Risk indicators of caries lesion activity in children.

AIM: Determine the risk indicators of caries lesion activity in a child sample from Porto Alegre, Brazil. MATERIALS AND METHODS: Study design: cross-sectional study included 97 individuals aged between 3 and 12-years who sought treatment at the Paediatric Clinic at the Dental Teaching Hospital at the Federal University of Rio Grande do Sul, between 2017 and 2018. Questionnaires recorded sociodemographic data, frequency of sugar intake, and toothbrushing frequency. Clinical examination included the visible plaque index, gingival blood index, and caries lesion activity. RESULTS: s The mean of surfaces with active caries lesions was 9.81 (IC 95% = 8.47-11.15). Children who presented a frequency of sugar intake of twice/day (PR = 1.62, IC 95% = 1.30-2.03), three times/day (PR = 1.68, IC 95% = 1.37-2.08), and four or more times/day (PR = 1.59, IC 95% = 1.26-2.01), were likely to have active lesions. Ages between 8 and 12-years were associated with a lower probability of active carious lesions (PR = 0.77, IC 95% = 0.66-088). STATISTICS: Poisson regression analysis was used to estimate the child's relative risk of developing new active caries lesions. CONCLUSIONS: The monitoring of sugar intake should be considered a strong instrument for the strategies of control of dental caries in children.

Partial caries removal in deep caries lesions: a 5-year multicenter randomized controlled trial.

OBJECTIVE: This multicenter randomized controlled clinical trial aimed to compare the outcomes of stepwise excavation (SW) and partial caries removal (PCR) regarding the maintenance of pulp vitality in deep caries lesions over 5 years. METHODS: At baseline, 299 permanent molars with deep caries lesions were randomly assigned to control or test groups. The control group received the stepwise excavation treatment (SW), while the test group received partial caries removal from the pulpal wall followed by restoration in a single session (PCR). Treatments were conducted in two centers located in the cities of Porto Alegre (South Brazil) and Brasília (Midwest Brazil). Survival analysis was performed to compare PCR and SW over time (Weibull regression models). The primary outcome of this study was pulp vitality, determined by the combination of the following characteristics: positive response to cold test, negative response to percussion, absence of spontaneous pain, and absence of periapical lesion (radiographic examination). RESULTS: This 5-year study includes data pertaining to 229 teeth: 121 teeth actually examined at the 5-year appointment, and 108 teeth contributed with data collected in previous follow-ups (18 months or 3 years). Survival analysis showed success rates of 80% in PCR group and 56% in SW group (p < 0.001). Failure was significantly associated with treatment [PCR, HR=0.38; 95%CI=0.23-0.63)] and region [South, HR=2.22; 95%CI=1.21-4.08]. CONCLUSION: PCR significantly reduced the occurrence of pulp necrosis when compared with SW. CLINICAL RELEVANCE: This study supports the PCR as a single-visit technique to manage deep caries lesions in permanent teeth.

Calibration of the maximum carboxylation velocity (Vcmax) using data mining techniques and ecophysiological data from the Brazilian semiarid region, for use in Dynamic Global Vegetation Models / Calibração da velocidade máxima de carboxilação (Vcmax), utilizando técnicas de mineração de dados e dados de ecofisiologia da região semiárida brasileira, para uso em Modelos de Vegetação Globais Dinâmicos

Abstract The semiarid region of northeastern Brazil, the Caatinga, is extremely important due to its biodiversity and endemism. Measurements of plant physiology are crucial to the calibration of Dynamic Global Vegetation Models (DGVMs) that are currently used to simulate the responses of vegetation in face of global changes. In a field work realized in an area of preserved Caatinga forest located in Petrolina, Pernambuco, measurements of carbon assimilation (in response to light and CO2) were performed on 11 individuals of Poincianella microphylla, a native species that is abundant in this region. These data were used to calibrate the maximum carboxylation velocity (Vcmax) used in the INLAND model. The calibration techniques used were Multiple Linear Regression (MLR), and data mining techniques as the Classification And Regression Tree (CART) and K-MEANS. The results were compared to the UNCALIBRATED model. It was found that simulated Gross Primary Productivity (GPP) reached 72% of observed GPP when using the calibrated Vcmax values, whereas the UNCALIBRATED approach accounted for 42% of observed GPP. Thus, this work shows the benefits of calibrating DGVMs using field ecophysiological measurements, especially in areas where field data is scarce or non-existent, such as in the Caatinga.

Resumo A região semiárida do nordeste do Brasil, a Caatinga, é extremamente importante devido à sua biodiversidade e endemismo. Medidas de fisiologia vegetal são cruciais para a calibração de Modelos de Vegetação Globais Dinâmicos (DGVMs) que são atualmente usados para simular as respostas da vegetação diante das mudanças globais. Em um trabalho de campo realizado em uma área de floresta preservada na Caatinga localizada em Petrolina, Pernambuco, medidas de assimilação de carbono (em resposta à luz e ao CO2) foram realizadas em 11 indivíduos de Poincianella microphylla, uma espécie nativa que é abundante nesta região. Estes dados foram utilizados para calibrar a velocidade máxima de carboxilação (Vcmax) usada no modelo INLAND. As técnicas de calibração utilizadas foram Regressão Linear Múltipla (MLR) e técnicas de mineração de dados como Classification And Regression Tree (CART) e K-MEANS. Os resultados foram comparados com o modelo INLAND não calibrado. Verificou-se que a Produtividade Primária Bruta (PPB) simulada atingiu 72% da PPB observada ao usar os valores de Vcmax calibrado, enquanto que o modelo não calibrado obteve-se 42% da PPB observada. Assim, este trabalho mostra os benefícios de calibrar DGVMs usando medidas ecofisiológicas de campo, especialmente em áreas onde os dados de campo são escassos ou inexistentes, como na Caatinga.

Calibration of the maximum carboxylation velocity (Vcmax) using data mining techniques and ecophysiological data from the Brazilian semiarid region, for use in Dynamic Global Vegetation Models.

The semiarid region of northeastern Brazil, the Caatinga, is extremely important due to its biodiversity and endemism. Measurements of plant physiology are crucial to the calibration of Dynamic Global Vegetation Models (DGVMs) that are currently used to simulate the responses of vegetation in face of global changes. In a field work realized in an area of preserved Caatinga forest located in Petrolina, Pernambuco, measurements of carbon assimilation (in response to light and CO2) were performed on 11 individuals of Poincianella microphylla, a native species that is abundant in this region. These data were used to calibrate the maximum carboxylation velocity (Vcmax) used in the INLAND model. The calibration techniques used were Multiple Linear Regression (MLR), and data mining techniques as the Classification And Regression Tree (CART) and K-MEANS. The results were compared to the UNCALIBRATED model. It was found that simulated Gross Primary Productivity (GPP) reached 72% of observed GPP when using the calibrated Vcmax values, whereas the UNCALIBRATED approach accounted for 42% of observed GPP. Thus, this work shows the benefits of calibrating DGVMs using field ecophysiological measurements, especially in areas where field data is scarce or non-existent, such as in the Caatinga.

Evolution and challenges of dynamic global vegetation models for some aspects of plant physiology and elevated atmospheric CO2.

Dynamic global vegetation models (DGVMs) simulate surface processes such as the transfer of energy, water, CO2, and momentum between the terrestrial surface and the atmosphere, biogeochemical cycles, carbon assimilation by vegetation, phenology, and land use change in scenarios of varying atmospheric CO2 concentrations. DGVMs increase the complexity and the Earth system representation when they are coupled with atmospheric global circulation models (AGCMs) or climate models. However, plant physiological processes are still a major source of uncertainty in DGVMs. The maximum velocity of carboxylation (Vcmax), for example, has a direct impact over productivity in the models. This parameter is often underestimated or imprecisely defined for the various plant functional types (PFTs) and ecosystems. Vcmax is directly related to photosynthesis acclimation (loss of response to elevated CO2), a widely known phenomenon that usually occurs when plants are subjected to elevated atmospheric CO2 and might affect productivity estimation in DGVMs. Despite this, current models have improved substantially, compared to earlier models which had a rudimentary and very simple representation of vegetation-atmosphere interactions. In this paper, we describe this evolution through generations of models and the main events that contributed to their improvements until the current state-of-the-art class of models. Also, we describe some main challenges for further improvements to DGVMs.

Biocompatibility of root filling pastes used in primary teeth.

AIM: To evaluate the biocompatibility of two pastes designed to fill the root canals of primary teeth. METHODOLOGY: A study group of 54 mice received subcutaneous tissue implants of polyethylene tubes containing CTZ or calcium hydroxide paste or, as a negative control, empty tubes. Biocompatibility was evaluated on days 7, 21 and 63, yielding a total of nine groups of six animals each. Following the experimental intervals, the implant areas were removed and subjected to histologic processing. After the tissues were stained with HE and Masson trichrome, two pathologists performed a histologic analysis of the samples in a blinded manner. Collagen fibre formation, tissue thickness and inflammatory cell infiltration were analysed qualitatively. Quantitative morphometry was performed for the thickness, perimeter length and tissue area of the region in direct contact with the open tube. anova with the Tukey post-test and Kruskal-Wallis analysis followed by Dunn's post-test, with significance established as P < 0.05, were used for data analysis. RESULTS: At 7 days, all groups had severe acute inflammatory infiltrates. Inflammation was reduced at 21 days in the CTZ paste group. Mild chronic inflammatory infiltrates were observed after 63 days in the CTZ and Ca(OH)2 paste groups; these groups also showed a significant decrease in collagen fibre density (P < 0.05), which was not observed in the control group. The average tissue thickness, perimeter length and area in contact with the tube decreased during the experimental periods in all groups. CONCLUSION: The CTZ and calcium hydroxide pastes demonstrated biocompatibility with subcutaneous tissue in this experimental model.

Genes de virulência e diversidade genética em Salmonella spp. isoladas de amostras de origem suína / Virulence genes and genetic diversity in Salmonella spp. isolated from samples of swine origin

A diversificação da produção industrial de alimentos de origem suína e o intercâmbio comercial de animais e seus derivados destinados ao consumo humano podem ser importantes disseminadores de sorovares de Salmonella spp. na cadeia alimentar. Objetivou-se avaliar em 86 cepas de Salmonella spp., isoladas em granja de terminação e no abate de suínos, a ocorrência de três genes de virulência (invA, agfA e lpfA), bem como a similaridade genética entre elas. A ocorrência do gene invA foi verificada em 100% das amostras. O gene lpfA foi detectado em 80,23% (69/86) das cepas, não foi detectado em S. Panama e estava presente em todas as cepas de S. Infantis. O gene agfA foi detectado em 63,95% (55/86) das amostras. S. Agona apresentou positividade para todos os genes de virulência estudados. A análise de homologia entre as cepas agrupou os diferentes sorovares em clusters. A similaridade foi independente do local de isolamento, o que demonstra a presença de clones ao longo da cadeia de produção e a existência de multiplicidade de fontes para a infecção dos animais, como a ração, e a contaminação cruzada das carcaças. A pesquisa de genes de virulência e a avaliação da proximidade gênica permitem a caracterização e um maior entendimento sobre cepas de Salmonella circulantes na cadeia produtiva de suínos e, assim, podem subsidiar medidas de controle durante o processo produtivo com o objetivo de garantir a saúde do consumidor...

The diversification of industrial food production of swine origin and trade of animals and their derivatives for human consumption may be important disseminators of serovars of Salmonella spp. in the food chain. This study aimed to evaluate 86 strains of Salmonella spp. isolated form in the finishing and slaughter of pigs, the occurrence of three virulence genes (invA, agfa and lpfA), as well as the genetic similarity between them. The occurrence of gene invA was observed in 100% of the samples. The gene lpfA was detected in 80.23% (69/86) strains and is not detected in S. Panama, but present in all strains of S. Infantis. The gene agfA was detected in 63.95% (55/86). S. Agona was positive for all virulence genes studied. The analysis of homology between the different serovars grouped the isolates in clusters. The similarity was regardless of the location of isolation, demonstrating the presence of clones along the production chain and that there are multiple sources for the infection of animals, such as feed, and cross-contamination of carcasses. A survey of virulence genes and evaluation of gene proximity allow characterization and better understanding of Salmonella strains circulating in the pig production chain, thus being able to support control measures during the production process in order to ensure consumer health...

Partial removal of carious dentine: a multicenter randomized controlled trial and 18-month follow-up results.

AIM: The aim of this study was to evaluate the effectiveness of partial removal of carious dentine and restoration in a single session (PDR) and stepwise excavation (SW), both of which are treatments for deep carious lesions, in Public Health Services in Brazil. INCLUSION CRITERIA: patients ≥6 years old, permanent molars with deep caries lesions (having a radiolucency halfway or more into dentine) and pulp vitality but absence of spontaneous pain, positive percussion test, and periapical alterations. The subjects received either PDR (test group) or SW (control group). The radiological and clinical exams were performed after a mean time of 18 months. OUTCOMES: success was defined as pulp sensitivity to cold test and absence of periapical alterations. RESULTS: Of the 299 treatments performed, 146 were SW and 153 were PDR; 122 were amalgam restorations and 168 resin-composite restorations. There were no differences between the groups regarding the baseline characteristics (i.e. age, gender and family income). After 18 months, 212 evaluations were performed, which indicated 99 and 86% success rates in the PDR and SW groups, respectively (p = 0.016). Reasons for failure were: PDR - 1 pulpitis; SW - 8 pulpitis; 1 osteitis; 4 necrosis; 1 endodontic treatment. None of the baseline variables were significantly associated with the outcomes. CONCLUSION: The retention of carious dentine does not interfere in pulp vitality. Data from this 18-month study suggest that the procedure of reopening the cavity to remove the residual infected dentine is not necessary.

Randomized trial of partial vs. stepwise caries removal: 3-year follow-up.

This randomized, multicenter clinical trial evaluated the effectiveness of 2 treatments for deep caries lesions - partial caries removal (PCR) and stepwise excavation (SW) - with respect to the primary outcome of pulp vitality for a 3-year follow-up period. Inclusion criteria were as follows: patients with permanent molars presenting deep caries lesions (lesion affecting ≥ 1/2 of the dentin on radiographic examination), positive response to a cold test, absence of spontaneous pain, negative sensitivity to percussion, and absence of periapical lesions (radiographic examination). Teeth randomly assigned to PCR (test) received incomplete caries removal and filling in a single session. Outcome success was evaluated by assessment of pulp vitality, determined by pulp sensitivity to a cold test and the absence of periapical lesions. Data were analyzed by a Weibull regression model with shared frailty term (survival analysis). At baseline, 299 treatments were executed: PCR, 152 and SW, 147. By the end of the 3-year follow-up period, 213 teeth had been evaluated. Adjusted survival rates were 91% for PCR and 69% for SW (p = 0.004). These results suggest that there is no need to re-open a cavity and perform a second excavation for pulp vitality to be preserved (Clinical trials registration NCT00887952).

Treatment of a crown-root fracture with intentional replantation - case report with 16-year follow-up.

AIM: To report the intentional replantation of a maxillary central incisor with a crown-root fracture. SUMMARY: An 11-year-old girl was referred to a paediatric clinic with an extensive crown-root fracture of the maxillary right central incisor (tooth 11) with pulp exposure. Radiographs revealed that tooth 11 had a periapical radiolucent lesion, which suggested pulpal necrosis. The treatment option chosen was planned extraction and immediate intentional replantation of tooth 11 in a more coronal position. Sixteen years after treatment, tooth 11 was aesthetically and functionally sound, suggesting that the treatment was successful. KEY LEARNING POINT: Intentional replantation may be considered as a treatment option for teeth with crown-root fractures.

[An evaluation of municipal actions in the control of dengue vectors in the region of São José do Rio Prêto, São Paulo, 1989 to 1995]. / Avaliação de ações municipais de combate a vetores da dengue na região de São José do Rio Prêto, São Paulo, 1989 a 1995.

The aim of this study was to determine the coverage of municipal activities in terms of the control of Aedes aegypti and/or Aedes albopictus by routine house-to-house visits and by emergency activity, carried out between 1989 and 1995 in the area of São José do Rio Prêto, São Paulo State, and to evaluate the cross-correlation between them and the Breteau index (BI). For towns with up to 50,000 real estate properties, the joint coverage by routine and emergency activities was mostly appropriate and the routine activities showed a negative cross-correlation with the BI. For the county seat (more than 50,000 real estate properties), the coverage provided by the above activities was not correlated with the BI. In general, the coverage was inversely proportional to town size. Emergency activities did not show a correlation with the BI in any town size range, proving to be ineffective.