to a new political regime: the Europeanism of Macron vs. the Euroscepticism of Le Pen. This paper aims to delve into the communication strategy of the latter formation, to see how it has been able to shift the party's fascist image towards that of a protector of national sovereignty and interests (against the European ones). To this end, the 1256 tweets posted on its official Twitter profile during the fortnight of the 2014 and 2019 European election campaigns have been qualitatively analysed. The results point to a whitening of its image, in order to present itself as a potential voting option for the majority of the French electorate while retaining a certain populist essence.

Evaluation of the occlusal contact area of molar dental implants comparing two different thicknesses (16 µm and 200 µm) of articulating occlusal papers and forces (200 and 250 N): a pivot in vitro study

Introduction: The goal of this pilot study was to evaluate the differences between checking occlusion on implants crowns using 16 or 200 µm thickness of articulating occlusal paper, and to compare the stained occlusal area between the groups after bite forces of 200 and 250 N. Methods: It was included 10 casts of articulated-type IV gypsum, 10 NiCr crowns, articulating occlusal papers (16 µm and 200 µm thick), and a compression test machine. Compressive forces (200 and 250 N.mm) were applied on models, to check the occlusal contact area of fixed and cemented crowns. The contact areas on the crowns were measured through images obtained by the scanning electron microscope. Statistical tests were performed considering the significant level of 5% (p≤0.05). Results: The stains found using 200 µm of articulating paper were higher than those with 16 µm, independent of the force applied. However, the stains obtained in lower teeth with different strengths (200 and 250N) marked with 16 µm articulating paper were not possible to score. The articulating paper variable had significant statistical results (p=0.002), while the variables force (p=0.443) and articulating paper-force interaction (p=0.607) were not significant. The mean area found in staining using the 200 µm and 16 µm papers was, respectively, 8.3380 mm2 and 3.4759 mm2. Conclusion: It was possible to confirm that 200 µm of articulating occlusal paper showed better and significant results to stain the occlusal area, permitting a more accurate adjustment independent of the force applied.

Comparison between different fracture toughness techniques in zirconia dental ceramics.

Vickers indentation (IF) and single-edge-V-notched beam (SEVNB), to measure the fracture toughness (KIC ) of zirconia-based dental ceramics and mathematical models were proposed to establish a correlation between both. Zirconia (ZrO2 ) stabilized with 3 mol. % of Y2 O3 (3Y-TZP) and 5 mol% of Y2 O3 (5Y-PSZ) were compacted (n = 42) and sintered for 2 h at different temperatures (1475°C, 1500°C, 1550°C, or 1600°C). After sintering, they were characterized by relative density using the ASTM C373-88 standard, X-ray diffraction (XRD) and scanning electron microscopy (SEM). The average grain size was measured according to the ASTM E1382-97 standard. The fracture toughness (KIC ) was determined using two methods: Vickers indentation fracture toughness (KIC-IF ): method based on mathematical modeling that considers the parameters used for the Vickers hardness test and Fracture toughness by the single-edge-V-notch-beam (KIC-SEVNB ): method proposed by ISO 23146:08. The main phases of the 3Y-TZP and 5Y-PSZ ceramics were ZrO2 -tetragonal and ZrO2 -cubic, respectively. The 3Y-TZP specimens showed equiaxed grains with average grain sizes ranging from 0.55 to 0.79 µm. The grain sizes of 5Y-PSZ of specimens sintered at 1475°C and 1600°C were 0.62 and 2.32 µm, respectively. For all ceramics the crack size ratio was c/a < 2.5, suggesting a Palmqvist-type crack system. The fracture toughness measured by the Vickers indentation method (KIC-IF ) and by the SEVNB method (KIC-SEVNB ) was the same when the experimental data were fit to a mathematical model.

Influence of Heat Treatment of Nickel-Titanium Instruments on Cyclic Fatigue Resistance in Simulated Curved Canals.

OBJECTIVE: The aim of this study was to compare the cyclic fatigue of heat-treated and non-treated instruments. MATERIALS AND METHODS: Twenty instruments with and without heat treatment from Bassi Logic were evaluated (n = 10). All instruments were subjected to dynamic cyclic fatigue through continuous rotations inside a stainless-steel tube (1.4-mm diameter, 9-mm curvature with 6-mm radius, and 90° angle) using a custom-made device, which performed 1 axial oscillation every 2 seconds with an amplitude of 3 mm, powered by a torque-controlled motor (Silver Reciproc, VDW, Germany), with speed adjusting to 950 rpm and torque to 4 N, according to manufacturer's guidance. The groups were compared using the Mann-Whitney test. RESULT: The fracture time of the heat-treated instruments (97.20 ± 39.94 second and non-treated instruments (14.30 ± 6.78 seconds had statistical differences [p < 0.05]). Heat-treated instruments were 6.8 times more resistant to fatigue than non-treated instruments (p < 0.05). CONCLUSION: Heat treatment provides increased fatigue resistance of NiTi alloy with the same design.

Protein interactions with osseointegrable titanium implants

This review aims to present the mechanisms of protein interactions with titanium dental implant surfaces. Methods: the analyses were based on searches of scientific articles available in English and Portuguese in PubMed (MEDLINE), Bireme (LILACS), Scielo, Web of Science and Google Scholar. Results: titanium dental implant treatments success rates (95-98%) are mainly due to the biocompatibility of titanium oxide on the implant surface, surgical techniques adopted, good implants manufacturing processes and biomechanical knowledge of the systems. Studies in past decades has empirically developed implant surfaces with significant changes in morphologies, roughness, wettability, surface energy, chemical composition, and chemical groups density or deposited molecules. These changes promoted better protein adsorption, osteoblast adhesion, and changes in the mechanisms involved in osseointegration. Thus, the time to put the implant in function has been reduced and the success rates have increased. In the osseointegration process, at the nanoscale, there is no contact between the bone and the implant surface, but there is the formation of a protein anchorage between the periosteum and the implant with an interface formed by proteins. In all the reactions between the body and the implant surface, the activities of fibronectin and integrin are essential, since they are responsible for transmitting information to the cell for its differentiation, adhesion and mobility. Conclusion: thus, the analyses of protein-implant interactions are indispensable for a better understanding of the performance of osseointegrated dental implants

Influência da pressão dos alicates na rugosidade superficial de fios ortodônticos / Influence of gripping with pliers on the surface rugosity of orthodontic wires

Resumo Proposição: avaliar in vitro a rugosidade superficial de fios ortodônticos antes e após a compressão com pinças ortodônticas. Material E Métodos: 30 fios 0,014" de níckel-titânio termoativados (Neosentalloy, GAC) e 30 fios 0,019 x 0,025" de aço foram usados nos experimentos. Avaliou-se a rugosidade superficial com rugosímetro (NewViewTM 7100, Zygo), antes e após a compressão com alicate Weingart do lado esquerdo e pinça Mathieu do lado direito (Dentaurum). Foram determinados os parâmetros de rugosidade Ra (µm), Rq (µm), PV (µm), Srmax Iso (nm). Testes estat´siticos Wilcoxon foram realizados para analisar a variação dos parâmetros da rugosidade com nível de confiança de 95% e p<0,05. Resultados: Os fios redondos de NiTi apresentaram diferenças significaticas dos parâmetros Ra e Rq antes e após a compressão com pinça Mathieu. O emprego do alicate Weingart não alterou a rugosidade dos fios redondos. Os fios retangulares apresentaram diferenças significativas em todos os parâmetros com uso das duas pinças. As médias das diferenças dos parâmetros entre o alicate Weingart e a pinça Mathieu nos fios redondos, não foram estatisticamente significativos. Os fios retangulares apresentaram maior rugosidade com o emprego do alicate Weingart, com diferenças significativas. Conclusão: O uso do alicate tipo Weingart e da pinça tipo Mathieu aumentam a rugosidade dos fios de NiTi e de aço (AU)

Abstract Proposition: the surface roughness of orthodontic wires was evaluated in vitro before and after gripping with two different orthodontic pliers. Material And Methods: Units were made of 30 round heat-activated Nickel Titanium alloy wires 0,014" (Neosentalloy, GAC), and another group with 30 rectangular steel wires 0,019 x 0,025". The surface roughness was evaluated with a rugosimeter (NewViewTM 7100, Zygo), before and after gripping with Weingart plier on the left side and Mathieu plier on the right side (Dentaurum), in addition to the average difference in roughness between groups of the same types of wires with parameters Ra (µm), Rq (µm), PV (µm), Srmax Iso (nm). The variation of parameters with different clamps was evaluated (Wilcoxon test); different alloys by the same clamp, 95% confidence level and p<0.05. Results: The round wires showed significant differences (Ra and Rq) before and after being gripped with Mathieu plier. The roughness was higher after being gripped. Weingart pliers and round wires obtained the same results, with greater roughness after being clamped. Rectangular wires showed significant differences in all parameters, with both clamps. The means of the differences in the parameters between the Weingart pliers and the Mathieu forceps on the round wires were not statistically significant. In the rectangular wire, the values between the tweezers showed greater roughness with the grip of the Weingart pliers, with significant differences.Conclusion: After securing the orthodontic wires, the Weingart pliers and the Mathieu tweezers increased the roughness parameters (AU)

Spatial patterns of mortality in low birth weight infants at term and its determinants in the State of São Paulo, Brazil / Padrões espaciais de mortalidade em recém-nascidos de baixo peso a termo e seus determinantes no Estado de São Paulo, Brasil

ABSTRACT Objective: Low birth weight (LBW) is a public health problem strongly associated with infant mortality. This study aimed to identify the spatial distribution of infant mortality in newborns with LBW (750-2,500 g) at term (≥37 weeks of gestation), due to their being small for gestational age, analyzing its association with mother-related determinants, as well as to identify priority areas of mortality in the State of São Paulo, 2010-2019. Methods: Infant mortality rate was analyzed in the division of neonatal mortality and postneonatal mortality of newborns with LBW at term. The empirical Bayesian method smoothed the rates, the univariate Moran index was used to measure the degree of spatial association between the municipalities, and the bivariate Moran index was employed to identify the existence of a spatial association between the rates and the selected determinants. Thematic maps of excess risk and local Moran were prepared to identify spatial clusters, adopting 5% as a significance level. Results: The excess risk map showed that more than 30% of the municipalities had rates above the state rate. High-risk clusters were identified in the southwest, southeast, and east regions, mainly among more developed municipalities. The determinants of adolescent mothers, mothers over 34 years of age, low education, human development index, social vulnerability index, gross domestic product, physicians, and pediatric beds showed a significant association with the rates evaluated. Conclusions: Priority areas and significant determinants associated with reduced mortality in newborns with LBW were identified, suggesting the need for intervention measures to achieve the Sustainable Development Goal.

RESUMO Objetivo: O baixo peso ao nascer (BPN) é um problema de saúde pública e está fortemente associado à mortalidade infantil. Este estudo teve como objetivo identificar a distribuição espacial da mortalidade infantil em recém-nascidos com BPN (750-2.500 g) a termo (≥37 semanas de gestação), por serem pequenos para a idade gestacional, analisando sua associação com determinantes relacionados à mãe, bem como identificar áreas prioritárias de mortalidade no Estado de São Paulo, 2010-2019. Métodos: A taxa de mortalidade infantil foi analisada na divisão da mortalidade neonatal e mortalidade pós-neonatal de recém-nascidos com BPN a termo. O método bayesiano empírico alisou as taxas, o índice de Moran univariado foi utilizado para medir o grau de associação espacial entre os municípios e o índice de Moran bivariado foi empregado para identificar a existência de associação espacial entre as taxas e os determinantes selecionados. Mapas temáticos de excesso de risco e Moran local foram elaborados para identificar aglomerados espaciais, adotando-se 5% como nível de significância. Resultados: O mapa de excesso de risco mostrou que mais de 30% dos municípios apresentaram taxas acima da taxa estadual. Aglomerados de alto risco foram identificados nas regiões sudoeste, sudeste e leste, principalmente entre os municípios mais desenvolvidos. Os determinantes mães adolescentes, mães acima de 34 anos, baixa escolaridade, índice de desenvolvimento humano, índice de vulnerabilidade social, produto interno bruto, médicos e leitos pediátricos apresentaram associação significativa com as taxas avaliadas. Conclusões: Foram identificadas áreas prioritárias e determinantes significativos associados à redução da mortalidade em recém-nascidos com BPN, sugerindo a necessidade de medidas de intervenção para atingir o Objetivo de Desenvolvimento Sustentável.

Titanium Coated with Graphene and Niobium Pentoxide for Biomaterial Applications.

Graphene and niobium oxide are used in biomaterial coatings. In this work, commercially pure titanium (cp Ti) was coated with graphene oxide (GO), niobium pentoxide (Nb2O5), and a mixture of both materials (NbGO) by the electrochemical deposition method. The surface morphology, roughness, wettability, and degradation of coated and uncoated samples were analyzed by scanning electron microscopy, interferometry, and contact angle. The results showed that the specimens coated with NbGO (cp Ti-NbGO) showed the highest surface roughness (Ra = 0.64 µm) and were hydrophobic. The contact (θ) angle between water and the surface of uncoated specimens (cp Ti), coated with GO (cp Ti-GO), coated with a mixture with GO and Nb2O5) (cp Ti-NbGO), and coated with Nb2O5 were 50.74°, 44.35°, 55.86°, and 100.35°, respectively. The electrochemical corrosion tests showed that coating with graphene oxide increased the corrosion resistance and coating with Nb2O5 decreased the corrosion resistance. The negative effect of the effect of Nb2O5 coating in corrosion resistance compensated for the release of Nb2O5, which helps osseointegration, increasing cell viability, and proliferation of osteoblasts. The NbGO coating may be a good way to combine the bactericidal effect of graphene oxide with the osseointegration effect of Nb2O5.

Genetic diversity of Trypanosoma cruzi strains isolated from chronic chagasic patients and non-human hosts in the state of São Paulo, Brazil.

BACKGROUND: Trypanosoma cruzi shows an exuberant genetic diversity. Currently, seven phylogenetic lineages, called discrete typing units (DTUs), are recognised: TcI-TcVI and Tcbat. Despite advances in studies on T. cruzi and its populations, there is no consensus regarding its heterogeneity. OBJECTIVES: This study aimed to perform molecular characterisation of T. cruzi strains, isolated in the state of São Paulo, to identify the DTUs involved and evaluate their genetic diversity. METHODS: T. cruzi strains were isolated from biological samples of chronic chagasic patients, marsupials and triatomines through culture techniques and subjected to molecular characterisation using the fluorescent fragment length barcoding (FFLB) technique. Subsequently, the results were correlated with complementary information to enable better discrimination between the identified DTUs. FINDINGS: It was possible to identify TcI in two humans and two triatomines; TcII/VI in 19 humans, two marsupials and one triatomine; and TcIII in one human host, an individual that also presented a result for TcI, which indicated the possibility of a mixed infection. Regarding the strains characterised by the TcII/VI profile, the correlation with complementary information allowed to suggest that, in general, these parasite populations indeed correspond to the TcII genotype. MAIN CONCLUSIONS: The TcII/VI profile, associated with domestic cycles and patients with chronic Chagas disease, was the most prevalent among the identified DTUs. Furthermore, the correlation of the study results with complementary information made it possible to suggest that TcII is the predominant lineage of this work.

A Lip Repositioning Technique Using Polyester Threads for Gummy Smile Treatment.

A new technique is proposed in this study to correct the gummy smile (GS) with myotomy, combining lip repositioning with the insertion of polyester threads at the surgical site to act as a physical barrier and control relapse. 11 patients were clinically assessed (30.2 ± 7.43 years old, 90.9% females and 9.10% males). All patients presented gingival display (GD) greater than 4 mm. Hypermobile upper lip (HUL), vertical maxillary excess (VME) + HUL, altered passive eruption (APE) + HUL, and VME + APE were the etiologies identified. Three polyester threads were inserted in each patient one month after the surgery. The GS was measured before, 6 months, and 12 months after the surgery. The results showed a reduction in the mean GD of the patients, 4.42 mm after 6 months (p value = 0.000) and 4.13 mm after 12 months (p value = 0.000). The largest relapse was 0.29 mm and was not statistically significant (p value = 0.07). The Friedman test with pairwise comparisons was used to determine the existence of statistically significant differences in GD between the periods analyzed. The results showed that the proposed technique was successful in treating GS, presenting significant reductions in the GD 12 months after surgery and controlling the relapse.

Effect of cigarette smoke on aesthetic brackets: an in vitro study.

OBJECTIVE: The objective of this study was to evaluate the effect of cigarette smoke (CS) on physical and mechanical properties of ceramic, polycarbonate and alumina ceramic brackets. The null hypothesis tested was that aesthetic brackets would not be influenced by CS. METHODS: Ninety aesthetic brackets were allocated to three groups (n = 30): ceramic (GCE), polycarbonate (GCO) and alumina ceramic (GPS). Ten samples of each group were assigned to color and surface roughness analysis, performed before (T0) and after (T1) exposure to CS; and twenty samples were allocated into control and experimental groups (n = 10) (not exposed and exposed to CS, respectively) for shear bond strength test (SBS). Exposure to CS followed an adaptation of the method described by Le Mesurier. Colorimetric reading, surface morphology and roughness, SBS and adhesive remnant index (ARI) were assessed. Statistical analysis comprised independent and paired t-tests, ANOVA/Tukey and Fisher's exact tests (α = 0.05). RESULTS: Changes were observed in brackets' color (NBS: GCE = 2.4; GCO = 1.9; GPS = 2.1), surface roughness (ΔRa: GCE = 1.1 ± 0.8 µm; GCO = 1.9 ± 1.5µm; GPS = -0.3 ± 0.1 µm / ΔRz: GCE = 1.4 ± 1.0 nm; GPS = -0.5 ± 0.1 nm); and SBS (GPS - experimental = 221.8 ± 48.6 N) after exposure to CS (p< 0.05). CONCLUSIONS: Exposure, in vitro, of aesthetic brackets to CS resulted in changes of color to darker and more opaque shades, surface roughness alterations, and higher SBS values. ARI scores were not associated with exposure to CS.

Physical Properties and Color Stainability by Coffee and Red Wine of Opaque and High Translucency Zirconia Dental Ceramics after Hydrothermal Degradation.

The objective was to evaluate the bending strength, phase transformation, roughness, and color stainability by coffee and red wine of opaque and high translucency yttria-stabilized zirconia before and after hydrothermal degradation in saline solution or oral mouthwash. Presintered zirconia blocks with medium opacity (ZrO2-3 mol. % of Y2O3) designed as ZrOp and high translucency zirconia (5.2 mol. % of Y2O3) designed as ZrTrans were used. Specimens (n = 80/group) were cut and sintered at 1500°C for 2 h. The specimens were hydrothermally degraded in an autoclave (134°C-1.8 kg/cm2) for 20 h in saline solution (0.5 g/L) and oral mouthwash solution (0.02% sodium fluoride, without alcohol and with 21.6% alcohol). After hydrothermal degradation, the samples were immersed in containers with coffee or red wine for 14 days to determine their color stainability. The results showed that the ZrOp had a higher bending strength than the ZrTrans before and after hydrothermal aging. In ZrOp and ZrTrans, the roughness increased after hydrothermal degradation. ZrOp samples had a higher Ra roughness than the ZrTrans samples. Roughness did not change after immersion in coffee or red wine. The X-ray diffraction (XRD) results showed that ZrOp samples underwent a tetragonal to monoclinic phase transformation, while ZrTrans samples were unchanged. Both ZrOp and ZrTrans samples changed color after immersion in coffee and red wine.

Flexural Strength of Vitreous Ceramics Based on Lithium Disilicate and Lithium Silicate Reinforced with Zirconia for CAD/CAM.

The dental prosthesis market is rapidly evolving to meet patient and clinical demands. These new materials must have good flexural strength, toughness, aesthetic properties, and reliability in performance for structural applications. The present work aimed to compare the bending strength of 4 types of chairside lithium disilicate (Li2Si2O5) glass-ceramics used for dental prosthesis and to analyze the influence of heat treatment on the transformation of lithium metasilicate (Li2SiO3) into lithium disilicate. The three-ball test for the biaxial flexion test (B3B) was used. Weibull statistical analysis was used, and it showed that samples with a higher percentage of zirconia have a greater tendency to fail. The flexion tests showed that the addition of more than 10% of zirconia reduced the flexural strength. The heat treatment process improves and provides greater mechanical strength. The XRD results indicated that the samples with the lowest percentage of zirconia exhibited greater crystallinity and corroborated the microstructural analysis. SEM analyses showed a greater amount and elongated crystals of lithium disilicate when comparing samples with a higher percentage of zirconia. Therefore, samples with lower zirconia showed greater flexural strength than samples with higher additions of zirconia.