Polysacharide of Agaricus blazei gel mitigates bone necrosis in model of the jaws related to bisphosphonate via Wnt signaling.

To investigate de effect of PAb gel on the bone tissue of rats submitted to Bisphosphonate-related osteonecrosis of the jaws (BRONJ). Initially, 54 animals were submitted to BRONJ model by Zoledronic Acid (ZA) (0.1 mg/kg 3x/wk for 9 wk, ip), followed by the 1st upper left molar extraction at the 8th wk. After tooth removal, the animals were divided into 3 groups, ZA that received placebo gel or PAb gel that received 1% PAb gel, inside the dental alveolus. The control Group (CONTROL) received 0.1 mg/kg of 0.9% saline and then placebo gel. Three weeks after tooth extraction, the animals were euthanized, and maxillae were colleted for macroscopic, radiographic, histological and Raman spectomery assays. Additionally, GSK3b, beta-catenin, and Runx2 mRNA expressions were determined. Blood samples were collected for the analysis of Bone-specific alkaline phosphatase (BALP) levels. PAb gel improved mucosal healing, increased the number of viable osteocytes, while it reduced the number of empty lacunae, as well as the amount of bone sequestration. Furthermore, PAb gel positively influenced the number and functionality of osteoblasts by stimulating Wnt signaling, thereby inducing bone remodeling. Additionally, PAb gel contributed to improved bone quality, as evidenced by an increase in bone mineral content, a decrease in bone solubility, and an enhancement in the quality of collagen, particularly type I collagen. PAb gel mitigated bone necrosis by stimulating of bone remodeling through Wnt signaling and concurrently improved bone quality. PAb gel emerges as a promising pharmacological tool for aiding in BRONJ therapy or potentially preventing the development of BRONJ.

Characterization of central-involved diabetic macular edema using OCT and OCTA.

PURPOSE: To characterize the occurrence of diabetic macular edema and the presence of abnormal retinal fluid accumulation in nonproliferative diabetic retinopathy (NPDR). METHODS: In this two-year prospective study, a total of 122 eyes with diabetes type 2 underwent optical coherence tomography (OCT) and OCT-Angiography in association with OCT-Fluid imaging, a novel algorithm of OCT analysis allowing quantification of abnormal accumulation of fluid in the retina through low optical reflectivity ratios (LOR). Early Treatment Diabetic Retinopathy Study (ETDRS) grading for diabetic retinopathy (DR) severity assessment was performed using 7-field color fundus photography. Best corrected visual acuity was also recorded. RESULTS: During the 2-year follow-up, 23 eyes (19%) developed central-involved diabetic macular edema (CI-DME) and 2 eyes (2%) developed clinically significant macular edema (CSME). In the two-year period of the study, eyes that developed CI-DME showed a progressive increase in central retinal thickness (CRT) (ß = 7.7 ± 2.1 µm/year, p < 0.001) and in LOR values (ß = 0.009 ± 0.004 ratio/year, p = 0.027). The increase in CRT and abnormal retinal fluid, represented by increased LOR ratios, are associated with increased retinal perfusion in the deep capillary plexus (DCP) (skeletonized vessel density, p = 0.039). In contrast, the eyes with CSME showed decreased retinal perfusion and abnormal fluid located in the outer layers of the retina. CONCLUSIONS: CI-DME and CSME appear to represent different entities. Eyes with CI-DME show increases in abnormal retinal fluid associated with increased retinal vascular perfusion in the DCP. Eyes with CSME are apparently associated with decreased retinal vascular perfusion in the DCP and abnormal fluid in the outer retina.

Beach surface model construction: A strategy approach with structure from motion - multi-view stereo.

In contrast to traditional beach profiling methods like topographic surveys and GNSS, which pose significant challenges in terms of cost and time, this research underscores the efficiency, cost-effectiveness, and simplicity of terrestrial photogrammetry employing the Structure from Motion-Multi View Stereo (SfM-MVS) method. Notably, this approach enables the utilization of commonplace devices such as smartphones for data capture. The methodology integrates a 12-megapixel camera for image acquisition, processed through Agisoft Metashape Professional software, and validated for accuracy using ground control points (GCPs) and checkpoints (CKPs) calibrated via GNSS. Findings reveal substantial disparities in positional accuracy according to the Ground Control Points distribution. The study underscores the critical role of strategically distributing GCPs and CKPs in effectively mapping coastal areas, thus affirming the potential of SfM-MVS as a powerful and accessible tool for coastal monitoring initiatives. This research contributes significantly to advancing the efficiency and accessibility of beach profile monitoring, offering invaluable insights for researchers and practitioners in coastal management and environmental conservation efforts.•A simplified beach profile modeling methodology is proposed.•The method is faster and more cost-effective than traditional surveys (RTK GNSS, lidar, RPA).•The study highlights the importance of GCP and CKP distribution in enhancing SfM-MVS accuracy for coastal mapping.

Short-duration dynamic power training with elastic bands combined with endurance training: a promising approach to hypertension management in older adults.

Previous studies have investigated the effects of different combined training programs involving traditional resistance training and aerobic exercise on hemodynamic parameters and arterial stiffness in older adults. However, little is known about the impact of power training combined with endurance training on these variables in hypertensive older adults. Therefore, this study aimed to investigate the effects of dynamic power training with elastic bands combined with endurance training on arterial stiffness and hemodynamic parameters in hypertensive older adults. Twenty-six participants were randomly assigned to the control group (CG; n = 13) and the intervention group (n = 13). IG participants performed power training with elastic bands combined with endurance training twice a week for 8 weeks. Pulse pressure, central pulse pressure, pulse wave velocity, SBP, DBP, central SBP, and central DBP were assessed before and after 8 weeks using the triple pulse wave velocity method. Pulse pressure, central pulse pressure, pulse wave velocity, SBP, DBP, central SBP, and central DBP significantly improved after 8 weeks of intervention (P < 0.05). These findings indicate that power training with elastic bands combined with endurance training reduces arterial stiffness and significantly improves hemodynamic parameters in older adults diagnosed with grade 1 hypertension. In addition, underscores the potential of this approach as a promising strategy for the management of hypertension in older adults.

Long-term trajectories of clinical staging in first-episode psychosis and their associated cognitive outcome: A 21-year follow-up study.

Cognitive deficits are already present before psychosis onset but are a key feature of first-episode psychosis (FEP). The objective of this study was to investigate the cognitive outcomes of a cohort of FEP patients who were diagnosed using the clinical staging approach and were followed for up to 21 years. We analyzed data from 173 participants with first-admission psychosis who were followed-up for a mean of 20.9 years. The clinical staging assessment was adapted from the clinical staging framework developed by McGorry et al.1 Cognitive assessment was performed using the MATRICS Consensus Cognitive Battery (MMCB) at the end of follow-up. FEP patients who were longitudinally diagnosed in the lowest clinical stages (stages 2A and 2B) showed better performance in attention, processing speed, and MCCB overall composite score than those in the highest clinical stages (stages 4A and 4B). There was a significant linear trend association between worsening of all MCCB cognitive functions and MCCB overall composite score and progression in clinical staging. Furthermore, the interval between two and five years of follow-up appears to be associated with deficits in processing speed as a cognitive marker. Our results support the validation of the clinical staging model over a long-term course of FEP based on neuropsychological performance. A decline in some cognitive functions, such as processing speed, may facilitate the transition of patients to an advanced stage during the critical period of first-episode psychosis.

Catheter-Related Right Atrial Endocarditis in a Dialysis Patient.

Hemodialysis catheters are frequently used for vascular access in end-stage chronic kidney disease patients lacking mature arteriovenous fistula. The incidence of infective endocarditis in hemodialysis patients is higher than in the general population and is associated with severe and potentially life-threatening complications. A high index of suspicion is imperative for early diagnosis and timely intervention to enhance the prognosis of this high-mortality condition. Imaging studies, like transthoracic and transesophageal echocardiography, are crucial for prompt diagnosis. We present a case of a 36-year-old woman undergoing hemodialysis, whose prolonged use of a permanent catheter led to the development of infective endocarditis complicated with septic pulmonary embolism. Our case report presents an example of right atrial endocarditis with a poor outcome due to delayed diagnosis.

An Unusual Case of Vasospastic Angina Resulting in Multiple Episodes of Cardiac Arrest.

Coronary vasospasm is a well-recognized cause of angina (also known as Prinzmetal angina) and a common cause of admissions to the emergency department and coronary intensive care units. It is however an uncommon cause of cardiac arrest. We describe a patient with multiple episodes of chest pain followed by cardiac arrest in pulseless electrical activity (PEA) due to coronary vasospasm. Telemetry and electrocardiography showed ST-segment elevation followed by PEA. Each event was short-lived and resolved after a maximum of six minutes of advanced life support measures. The patient was started on treatment with a dihydropyridine calcium channel blocker (CCB) and nitroglycerin patch with no further episodes recorded to date.

Phenotypic characterisation and production system of the Nordestino horse from a multivariate perspective.

Zootechnical data is a big challenge in the extensive rearing system of Brazilian locally adapted breeds once smallholdings with limited resources and funds rear them. So, information on Brazil's breeding system of locally adapted breeds is still scarce; this situation is more challenging for equine breeds. The present study aimed to describe the local rearing systems and the phenotypic profile of the Nordestino horse breed in Paraíba state and contribute to breed conservation. Data from males (entire and castrated) and females from 50 municipalities in Paraíba state were used. Two hundred sixty-nine animals (111 females, 121 castrated males, and 37 entire males) from 129 breeders were analyzed. A questionnaire consisting of direct and objective questions was applied to understand the breeding system adopted. There was a predominance of the extensive breeding system (85%), which reflects the adaptation of the Nordestino Horse to the region's natural conditions. The lower frequency of use of cultivated pastures may be related to issues of economic viability since the maintenance of cultivated pastures may require additional investments compared to the use of natural pastures. Entire males had a minimum withers height (WH) of 135 cm. Of the 11 morphometric measurements, only five were considered discriminating by the stepwise analysis. The remaining Nordestino horses have morphological characteristics within the breed standard.

The Psychological Experience of Grandparents: Proposal of a Qualitative Clinical Assessment Tool in Pediatric Palliative Care.

In Portugal, there are over 7800 children with life-limiting conditions. The context of pediatric palliative care represents a complex and distressing experience for families. Compared to parental caregivers and healthy siblings, grandparents are underexplored in the literature and clinical practice. The aim of the present study is to propose a psychological experience assessment tool of grandparents in this context. It consists of a sociodemographic and clinical data sheet and a semi-structured interview based on sharing a testimony with other grandparents. On the basis of the latter, 10 dimensions were explored through the grandparents' own perspective: representation of the illness; representation of the sick grandchild; changes in routine and life; family impact; grandparents' contributions to the family system; social support and coping strategies; emotional impact; triple concern; needs identification; and post-traumatic growth. The tool can be used in person or remotely and may be combined with other instruments. Its application enables a personalized identification of needs and challenges for each family, promoting the adjustment of the clinical intervention to their wellbeing and resilience from an eco-systemic perspective. The clinical tool is presented in detail and its importance in the context of research and systemic intervention is discussed.

Effect of four different mono and multi-wave light-curing units on the Knoop hardness of veneer resin composites.

OBJECTIVES: To evaluate the effect of mono and multi-wave light-curing units (LCUs) on the Knoop hardness of resin-based composites (RBC) that use different photoinitiators. METHODS: Central incisor-shaped specimens 12 mm long, 9 mm wide, and 1.5 mm thick were made from 2 RBCs that use different photoinitiators: Tetric N-Ceram (Ivoclar Vivadent) - and Vittra APS (FGM), both A2E shade. They were light-cured with 4 different LCUs: two claimed to be multi-wave - VALO Grand (Ultradent) and Emitter Now Duo (Schuster); and two were monowave - Radii Xpert (SDI) and Elipar DeepCure-L (3 M Oral Care) using 2 different light exposure protocols: one 40 s exposure centered over the specimen; and two 20 s light exposures that delivered light from two positions to better cover the entire tooth. 16 groups with 10 specimens in each group were made. The Knoop hardness (KH, kg/mm2) was measured at the top and bottom of the specimen in the center and at the cervical, incisal, mesial, and distal peripheral regions. The active tip diameters (mm) and spectral radiant powers (mW/nm) of the LCUs were measured with and without the interposition of the RBC, as well as the radiant exposure beam profiles (J/cm²) delivered to the top of the RBCs. The data was analyzed using Three-way ANOVA and Tukey's tests (α = 0.05). RESULTS: The VALO Grand (1029 mW) emitted twice the power of the Radii Xpert (500 mW). The KH values of VI and TN resin composite specimens were significantly affected by the LCU used (p < .001), the measurement location (p < .001), and the surface of the specimen (p < .001). LCUs with wider tip diameters produced greater Knoop hardness values at the peripheries of the 12 mm of long, 9 mm wide specimens. In general, the VALO Grand produced the highest KH values, followed by Elipar DeepCure-L, then by Radii Xpert. The Emitter Now Duo LCU produced the lowest values. Exposing the veneers from two locations reduced the differences between the LCUs and the effect of the measurement location. Only the VALO Grand could fully cover the composite veneer with light when the two locations were used. SIGNIFICANCE: The light tip must cover the entire restoration to photocure the RBC beneath the light tip.

GC/MS and 2D NMR-based approach to evaluate the chemical profile of hydroalcoholic extract from Agaricus blazei Murill and its anti-inflammatory effect on human neutrophils.

ETHNOPHARMACOLOGICAL RELEVANCE: Agaricus blazei Murill (AbM) is one of the main mushrooms used for medicinal purposes. The use of AbM in the preparation of teas is widespread mainly in Asian countries, while in Brazil it is used as a functional food to combat inflammatory diseases and cancer. AIM OF THE STUDY: The main focus of this study was the characterization of the chemical profile of the hydroalcoholic extract of Agaricus blazei Murill (AbE), as well as the evaluation of its cytotoxic and anti-inflammatory potential using human neutrophils. MATERIALS AND METHODS: The extract was prepared by dynamic maceration using a mixture of ethanol and water (70/30, v v-1) as solvent. The chemical profile characterization was carried out by 2D NMR and GC-MS techniques. The cytotoxicity of AbE was evaluated through studies of hemolytic potential, cell viability and membrane integrity. The anti-inflammatory activity was analyzed by a PMA-induced neutrophil degranulation assay. RESULTS: Chemical analysis of AbE revealed the presence of 28 metabolites in its composition, with mannitol as the major compound. AbE at 1-200 µg mL-1 and mannitol at 4-160 µg mL-1, showed low hemolytic and cytotoxic potential against human red blood cells and neutrophils. Furthermore, both were able to significantly reduce the release of myeloperoxidase. CONCLUSIONS: These results indicate that AbE is a promising natural product to be incorporated into pharmaceutical dosage forms intended for the adjuvant treatment of inflammatory diseases.

Funções neuropsicológicas de escolares na reabertura das escolas brasileiras na pandemia da Covid-19 / The neuropsychological functions of schoolchildren after the reopening of brazilian schools during the Covid-19 pandemic

RESUMO Objetivo O objetivo desse estudo foi analisar as funções neuropsicológicas de estudantes de uma escola pública do Distrito Federal (Brasil), matriculadas 1º e 2º ano de Ensino Fundamental na reabertura das escolas públicas na pandemia da COVID-19 e a influência dos fatores familiares e contextuais sobre o desempenho dessas habilidades. Métodos Participaram 117 estudantes, bem como seus responsáveis. As crianças foram avaliadas presencialmente por meio do Instrumento de Avaliação Neuropsicológica Breve Infantil (NEUPSILIN-Inf). Os pais/responsáveis responderam remotamente ao Inventário de Recursos do Ambiente Familiar e as questões para classificação socioeconômica e de escolaridade materna. Resultado Os dados apontam alta prevalência de crianças em fase de alfabetização que apresentam alerta ou déficit das funções de orientação, memória, linguagem, habilidades visuoespaciais, habilidades aritméticas e fluência verbal. Ainda, as atividades previsíveis que sinalizam algum grau de estabilidade na vida familiar são preditoras do desempenho das crianças na habilidade de orientação e os recursos que promovem processos proximais refletem significativamente no desempenho em linguagem. Os resultados sugerem que crianças inseridas em família com estimativas da renda domiciliar abaixo de um salário mínimo apresentam piores desempenhos do controle inibitório. Conclusão Foram apresentados e discutidos os impactos das alterações das habilidades neuropsicológicas para o aprendizado das crianças, destacando a necessidade de intervenções imediatas e direcionadas para essas funções. Foram considerados os fatores contextuais que apresentaram influência sobre o desempenho das habilidades neuropsicológicas.

ABSTRACT Purpose The objective of this study was analyzed the neuropsychological functions of students from a public school in Brazil, enrolled in the 1st and 2nd year of Elementary School at the time of the reopening of schools during the COVID-19 pandemic and to access the influence of family and contextual information on the performance of these skills. Methods 117 students participated in the study, as well as their parents or guardians. The children were evaluated in person using the Brief Child Neuropsychological Assessment Instrument (NEUPSILIN-Inf). The parents/guardians answered remotely the Inventory of Resources of the Family Environment and questions about socioeconomic classification and maternal education. Results The data showed a high prevalence of children who had problems or deficits in the functions of orientation, memory, language, visuospatial skills, arithmetic skills and verbal fluency. Furthermore, predictable activities that signal some degree of stability in family life are predictors of children's performance in orientation skills and resources that promote proximal processes significantly reflect on language performance. The results suggest that children included in families with a household income below one Brazilian minimum monthly salary presented poorer inhibitory control performances. Conclusion The impact of changes in neuropsychological skills in children's learning were presented and discussed, highlighting the need for immediate and targeted intervention of these functions. Contextual factors that influenced the performance of neuropsychological skills were also considered.

Performance of collagen-based matrices from Nile tilapia skin: A pilot proteomic study in a murine model of wound healing.

Full-thickness cutaneous trauma, due to the lack of dermis, leads to difficulty in epithelialization by keratinocytes, developing a fibrotic scar, with less elasticity than the original skin, which may have disorders in predisposed individuals, resulting in hypertrophic scar and keloids. Biomedical materials have excellent characteristics, such as good biocompatibility and low immunogenicity, which can temporarily replace traditional materials used as primary dressings. In this work, we developed two dermal matrices based on Nile tilapia collagen, with (M_GAG) and without (M) glycosaminoglycans, using a sugarcane polymer membrane as a matrix support. To assess the molecular mechanisms driving wound healing, we performed qualitative proteomic analysis on the wound bed in an in vivo study involving immunocompetent murine models at 14 and 21 days post-full-thickness skin injury. Gene Ontology and Pathway analysis revealed that both skins were markedly represented by modulation of the immune system, emphasizing controlling the acute inflammation response at 14 and 21 days post-injury. Furthermore, both groups showed significant enrichment of pathways related to RNA and protein metabolism, suggesting an increase in protein synthesis required for tissue repair and proper wound closure. Other pathways, such as keratinization and vitamin D3 metabolism, were also enriched in the groups treated with M matrix. Finally, both matrices improved wound healing in a full post-thick skin lesion. However, our preliminary molecular data reveals that the collagen-mediated healing matrix lacking glycosaminoglycan (M) exhibited a phenotype more favorable to tissue repair, making it more suitable for use before skin grafts.

Sustainable trehalose lipid production by Rhodotorula sp.: a promising bio-based alternative.

Global environmental concerns drive research toward the development of new eco-friendly compounds to replace pollutant chemicals. This study focuses on optimizing the production of trehalose lipids (TLs), which are glycolipid biosurfactants (BS) with various applications like antimicrobial or surface tension reduction. New microorganism sources, growth conditions, medium composition, purification conditions, and physicochemical properties of TLs are studied. Addressing a microscale approach, TLs production was successfully achieved using Rhodotorula sp. and Rhodococcus erythropolis to compare, with different media compositions including glucose-based and salt media supplemented with glycerol, glucose, n-hexadecane, n-dodecane. Liquid-liquid extraction using ethyl acetate and methanol was employed for compound extraction, followed by characterization using analytical methods such as Thin layer chromatography (TLC), High performance liquid chromatography (HPLC), and UHPLC. The produced TLs exhibited a minimum surface tension of 47 mN/m and a critical micellar concentration of 4.4 mg/mL. This study also identified Rhodotorula sp. as a new sustainable producer of TLs with improved productivity.

Induced Pluripotent Stem Cell-Derived Cardiomyocytes: From Regulatory Status to Clinical Translation.

Cardiovascular diseases, considered the deadliest worldwide by the World Health Organization (WHO), lack effective therapies for regenerating cardiomyocytes. With their self-renewal and pluripotency capabilities, stem cell therapies are increasingly used in precision medicine. Induced pluripotent stem cells (iPSCs) are a promising alternative to embryonic stem cells. Good Manufacturing Practice (GMP) principles are not yet adapted for large-scale production of iPSCs. Additionally, the quality risk for iPSC products may not always be possible to eliminate, potentially jeopardizing the health of patients. This review aims to identify critical quality attributes (CQAs) for iPSC-derived cardiomyocytes (iPSC-CMs) for the development of cardiovascular therapy to ensure compliance with regulations and safety for patients. To attain these goals, the literature review was conducted with articles related to iPSCs and iPSC-CM therapies, legislation, and regulatory guidelines of the European Medicines Agency (EMA), Food and Drug Administration (FDA), and Pharmaceuticals and Medical Devices Agency (PMDA). In conclusion, additional regulations and guidelines are needed to monitor differentiation, maturation, and tumorigenicity. GMP-compliant cell banks and fast-track approval systems may increase accessibility for patients.

Adherence to Exercise Training and Physical Function in Older Adults Diagnosed with Knee Osteoarthritis.

Background: Knee osteoarthritis (KOA) provokes pain, muscle weakness, and consequent impairment in activities of daily living. On the other hand, adherence to exercise training (ET) is associated with the attenuation of the impairments. The aims of the present study were to a) investigate adherence to ET in older adults with KOA diagnosed attending public service; and b) to analyze the physical function of the older adults with KOA who did not adhere to the ET in public service. Methods: The adherence to ET programs was analyzed retrospectively from each patient's date of KOA diagnosis. After assessing the adherence to ET, the physical function of these older adults diagnosed with KOA (n=19) was analyzed and compared with another group composed of asymptomatic sedentary older adults without evidence of KOA (ASKOA) (n=17). Results: Although all older adults with KOA received guidelines to practice ET, only 58% were able to start a program. Additionally, 100% of the sample could not perform ET uninterruptedly. According to the findings, close to 80% of older adults had difficulties scheduling ET sessions in public places. Subjects with KOA (12.1±3.1; IC95%:10.6-13.6) had worse lower limb functional capacity than ASKOA (8.1±1.0; IC95%:7.6-8.6; p<.001; δ=4.0 sec; d=1.7). Likewise, they had a lower dynamic balance than KOA (12.4±2.7; IC95%:11.1-13.7 vs. 8.0±1.1; IC95%:7.4-8.6; p<.001; δ=4.4 sec; d=2.1). Conclusions: The investigated sample has a lack of ET adherence by difficulties in scheduling ET sessions in public places. In addition, it demonstrated impairment in physical function in older adults with KOA.

Exploring Functionalized Magnetic Hydrogel Polyvinyl Alcohol and Chitosan Electrospun Nanofibers.

Nanofibrous materials present interesting characteristics, such as higher area/mass ratio and reactivity. These properties have been exploited in different applications, such as drug-controlled release and site-specific targeting of biomolecules for several disease treatments, including cancer. The main goal of this study was to develop magnetized nanofiber systems of lysozyme (Lys) for biological applications. The system envisaged electrospun polyvinyl alcohol (PVA) and PVA/chitosan (CS) nanofibers, loaded with Lys, crosslinked with boronic acids [phenylboronic acid (PBA), including 2-acetylphenylboronic acid (aPBA), 2-formylphenylboronic (fPBA), or bortezomib (BTZ)] and functionalized with magnetic nanobeads (IONPs), which was successfully built and tested using a microscale approach. Evaluation of the morphology of nanofibers, obtained by electrospinning, was carried out using SEM. The biological activities of the Lys-loaded PVA/CS (90:10 and 70:30) nanofibers were evaluated using the Micrococcus lysodeikticus method. To evaluate the success of the encapsulation process, the ratio of adsorbed Lys on the nanofibers, Lys activity, and in vitro Lys release were determined in buffer solution at pH values mimicking the environment of cancer cells. The viability of Caco-2 cancer cells was evaluated after being in contact with electrospun PVA + Lys and PVA/CS + Lys nanofibers, with or without boronic acid functionalation, and all were magnetized with IONPs.

Survival of severely compromised endodontically treated teeth restored with or without a fiber glass post.

OBJECTIVE: The use of a fiber glass post (FGP) type and choice of FGP diameter to restore endodontically treated incisors without ferrule is controversial. This study evaluated survival rate and failure mode of severely compromised central incisors without ferrule rehabilitated using resin-based composite (RBC) with or without FGP with different diameters. METHODOLOGY: A total of 60 decoronated bovine incisors without a ferrule were endodontically treated and prepared for 1.4, 1.6, and 1.8 mm diameter FGPs (Whitepost System DC 0.5, Fit 0.4, and DCE 0.5; FGM). Half of the teeth received FGPs cemented using dual-cure resin cement (Allcem Core; FGM), the other half were filled using only bulk-fill RBC (OPUS Bulk Fill; FGM). The crowns were directly restored with RBC. The roots were embedded in polystyrene resin and the periodontal ligament was simulated with polyether impression material. Fatigue testing was conducted under 5 Hz cyclic loading at 30 degrees to the incisal edge, beginning at 50 N (5,000 cycles) as a warmup. After, the load was increased 100 N every 15,000 cycles until fracture occurred. All specimens were subjected to transillumination, micro-CT analysis, and digital radiography before and after fatigue testing. Fracture mode was classified according to severity and repair potential. Data were analyzed with Kaplan-Meier survival test and post hoc log-rank test (α=0.05) for pairwise comparisons. RESULTS: Using FGP significantly increased the number of cycles to failure, irrespective of FGP diameters (p=0.001). The FGP diameters had no statistically significant effect on cycles to failure or failure mode. CONCLUSION: Using FGP without ferrule improved survival rate of structurally severely compromised central incisors compared with rehabilitation without FGP. The diameter of the FGPs had no effect on the survival rate and failure mode.

Cerebral Metabolic Signature of Chronic Benzodiazepine Use in Nondemented Older Adults: An FDG-PET Study in the MEMENTO Cohort.

OBJECTIVE: We sought to examine the association between chronic Benzodiazepine (BZD) use and brain metabolism obtained from 2-deoxy-2-fluoro-D-glucose (FDG) positron emission tomography (PET) in the MEMENTO clinical cohort of nondemented older adults with an isolated memory complaint or mild cognitive impairment at baseline. METHODS: Our analysis focused on 3 levels: (1) the global mean brain standardized uptake value (SUVR), (2) the Alzheimer's disease (AD)-specific regions of interest (ROIs), and (3) the ratio of total SUVR on the brain and different anatomical ROIs. Cerebral metabolism was obtained from 2-deoxy-2-fluoro-D-glucose-FDG-PET and compared between chronic BZD users and nonusers using multiple linear regressions adjusted for age, sex, education, APOE ε 4 copy number, cognitive and neuropsychiatric assessments, history of major depressive episodes and antidepressant use. RESULTS: We found that the SUVR was significantly higher in chronic BZD users (n = 192) than in nonusers (n = 1,122) in the whole brain (beta = 0.03; p = 0.038) and in the right amygdala (beta = 0.32; p = 0.012). Trends were observed for the half-lives of BZDs (short- and long-acting BZDs) (p = 0.051) and Z-drug hypnotic treatments (p = 0.060) on the SUVR of the right amygdala. We found no significant association in the other ROIs. CONCLUSION: Our study is the first to find a greater global metabolism in chronic BZD users and a specific greater metabolism in the right amygdala. Because the acute administration of BZDs tends to reduce brain metabolism, these findings may correspond to a compensatory mechanism while the brain adapts with global metabolism upregulation, with a specific focus on the right amygdala.

A psychological experience assessment protocol of parent caregivers in paediatric palliative care.

Background: Paediatric Palliative Care (PPC) has undergone rapid growth in Portugal, where there are over 7800 children with life-limiting conditions. This is a complex experience for families due to the ongoing threat and vulnerability caused by the emergence of an illness, and therefore several studies have tended to focus on the adaptation of parent caregivers. The aim of the present study is to present a psychological experience assessment protocol of parents in PPC. Methods: It consists of a socio-demographic and clinical questionnaire and a semi-structured interview based on an incomplete narrative deriving from the Unwanted Guest Metaphor. Results: On the basis of the latter, 10 dimensions of the experience in the parental subsystem were explored through parents' own perspective, namely: confrontation with the diagnosis; representation of the illness; emotional impact; day-to-day challenges; family impact; resources and social support; coping strategies; posttraumatic growth; representation of the sick child; and future perspectives. Discussion: The protocol can be used in person or remotely and its application enables the identification of specific needs and the establishment of psychotherapeutic goals and strategies for each family, thus enhancing their well-being and resilience, from an eco-systemic perspective. Conclusions: The protocol is presented in detail and its importance in the context of research and systemic intervention in PPC is discussed.