Quality Standards in Upper Gastrointestinal Endoscopy: Can Deep Sedation Influence It?

Introduction: According to the guideline published by ESGE/UEG, a high-quality esophagogastroduodenoscopy (EGD) implies the application of some criteria that enable better healthcare outcomes. Although intra-procedural performance measures are dependent on patient factors, there is no reference to sedation practices in the guideline mentioned above. Objective: This study aimed to evaluate whether deep sedation influences EGD performance measures established by ESGE/UEG. Methods: This was a cross-sectional study, with a prospective enrollment, that considered for inclusion consecutive patients referred for EGD. Two questionnaires were used to assess performance measures and patient satisfaction after EGD. Results: Sedation had a statistically significant impact on most quality indicators, including complete examination (77.2% without sedation vs. 97.8% with sedation), inspection time (6.17 ± 3.45 vs. 8.39 ± 2.67 min), photodocumentation (78% vs. 97.8%), biopsies (39.3% vs. 60.7%), and patient satisfaction (5.42 ± 2.93 vs. 9.1 ± 1.19). The main reason for an incomplete procedure was patient intolerance (82.6%). Discussion: Deep sedation of patients submitted to EGD proved to be a determinant in the applicability of the ESGE/UEG quality indicators. Patient intolerance was eliminated in the group with sedation, enhancing procedure completeness, adequate pathology identification, management, and consequently, the effectiveness of the exam. Conclusion: Sedation administration should be considered in patients undergoing EGD since it ensures a high-quality procedure.

Introdução: Uma endoscopia digestiva alta (EDA) de qualidade proporciona melhores resultados em termos de saúde e implica a aplicação dos critérios descritos pelas recomendações da ESGE/UEG. Embora os critérios perprocedimento sejam dependentes da colaboração e tolerância do doente, não está explicito o papel da anestesia. Objetivos: Este estudo pretende avaliar se o recurso a anestesia influencia o cumprimento dos critérios de qualidade para a EDA publicados pela ESGE/UEG. Materiais e métodos: Estudo transversal, com recrutamento prospetivo, que incluiu pacientes consecutivamente encaminhados para realização de EDA. Foram utilizados 2 questionários para avaliar medidas de desempenho e satisfação dos pacientes após realização de EDA. Resultados: A anestesia teve um impacto estatisticamente significativo na maioria dos indicadores de qualidade: exame completo (77,2% sem anestesia vs. 97,8% com anestesia); tempo de inspeção (6,17 ± 3,45 vs. 8,39 ± 2,67 minutos); fotodocumentação (78% vs. 97,8%); biópsias (39,3% vs. 60,7%); satisfação do paciente (5,42 ± 2,93 vs. 9,1 ± 1,19). O principal motivo para um procedimento incompleto foi a intolerância do paciente (82,6%). Discussão: A sedação profunda dos doentes submetidos a EDA provou ser determinante na aplicabilidade dos critérios de qualidade da ESGE/UEG. Eliminando por completo a intolerância por parte do doente, proporcionou a realização de exames completos, com correta identificação e gestão de patologias, potenciando assim a efetividade do exame. Conclusão: A administração de anestesia deve ser ponderada, sempre que possível, nos doentes submetidos a EDA, visto que permite garantir a alta qualidade do procedimento.

Spatio-temporal dynamics of early somite segmentation in the chicken embryo.

During vertebrate embryo development, the body is progressively segmented along the anterior-posterior (A-P) axis early in development. The rate of somite formation is controlled by the somitogenesis embryo clock (EC), which was first described as gene expression oscillations of hairy1 (hes4) in the presomitic mesoderm of chick embryos with 15-20 somites. Here, the EC displays the same periodicity as somite formation, 90 min, whereas the posterior-most somites (44-52) only arise every 150 minutes, matched by a corresponding slower pace of the EC. Evidence suggests that the rostral-most somites are formed faster, however, their periodicity and the EC expression dynamics in these early stages are unknown. In this study, we used time-lapse imaging of chicken embryos from primitive streak to somitogenesis stages with high temporal resolution (3-minute intervals). We measured the length between the anterior-most and the last formed somitic clefts in each captured frame and developed a simple algorithm to automatically infer both the length and time of formation of each somite. We found that the occipital somites (up to somite 5) form at an average rate of 75 minutes, while somites 6 onwards are formed approximately every 90 minutes. We also assessed the expression dynamics of hairy1 using half-embryo explants cultured for different periods of time. This showed that EC hairy1 expression is highly dynamic prior to somitogenesis and assumes a clear oscillatory behaviour as the first somites are formed. Importantly, using ex ovo culture and live-imaging techniques, we showed that the hairy1 expression pattern recapitulates with the formation of each new pair of somites, indicating that somite segmentation is coupled with EC oscillations since the onset of somitogenesis.

Polifarmácia, medicamentos potencialmente inapropriados e a vulnerabilidade de pessoas idosas / Polypharmacy, potentially inappropriate medications, and the vulnerability of older adults

Resumo Objetivo Analisar a frequência de polifarmácia e prescrição de medicamentos potencialmente inapropriados (MPI) segundo os Critérios de Beers e CBMPI em pessoas idosas com vulnerabilidade clínico-funcional. Método Trata-se de um estudo transversal onde analisou-se os prontuários de 496 participantes com 60 anos ou mais, atendidos em primeira consulta em uma Policlínica Gerontológica. Os dados sociodemográficos, medicamentos, e o Índice de Vulnerabilidade Clínico Funcional 20 (IVCF-20) e quedas foram extraídos dos prontuários. A polifarmácia foi definida como o uso simultâneo de cinco ou mais medicamentos. Os participantes foram classificados em três grupos: robusto, em risco e vulnerável. Resultados A análise demonstrou que 69 (13,91%) dos participantes faziam uso de polifarmácia. Entre os usuários de polifarmácia, 40 (57,97%) faziam uso de pelo menos um MPI. Os MPIs mais encontrados foram a glibenclamida e o omeprazol, respectivamente. Pessoas idosas com vulnerabilidade apresentaram um risco três vezes maior de apresentar polifarmácia (RP 3,59; IC95% 2,109-6,092). Conclusão O uso de polifarmácia e MPI neste estudo estavam associados à vulnerabilidade da pessoa idosa, reforçando a necessidade de avaliação criteriosa de prescrições medicamentosas para essa população.

Abstract Objective To analyze the frequency of polypharmacy and the prescription of Potentially Inappropriate Medications (PIM) according to the Beers Criteria and CBMPI in older adults with clinical-functional vulnerability. Method This is a cross-sectional study where the medical records of 496 participants aged 60 and older, seen in their first appointment at a Gerontological Polyclinic, were analyzed. Sociodemographic data, medications, the Clinical-Functional Vulnerability Index-20 (IVCF-20), and falls were extracted from the medical records. Polypharmacy was defined as the simultaneous use of five or more medications. Participants were classified into three groups: robust, at risk, and vulnerable. Results The analysis revealed that 69 (13.91%) participants were using polypharmacy. Among polypharmacy users, 40 (57.97%) were using at least one PIM. The most commonly found PIM were glibenclamide and omeprazole, respectively. Older adults with vulnerability were three times more likely to have polypharmacy (OR 3.59; 95% CI 2.109-6.092). Conclusion The use of polypharmacy and PIM in this study was associated with the vulnerability of older adults, emphasizing the need for a thorough evaluation of medication prescriptions for this population.

Cuidado ao Paciente Oncológico na Perspectiva da Oncologia Integrativa / Care for Cancer Patients from the Perspective of Integrative Oncology / Atención al Paciente Oncológico desde la Perspectiva de la Oncología Integrativa

Introdução: A oncologia integrativa é um campo recente e promissor que visa ao cuidado integral centrado no paciente, com uma abordagem baseada em evidências. Objetivo: Verificar o conhecimento científico produzido sobre a oncologia integrativa na atenção hospitalar. Método: Revisão integrativa com buscas nas bases de dados PubMed, LILACS, SciELO e MOSAICO, realizadas de fevereiro a março de 2022. A partir dos critérios de elegibilidade (estudos referentes ao tema publicados de 2000 a 2022, disponíveis na íntegra no acesso público, nos idiomas inglês, português e espanhol), foram selecionados sete artigos, analisados de acordo com a modalidade temática. Resultados: Os artigos elegíveis foram publicados entre 2018 e 2021, com destaque para a produção europeia, que corresponde a quatro (57,14%) artigos. O conteúdo dos estudos foi organizado em dois temas: a implementação de cuidados de oncologia integrativa e o acesso equitativo à oncologia integrativa e outros desafios. Foi observado que a oncologia integrativa tem sido praticada em diferentes cenários, com variadas ações realizadas, e tem como desafio central a ampliação do acesso ao usuário, por meio do desenvolvimento de diretrizes baseadas em evidências e da implementação de políticas de financiamento e qualificação profissional. Conclusão: O conhecimento científico produzido aponta que a implementação de cuidados de oncologia integrativa na atenção hospitalar ainda é limitada, com desafios relacionados ao acesso equitativo, ao financiamento, à gestão e à qualificação dos profissionais de saúde

Introduction: Integrative oncology is a recent and promising field, which aims a patient-centered comprehensive care, within an evidence-based approach. Objective: To investigate the scientific knowledge produced on integrative oncology in hospital care. Method: Integrative review with searches in PubMed, LILACS, SciELO and MOSAICO databases carried out from February to March 2022. Based in the eligibility criteria (studies related to the subject published from 2000 to 2022, available in full by public access, in English, Portuguese and Spanish) seven articles were selected and analyzed according to the thematic modality. Results: The eligible articles were published between 2018 and 2021, with emphasis on European production, which corresponds to four (57.14%) articles. The content of the studies was organized in two themes, namely: the implementation of integrative oncology care and the equitable access to integrative oncology and other challenges. It has been observed that integrative oncology has been practiced in different scenarios, with variable actions taken, and its central challenge is to expand the user access, through the development of evidence-based guidelines and the implementation of funding and professional qualification policies. Conclusion: The scientific knowledge produced indicates that the implementation of integrative oncology care in hospital attention is still limited, with challenges related to equitable access, funding, management and qualification of health professionals

Introducción: La oncología integrativa es un campo reciente y prometedor, que apunta a la atención integral centrada en el paciente, en un enfoque basado en la evidencia. Objetivo: Verificar el conocimiento científico producido sobre oncología integrativa en la atención hospitalaria. Método: Revisión integrativa con búsquedas en las bases de datos PubMed, LILACS, SciELO y MOSAICO, realizada de febrero a marzo de 2022. A partir de los criterios de elegibilidad (estudios relacionados con el tema publicados entre 2000 y 2022, disponibles en su totalidad para acceso público, en inglés, portugués y español) fueron seleccionados siete artículos, analizados según la modalidad temática. Resultados: Los artículos elegidos fueron publicados entre 2018 y 2021, con énfasis en la producción europea, lo que corresponde a cuatro (57,14%) artículos. El contenido de los estudios se organizó en dos temas, a saber: la implementación de la atención oncológica integradora y el acceso equitativo a la oncología integradora y otros desafíos. Se ha observado que la oncología integrativa se ha practicado en diferentes escenarios, con acciones variables, y su desafío central es ampliar el acceso de los usuarios, a través del desarrollo de pautas basadas en evidencia y la implementación de políticas de financiamiento y calificación profesional. Conclusión: El conocimiento científico producido apunta que la implementación de la atención oncológica integrativa en la atención hospitalaria aún es limitada, con desafíos relacionados con el acceso equitativo, el financiamiento, la gestión y la calificación de los profesionales de la salud

Caracterização da mortalidade materna em uma região de saúde do interior de minas gerais / Caracterización de la mortalidad materna en una región de salud del interior de minas gerais / Characterization of maternal mortality in a health region of inland minas gerais

Objetivo: realizar um levantamento do perfil epidemiológico, assistencial e causal da mortalidade materna nos municípios de abrangência geográfica de uma Superintendência Regional de Saúde localizada no interior de Minas Gerais no período de 2004 a 2018. Método: estudo epidemiológico observacional descritivo, quantitativo, com análise de dados obtidos do Departamento de Informática do Sistema Único de Saúde, Declarações de Óbito e Fichas de Investigação de Óbitos Maternos. Resultados: dos 19 óbitos maternos analisados, 8 (42,10%) eram de mulheres de 20 a 29 anos, brancas, casadas, com 8 a 11 anos de estudo. Os óbitos ocorreram em instituições hospitalares (100,00%), destacando-se morte materna obstétrica direta (89,47%) com embolia obstétrica como causa (21,05%). Conclusão: as mortes maternas estudadas estão mais relacionadas à qualidade e acesso integral aos pontos de cuidados existentes na rede assistencial materno-infantil do que aos aspectos de vulnerabilidades sociais investigados.

Objetivo: realizar un estudio del perfil epidemiológico, asistencial y causal de la mortalidad materna en los municipios de cobertura geográfica de una Superintendencia Regional de Salud localizada en el interior de Minas Gerais en el período de 2004 a 2018. Método: estudio epidemiológico observacional descriptivo, cuantitativo, con análisis de datos obtenidos del Departamento de Informática del Sistema Único de Salud, Declaraciones de Óbito y Fichas de Investigación de Óbitos Maternos. Resultados: de los 19 óbitos maternos analizados, 8 (42,10%) eran de mujeres de 20 a 29 años, blancas, casadas, con 8 a 11 años de estudio. Los óbitos ocurrieron en instituciones hospitalarias (100,00%), destacándose muerte materna obstétrica directa (89,47%) con embolia obstétrica como causa (21,05%). Conclusión: las muertes maternas estudiadas están más relacionadas a la calidad y acceso integral a los puntos de atención existentes en la red asistencial materno-infantil que a los aspectos de vulnerabilidades sociales investigados.

Objective: to conduct a survey of the epidemiological, care and causal profile of maternal mortality in the cities of geographical coverage of a Regional Health Superintendence located in inland Minas Gerais in the period from 2004 to 2018. Method: descriptive, quantitative observational epidemiological study with data analysis obtained from the Department of Informatics of the Unified Health System, Death Certificates and Maternal Death Investigation Forms. Results: of the 19 maternal deaths analyzed, 8 (42.10%) were women aged 20 to 29 years, white, married, with 8 to 11 years of schooling. Deaths occurred in hospital institutions (100.00%), highlighting direct obstetric maternal death (89.47%) with obstetric embolism as the cause (21.05%). Conclusion: the maternal deaths studied are more related to quality and full access to existing points of care in the maternal-child care network than to the aspects of social vulnerabilities investigated.

Facetas de desgaste por atrição em criancas brasileiras e má oclusão: um estudo trasnversal / Attribution wear facets in brazilian children and malocclusion: a transversal study / Hechos de gasto de atracción en niños brasileños y mal occusión: un estudio trasnversal

O objetivo do estudo foi avaliar a associação entre facetas de desgaste por atrição e má oclusão em escolares brasileiros. Este estudo transversal realizado com 433 escolares de 8 a 10 anos, junto a seus pais/responsáveis, das redes pública e privada na cidade de Diamantina. Informações sobre sociodemográfico da família da criança e saúde geral da criança foram colhidos a partir de um questionário previamente estruturado, direcionado aos pais/cuidadores. Foram realizados exame intrabucal em cada criança para avalição da presença de facetas de desgaste por atrição, perda de tecido dentário por erosão, ausência/presença de má oclusão e traumatismo dentário. Os resultados foram obtidos a partir da análise descritiva de frequência absoluta e relativa dos dados e analise de Regressão de Poisson (IC 95%; p<0,05). Os resultados mostraram uma prevalência de crianças com facetas de desgaste de 73,7%, a sobressaliência anterior superior (RP= 1,16; IC: 95%; 1,03-1,31; p= 0,014) e a relação molar (RP=1,15; IC 95%: 1,00­1,29; p=0,030) associadas a presença de facetas de desgastes por atrição, e o apinhamento dentário (RP: 0,87; IC: 95%; 0,78-0,98; P= 0,023) um fator de proteção para a facetas de desgaste em escolares, independentemente do sexo e idade da criança. Os resultados do presente mostraram que a alta prevalência de facetas de desgaste, sendo a sobressaliência anterior superior e a relação molar associadas a presença desse desgaste dentário. Dessa forma, os dados sinalizam a necessidade dos cirurgiões-dentistas estarem atentos a presença de desgaste fora dos padrões fisiológicos e relacionados a presença de má-oclusão.

The aim of the study was to evaluate the association between attrition wear facets and malocclusion in Brazilian schoolchildren. This cross-sectional study was carried out with 433 schoolchildren aged 8 to 10 years, along with their parents/guardians, from public and private schools in the city of Diamantina. Information about the child's family sociodemographic and general health was collected from a previously structured questionnaire, directed to parents/caregivers. Intraoral examinations were performed on each child to assess the presence of attrition wear facets, loss of dental tissue by erosion, absence/presence of malocclusion and dental trauma. The results were obtained from the descriptive analysis of absolute and relative frequency of data and Poisson Regression analysis (95% CI; p<0.05). The results showed a prevalence of 73.7% of children with wear facets, superior anterior overjet (PR= 1.16; CI: 95%; 1.03-1.31; p= 0.014) and molar relationship ( PR=1.15; 95% CI: 1.00­1.29; p=0.030) associated with the presence of attrition wear facets, and dental crowding (PR: 0.87; CI: 95%; 0. 78-0.98; P= 0.023) a protective factor for wear facets in schoolchildren, regardless of gender and age of the child. The present results showed that the high prevalence of wear facets, with superior anterior overjet and molar relationship associated with the presence of this tooth wear. Thus, the data indicate the need for dentists to be aware of the presence of wear outside of physiological standards and related to the presence of malocclusion.

objetivo del estudio fue evaluar la asociación entre las facetas del desgaste por atracción y la pobre oclusión en las escuelas brasileñas. Este estudio transversal se llevó a cabo con 433 escuelas de 8 a 10 años de edad, con sus padres/directores, en redes públicas y privadas de la ciudad de Diamantina. La información sobre la sociodemografía familiar del niño y la salud general del niño se recopiló a partir de un cuestionario preestructurado dirigido a los padres y cuidadores. En cada niño se realizó un examen intraabucal para evaluar la presencia de rasgos de desgaste, pérdida de tejido dental por erosión, ausencia/presencia de maloclusión y trauma dental. Los resultados se obtuvieron a partir del análisis descriptivo de la frecuencia absoluta y relativa de los datos y análisis de la regresión de Poisson (IC 95%; p<0,05). Los resultados mostraron una prevalencia de niños con facetas de desgaste del 73,7%, sobresaliencia anterior superior (RP= 1,16; IC del 95%; IC del 1,03-1,31; p= 0,014) y relación molar (RP=1,15; IC del 95%: 1,00-1,29; p=0 030) asociada a la presencia de facetas de fragancia por atracción, y de plomería dental (RP: 0,87; IC: 95%; 0,78-0,98; P= 0,023), un factor de protección para las facetas de desgaste en las escuelas, independientemente del género y la edad del niño. Los resultados de la presente muestra que la alta prevalencia de las facetas desgaste, con la proyección de legado superior y la relación molar asociada con la presencia de este desgaste dental. Así pues, los datos indican la necesidad de que los cirujanos dentales estén alerta ante la presencia de desgaste y desgaste fuera de las normas fisiológicas y relacionados con la presencia de maloclusión.

Synthesis and Cytotoxicity Assessment of Citrate-Coated Calcium and Manganese Ferrite Nanoparticles for Magnetic Hyperthermia.

Calcium-doped manganese ferrite nanoparticles (NPs) are gaining special interest in the biomedical field due to their lower cytotoxicity compared with other ferrites, and the fact that they have improved magnetic properties. Magnetic hyperthermia (MH) is an alternative cancer treatment, in which magnetic nanoparticles promote local heating that can lead to the apoptosis of cancer cells. In this work, manganese/calcium ferrite NPs coated with citrate (CaxMn1-xFe2O4 (x = 0, 0.2, 1), were synthesized by the sol-gel method, followed by calcination, and then characterized regarding their crystalline structure (by X-ray diffraction, XRD), size and shape (by Transmission Electron Microscopy, TEM), hydrodynamic size and zeta potential (by Dynamic Light Scattering, DLS), and heating efficiency (measuring the Specific Absorption Rate, SAR, and Intrinsic Loss Power, ILP) under an alternating magnetic field. The obtained NPs showed a particle size within the range of 10 nm to 20 nm (by TEM) with a spherical or cubic shape. Ca0.2Mn0.8Fe2O4 NPs exhibited the highest SAR value of 36.3 W/g at the lowest field frequency tested, and achieved a temperature variation of ~7 °C in 120 s, meaning that these NPs are suitable magnetic hyperthermia agents. In vitro cellular internalization and cytotoxicity experiments, performed using the human cell line HEK 293T, confirmed cytocompatibility over 0-250 µg/mL range and successful internalization after 24 h. Based on these studies, our data suggest that these manganese-calcium ferrite NPs have potential for MH application and further use in in vivo systems.

Risk indicators of untreated dental caries incidence among preschoolers: a prospective longitudinal study.

The aim of the present study was to evaluate the influence of socioeconomic factors, oral conditions and the impact of OHRQoL as possible risk indicators related to the incidence of untreated dental caries in preschool children two years after an initial examination. A prospective longitudinal study was performed with a sample of 288 preschool children allocated to two groups at baseline (T0): caries free (n = 144) and with untreated dental caries (n = 144). Untreated dental caries was determined through clinical examinations performed by a calibrated dentist at T0 (Kappa > 0,89) and T1 (two years after the baseline) (Kappa > 0,91) using the dmft criteria. Parents/caregivers answered a socioeconomic questionnaire and the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS) at T0 and T1. Mann-Whitney test and hierarchically adjusted Poisson regression models were used (95%CI, p < 0,05). The incidence of untreated dental caries was 41.3%. Low (RR = 1.63; 95%CI:1.18-2.26; p < 0.001) and high severity of untreated dental caries (RR = 1.92; 95%CI:1.36-2.72; p < 0.001), monthly household income less than two times the Brazilian minimum salary (RR = 1.79; 95%CI:1.04-3.25; p = 0.042) and overall B-ECOHIS score (RR = 1.03; 95%CI:1.02-1.05; p < 0.001) at T0 were risk indicators for the incidence of untreated dental caries among the preschool children. In conclusion, the incidence of untreated dental caries was high and the higher severity of untreated dental caries, the lower monthly income and the higher the B-ECOHIS score (indicating a negative impact on quality of life) were risk indicators to the developing of new lesions of untreated dental caries after 2 years.

Oxidative Precipitation Synthesis of Calcium-Doped Manganese Ferrite Nanoparticles for Magnetic Hyperthermia.

Superparamagnetic nanoparticles are of high interest for therapeutic applications. In this work, nanoparticles of calcium-doped manganese ferrites (CaxMn1-xFe2O4) functionalized with citrate were synthesized through thermally assisted oxidative precipitation in aqueous media. The method provided well dispersed aqueous suspensions of nanoparticles through a one-pot synthesis, in which the temperature and Ca/Mn ratio were found to influence the particles microstructure and morphology. Consequently, changes were obtained in the optical and magnetic properties that were studied through UV-Vis absorption and SQUID, respectively. XRD and Raman spectroscopy studies were carried out to assess the microstructural changes associated with stoichiometry of the particles, and the stability in physiological pH was studied through DLS. The nanoparticles displayed high values of magnetization and heating efficiency for several alternating magnetic field conditions, compatible with biological applications. Hereby, the employed method provides a promising strategy for the development of particles with adequate properties for magnetic hyperthermia applications, such as drug delivery and cancer therapy.

Does religiosity impact binge drinking among early adolescents? A cross-sectional study in a city in Southeastern Brazil / A religiosidade impacta o binge drinking na adolescência precoce? Um estudo transversal em uma cidade do sudeste do Brasil

Abstract This study evaluated the association between religiosity and binge drinking in early adolescence. A cross-sectional study was conducted with adolescents aged 10-13 from Belo Horizonte, Brazil. Stratified random sampling was performed considering the administrative district and school year. Adolescents filled an AUDIT-C form, containing questions about religiosity and binge drinking by parents and their best friends. Adolescents' caregivers answered a form regarding socioeconomic issues. Descriptive analysis, univariate, and multivariate logistic regression were performed. A total of 650 adolescents participated in the study. The frequency of binge drinking was 13.7%. In the adjusted model, religiosity was not associated with binge drinking. The covariates associated were the age of 12-13 years (OR: 1.94; CI95%: 1.06-3.56; p=0.030), maternal binge drinking (OR: 3.12; CI95%: 1.76-5.52; p<0.001) best friend binge drinking (OR: 6.01; CI95%: 3.40-10.62; p<0.001) and nonnuclear family (OR: 1.80; CI95%: 1.01-3.23; p=0.045). The findings revealed that, for binge drinking, the main factors that influenced this decision were the best friend and maternal binge drinking and family structure, although the adolescents claimed to be religious.

Resumo O objetivo do estudo foi avaliar a associação entre religiosidade e binge drinking no início da adolescência. Um estudo transversal realizado com adolescentes de 10 a 13 anos de Belo Horizonte, Brasil. Foi realizada uma amostragem aleatória estratificada considerando distrito administrativo e ano escolar. Os adolescentes preencheram um formulário com o AUDIT C, perguntas sobre religiosidade e perguntas sobre binge drinking pelos pais e melhor amigo. Um formulário sobre questões socioeconômicas foi respondido pelos responsáveis. Foi realizada análise descritiva, regressão logística univariada e multivariada. Participaram do estudo 650 adolescentes. A frequência de binge drinking foi de 13,7%. No modelo ajustado, a religiosidade não esteve associada ao binge drinking. As covariáveis associadas foram idade de 12-13 anos (OR: 1,94 IC95%: 1,06-3,56; p=0,030), binge drinking pela mãe (OR: 3,12; IC95%: 1,76-5,52; p<0,001) binge drinking pelo melhor amigo (OR: 6,01; IC95%: 3,40-10,62; p<0,001) e família não nuclear (OR: 1,80; IC95%: 1,01-3,23; p=0,045). Os achados revelaram que apesar dos adolescentes afirmarem serem religiosos, para o binge drinking, os principais fatores que influenciaram essa decisão foi o binge drinking pelo melhor amigo, mãe e família não nuclear.

Does religiosity impact binge drinking among early adolescents? A cross-sectional study in a city in Southeastern Brazil.

This study evaluated the association between religiosity and binge drinking in early adolescence. A cross-sectional study was conducted with adolescents aged 10-13 from Belo Horizonte, Brazil. Stratified random sampling was performed considering the administrative district and school year. Adolescents filled an AUDIT-C form, containing questions about religiosity and binge drinking by parents and their best friends. Adolescents' caregivers answered a form regarding socioeconomic issues. Descriptive analysis, univariate, and multivariate logistic regression were performed. A total of 650 adolescents participated in the study. The frequency of binge drinking was 13.7%. In the adjusted model, religiosity was not associated with binge drinking. The covariates associated were the age of 12-13 years (OR: 1.94; CI95%: 1.06-3.56; p=0.030), maternal binge drinking (OR: 3.12; CI95%: 1.76-5.52; p<0.001) best friend binge drinking (OR: 6.01; CI95%: 3.40-10.62; p<0.001) and nonnuclear family (OR: 1.80; CI95%: 1.01-3.23; p=0.045). The findings revealed that, for binge drinking, the main factors that influenced this decision were the best friend and maternal binge drinking and family structure, although the adolescents claimed to be religious.

The vertebrate Embryo Clock: Common players dancing to a different beat.

Vertebrate embryo somitogenesis is the earliest morphological manifestation of the characteristic patterned structure of the adult axial skeleton. Pairs of somites flanking the neural tube are formed periodically during early development, and the molecular mechanisms in temporal control of this early patterning event have been thoroughly studied. The discovery of a molecular Embryo Clock (EC) underlying the periodicity of somite formation shed light on the importance of gene expression dynamics for pattern formation. The EC is now known to be present in all vertebrate organisms studied and this mechanism was also described in limb development and stem cell differentiation. An outstanding question, however, remains unanswered: what sets the different EC paces observed in different organisms and tissues? This review aims to summarize the available knowledge regarding the pace of the EC, its regulation and experimental manipulation and to expose new questions that might help shed light on what is still to unveil.

Cell-Fibronectin Interactions and Actomyosin Contractility Regulate the Segmentation Clock and Spatio-Temporal Somite Cleft Formation during Chick Embryo Somitogenesis.

Fibronectin is essential for somite formation in the vertebrate embryo. Fibronectin matrix assembly starts as cells emerge from the primitive streak and ingress in the unsegmented presomitic mesoderm (PSM). PSM cells undergo cyclic waves of segmentation clock gene expression, followed by Notch-dependent upregulation of meso1 in the rostral PSM which induces somite cleft formation. However, the relevance of the fibronectin matrix for these molecular processes remains unknown. Here, we assessed the role of the PSM fibronectin matrix in the spatio-temporal regulation of chick embryo somitogenesis by perturbing (1) extracellular fibronectin matrix assembly, (2) integrin-fibronectin binding, (3) Rho-associated protein kinase (ROCK) activity and (4) non-muscle myosin II (NM II) function. We found that integrin-fibronectin engagement and NM II activity are required for cell polarization in the nascent somite. All treatments resulted in defective somitic clefts and significantly perturbed meso1 and segmentation clock gene expression in the PSM. Importantly, inhibition of actomyosin-mediated contractility increased the period of hairy1/hes4 oscillations from 90 to 120 min. Together, our work strongly suggests that the fibronectin-integrin-ROCK-NM II axis regulates segmentation clock dynamics and dictates the spatio-temporal localization of somitic clefts.

Oral health issues in children and adolescents with vision impairment: A systematic review and meta-analysis.

BACKGROUND: Children and adolescents with vision impairment (VI) may be at increased risk of oral health issues, such as periodontal inflammation, poor oral hygiene, dental caries, and dental trauma, but this is inconclusive in the literature. AIM: To systematically review the literature to determine the main oral health issues of children and adolescents with VI compared to those without VI. DESIGN: Electronic and manual searches were performed to identify observational studies involving children and adolescents with and without VI, to determine and compare their oral health issues. The methodological quality was assessed using the Joanna Briggs Institute critical appraisal tool. Studies that had homogeneity of methods were incorporated into meta-analyses. RESULTS: Fifteen cross-sectional studies were included. Overall, most studies presented methodological flaws and high risk of bias. The meta-analysis showed that children and adolescents with VI were 3.86 times as likely to exhibit dental trauma (OR = 3.86, 95% CI = 2.63-5.68, I2  = 0%) and had higher/poorer values for plaque (MD = 0.80, 95% CI = 0.58-1.02, I2  = 96%), gingivitis (MD = 0.69, 95% CI = 0.02-1.37, I2  = 100%), calculus (MD = 0.04, 95% CI = 0.03-0.06, I2  = 0%), and oral hygiene indices (MD = 0.71, 95% CI = 0.24-1.18, I2  = 97%), as well as DMFS (MD = 0.90, 95% CI = 0.68-1.13, I2  = 26%). CONCLUSION: Across a wide array of assessments, children and adolescents with vision impairment had worse oral health outcomes than those without VI.

gga-miRNOME, a microRNA-sequencing dataset from chick embryonic tissues.

MicroRNAs (miRNAs) are small non-coding RNA molecules, with sizes ranging from 18 to 25 nucleotides, which are key players in gene expression regulation. These molecules play an important role in fine-tuning early vertebrate embryo development. However, there are scarce publicly available miRNA datasets from non-mammal embryos, such as the chicken (Gallus gallus), which is a classical model system to study vertebrate embryogenesis. Here, we performed microRNA-sequencing to characterize the early stages of trunk and limb development in the chick embryo. For this, we profiled three chick embryonic tissues, namely, Undetermined Presomitic Mesoderm (PSM_U), Determined Presomitic Mesoderm (PSM_D) and Forelimb Distal Cyclic Domain (DCD). We identified 926 known miRNAs, and 1,141 novel candidate miRNAs, which nearly duplicates the number of Gallus gallus entries in the miRBase database. These data will greatly benefit the avian research community, particularly by highlighting new miRNAs potentially involved in the regulation of early vertebrate embryo development, that can be prioritized for further experimental testing.

Longitudinal evaluation of determinants of the clinical consequences of untreated dental caries in early childhood.

OBJECTIVES: This study aimed to evaluate whether the trajectory of family income, parental education and clinical variables are associated with the clinical consequences of untreated dental caries among children. METHODS: A prospective cohort study was conducted with 439 children between one and three years of age, evaluated at baseline and re-evaluated after three years. Sociodemographic and economic variables, untreated dental caries and biofilm were investigated both at baseline and at the 3-year follow-up. The pufa index (pulpal involvement, ulceration, fistula and abscess) was used to diagnose the clinical consequences of untreated dental caries. RESULTS: The prevalence of pufa ≥1 was 18.2% in the follow-up. The following variables were associated with a higher risk of clinical consequences of untreated dental caries: mother's low schooling level at baseline and follow-up (RR = 1.51; 95% CI: 1.04-2.18), incidence or baseline presence of biofilm (RR = 4.66; 95% CI: 2.02-10.74), cavitated dental caries at baseline (RR = 3.57; 95% CI:1.86 to 6.83) and incidence of cavitated dental caries (RR = 2.04; 95% CI: 1.24-3.35). CONCLUSION: Low maternal schooling level, biofilm, cavitated dental caries at baseline, and incidence of dental caries were the factors determining the consequences of untreated dental caries.

Risk indicators of untreated dental caries incidence among preschoolers: a prospective longitudinal study

Abstract: The aim of the present study was to evaluate the influence of socioeconomic factors, oral conditions and the impact of OHRQoL as possible risk indicators related to the incidence of untreated dental caries in preschool children two years after an initial examination. A prospective longitudinal study was performed with a sample of 288 preschool children allocated to two groups at baseline (T0): caries free (n = 144) and with untreated dental caries (n = 144). Untreated dental caries was determined through clinical examinations performed by a calibrated dentist at T0 (Kappa > 0,89) and T1 (two years after the baseline) (Kappa > 0,91) using the dmft criteria. Parents/caregivers answered a socioeconomic questionnaire and the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS) at T0 and T1. Mann-Whitney test and hierarchically adjusted Poisson regression models were used (95%CI, p < 0,05). The incidence of untreated dental caries was 41.3%. Low (RR = 1.63; 95%CI:1.18-2.26; p < 0.001) and high severity of untreated dental caries (RR = 1.92; 95%CI:1.36-2.72; p < 0.001), monthly household income less than two times the Brazilian minimum salary (RR = 1.79; 95%CI:1.04-3.25; p = 0.042) and overall B-ECOHIS score (RR = 1.03; 95%CI:1.02-1.05; p < 0.001) at T0 were risk indicators for the incidence of untreated dental caries among the preschool children. In conclusion, the incidence of untreated dental caries was high and the higher severity of untreated dental caries, the lower monthly income and the higher the B-ECOHIS score (indicating a negative impact on quality of life) were risk indicators to the developing of new lesions of untreated dental caries after 2 years.

Desenvolvimento infantil e visita domiciliar na primeira infância: mapa conceitual / Desarrollo infantil y visita domiciliaria en la primera infancia: mapa conceptual / Child development and home visits in early childhood: concept map

Resumo Objetivo Identificar e analisar as evidências científicas sobre visita domiciliar (VD) à crianças menores de seis anos de idade, na perspectiva da promoção da saúde e do desenvolvimento na primeira infância. Métodos Revisão integrativa da literatura, nas bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde, Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science, PubMed e PsycINFO. Foram incluídos estudos científicos originais quantitativos, qualitativos e método misto, publicados entre 2016 e 2019, idiomas português e inglês, foco central de VD na primeira infância, e excluídos estudos de revisão, teses, dissertações, livros e capítulos de livros, resumos e editoriais publicados. Análise dos dados pautada na estratégia do mapa conceitual em teia de aranha, com síntese integrativa de 19 estudos selecionados. Resultados As evidências científicas mostram a importância da estratégia de VD na primeira infância, com características das ações oferecidas nessa abordagem. Os conteúdos e abordagens das VD foram identificados como criadores de condições propícias para retratar temas, situações e necessidades da primeira infância, essenciais à vitalidade da saúde e estímulo ao bom desenvolvimento nos primeiros anos de vida. Conclusão A síntese integrativa identificou que a VD é uma valiosa estratégia para a primeira infância, indicando os benefícios ao desenvolvimento da criança e de seus cuidadores, para promover saúde e prevenir agravos. O Mapa Conceitual elaborado sugere uma gama de elementos relevantes que qualifica a VD na primeira infância com contribuições à atenção integral à saúde da criança e às boas práticas parentais.

Resumen Objetivo Identificar y analizar las evidencias científicas sobre la visita domiciliaria (VD) a los niños menores de seis años de edad, en la perspectiva de la promoción de la salud y del desarrollo en la primera infancia. Métodos Revisión integradora de la literatura en las bases de datos Literatura Latino-Americana e do Caribe em Ciências da Saúde, Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science, PubMed y PsycINFO. Se incluyeron estudios científicos originales, cuantitativos, cualitativos y método mixto, publicados entre 2016 y 2019, idiomas portugués e inglés, enfoque central de VD en la primera infancia, y excluidos estudios de revisión, tesis, disertaciones, libros y capítulos de libros, resúmenes y editoriales publicados. Análisis de los datos orientado en la estrategia del mapa conceptual de telaraña, con síntesis integrativos de 19 estudios seleccionados. Resultados Las evidencias científicas muestran la importancia de la estrategia de VD en la primera infancia, con características de las acciones que se ofrecen en ese enfoque. Los contenidos y enfoques de las VD fueron identificados como los creadores de condiciones adecuadas para retratar temas, situaciones y necesidades de la primera infancia, esenciales para la vitalidad de la salud y el estímulo al buen desarrollo en los primeros años de vida. Conclusión La síntesis integrativa identificó que la VD es una estrategia valiosa para la primera infancia, indicando los beneficios para el desarrollo del niño y de sus cuidadores, para promover la salud y prevenir agravamientos. El Mapa Conceptual elaborado sugiere una gama de elementos relevantes que califica a VD en la primera infancia con contribuciones a la atención integral a la salud del niño y a las buenas prácticas parentales.

Abstract Objective To identify and analyze the scientific evidence on home visits (HV) to children under six years of age, from the perspective of promoting health and early childhood development. Methods This is an integrative literature review, in the Latin American and Caribbean Literature in Health Sciences, Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science, PubMed and PsycINFO databases. Quantitative, qualitative and mixed method original scientific studies, published between 2016 and 2019, in Portuguese and English, central focus of HV in early childhood, were included, and review studies, theses, dissertations, books and book chapters, abstracts and editorials were excluded published. Data analysis based on the concept map strategy in a spider's web, with an integrative synthesis of 19 selected studies. Results Scientific evidence shows the importance of the HV strategy in early childhood, with characteristics of the actions offered in this approach. The contents and approaches of HV were identified as creating favorable conditions to portray themes, situations and needs of early childhood, essential to health vitality and encourage good development in the first years of life. Conclusion The integrative synthesis identified that HV is a valuable strategy for early childhood, indicating the benefits to child development and their caregivers to promote health and prevent injuries. The conceptual map developed suggests a range of relevant elements that qualify HV in early childhood with contributions to comprehensive child health care and good parenting practices.

Prevalence of oral health-related shame and associated factors among Brazilian schoolchildren.

The aim of the present study was to investigate the prevalence of oral health-related shame and the associated factors among 8-to-10-year-old Brazilian schoolchildren. A cross-sectional study was conducted with 388 children randomly selected from public and private schools of Diamantina, southeastern Brazil. In order to identify the feeling of shame, self-reports were collected through a single question, "In the last month, did you feel ashamed because of your teeth or mouth? Two calibrated examiners performed the clinical examination for dental caries (DMFT/dmft index), traumatic dental injuries (O' Brien), and malocclusion (Dental Aesthetic Index). Sociodemographic indicators were obtained through a questionnaire answered by the children's caregivers. Descriptive analysis, chi-square test, and hierarchical Poisson regression models were performed (95%CI; p < 0.05). The prevalence of shame was 38.1% (n = 148). The adjusted regression analysis demonstrated a significant association between shame and untreated dental caries (PR: 1.34; 95%CI: 1.04-1.74; p = 0.02), age of 10 years (PR: 1.36; 95%CI: 1.05-1.76; p = 0.01), and with parents with less than eight years of schooling (PR: 1.30; 95%CI: 1.00-1.68; p = 0.04). Older children with untreated dental caries and whose parents had lower education level presented a higher prevalence of oral health-related shame.