Expert Insights from a Delphi-driven Neurologists' Panel: Real-world Mexiletine use in Patients with Myotonic Disorders in Italy.

Background: Myotonic disorders, such as non-dystrophic myotonias (NDMs) and myotonic dystrophies (DMs) are characterized by a delay in muscle relaxation after a contraction stimulus. There is general consensus that protocols to treat myotonia need to be implemented. Objective: Mexiletine is the only pharmacological agent approved for the symptomatic treatment of myotonia in adult patients with NDM and is considered to be the first-line treatment for DMs; however, its production in Italy was halted in 2022 making its availability to patients problematic. Methods: A panel of 8 Italian neurologists took part in a two-round Delphi panel between June and October 2022, analyzing the current use of mexiletine in Italian clinical practice. Results: The panelists assist 1126 patients (69% DM type1, 18% NDM and 13% DM type2). Adult NDM patients receive, on average, 400-600 mg of mexiletine hydrochloride (HCl) while adult DM patients receive 100-600 mg, per day in the long-term. The severity of symptoms is considered the main reason to start mexiletine treatment for both NDM and DM patients. Mexiletine is reckoned to have a clinical impact for both NDM and DM patients, but currently drug access is problematic. Conclusions: Mexiletine treatment is recognized to have a role in the reduction of the symptomatic burden for NDM and DM patients. Patient management could be improved by facilitating access to therapy and developing new drug formulations.

EXPANSION: a webserver to explore the functional consequences of protein-coding alternative splice variants in cancer genomics.

Summary: EXPANSION (https://expansion.bioinfolab.sns.it/) is an integrated web-server to explore the functional consequences of protein-coding alternative splice variants. We combined information from Differentially Expressed (DE) protein-coding transcripts from cancer genomics, together with domain architecture, protein interaction network, and gene enrichment analysis to provide an easy-to-interpret view of the effects of protein-coding splice variants. We retrieved all the protein-coding Ensembl transcripts and mapped Interpro domains and post-translational modifications on canonical sequences to identify functionally relevant splicing events. We also retrieved isoform-specific protein-protein interactions and binding regions from IntAct to uncover isoform-specific functions via gene-set over-representation analysis. Through EXPANSION, users can analyze precalculated or user-inputted DE transcript datasets, to easily gain functional insights on any protein spliceform of interest. Availability and Implementation: EXPANSION is freely available at http://expansion.bioinfolab.sns.it/. The code of the scripts used for EXPASION is available at: https://github.com/raimondilab/expansion. Datasets associated to this resource are available at the following URL: https://doi.org/10.5281/zenodo.8229120. The web-server was developed using Apache2 (https://https.apache.org/) and Flask (v2.0.2) (http://flask.pocoo.org/) for the web frontend and for the internal pipeline to handle back-end processes. We additionally used the following Python and JavaScript libraries at both back- and front-ends: D3 (v4), jQuery (v3.2.1), DataTables (v2.3.2), biopython (v1.79), gprofiler-officia l(v1.0.0), Mysql-connector-python (v8.0.31). To construct the API, Fast API library (v0.95.1) was used.

How does the methodological clinical evaluation impact organ donation? Experience from 4 Organ Procurement Organizations (OPO)

INTRODUCTION: The lack of a clear and reproducible methodology for evaluating potential organ donors, which ensures traceability in the process, can compromise the number of utilized organ donors and the transplantation quality. METHODOLOGY: We developed a reproducible and safe method for the evaluation and validation of Potential Organ Donors (PD) based on 2 principles:1) Updated knowledge of absolute contraindications for organ donation and, 2) Decision making supported by 3 questions. The first principle was absolute contraindications. They were categorized into 4 groups: A) Serologies, B) Tumors, C) Infections, and D) Biological risk for transmission of infectious diseases and cancer. The second principle was the decision-making questions: A) What is the cause of death? B) Are there absolute contraindications to organ donation? and, C) Are there relative contraindications to organ donation? Each PD was subjected to the same methodology. The questions were answered after knowing the PD's clinical file. The PD was valid only if the set of answers adhered to an established matrix respecting different guidelines. The same physician evaluated each PD in all OPO. We applied in 4 different OPO, 3 of them in the State of São Paulo/Brazil and one in the United Arab Emirates, in different periods, including the SARS-COV 2 pandemic. RESULTS: OPO­SCSP, before the methodology (2007): 62 utilized donors, 205 transplants. After the methodology has been started (2008/2009/2010): 117, 154, 186 utilized donors and 348, 533, 487 transplants, respectively. 2) OPO-BTU, before the methodology (2009): 9 utilized donors and 19 transplants. After the methodology has been started (2010/2011/2012): 17, 36, 49 utilized donors and 38, 90, 143 transplants, respectively. 3) OPO-IDPC, before the methodology (2017): 93 utilized donors and 202 transplants. After the methodology has been started (2018/2019/2020): 107, 177, 187 utilized donors and 219, 395, 356 transplants, respectively. 4) UAE OPO, before the methodology (2020): 9 utilized donors and 35 transplants. After the methodology has been started (2021/2022): 39, 55 utilized donors and 147, 203 transplants, respectively. The percentage increase after the beginning of the methodology, considering the last year evaluated: 1) OPO-SCSP: 195% (Utilized donors) and 137% (Transplants); 2) OPO-BTU: 444% (Utilized donors) and 652% (Transplants); C) OPO-IDPC: 101% (Utilized Donors) and 76% (Transplants); 4) OPO-EOTC (United Arab Emirates): 511% (Utilized donors) and 480% (Transplants). CONCLUSION: The methodology used demonstrates that it can directly contribute to increasing the percentage of effective donors and transplants. The increase in donors ranged from 101% to 444%. The percentage growth of transplantation ranged from 76% to 652%. Indirectly, an increase the referrals was observed, motivated by frequent contact with OPO members and ICU professionals.

Long-Term Outcomes of Sternal-Sparing Versus Sternotomy Approaches for Mitral Valve Repair: Meta-Analysis of Reconstructed Time-to-Event Data.

OBJECTIVE: Since there are concerns about the durability of mitral valve repair (MVRp) with minimally invasive techniques in patients with mitral regurgitation (MR), we aimed to evaluate the long-term outcomes of these sternal-sparing approaches when compared with conventional approaches with sternotomy in patients undergoing MVRp. METHODS: We performed a systematic review according to a preestablished protocol and performed a pooled analysis of Kaplan-Meier-derived reconstructed time-to-event data from studies with longer follow-up comparing sternal-sparing versus sternotomy approaches for MVRp. Our outcomes of interest were survival, freedom from recurrent MR, and freedom from reoperation. RESULTS: Eleven studies met our eligibility criteria comprising 7,596 patients with follow-up (sternal sparing, n = 4,246; sternotomy, n = 3,350). Patients who underwent sternal-sparing MVRp had a significantly lower risk of mortality over time compared with patients who underwent MVRp with sternotomy (hazard ratio [HR] = 0.29, 95% confidence interval [CI]: 0.23 to 0.36, P < 0.001) in the overall analysis. However, we found no statistically significant difference between the groups in the sensitivity analysis with adjusted populations (HR = 0.85, 95% CI: 0.63 to 1.15, P = 0.301). Regarding the outcomes freedom from recurrent MR and freedom from reoperation, we found no statistically significant differences between the groups in the follow-up in both overall and sensitivity analyses. CONCLUSIONS: In comparison with MVRp with sternotomy approaches, sternal-sparing MVRp was not associated with worse outcomes in terms of survival, recurrent MR, and reoperations over time.

The importance of the 'magic square' in immediate implant placement and provisionalization in postextraction sites.

With changing expectations for dental treatment, esthetics have become an essential factor in defining successful rehabilitation with dental implants. The stability of the gingival contours as well as the color and texture of the surrounding tissue are critical for the long-term maintenance of successful implant treatment outcomes. The aim of the present article is to demonstrate the correlation of the 3D implant position and the adjacent tissue management protocol with the long-term maintenance of immediate implant placement results in postextraction sites. A series of 12 cases with a mean follow-up of 21.91 months is presented to introduce the concept of the 'magic square' (MS), denoting the area formed in the cervical implant region when the ideal 3D implant position is achieved. This position is 3-mm coronoapical from the implant platform to the gingival margin, with the maintenance of a 3-mm vestibulopalatine thickness of the buccal bone (ie, hard tissue gap from the buccal implant surface to the outer portion of the buccal bone wall), and a ≥ 3-mm soft tissue gap at the cervical portion of the implant. The achievement of the MS promotes soft tissue growth and the formation of a thicker peri-implant bone ridge, and ensures the stability of treatment outcomes over time.

Selective laser trabeculoplasty versus micropulse laser trabeculoplasty for intraocular pressure control in patients with primary open angle glaucoma: a 12-month retrospective comparative study.

This study was designed to compare the efficacy of selective laser trabeculoplasty (SLT) and micropulse laser trabeculoplasty (MLT) in patients with primary open angle glaucoma (POAG) requiring additional IOP control. In this retrospective, comparative study, we reviewed the charts of POAG patients requiring additional IOP lowering, who underwent either SLT or MLT and were followed for at least one year. We evaluated mean intraocular pressure (IOP), mean IOP reduction from baseline and mean number of glaucoma medications 1, 3, 6 and 12 months after treatment. Success rates (success defined as IOP ≤ 21 mmHg and ≥ 20% reduction from baseline IOP without additional medications, new laser session, or glaucoma surgery) at one year were also compared. A total of 98 POAG patients were included, 52 individuals in the SLT group and 46 in the MLT group. Laser treatment resulted in significant mean IOP reductions from baseline in both groups (SLT = -6.0 ± 3.3 mmHg (24.9%) and MLT = -5.8 ± 2.6 mmHg (23.4%)) (p < 0.001). However, there was no statistically significant difference between the mean IOP reductions in both groups (p = 0.74). At 12 months, the mean number of glaucoma medications was significantly smaller in the SLT group (1.17 + 0.4) when compared to the MLT group (2.21 + 0.2) (p = 0.001). Additionally, after 12 months, success was obtained in 32 (61.5%) SLT cases compared to 27 (58.7%) MLT-treated eyes (p = 1.0). MLT and SLT are both effective in controlling the IOP in POAG patients requiring additional IOP reduction. However, after 12 months, SLT demonstrated a greater efficacy in reducing medication burden when compared to MLT.Trial registration: CEP/CONEP/MS Brazil 40948620.9.0000.5600.

Molecular detection and genetic characterization of Ehrlichia canis and Ehrlichia sp. in neotropical primates from Brazil.

The Anaplasmataceae family includes obligate, arthropod-transmitted intracellular bacteria that can be zoonotic and potentially fatal. Studies focusing on the interaction between neotropical primates and the agents of this family are scarce. The present study aimed to identify agents of the Anaplasmataceae family in the whole blood of free-living and captive neotropical primates in the State of Mato Grosso, Central-West Brazil. Thirty-eight samples of six nonhuman primate (NHP) species were collected in seven municipalities and analysed through polymerase chain reaction (PCR), nucleotide sequencing, and phylogenetic analysis of the dsb, groEL, 16S rRNA, and gltA genes. DNA fragments similar to those of Ehrlichia canis were detected in Sapajus apella and Ehrlichia chaffeensis from Mico melanurus. The sequences generated in this study and homologous sequences retrieved from GenBank® were used for phylogenetic analyses to characterize the Ehrlichial agents detected in NHPs. The agents were then grouped into clades corresponding to different isolates from the NHP species. In addition, an Anaplasma sp. closely related to Anaplasma marginale was identified in two S. apella individuals. These findings shed light on the susceptibility of neotropical NHPs to Anaplasmataceae agents. These bacteria are known to be transmitted by ticks, which can also serve as possible sources of infection for other animals, including humans.

Dispositional mindfulness, emotional regulation and perceived stress among nursing students.

OBJECTIVE: To investigate the correlation between dispositional mindfulness, emotional regulation and perceived stress and to verify factors associated with dispositional mindfulness among nursing students. METHOD: A correlational, cross-sectional study with public undergraduate students. The following instruments were used: Mindful Attention Awareness Scale, Emotional Regulation Questionnaire and Perceived Stress Scale. Analyzes were performed using t tests, Pearson's correlation and multiple linear regression. RESULTS: The study included 330 students. There was no correlation between dispositional mindfulness and general emotional regulation score and/or perceived stress and a weak correlation with the emotional regulation dimension emotional suppression. Being in psychological treatment and psychoactive substance use were associated with decreased dispositional mindfulness. Age, sufficient sleep hours and emotional suppression were associated with an increase in this variable. CONCLUSION: There was a relationship between dispositional mindfulness only with emotional suppression, in addition to the connection of this variable with the perception of sufficient sleep hours, age, use of alcohol or psychoactive substances, undergoing psychological/psychiatric follow-up and emotional suppression.

PRECOGx: exploring GPCR signaling mechanisms with deep protein representations.

In this study we show that protein language models can encode structural and functional information of GPCR sequences that can be used to predict their signaling and functional repertoire. We used the ESM1b protein embeddings as features and the binding information known from publicly available studies to develop PRECOGx, a machine learning predictor to explore GPCR interactions with G protein and ß-arrestin, which we made available through a new webserver (https://precogx.bioinfolab.sns.it/). PRECOGx outperformed its predecessor (e.g. PRECOG) in predicting GPCR-transducer couplings, being also able to consider all GPCR classes. The webserver also provides new functionalities, such as the projection of input sequences on a low-dimensional space describing essential features of the human GPCRome, which is used as a reference to track GPCR variants. Additionally, it allows inspection of the sequence and structural determinants responsible for coupling via the analysis of the most important attention maps used by the models as well as through predicted intramolecular contacts. We demonstrate applications of PRECOGx by predicting the impact of disease variants (ClinVar) and alternative splice forms from healthy tissues (GTEX) of human GPCRs, revealing the power to dissect system biasing mechanisms in both health and disease.

Molecular detection of Toxoplasma gondii and Neospora caninum in neotropical primates.

BACKGROUND: Toxoplasma gondii and Neospora caninum infections in primates are potentially fatal and directly impact the conservation of these animals and public health. MATERIALS AND METHODS: A total of 38 blood/clot samples collected from free-living and captive neotropical primates undergoing clinical care or found dead by environmental authorities in the Mato Grosso State, Brazil, were analyzed by PCR for DNA detection of T. gondii and N. caninum. Furthermore, eight animals were submitted to immunohistochemistry for the detection of T. gondii. RESULTS: DNA of T. gondii and N. caninum was amplified in 11 (28.95%) 10 (26.32%) of samples analyzed, respectively. Coinfection was observed in three individuals. One animal returned a positive result in the immunohistochemistry for the detection of T. gondii. CONCLUSION: These findings reflect a concern for the conservation of these animals, as the pathogen-host interaction is unpredictable and infections by these protozoa can lead to animal mortality, which has a substantial impact on endangered species.

In-Hospital Outcomes of Right Minithoracotomy vs. Periareolar Access for Minimally Invasive Video-Assisted Mitral Valve Repair

Abstract Introduction: In minimally invasive mitral valve repair, right minithoracotomy is the most widely performed method, providing a good view of the mitral valve. But regarding other techniques and although it offers limited visualization, the periareolar access is a less traumatic alternative. This study's purpose is to compare in-hospital outcomes in patients who underwent video-assisted minimally invasive mitral valve repair via right minithoracotomy and periareolar access. Methods: This is a retrospective observational study including 37 patients (> 18 years old), without previous right thoracic surgery, who underwent their primary mitral valve repair, with indication for minimally invasive video-assisted approach (via right minithoracotomy or periareolar access), between January 2018 and August 2019. Patients' medical records were consulted to collect demographics data, operative details, and in-hospital outcomes. Results: Twenty-one patients underwent right minithoracotomy, and 16 were operated via periareolar access. The mean patients' age was 62±12 years in the right minithoracotomy group and 61±9 years in the periareolar access group (P=0.2). There are no significant differences in incision length, cardiopulmonary bypass time, aortic cross-clamping time, hematocrit, amount of chest tube drainage, and intensive care unit and in-hospital length of stay. Time to extubation presented significant differences between the right minithoracotomy and the periareolar access group (4.85 hours vs. 5.62 hours, respectively) (P=0.04). Conclusion: In this study, we found similar results in the two applied surgical techniques, except for the time to extubation.

In-Hospital Outcomes of Right Minithoracotomy vs. Periareolar Access for Minimally Invasive Video-Assisted Mitral Valve Repair.

INTRODUCTION: In minimally invasive mitral valve repair, right minithoracotomy is the most widely performed method, providing a good view of the mitral valve. But regarding other techniques and although it offers limited visualization, the periareolar access is a less traumatic alternative. This study's purpose is to compare in-hospital outcomes in patients who underwent video-assisted minimally invasive mitral valve repair via right minithoracotomy and periareolar access. METHODS: This is a retrospective observational study including 37 patients (> 18 years old), without previous right thoracic surgery, who underwent their primary mitral valve repair, with indication for minimally invasive video-assisted approach (via right minithoracotomy or periareolar access), between January 2018 and August 2019. Patients' medical records were consulted to collect demographics data, operative details, and in-hospital outcomes. RESULTS: Twenty-one patients underwent right minithoracotomy, and 16 were operated via periareolar access. The mean patients' age was 62±12 years in the right minithoracotomy group and 61±9 years in the periareolar access group (P=0.2). There are no significant differences in incision length, cardiopulmonary bypass time, aortic cross-clamping time, hematocrit, amount of chest tube drainage, and intensive care unit and in-hospital length of stay. Time to extubation presented significant differences between the right minithoracotomy and the periareolar access group (4.85 hours vs. 5.62 hours, respectively) (P=0.04). CONCLUSION: In this study, we found similar results in the two applied surgical techniques, except for the time to extubation.

Conventional Versus Minimally Invasive Aortic Valve Replacement Surgery: A Systematic Review, Meta-Analysis, and Meta-Regression.

Objective: To assess the potential benefits of minimally invasive aortic valve replacement (MIAVR) compared with conventional AVR (CAVR) by examining short-term outcomes. Methods: A systematic search identified randomized trials comparing MIAVR with CAVR. To assess study limitations and quality of evidence, we used the Cochrane Risk of Bias tool and GRADE and performed random-effects meta-analysis. We used meta-regression and sensitivity analysis to explore reasons for diversity. Results: Thirteen studies (1,303 patients) were included. For the comparison of MIAVR and CAVR, the risk of bias was judged low or unclear and the quality of evidence ranged from very low to moderate. No significant difference was observed in mortality, stroke, acute kidney failure, infectious outcomes, cardiac events, intubation time, intensive care unit stay, reoperation for bleeding, and blood transfusions. Blood loss (mean difference [MD] = -130.58 mL, 95% confidence interval [CI] = -216.34 to -44.82, I2 = 89%) and hospital stay (MD = -0.93 days, 95% CI = -1.62 to -0.23, I2 = 81%) were lower with MIAVR. There were shorter aortic cross-clamp (MD = 5.99 min, 95% CI = 0.99 to 10.98, I2 = 93%) and cardiopulmonary bypass (CPB) times (MD = 7.75 min, 95% CI = 0.27 to 15.24, I2 = 94%) in the CAVR group. In meta-regression analysis, we found that age was the variable with the greatest influence on heterogeneity. Conclusions: MIAVR seems to be an excellent alternative to CAVR, reducing hospital stay and incidence of hemorrhagic events. Despite significantly greater aortic cross-clamp and CPB times with MIAVR, this did not translate into adverse effects, with no changes in the results found with CAVR.

Dispositional mindfulness, emotional regulation and perceived stress among nursing students / Mindfulness disposicional, regulación emocional y estrés percibido en estudiantes de enfermería / Atenção plena disposicional, regulação emocional e estresse percebido em estudantes de enfermagem

ABSTRACT Objective: To investigate the correlation between dispositional mindfulness, emotional regulation and perceived stress and to verify factors associated with dispositional mindfulness among nursing students. Method: A correlational, cross-sectional study with public undergraduate students. The following instruments were used: Mindful Attention Awareness Scale, Emotional Regulation Questionnaire and Perceived Stress Scale. Analyzes were performed using t tests, Pearson's correlation and multiple linear regression. Results: The study included 330 students. There was no correlation between dispositional mindfulness and general emotional regulation score and/or perceived stress and a weak correlation with the emotional regulation dimension emotional suppression. Being in psychological treatment and psychoactive substance use were associated with decreased dispositional mindfulness. Age, sufficient sleep hours and emotional suppression were associated with an increase in this variable. Conclusion: There was a relationship between dispositional mindfulness only with emotional suppression, in addition to the connection of this variable with the perception of sufficient sleep hours, age, use of alcohol or psychoactive substances, undergoing psychological/psychiatric follow-up and emotional suppression.

RESUMEN Objetivo: Investigar la correlación entre mindfulness disposicional, regulación emocional y estrés percibido y verificar factores asociados al mindfulness disposicional en estudiantes de enfermería. Método: Estudio transversal, correlacional con estudiantes de universidades públicas. Los instrumentos fueron utilizados: Mindful Attention Awareness Scale, Emotional Regulation Questionnaire y Perceived Stress Scale. Los análisis se realizaron mediante pruebas t, correlación de Pearson y regresión lineal múltiple. Resultados: Participaron 330 estudiantes. No hubo correlación entre mindfulness disposicional y puntuación general de regulación emocional y/o estrés percibido y una débil correlación con la dimensión de regulación emocional supresión de emociones. Estar en tratamiento psicológico y el consumo de sustancias psicoactivas se asociaron con una disminución del mindfulness disposicional. La edad, la suficiencia de horas de sueño y la supresión emocional se asociaron con un aumento de esta variable. Conclusión: Hubo relación entre el mindfulness disposicional solo con la supresión de emociones, además de la conexión de esta variable con la percepción de suficientes horas de sueño, edad, consumo de alcohol o sustancias psicoactivas, estar en seguimiento psicológico/psiquiátrico y supresión emocional.

RESUMO Objetivo: Investigar a correlação entre atenção plena disposicional, regulação emocional e estresse percebido e verificar fatores associados à atenção plena disposicional em estudantes de enfermagem. Método: Estudo correlacional, transversal, com estudantes de universidade pública. Foram utilizados os instrumentos: Mindful Attention Awareness Scale, Emotional Regulation Questionnaire e Perceived Stress Scale. Análises foram realizadas por meio de testes t, correlação de Pearson e regressão linear múltipla. Resultados: Participaram 330 estudantes. Identificou-se ausência de correlação entre a atenção plena disposicional e escore geral de regulação emocional e/ou estresse percebido e correlação fraca com a dimensão de regulação emocional supressão das emoções. Estar em tratamento psicológico e uso de substância psicoativas se associou à diminuição da atenção plena disposicional. Já idade, suficiência de horas de sono e supressão emocional se associaram ao aumento desta variável. Conclusão Houve relação entre a atenção plena disposicional apenas com a supressão das emoções, além de ligação desta variável com percepção de horas suficientes de sono, idade, uso de álcool ou substâncias psicoativas, estar em acompanhamento psicológico/psiquiátrico e supressão emocional.

Clinical, Tomographic, and Histologic Evaluation of an Autogenous Bone Graft Harvested from the Maxillary Tuberosity for Guided Bone Regeneration: Case Report with a 4-Year Follow-up.

This report presents a case in which autogenous bone grafts were harvested from the maxillary tuberosity for guided bone regeneration and dental implant placement, with long-term follow-ups and assessment at the clinical, tomographic, and histologic levels. Particulate and block autogenous bone grafts were covered with a resorbable collagen membrane. Advanced bone remodeling and good bone quality, enabling dental implant placement, were observed after a short healing time (3 months). The differences in buccal bone plate thickness in the grafted area between the period immediately after implant placement and 4 years thereafter ranged from +0.879 mm to -0.001 mm. The implants osseointegrated uneventfully, and alveolar bone regeneration remained stable with a satisfactory result after 4 years.

Saúde bucal de crianças com microcefalia associada ao Zika vírus / Oral health of children with microcephaly associated with Zika vírus / Salud bucal de los niños con microcefalia asociada al virus del Zika

Objetivo: descrever sobre as condições bucais das crianças com Microcefalia associada ao Zika vírus. Metodologia: Estudo transversal realizado com 13 crianças atendidas no projeto institucional e multidisciplinar "Atenção Integrada às crianças com microcefalia por Zika vírus" e seus respectivos cuidadores. Foi realizado entrevista com os cuidadores e de exame clínico bucal nas crianças, sendo coletados dados sobre características sociodemográficas e econômicas, hábitos de higiene, comportamentais e alimentares, assim como as características oclusais e os índices clínicos odontológicos (ISG, IPV e ceo-d). Os dados foram analisados de maneira descritiva e através do teste Wilcoxon no software Statistical Package for the Social Sciences, versão 20. Resultados: A maioria das crianças eram do sexo feminino (53,8%), entre 24 e 35 meses (76,9%) e a mãe era o principal cuidador (76,9%). Em relação aos hábitos das crianças, 61,5% apresentavam alimentação semissólida, com frequência de escovação diária de duas vezes ou mais (46,2%), utilizavam mamadeira (76,9%) e chupeta (53,8%). As crianças não apresentavam cárie, o ISG e IPV foram considerados satisfatórios. Além disso, 92,3% das crianças rangiam os dentes durante a noite, 61,5% apresentavam mordida aberta anterior, sobressaliência aumentada (84,6%) e cronologia de erupção alterada (84,6%). Conclusão: As crianças apresentavam erupção dentária tardia, presença de facetas de desgastes, chave de canino com classificação I, mordida aberta anterior e sobressaliência aumentada. Além disso, possuíam frequência de escovação satisfatória, alimentações semissólida, usavam mamadeira e chupeta. A partir dos índices odontológicos, observou-se que as crianças apresentavam uma saúde bucal satisfatória(AU)

Objective: to describe the oral conditions of children with microcephaly associated with Zikavirus. Methodology: Cross-sectional study carried out with 13 children assisted in the institutional and multidisciplinary project "Integrated Care for children with microcephaly due to Zika virus" and their respective caregivers. Interviews were conducted with caregivers and a clinical oral exam was carried out on the children, with data on sociodemographic and economic characteristics, hygiene, behavioral and dietary habits, as well as occlusal characteristics and clinical dental indexes (ISG, IPV and ceo-d) being collected. The data were analyzed descriptively and using the Wilcoxon test in the Statistical Package for the Social Sciences software, version 20. Results: Most children were female (53.8%), between 24 and 35 months (76.9 %) and the mother wasthe main caregiver (76.9%). Regarding the children's habits, 61.5% had a semi-solid diet, with a daily brushing frequency of twice or more (46.2%), used a bottle (76.9%) and pacifier (53.8%). The children did not present caries, the ISG and IPV were considered satisfactory. In addition, 92.3% of children gritted their teeth at night, 61.5% had an open anterior bite, increased overjet (84.6%) and altered rash chronology (84.6%) Conclusion: Children had a rash late dental, presence of wear facets, canine keywith classification I, anterior open bite and increased overjet. In addition, they had a satisfactory brushing frequency, semi-solid food, used a bottle and used a pacifier. From the dental indexes, it was observed that the children had satisfactory oral health(AU)

Objetivo: describir las condiciones bucales de los niños con microcefalia asociada al virus del Zika. Metodología: Estudio transversal realizado con 13 niños atendidos en el proyecto institucional y multidisciplinario "Atención integral a niños conmicrocefalia por virus Zika" y sus respectivos cuidadores. Se realizaron entrevistas con los cuidadores y se realizó un examen clínico bucal a los niños, con datos de características sociodemográficas y económicas, higiene, hábitos de comportamiento y dietéticos, así como características oclusales e índices clínico-odontológicos (ISG, IPV y ceo). -d) siendo recogido. Los datos se analizaron de forma descriptiva y mediante la prueba de Wilcoxon en el software Statistical Package for the Social Sciences, versión 20. Resultados: La mayoría de los niños eran mujeres (53,8%), entre 24 y 35 meses (76,9%) y la madre era la principal cuidadora. (76,9%). En cuanto a los hábitos de los niños, el 61,5% tenía alimentación semisólida, con una frecuencia de cepillado diario de dos o más (46,2%), utilizaba biberón (76,9%) y chupete (53,8%). Los niños no presentaron caries, la ISG y la IPV se consideraron satisfactorias. Además, el 92,3% de los niños apretaban los dientes por la noche, el 61,5% tenía una mordida anterior abierta, un resalte elevado (84,6%) y una cronología de la erupción alterada (84,6%) Conclusión: los niños tenían una erupción dental tardía, presencia de facetas de desgaste, canino clave con clasificación I, mordida abierta anterior y resalte aumentado. Además, tenían una frecuencia de cepillado satisfactoria, alimentos semisólidos, usaban biberón y usaban chupete. A partir de los índices dentales, se observó que los niños tenían una salud bucal satisfactoria(AU)

Polymorphisms of the vitamin D receptor gene in Crohn's disease / Polimorfismos do gene do receptor de vitamina D na doença de Crohn

Introduction: Crohn's disease (CD) and ulcerative colitis (UC) are chronic inflammatory conditions of the gastrointestinal tract. Studies have shown that polymorphisms of the vitamin D receptor (VDR) gene may help elucidate the pathogenesis of CD. Objectives: To analyze the role of VDR gene polymorphisms (ApaI, BsmI, FokI, and TaqI) in the development of CD. Methods: The present study is a systematic review with meta-analysis. a total of 50 articles in English and Portuguese published from 2000 to 2020 were selected from 3 databases. The relationship between CD and the VDR gene was addressed in 16 articles. Results: The TaqI polymorphism was analyzed in 3,689 patients and 4,645 control subjects (odds ratio [OR]=0.948; 95% confidence interval [95%CI]=0.851-1.056; p=0.3467). The ApaI polymorphism was studied in 3,406 patients and 4,415 control subjects (OR=1,033; 95%CI=0.854-1.250; p=0.7356). For FokI polymorphism, there were 2,998 patients and 4,146 control subjects (OR=0.965; 95%CI=0.734-1.267; p=0.7958). Lastly, the BsmI polymorphism was analyzed in 2,981 patients and 4,477 control subjects (OR=1,272; 95%CI=0.748-2.161; p=0.3743). Conclusion: These four VDR gene polymorphisms were not associated with CD. Therefore, further studies with larger samples are required to corroborate or rectify the conclusions from the present meta-analysis. (AU)

Introdução: A doença de Crohn (DC) e a retocolite ulcerativa (RU) são condições inflamatórias crônicas do trato gastrointestinal. Estudos indicam que os polimorfismos do gene do receptor de vitamina D (RVD) são promissores para a patogênese da DC. Objetivos: Avaliar papel dos os polimorfismos do gene do RVD (ApaI, BsmI, FokI e TaqI) no desenvolvimento da DC. Métodos: Trata-se de uma revisão sistemática com metanálise. Foram identificados 50 artigos em inglês e português publicados entre 2000 a 2020 em 3 bases de dados. Destes, foram selecionados 16 artigos que contemplavama relação entre a DC e o genedo RVD. Resultados: Para o polimorfismo TaqI, a amostra foi composta por 3.689 pacientes e 4.645 controles (razão de probabilidade [RP]=0,948; intervalo de confiança de 95% [IC95%]=0,851-1,056; p=0,3467). Para o polimorfismo ApaI, 3.406 pacientes e 4.415 controles (RP=1,033; IC95%=0,854-1,250; p=0,7356). Para o polimorfismo FokI, 2.998 pacientes e 4.146 controles (RP=0,965; IC95%=0,734-1,267; p=0,7958). E, para o polimorfismo BsmI, 2.981 pacientes e 4.477 controles (RP =1,272; IC95%=0,748-2,161; p=0,3743). Conclusão: Esses quatro polimorfismos do gene do RVD não apresentaram associação coma DC. Logo, sugere-se a realização de mais estudos com amostras maiores a fimde corroborar ou retificar a conclusão desta metanálise. (AU)

Computerized Cognitive Training for ADHD as an Add-On Treatment to Stimulants: A Randomized Clinical Trial.

Objective: Computerized cognitive training (CCT) as add-on treatment to stimulants for ADHD core symptoms is scarcely investigated. The purpose of this study is to assess the effect of CCT in a randomized controlled clinical trial for ADHD in children and adolescents treated with stimulants. Method: Fifty-three participants aged 6 to 13 years receiving stimulant treatment and presenting ADHD residual symptoms were randomized either to a CCT (n = 29) or to a controlled nonactive condition (n = 24) for four sessions/week during 12 weeks. The main outcome measure was inattentive symptoms assessed using the Swanson, Nolan, and Pelham-IV (SNAP-IV) Scale. Secondary outcomes include, among others, hyperactive/impulsive symptoms and cognitive tests. Results: There were neither significant group differences on ADHD-inattentive symptoms after the intervention nor on both ADHD-hyperactivity/impulsivity symptoms and cognitive measures. Conclusion: Our study does not provide evidence for the benefits of cognitive training over nonactive training on core ADHD symptoms in medicated ADHD children and adolescents.

Intelligent System for Dispatch Ranking of Generating Units in Thermoelectric Power-Plants

Abstract The multicriteria decision-making process is still an open problem, especially when the decision criteria are not numerical or fully outlined. Several numerical, intelligent, or hybrid techniques have been developed, creating contributions to this problem's solution. This paper is another step in this direction. Based on the Modified Analytic Hierarchy Process (MAHP), a methodology for diagnosis and performance analysis is presented for the dispatch ranking of generating units in a thermoelectric plant. The problem is complex because it covers a power plant, where 99 generating units may be dispatched, according to 10 possible evaluation criteria, which should be used together. This article also presents details of the implementation of the sensors necessary to add to the supervisory system existing in the Palmeiras de Goias Thermal Power Plant.