Behaviour support in dentistry: A Delphi study to agree terminology in behaviour management.

OBJECTIVES: Dental behaviour support (DBS) describes all specific techniques practiced to support patients in their experience of professional oral healthcare. DBS is roughly synonymous with behaviour management, which is an outdated concept. There is no agreed terminology to specify the techniques used to support patients who receive dental care. This lack of specificity may lead to imprecision in describing, understanding, teaching, evaluating and implementing behaviour support techniques in dentistry. Therefore, this e-Delphi study aimed to develop a list of agreed labels and descriptions of DBS techniques used in dentistry and sort them according to underlying principles of behaviour. METHODS: Following a registered protocol, a modified e-Delphi study was applied over two rounds with a final consensus meeting. The threshold of consensus was set a priori at 75%. Agreed techniques were then categorized by four coders, according to behavioural learning theory, to sort techniques according to their mechanism of action. RESULTS: The panel (n = 35) agreed on 42 DBS techniques from a total of 63 candidate labels and descriptions. Complete agreement was achieved regarding all labels and descriptions, while agreement was not achieved regarding distinctiveness for 17 techniques. In exploring underlying principles of learning, it became clear that multiple and differing principles may apply depending on the specific context and procedure in which the technique may be applied. DISCUSSION: Experts agreed on what each DBS technique is, what label to use, and their description, but were less likely to agree on what distinguishes one technique from another. All techniques were describable but not comprehensively categorizable according to principles of learning. While objective consistency was not attained, greater clarity and consistency now exists. The resulting list of agreed terminology marks a significant foundation for future efforts towards understanding DBS techniques in research, education and clinical care.

Mapping secondary substrate-binding sites on the GH11 xylanase from Bacillus subtilis.

Xylanases are of significant interest for biomass conversion technologies. Here, we investigated the allosteric regulation of xylan hydrolysis by the Bacillus subtilis GH11 endoxylanase. Molecular dynamics simulations (MDS) in the presence of xylobiose identified binding to the active site and two potential secondary binding sites (SBS) around surface residues Asn54 and Asn151. Arabinoxylan titration experiments with single cysteine mutants N54C and N151C labeled with the thiol-reactive fluorophore acrylodan or the ESR spin-label MTSSL validated the MDS results. Ligand binding at the SBS around Asn54 confirms previous reports, and analysis of the second SBS around N151C discovered in the present study includes residues Val98/Ala192/Ser155/His156. Understanding the regulation of xylanases contributes to efforts for industrial decarbonization and to establishing a sustainable energy matrix.

Impact of Synergy Partner Cel7B on Cel7A Binding Rates: Insights from Single-Molecule Data.

Enzymatic degradation of cellulosic biomass is a well-established route for the sustainable production of biofuels, chemicals, and materials. A strategy employed by nature and industry to achieve an efficient degradation of cellulose is that cellobiohydrolases (or exocellulases), such as Cel7A, work synergistically with endoglucanases, such as Cel7B, to achieve the complete degradation of cellulose. However, a complete mechanistic understanding of this exo-endo synergy is still lacking. Here, we used single-molecule fluorescence microscopy to quantify the binding kinetics of Cel7A on cellulose when it is acting alone on the cellulose fibrils and in the presence of its synergy partner, the endoglucanase Cel7B. To this end, we used a fluorescently tagged Cel7A and studied its binding in the presence of the unlabeled Cel7B. This provided the single-molecule data necessary for the estimation of the rate constants of association kON and dissociation kOFF of Cel7A for the substrate. We show that the presence of Cel7B does not impact the dissociation rate constant, kOFF. But, the association rate of Cel7A decreases by a factor of 2 when Cel7B is present at a molar proportion of 10:1. This ratio has previously been shown to lead to synergy. This decrease in association rate is observed in a wide range of total enzyme concentrations, from sub nM to µM concentrations. This decrease in kON is consistent with the formation of cellulase clusters recently observed by others using atomic force microscopy.

Application of 20% silver nanoclusters in polymethacrylic acid on simulated dentin caries; its penetration depth and effect on surface hardness.

The aims of this study were: To evaluate the surface hardness of simulated dentin caries lesions treated with either silver nanoclusters (AgNCls) synthesized in polymethacrylic acid (PMAA) or 38% silver diammine fluoride (SDF), as well as observe the penetration of the treatment solutions into the simulated caries lesions. Dentin blocks 4 mm thick obtained from caries-free third molars were sectioned and then simulated caries lesions on the occlusal dentin surfaces were created. Each specimen (n = 8) was divided into four sections: (A) treated with 20% AgNCls/PMAA; (B) treated with SDF 38% (FAgamin, Tedequim, Cordoba, Argentina); (C) sound tooth protected by nail-varnish during artificial caries generation (positive control); and (D) artificial caries lesion without surface treatment (negative control). AgNCls/PMAA or SDF were applied on the simulated lesions with a microbrush for 10 s, then excess removed. The surface hardness was measured by means of Vickers indentation test. To trace the depth of penetration, up to 400 µm, of silver ions, elemental composition of the samples was observed using EDX, coupled with SEM, and measured every 50 µm from the surface towards the pulp chamber. Laser Induced Breakdown Spectroscopy (LIBS) was also employed to trace silver ion penetration; the atomic silver line 328.06 nm was used with a 60 µm laser spot size to a depth of 240 µm. Student's-t test identified significant differences between treatment groups for each depth and the Bonferroni test was used for statistical analysis of all groups (p < 0.05). Mean surface hardness values obtained were 111.2 MPa, 72.3 MPa, 103.3 MPa and 50.5 MPa for groups A, B, C and D respectively. There was a significant difference between groups A and C compared with groups B and D, the group treated with AgNCls/PMAA achieved the highest surface hardness, similar or higher than the sound dentin control. A constant presence of silver was observed throughout the depth of the sample for group A, while group B showed a peak concentration of silver at the surface with a significant drop beyond 50 µm. The 20% AgNCls/PMAA solution applied to simulated dentin caries lesions achieved the recovery of surface hardness equivalent to sound dentin with the penetration of silver ions throughout the depth of the lesion.

Green nanoarchitectonics of carbon quantum dots from Cinchona Pubescens Vahl as targeted and controlled drug cancer nanocarrier.

Carbon quantum dots (CQDs) are a new carbon-based nanomaterial that has attracted tremendous attention due to their excellent fluorescent properties, chemical stability, water solubility, and biocompatibility features. Here, fluorescent CQDs synthesized by a green nanoarchitectonic method using Cinchona Pubescens Vahl extract were evaluated as drug nanocarriers for carboplatin (CBP) delivery. The characterization methods showed CQDs with semispherical shapes and sizes around 5 nm, temperature- and pH-dependent functional groups that interact with the CBP molecule adding specificity to the drug-delivery system. Based on the load efficiency results, it seems that the CQDs can carry almost 100 µg of carboplatin for every 1 mg of CQDs. This is possible due to the self-assembly process that takes place through the interaction between the protonation/deprotonation functional groups of CQDs and the hydrolyzed CBP molecule. Through this process, it is created spherical nanoparticles with an average size of 77.44 nm. The CQDs-CBP nanoparticles release the drug through a diffusion-controlled release mechanism where the acidic media is preferred, and the EPR effect also plays a helpful role. Besides, the viability test shows that the CQDs have almost null cytotoxicity suggesting that they could be used as a promising cancer treatment, improving the efficiency of cell internalization and significantly increasing their drug delivery.

WHF Recommendations for the Use of Echocardiography in Chagas Disease.

Chagas disease (ChD) represents a significant health burden in endemic regions of Latin America and is increasingly being recognized as a global health issue. The cardiac involvement in ChD, known as Chagas cardiomyopathy (ChCM), is the most severe manifestation and a leading cause of heart failure and mortality in affected individuals. Echocardiography, a non-invasive imaging modality, plays a crucial role in the diagnosis, monitoring, and risk stratification of ChCM. This consensus recommendation aims to provide guidance on the appropriate use of echocardiography in ChD. An international panel of experts, including cardiologists, infectious disease specialists, and echocardiography specialists, convened to review the available evidence and provide practical recommendations based on their collective expertise. The consensus addresses key aspects related to echocardiography in ChD, including its role in the initial evaluation, serial monitoring, and risk assessment of patients. It emphasizes the importance of standardized echocardiographic protocols, including the assessment of left ventricular function, chamber dimensions, wall motion abnormalities, valvular involvement, and the presence of ventricular aneurysm. Additionally, the consensus discusses the utility of advanced echocardiographic techniques, such as strain imaging and 3D echocardiography, in assessing myocardial mechanics and ventricular remodeling.

Sustainability approaches for agrowaste solution: Biodegradable packaging and microbial polysaccharides bio-production.

Global growth impacts on the increased use and demand for natural resources, requiring solutions for the high volume of industrial waste and by-products generated from the most diverse commercial areas, mainly the food sector. Among the main residues with a large volume generated, those from fruit processing, grain cleaning in processing units, vegetables, and discards from the animal production industry stood out. Approximately 1.3 billion all food produced worldwide is lost or wasted per year being fruits, vegetables, roots, and tubers responsible for about half of the total amount. Many of these by-products have interesting nutrients in their composition such as fibers, proteins, and bioactive compounds. An interesting example is the sugarcane bagasse. Fibrous residue, derived from sugarcane extraction, the bagasse represents about 30-34 % of the total sugarcane mass. This is one of the most abundant cellulosic residues and contains approximately 39 % of cellulose, 28 % of hemicellulose, and 18 % of lignin. Therefore, as well as the bagasse, several residues from agroindustrial can be considered promising alternative substrates, being valuable sources for the development of high-value-added products, such as biopolymers, bioenergy, and chemical products. In addition, the reuse of agroindustrial wastes may be considered an attractive option for reducing the environmental impact caused by their generation. In the case of biopolymers, the energy savings of bio-based polymers is around 20-50 GJ/t of polymer. In this review, we have selected two commercially promising approaches to the application and use of agroindustrial residues, aiming their use for biodegradable packaging and microbial polysaccharides bio-production, improving overall sustainability and economic aspects of the scientific research, technology and modern industry.

Sargassum natans I Algae: An Alternative for a Greener Approach for the Synthesis of ZnO Nanostructures with Biological and Environmental Applications.

In this work, the influence of the Sargassum natans I alga extract on the morphological characteristics of synthesized ZnO nanostructures, with potential biological and environmental applications, was evaluated. For this purpose, different ZnO geometries were synthesized by the co-precipitation method, using Sargassum natans I alga extract as stabilizing agent. Four extract volumes (5, 10, 20, and 50 mL) were evaluated to obtain the different nanostructures. Moreover, a sample by chemical synthesis, without the addition of extract, was prepared. The characterization of the ZnO samples was carried out by UV-Vis spectroscopy, FT-IR spectroscopy, X-ray diffraction, and scanning electron microscopy. The results showed that the Sargassum alga extract has a fundamental role in the stabilization process of the ZnO nanoparticles. In addition, it was shown that the increase in the Sargassum alga extract leads to preferential growth and arrangement, obtaining well-defined shaped particles. ZnO nanostructures demonstrated significant anti-inflammatory response by the in vitro egg albumin protein denaturation for biological purposes. Additionally, quantitative antibacterial analysis (AA) showed that the ZnO nanostructures synthesized with 10 and 20 mL of extract demonstrated high AA against Gram (+) S. aureus and moderate AA behavior against Gram (-) P. aeruginosa, depending on the ZnO arrangement induced by the Sargassum natans I alga extract and the nanoparticles' concentration (ca. 3200 µg/mL). Additionally, ZnO samples were evaluated as photocatalytic materials through the degradation of organic dyes. Complete degradation of both methyl violet and malachite green were achieved using the ZnO sample synthesized with 50 mL of extract. In all cases, the well-defined morphology of ZnO induced by the Sargassum natans I alga extract played a key role in the combined biological/environmental performance.

RADIOGRAPHIC EVALUATION OF THE SUCCESS OF IMPLANT-SUPPORTED TOTAL PROSTHESES ON CONICAL EXTERNAL HEXAGON IMPLANTS AND 6-MONTH FOLLOW-UP AFTER INSTALLATION OF THE PROSTHESES

The development of dental implants has revolutionized the rehabilitation possibilities for partially or totally edentulous patients. The long-term success of the dental implant depends on osseointegration and this is achieved by the combination of two essential stabilities: primary and secondary. Implant-supported prostheses are a great evolution for these treatments, positively interfering in the quality of life of the population, as they generate function and aesthetics for the patient. Thus, the present study aimed to radiographically evaluate complete dentures supported by an external hexagon conical implant in the anterior region of the mandible. More specifically, to evaluate the feasibility of using these implants in cortical bone of the mandible, to verify the success rate regarding the significance of peri-implant bone loss and to compare peri-implant bone loss between patients.

Antibacterial and Anti-Inflammatory Properties of ZnO Nanoparticles Synthesized by a Green Method Using Sargassum Extracts.

The present work shows the synthesis of ZnO nanoparticles through a green method, using sargassum extracts, which provide the reducing and stabilizing compounds. The conditions of the medium in which the reaction was carried out was evaluated, that is, magnetic stirring, ultrasound assisted, and resting condition. UV-Vis, FTIR spectroscopy, and X-ray diffraction results confirmed the synthesis of ZnO with nanometric crystal size. The scanning electron microscopy analysis showed that the morphology and size of the particles depends on the synthesis condition used. It obtained particles between 20 and 200 nm in the sample without agitation, while the samples with stirring and ultrasound were 80 nm and 100 nm, respectively. ZnO nanoparticles showed antibacterial activity against Gram-positive S. aureus and Gram-negative P. aeruginosa. A quantitative analysis was performed by varying the concentration of ZnO nanoparticles. In all cases, the antibacterial activity against Gram-positives was greater than against Gram-negatives. Ultrasound-assisted ZnO nanoparticles showed the highest activity, around 99% and 80% for S. aureus and P. aeruginosa, respectively. Similar results were obtained in the study of the anti-inflammatory activity of ZnO nanoparticles; the ultrasound-assisted sample exhibited the highest percentage (93%), even above that shown by diclofenac, which was used as a reference. Therefore, the ZnO nanoparticles synthesized with sargassum extracts have properties that can be used safely and efficiently in the field of biomedicine.

Surface gloss, gloss retention, and color stability of 2 nano-filled universal resin composites.

Objectives: This study compared the surface gloss (SG), gloss retention (GR), and color stability (CS) of 2 universal resin composites after chemical (CA) and mechanical (MA) aging. Materials and Methods: Twenty disc-shaped samples of G-ænial A´Chord (GC-Europe) and Filtek Universal (3M-ESPE) were polished with sequential abrasive papers. For CA, specimens were stored in 1 mL of 75% ethanol for 15 days at 37°C, and readings (SG, GR, and CS) were obtained at baseline and 5, 10, and 15 days. For MA, specimens were subjected to 10,750 simulated brushing cycles. SG and CS were evaluated after every 3,583 cycles. SG was measured with a glossmeter (geometrical configuration: 60°), and values were expressed in gloss units. Color was measured with a spectrophotometer using the CIE-L*a*b* color system. The Student's t-test, 1-way analysis of variance, and Scheffé test were used for statistical analysis (α = 0.05). Results: G-ænial presented significantly higher SG values than Filtek (p = 0.02), with GR reductions of 5.2% (CA) and 5.3% (MA) for G-ænial and 7.6% (CA) and 7.2% (MA) for Filtek. The aging protocol had no statistically significant effect on SG or GR (p = 0.25) from baseline to the final readings. G-ænial-MA presented the lowest color difference (∆E = 1.8), and G-ænial-CA and Filtek-CA had the largest changes (∆E = 8.6 and ∆E = 11.8, respectively). Conclusion: G-ænial presented higher SG values and better CS. Both restorative materials demonstrated acceptable GR and CS. Aging protocols impacted these properties negatively.

The Sabatier principle as a tool for discovery and engineering of industrial enzymes.

The recent breakthrough in all-atom, protein structure prediction opens new avenues for a range of computational approaches in enzyme design. These new approaches could become instrumental for the development of technical biocatalysts, and hence our transition toward more sustainable industries. Here, we discuss one approach, which is well-known within inorganic catalysis, but essentially unexploited in biotechnology. Specifically, we review examples of linear free-energy relationships (LFERs) for enzyme reactions and discuss how LFERs and the associated Sabatier Principle may be implemented in algorithms that estimate kinetic parameters and enzyme performance based on model structures.

Management of dental caries lesions in patients with disabilities: Update of a systematic review.

The aim of this systematic review was to update an existing review on the management of dental caries lesions in patients with disabilities so as to provide an up-to-date summary of the evidence. Randomized clinical trials and cohort studies related to preventive and restorative programmes for dental caries among people requiring special care, published in English, Spanish, Portuguese, French and German languages from February 1st 2011 to April 1st 2022, were retrieved from three databases ("updated review"). From the 1,105 titles identified using the search topic "Caries AND Disability", 17 papers informed in the analyses: 6 referring to caries preventive strategies and 11 related to restorative care strategies. Most of these studies targeted children and adults with intellectual/physical disability, although preventive and therapeutic strategies were also reported for frail older adults and onchohematological patients. Fluorides in tablets, gels or varnishes forms and the use of xylitol as a sugar substitute were reported as effective approach to prevent the onset of caries in high-risk groups. Minimally intervention treatment options such as the Hall technique, the ART approach and the use of SDF for arresting caries, were deemed suitable and effective strategies for treating existing lesions in-office. In conclusion, in the past decade (2011-2022) an increased number of articles reported strategies to prevent and manage caries among people requiring special care. Although an array of preventive and therapeutic strategies for dental caries exists, more and better-quality clinical evidence is needed to offer guidance to inform policy and practice for special care dentistry.

Color changes and shear bond strength to simulated caries lesions treated with a novel solution of 20% silver nanoclusters in polymethacrylic acid.

The aims of the study were: (1) To compare the staining effect on demineralized dentin simulating caries between silver nanoclusters (AgNCls) synthesized using polymethacrylic acid (PMAA) and silver diammine fluoride (SDF), and (2) to measure the shear bond strength (SBS) of a glass ionomer cement (GIC) to simulated caries lesions with and without the application of AgNCls/PMAA or SDF. Dentine blocks 4 mm thick from twenty-four non-carious third molars were sectioned and coated with nail varnish (Revlon, New York, USA). Simulated caries lesions on occlusal dentin surfaces were created (66 h in 0.05 M acetate buffer 2.2 mM calcium/phosphate pH 5.0). Specimens were divided into groups and treated with (n = 8): (A) 20% AgNCls/PMAA; (B) SDF 38% (Fagamin, Tedequim, Córdoba, Argentina); or (C) without treatment. AgNCls/PMAA or SDF were applied on the exposed surfaces with a microbrush for 10 s. Samples were incubated for 24 h at 37 °C at 100% relative humidity. Surface color was measured according to the CIE-L*a*b* system before and after demineralization (R0 and R1), 24 h and one week after treatment (R2 and R3), using a spectrophotometer (CM-600D Konica Minolta Sesing Inc., Japan). Groups A and B received an extra application of AgNCls/PMAA or SDF before a conventional GIC (Fuji IX-Gold Label, GC Corp, Tokyo, Japan) was bonded using a mold, 4 mm diameter × 3 mm high. For SBS, a Universal Testing Machine (Digimess RS-8000-5, China)-crosshead speed of 1 mm/min-was used. Statistical analysis was performed using ANOVA, Student-t and Scheffe-test at a significance of p < 0.05. Group A presented a stable color p = 0.24 between R1-R2 and R1-R3 in contrast to significant color changes in Group B (p = 0.02). SBS was higher (p < 0.01) in Group A (10.4 ± 2.7 MPa) compared to Groups B (3.3 ± 1.3 MPa) and C (4.0 ± 0.4 MPa), where no differences between the latter groups were observed (p = 0.77). Results of this preliminary study demonstrated that 20% AgNCls/PMAA did not stain simulated carious dentin and improved SBS of the GIC. The relevance of this study relies on the development of a therapeutic system to potentially arrest caries lesions without staining.

Ecofriendly and sustainable Sargassum spp.-based system for the removal of highly used drugs during the COVID-19 pandemic.

Analgesic consumption increased significantly during the COVID-19 pandemic. A high concentration of this kind of drug is discarded in the urine, reaching the effluents of rivers, lakes, and seas. These medicines have brought serious problems for the flora and, especially, the ecosystems' fauna. This paper presents the results of removing diclofenac, ibuprofen, and paracetamol in an aqueous solution, using Sargassum spp. from the Caribbean coast. The study consisted of mixing each drug in an aqueous solution with functionalized Sargassum spp in a container under constant agitation. Therefore, this work represents an alternative to solve two of the biggest problems in recent years; first, the reduction of the overpopulation of sargassum through its use for the remediation of the environment. Second is the removal of drug waste used excessively during the COVID-19 pandemic. Liquid samples of the solution were taken at intervals of 10 min and analyzed by fluorescence to determine the concentration of the drug. The sorption capacity for diclofenac, ibuprofen, and paracetamol was 2.46, 2.08, and 1.41 µg/g, corresponding to 98 %, 84 %, and 54 % of removal, respectively. The removal of the three drugs was notably favored by increasing the temperature to 30 and 40 °C, reaching efficiencies close to 100 %. Moreover, the system maintains its effectiveness at various pH values. In addition, the Sargassum used can be reused for up to three cycles without reducing its removal capacity. The wide diversity of organic compounds favors the biosorption of drugs, removing them through various kinetic mechanisms. On the other hand, the Sargassum used in the drugs removal was analyzed by X-ray diffraction, FTIR spectroscopy, TGA analysis, and scanning electron microscopy before and after removal. The results showed an evident modification in the structure and morphology of the algae and demonstrated the presence of the biosorbed drugs. Therefore, this system is sustainable, simple, economical, environmentally friendly, highly efficient, and scalable at a domestic and industrial level that can be used for aquatic remediation environments.

Nonrestorative Caries Treatment: A Systematic Review Update.

Caries is the most prevalent chronic noncommunicable disease. Strategies to prevent its onset and early interventions to arrest the progression of early lesions have been emphasised throughout recent decades to avoid or delay the restorative spiral of the tooth. More individuals are retaining their natural teeth into old age, thereby necessitating ongoing restorative dentistry intervention for their maintenance. The aim of this systematic review was to update the state of the art regarding clinical studies reporting the effectiveness of different nonrestorative caries treatment options in the 5-year period from 2017 to 2022. Relevant articles were retrieved from 2 electronic databases, including randomised clinical trials (RCTs) published from January 2017 until April 2022, assessing effectiveness and secondary effects of at least one nonrestorative caries treatment option, carried out with adults and/or children with noncavitated or cavitated carious lesions on either primary or permanent teeth and diagnosed by radiographs or visual/tactile assessment. All 35 included articles presented the results of RCTs with a follow-up period ranging from 6 to 84 months. Most of these studies were considered high-quality articles with a low risk of bias. Sealants and fluoride gels and varnishes were mentioned in 12 studies as effective strategies to prevent the onset of caries lesions and to arrest them in the early stages. Resin infiltration reported high caries arresting rates in noncavitated proximal lesions in 10 publications. Silver diammine fluoride presented high caries-arresting rates in open dentin lesions, both in primary and permanent dentitions as well as in root caries lesions that were accessible for cleansing. New evidence has been published between 2017 and 2022 as the result of numerous clinical studies providing further evidence of the effectiveness of nonrestorative caries treatment options.

Green Synthesis of Homogeneous Gold Nanoparticles Using Sargassum spp. Extracts and Their Enhanced Catalytic Activity for Organic Dyes.

Sargassum species-based extracts were used to carry out the synthesis of homogeneous gold nanoparticles. Various techniques were used to determine the characteristics and composition of the nanoparticles. The UV-Vis results showed that the 50% water/ethanol extract had the most reducing agents and stabilizers. Therefore, this type of extract was used to synthesize nanoparticles and for their subsequent characterization. Crystallinity and crystal size were evaluated using X-ray diffraction. Size and morphology were analyzed using scanning electron microscopy, showing that the gold nanoparticles were mostly spherical, with a size range of 15-30 nm. The catalytic activity of the gold nanoparticles was evaluated through the degradation of organic dyes: methylene blue, methyl orange, and methyl red. The degradation rates were different, depending on the nature of each dye, the simplest to degrade was methylene blue and methyl red was the most difficult to degrade. The results indicated that the use of Sargassum spp. for the synthesis of gold nanoparticles has potential in the remediation of water that is contaminated with organic dyes. Moreover, given the recent serious environmental and economic problems caused by the overpopulation of Sargassum spp. in the Mexican Caribbean, the findings hold promise for their practical and sustainable use in the synthesis of nanomaterials.

Thrombolytic Enzymes of Microbial Origin: A Review.

Enzyme therapies are attracting significant attention as thrombolytic drugs during the current scenario owing to their great affinity, specificity, catalytic activity, and stability. Among various sources, the application of microbial-derived thrombolytic and fibrinolytic enzymes to prevent and treat vascular occlusion is promising due to their advantageous cost-benefit ratio and large-scale production. Thrombotic complications such as stroke, myocardial infarction, pulmonary embolism, deep venous thrombosis, and peripheral occlusive diseases resulting from blood vessel blockage are the major cause of poor prognosis and mortality. Given the ability of microbial thrombolytic enzymes to dissolve blood clots and prevent any adverse effects, their use as a potential thrombolytic therapy has attracted great interest. A better understanding of the hemostasis and fibrinolytic system may aid in improving the efficacy and safety of this treatment approach over classical thrombolytic agents. Here, we concisely discuss the physiological mechanism of thrombus formation, thrombo-, and fibrinolysis, thrombolytic and fibrinolytic agents isolated from bacteria, fungi, and algae along with their mode of action and the potential application of microbial enzymes in thrombosis therapy.

Description of custom thread IGM technique with use of PDO facial support threads in the orofacial harmonization

The aim of this article was to describe a thread lifting procedure used for face lifting and skin rejuvenation, developed by the Doctor Molina Dental Institute (IGM, in the Portuguese acronym), termed "IGM custom thread technique" that has shown excellent results in facial tissue repositioning for facial harmonization. In this study, rather than presenting the results, we have described and discussed the proposed custom thread injection technique.