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

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

Morbidity trend and space-time clusters of COVID-19 occurrence in children and adolescents.

OBJECTIVE: To analyze the morbidity trend and space-time distribution clusters of confirmed COVID-19 cases in children and adolescents. METHOD: An ecological study of COVID-19 cases confirmed in the Information System from 2020 to 2022 in the age group from 0 to 19 years old, residents in Mato Grosso municipalities, Brazilian Midwest region. A trend analysis of the monthly morbidity rate of cases/100,000 inhabitants was used, following Prais-Winsten's regression. A space-time distribution of the Bayesian incidence rate per 100,000 inhabitants was performed, in addition to a space-time scan to identify high-risk clusters. RESULTS: Of all 79,592 COVID-19 cases studied, 51.6% were in females and 44.21% in people aged 15-19 years old. The mean monthly rate was 265.87 cases per 100,000 inhabitants, with a stationary trend in the period analyzed (Monthly Percentage Variation [MPV]) = 12.15; CI95%[MPV]: -0.73;26.70). The morbidity rate due to COVID-19 was higher in the female gender (283.14/100,000 inhabitants) and in the age group from 15 to 19 years old (485.90/100,000 inhabitants). An increasing trend was observed with a greater monthly time variation of 14.42% (CI95%[MPV]: 1.28;29.28)] among those aged from 10 to 14 years old. The primary cluster, which was also the one with the highest Relative Risk (RR = 5,16, p-value = 0.001), included 19 municipalities located in the North health macro-region. CONCLUSION: The findings indicated a monthly stationary trend in the study population, an increase in the age group from 10 to 14 years old, and areas at a higher risk for the disease in the North health macro-region of the state.

Direct costs of treating men with prostate cancer with High Intensity Focused Ultrasound.

OBJECTIVE: To analyze the direct costs of materials, medicines/solutions and healthcare professionals required to treat men with prostate cancer using High Intensity Focused Ultrasound. METHOD: Quantitative, exploratory-descriptive research, single case study type. Data were collected from electronic medical records/printed documentation from the Operating Room of a public teaching and research hospital. Health professionals estimated the respective time spent on activities in the following stages: "Before anesthetic induction", "Before performing thermal ablation", "During thermal ablation" and "After performing thermal ablation". Costs were calculated by multiplying the (estimated) time spent by the unit cost of direct labor, adding to the measured cost of materials, medicines/solutions. RESULTS: The measured costs with materials corresponded to US$851.58 (SD = 2.17), with medicines/solutions to US$72.13 (SD = 25.84), and estimated personnel costs to US$196.03, totaling US$1119.74/procedure. CONCLUSION: The economic results obtained may support hospital managers in the decision-making process regarding the adoption of the High Intensity Focused Ultrasound for the treatment of prostate cancer.

Effect of Support Matrix and Crosslinking Agents on Nutritional Properties of Orange Juice during Enzyme Clarification: A Comparative Study.

This study investigated the impact of a support matrix and active group on the support to the nutritional properties of orange juice after juice clarification. Pectinase was immobilized on chitosan and aminated silica supports, activated with genipin or glutaraldehyde, and applied for juice clarification. The effects on various juice properties, including reducing sugars, total soluble solids, vitamin C, and phenolic compounds, juice color, and pH, were evaluated. The results revealed that the immobilization on chitosan activated using genipin resulted in the highest biocatalyst activity (1211.21 U·g-1). The juice treatments using the biocatalysts led to turbidity reduction in the juice (up to 90%), with the highest reductions observed in treatments involving immobilized enzyme on chitosan. Importantly, the enzymatic treatments preserved the natural sugar content, total soluble solids, and pH of the juice. Color differences between treated and raw juice samples were especially relevant for those treated using enzymes, with significant differences in L* and b*, showing loss of yellow vivid color. Analysis of phenolic compounds and vitamin C showed no significant alterations after the enzymatic treatment of the raw juice. According to our results, the clarification of orange juice using immobilized enzymes can be a compromise in turbidity reduction and color reduction to maintain juice quality.

"Prevalence of middle crossed syndrome in young healthy individuals from a health science university in India".

BACKGROUND: A myofascial sling is a chain of anatomically interconnected muscles. Anatomical slings work by transferring forces between upper and lower limbs while maintaining a steady core. Middle Crossed Syndrome refers to an imbalance in the transverse plane musculature through sling systems of the trunk; often associated with laterality patterns. OBJECTIVE: The primary objective of this study was to find the prevalence of Middle Crossed Syndrome(MCS) and secondary objective was to find an association of MCS with leg dominance in young healthy individuals. METHODS: This observational study, included 382 participants aged 19-26 years. The participants were screened for presence of Middle Crossed Syndrome using Supine Lateral Ball Roll Test, Active Straight Leg Raise and Gait Parameters (step length, stride length, degree of toe out, cadence, base of support). RESULTS: The results were obtained by statistical analysis using Chi-square test for prevalence of MCS in young healthy individuals with respect to age groups, gender and leg dominance. Of the total 382 screened, 25 (69.37%) were positive either unilaterally or bilaterally for MCS. CONCLUSION: The study concluded that over half of the participants clinically tested positive for MCS with no correltion of MCS with leg dominance.

Impact of plasma-activated water on the supramolecular structure and functionality of small and large starch granules.

Hydrothermal (HMT) and water agitation (WA) treatments using plasma-activated water (PAW) were employed as sustainable methods to modify the molecular and functional performance of small (rice) and large (potato) starch granules. HMT-PAW and WA-PAW treatments resulted in etched and damaged granular surfaces that rearranged the long and short-range crystallinity of the modified starches. Both treatments seemed to predominantly occur in the amorphous region of the rice starch and the crystalline regions of the potato starch, changing the crystallinity values from 22.9 and 14.8 % to 31.8 and 10.4 %, respectively. Thus, the level of the arrangement of chains reached after PAW treatment decreased the ability of rice starch granules to swell (16 to 9 %) and leach out starch molecules from the granules (4.5 to 1.3 %), decreasing the viscosity and pasting profiles as indicated by n and k values. Opposite behavior was observed in the modified potato starches since starch components leached out to a higher extent (1.7 to 5.4 %). The results showed that HMT and WA treatments using PAW are feasible eco-friendly methods for modifying starch granules without chemical reagents. These modified starches could be suitable as functional ingredients or biopolymeric matrices for the food and packaging industry.

Interaction between starch and dietary compounds: New findings and perspectives to produce functional foods.

Due to the increased prevalence of overweight, obesity, diabetes, colon cancer, cardiovascular diseases, and metabolic syndrome, dietary approaches to reduce starch digestion and regulate glucose homeostasis have gained attention. Starch is a polysaccharide in most daily food consumed as bakery products, snacks, breakfast cereals, and pasta, which are often vilified. However, it is also present in beans, lentils, and oatmeal, which are considered healthy food products. The difference relays on the food matrix and the thermal process that can produce interactions between starch and dietary compounds (protein, lipid, non-starch polysaccharide, and bioactive compounds) or among starch chains (retrogradation). Such interactions produce structural changes so the digestive enzymes cannot hydrolyze them; additionally, the physical barrier of some macromolecules (proteins, hydrocolloids) restricts starch gelatinization and accessibility of the digestive enzymes to hydrolyze the starch. The interactions mentioned above and the use of some macromolecules as physical barriers could be explored as a pathway to develop functional foods. This review analyzes the interactions between starch and dietary compounds influenced by the processing of some food matrices to better understand their potential for developing functional foods.

A bvrR/bvrS Non-Polar Brucella abortus Mutant Confirms the Role of the Two-Component System BvrR/BvrS in Virulence and Membrane Integrity.

Brucella abortus is a bacterial pathogen causing bovine brucellosis worldwide. This facultative extracellular-intracellular pathogen can be transmitted to humans, leading to a zoonotic disease. The disease remains a public health concern, particularly in regions where livestock farming is present. The two-component regulatory system BvrR/BvrS was described by isolating the attenuated transposition mutants bvrR::Tn5 and bvrS::Tn5, whose characterization led to the understanding of the role of the system in bacterial survival. However, a phenotypic comparison with deletion mutants has not been performed because their construction has been unsuccessful in brucellae and difficult in phylogenetically related Rhizobiales with BvrR/BvrS orthologs. Here, we used an unmarked gene excision strategy to generate a B. abortus mutant strain lacking both genes, called B. abortus ∆bvrRS. The deletion was verified through PCR, Southern blot, Western blot, Sanger sequencing, and whole-genome sequencing, confirming a clean mutation without further alterations at the genome level. B. abortus ∆bvrRS shared attenuated phenotypic traits with both transposition mutants, confirming the role of BvrR/BvrS in pathogenesis and membrane integrity. This B. abortus ∆bvrRS with a non-antimicrobial marker is an excellent tool for continuing studies on the role of BvrR/BvrS in the B. abortus lifestyle.

If You're Not Confused, You're Not Paying Attention: Ochrobactrum Is Not Brucella.

Bacteria of the genus Brucella are facultative intracellular parasites that cause brucellosis, a severe animal and human disease. Recently, a group of taxonomists merged the brucellae with the primarily free-living, phylogenetically related Ochrobactrum spp. in the genus Brucella. This change, founded only on global genomic analysis and the fortuitous isolation of some opportunistic Ochrobactrum spp. from medically compromised patients, has been automatically included in culture collections and databases. We argue that clinical and environmental microbiologists should not accept this nomenclature, and we advise against its use because (i) it was presented without in-depth phylogenetic analyses and did not consider alternative taxonomic solutions; (ii) it was launched without the input of experts in brucellosis or Ochrobactrum; (iii) it applies a non-consensus genus concept that disregards taxonomically relevant differences in structure, physiology, population structure, core-pangenome assemblies, genome structure, genomic traits, clinical features, treatment, prevention, diagnosis, genus description rules, and, above all, pathogenicity; and (iv) placing these two bacterial groups in the same genus creates risks for veterinarians, medical doctors, clinical laboratories, health authorities, and legislators who deal with brucellosis, a disease that is particularly relevant in low- and middle-income countries. Based on all this information, we urge microbiologists, bacterial collections, genomic databases, journals, and public health boards to keep the Brucella and Ochrobactrum genera separate to avoid further bewilderment and harm.

Phenotypes controlled by the Brucella abortus two component system BvrR/BvrS are differentially impacted by BvrR phosphorylation.

Brucella abortus is a zoonotic pathogen whose virulence depends on its ability to survive intracellularly at the endoplasmic reticulum derived compartment. The two-component system BvrR/BvrS (BvrRS) is essential for intracellular survival due to the transcriptional control of the type IV secretion system VirB and its transcriptional regulator VjbR. It is a master regulator of several traits including membrane homeostasis by controlling gene expression of membrane components, such as Omp25. BvrR phosphorylation is related to DNA binding at target regions, thereby repressing or activating gene transcription. To understand the role of BvrR phosphorylation we generated dominant positive and negative versions of this response regulator, mimicking phosphorylated and non-phosphorylated BvrR states and, in addition to the wild-type version, these variants were introduced in a BvrR negative background. We then characterized BvrRS-controlled phenotypes and assessed the expression of proteins regulated by the system. We found two regulatory patterns exerted by BvrR. The first pattern was represented by resistance to polymyxin and expression of Omp25 (membrane conformation) which were restored to normal levels by the dominant positive and the wild-type version, but not the dominant negative BvrR. The second pattern was represented by intracellular survival and expression of VjbR and VirB (virulence) which were, again, complemented by the wild-type and the dominant positive variants of BvrR but were also significantly restored by complementation with the dominant negative BvrR. These results indicate a differential transcriptional response of the genes controlled to the phosphorylation status of BvrR and suggest that unphosphorylated BvrR binds and impacts the expression of a subset of genes. We confirmed this hypothesis by showing that the dominant negative BvrR did not interact with the omp25 promoter whereas it could interact with vjbR promoter. Furthermore, a global transcriptional analysis revealed that a subset of genes responds to the presence of the dominant negative BvrR. Thus, BvrR possesses diverse strategies to exert transcriptional control on the genes it regulates and, consequently, impacting on the phenotypes controlled by this response regulator.

Experimental model of nephropathy associated with diabetes mellitus in mice.

PURPOSE: Nontransmissible chronic diseases, such as diabetes mellitus (DM) and nephropathy, affect a significant portion of the population, often treated due to injuries that require healing and regeneration. To create an experimental model of associated comorbidities, for healing and regeneration studies, protocols for induction of nephropathy by ischemia and reperfusion (I/R) and induction of DM by injection of streptozotocin (STZ) were associated. METHODS: Sixty-four mice (Mus musculus), female, adult, Swiss strain, weighing approximately 20 g, were divided into four groups: G1: control (n = 24), G2: nephropathy group (N) (n = 7), G3, DM (n = 9), and G4: N+DM (n = 24). Arteriovenous stenosis (I/R) of the left kidney was performed as the first protocol. The animals received a hyperlipidemic diet for 7 days after the injection of STZ (150 mg/kg, via i.p.) and an aqueous glucose solution (10%) for 24 h. The animals in the G3 and G4 groups were observed for 14 days before receiving the diet and STZ. The evolution of nephropathy was observed using a urine test strip and the DM, through the analysis of blood glucose with a reagent strip on a digital monitor. RESULTS: The ischemic induction protocols of nephropathy and DM with STZ, associated, were sustainable, low-cost, and without deaths. There were alterations compatible with initial renal alterations, in the first 14 days, such as increased urinary density, pH alteration, presence of glucose, proteins and leukocytes, when compared to the control group. DM was confirmed by the presence of hyperglycemia 7 days after induction and its evolution after 14 days. The animals in the G4 group showed constant weight loss when compared to the other groups. It was possible to observe morphological alterations in the kidneys submitted to I/R, regarding coloration, during surgery and after the end of the observation period, in the volume and size of the left kidney, when compared to the contralateral kidney. CONCLUSIONS: It was possible to induce nephropathy and DM associated in the same animal, in a simple way, confirmed with rapid tests, without losses, providing a basis for future studies.

Effect of retrograded starch with different amylose content on the rheological properties of stored yogurt.

Resistant starch (RS) promotes health benefits; however, when added to foods, it could change the rheological properties. The effect of adding different concentrations (2.5, 5, 7.5, and 10%) of retrograded corn starch with 27% (RNS) or 70% (RHS) amylose content on the properties of yogurt was evaluated through measurements of flow behavior and gel structure. Syneresis and resistant starch content were also assessed. Results were analyzed using multiple regression to describe the effect of starch concentration and storage time on the properties of yogurt added with RNS or RHS. Syneresis was reduced, RNS reinforced the structure increasing the water absorption capacity and the consistency index; meanwhile, RHS provided a yogurt containing up to 10 g of RS in 100 g of sample, allowing obtaining a functional dairy product. Creep-recovery test showed that adding RNS or RHS favored the matrix conformation, and the yogurt samples were able to recover. The final product behaved like a solid material with a firmer and more stable gel structure, resulting in a strengthened gel without weakening the yogurt structure, showing a characteristic like Greek-style or stirred yogurt depending on the type and concentration of retrograded starch. Supplementary Information: The online version contains supplementary material available at 10.1007/s13197-023-05735-x.

Reabilitação estética e funcional com resina composta após trauma dentário: relato de caso / Aesthetic and functional rehabilitation with composite resin after dental trauma: case report

As lesões dentárias traumáticas são um problema de saúde pública mundial, dentre as quais a fratura dentária é a de maior ocorrência, envolvendo principalmente os dentes anteriores. A abordagem de grandes fraturas anteriores é um desafio para cirurgiões dentistas de qualquer nível pois, além da função, afetam diretamente a estética do paciente, fazendo-se necessário um planejamento que envolva diferentes especialidades na odontologia. Objetivo: Relatar um caso clínico de reabilitação funcional e estética de fratura dentária nos incisivos centrais superiores envolvendo tratamento endodôntico, instalação de pino de fibra de vidro e restauração direta em resina composta. Relato de Caso: O paciente de 17 anos sofreu fratura nos incisivos centrais superiores causada por uma queda de bicicleta. Devido à busca tardia por tratamento o elemento 21 foi diagnosticado com necrose pulpar e, portanto, foi submetido à tratamento endodôntico pela Técnica Crown Down e reabilitação com pino de fibra de vidro Splendor-SAP. Posteriormente, os elementos 11 e 21 foram restaurados com facetas diretas em resina composta pela técnica incremental. Conclusão: A reabilitação com instalação de pino de fibra de vidro associada à técnica de estratificação incremental em resina composta se mostra como uma boa opção para reabilitação estética pois permite dar forma anatômica ao dente com riqueza de detalhes na estratificação da dentina e esmalte, além de máxima preservação da estrutura dental. Os resultados obtidos reforçam o sucesso estético e funcional com significativo impacto na qualidade de vida do paciente(AU)

Traumatic dental injuries are a worldwide public health problem, among which dental fractures are the most frequent, mainly involving the anterior teeth. The approach of large anterior fractures is a challenge for dental surgeons of any level because, in addition to function, they directly affect the patient's esthetics, requiring a plan that involves different specialties in dentistry. Objective: Report a clinical case of functional and aesthetic rehabilitation of dental fractures in maxillary central incisors involving endodontic treatment, installation of a fiberglass post and direct restoration in composite resin. Case Report: The 17-year-old patient suffered a fracture in the upper central incisors caused by a fall from a bicycle. Due to the late search for treatment, element 21 was diagnosed with pulp necrosis and, therefore, underwent endodontic treatment using the Crown Down Technique and rehabilitation with a Splendor-SAP fiberglass pin. Later, elements 11 and 21 were restored with direct veneers in composite resin using the incremental technique. Conclusion: Rehabilitation with the installation of a fiberglass post associated with the incremental layering technique in composite resin is a good option for aesthetic rehabilitation as it allows the anatomical shape of the tooth with rich details in the layering of dentin and enamel, in addition to maximum preservation of the tooth structure. The results obtained reinforce the aesthetic and functional success with a significant impact on the patient's quality of life(AU)

Elucidating dynamic anaerobe metabolism with HRMAS 13C NMR and genome-scale modeling.

Anaerobic microbial metabolism drives critical functions within global ecosystems, host-microbiota interactions, and industrial applications, yet remains ill-defined. Here we advance a versatile approach to elaborate cellular metabolism in obligate anaerobes using the pathogen Clostridioides difficile, an amino acid and carbohydrate-fermenting Clostridia. High-resolution magic angle spinning nuclear magnetic resonance (NMR) spectroscopy of C. difficile, grown with fermentable 13C substrates, informed dynamic flux balance analysis (dFBA) of the pathogen's genome-scale metabolism. Analyses identified dynamic recruitment of oxidative and supporting reductive pathways, with integration of high-flux amino acid and glycolytic metabolism at alanine's biosynthesis to support efficient energy generation, nitrogen handling and biomass generation. Model predictions informed an approach leveraging the sensitivity of 13C NMR spectroscopy to simultaneously track cellular carbon and nitrogen flow from [U-13C]glucose and [15N]leucine, confirming the formation of [13C,15N]alanine. Findings identify metabolic strategies used by C. difficile to support its rapid colonization and expansion in gut ecosystems.

Sodium Tungstate (NaW) Decreases Reactive Oxygen Species (ROS) Production in Cells: New Cellular Antioxidant.

Diabetic nephropathy (DN) is the leading cause of end-stage renal failure worldwide. Hyperglycemia generates reactive oxygen species (ROS), contributing to diabetic complications, especially in DN. Sodium Tungstate (NaW) is an effective antidiabetic agent for short and long-term treatments of both type 1 and type 2 diabetes models. In this study, we evaluated the effect of NaW on ROS production in bovine neutrophils incubated with platelet-activating factor (PAF) and in HK-2 cells induced by high glucose or H2O2. In addition, we evaluated the effect on iNOS expression in the type 1 diabetic rat model induced with streptozotocin (STZ). NaW inhibited ROS production in PAF-induced bovine neutrophils, and human tubular cells (HK-2) were incubated in high glucose or H2O2. In addition, NaW inhibited iNOS expression in glomeruli and tubular cells in the type 1 diabetic rat. This study demonstrates a new role for NaW as an active antioxidant and its potential use in treating DN.

Comparative effect of progressive relaxation technique and Benson's technique on anxiety and fatigue in cancer survivors - an experimental study.

BACKGROUND AND PURPOSE: Anxiety and fatigue is a common symptom that is seen in cancer survivors, who have recently been diagnosed as well as those who are undergoing chemotherapy and radiation therapy as they are emotionally distressed. Progressive relaxation technique and Benson's relaxation is seen to be efficacious in lowering anxiety and fatigue in cancer survivors as individual treatment. To compare the depiction of progressive relaxation technique and Benson's technique on anxiety using Hamilton anxiety scale (HAM-A), blood pressure (BP) and heart rate (HR), and fatigue using cancer fatigue scale (CFS). MATERIALS AND METHODS: A randomized clinical trial (chit method) was carried out on 42 subjects with cancer related anxiety and fatigue. Subjects were randomly allotted to Group A and Group B. Group A was administered Progressive relaxation technique. Group B was administered Benson's technique. Primary outcome measures used were Hamilton Anxiety Scale and Cancer fatigue scale, secondary outcome measures were HR and BP. Outcomes were evaluated at baseline, immediate and after 5 days of the treatment. RESULTS: The results were analyzed using independent t test for comparing the 2 groups. On comparing group, A and B for baseline to immediate and baseline to after 5 days, using HAM-A, BP, HR, CFS, no statistical significance was found. Whereas within group analysis (within group A and B) showed significant reduction in anxiety and fatigue in cancer survivors, with a P value significant at <0.05 as seen from baseline to immediate and baseline to 5 days, with 0.7 effect size. CONCLUSION: The study concludes that both Progressive relaxation technique and Benson's technique are equally effective in reducing anxiety and PRT lowers fatigue more effectively than Benson's technique in cancer survivors.

Temporomandibular disorders: knowledge, competency, and attitudes of predoctoral dental students.

OBJECTIVE: To evaluate knowledge, competency, and attitudes related to temporomandibular disorders (TMD) among predoctoral dental students, and to investigate the curricular organization of contents related to TMD and occlusion. METHODS: Predoctoral dental students (n = 147) answered a questionnaire with topics related to TMD. Another questionnaire evaluated the organization of TMD and occlusion courses. RESULTS: Contents related to TMD and occlusion were taught in the same course in all dental schools. The students' responses showed low agreement with the current gold standards pertaining to TMD. Most students declared that they did not feel confident to treat patients with TMD (62.6%), were not satisfied with the content pertaining to TMD (55.8%), and considered a lack of clinical practice to be the primary limitation in their training (59.2%). DISCUSSION: Students' knowledge of basic concepts related to TMD was limited, highlighting the need for readjustment of the dental curriculum to increase clinical experience.