Low absolute risk of thrombotic and cardiovascular events in outpatient pregnant women with COVID-19.

INTRODUCTION: Pregnancy may contribute to an excess risk of thrombotic or cardiovascular events. COVID-19 increases the risk of these events, although the risk is relatively limited among outpatients. We sought to determine whether outpatient pregnant women with COVID-19 are at a high risk for cardiovascular or thrombotic events. MATERIALS & METHODS: We analyzed pregnant outpatients with COVID-19 from the multicenter CORONA-VTE-Network registry. The main study outcomes were a composite of adjudicated venous or arterial thrombotic events, and a composite of adjudicated cardiovascular events. Events were assessed 90 days after the COVID-19 diagnosis and reported for non-pregnant women ≤45 years, and for men ≤45 years, as points of reference. RESULTS: Among 6585 outpatients, 169 were pregnant at diagnosis. By 90-day follow-up, two pregnant women during the third trimester had lower extremity venous thrombosis, one deep and one superficial vein thrombosis. The cumulative incidence of thrombotic events was 1.20 % (95 % confidence interval [CI]: 0.0 to 2.84 %). Respective rates were 0.47 % (95 % CI: 0.14 % to 0.79 %) among non-pregnant women, and 0.49 % (95 % CI: 0.06 % to 0.91 %) among men ≤45 years. No non-thrombotic cardiovascular events occurred in pregnant women. The rates of cardiovascular events were 0.53 % (95 % CI: 0.18 to 0.87) among non-pregnant women, and 0.68 % (95 % CI: 0.18 to 1.18) in men aged ≤45 years. CONCLUSIONS: Thrombotic and cardiovascular events are rare among outpatients with COVID-19. Although a higher event rate among outpatient pregnant women cannot be excluded, the absolute event rates are low and do not warrant population-wide cardiovascular interventions to optimize outcomes.

The Pharmacoeconomic Impact of Pharmaceutical Care in the Hospital: Protocol for an Overview of Systematic Reviews.

BACKGROUND: The clinical activities developed by pharmacists in a hospital environment can improve health outcomes and generate savings for hospitals. However, to determine whether pharmaceutical interventions are cost effective, it is essential to define a method according to which cost-effectiveness is intended to be measured. In addition, the quality of economic assessments and the amount of information present in systematic reviews in the literature make it difficult to analyze the effects of this intervention. OBJECTIVE: This paper aims to provide an overview of systematic reviews on the pharmacoeconomic impact of the performance of pharmaceutical care in hospitals. METHODS: A systematic search of the Cochrane Library databases, PubMed or MEDLINE, LILACS, Scopus, Web of Science, Google Scholar, and Open Thesis will be performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. The search will involve the use of keywords determined using the Medical Subject Headings database to define the search terms and include the following terms: "pharmacoeconomics," "pharmaceutical care," and "hospital." The study designs to be included will be systematic reviews of good quality. Studies will be included that address pharmacoeconomics; studies that evaluated pharmaceutical care in hospitals; and studies published in Portuguese, English, or Spanish. The primary outcome sought in the systematic reviews will be the cost ratio in monetary units and the outcomes in monetary or natural units. The secondary economic outcomes considered will be determined based on factors associated with the drugs and translated into benefit, efficacy, or utility. RESULTS: It is intended to start this overview in January 2023. Thus far, only previous searches have been carried out to contextualize the theme and build the protocol. CONCLUSIONS: This overview will determine the pharmacoeconomic impact of pharmaceutical care interventions in the hospital environment. In addition, this study will point out which clinical outcomes in natural units are impacted by the performance of pharmaceutical care and the strengths and limitations of each approach. It will also identify gaps in the literature and areas for future work. TRIAL REGISTRATION: PROSPERO CRD42019140665; https://tinyurl.com/bddwnz43.

Niche breadth of Amazonian trees increases with niche optimum across broad edaphic gradients.

Understanding how biotic interactions and environmental filtering mediated by soil properties shape plant community assembly is a major challenge in ecology, especially when studying complex and hyperdiverse ecosystems like tropical forests. To shed light on the influence of both factors, we examined how the edaphic optimum of species (their niche position) related to their edaphic range (their niche breadth) along different environmental gradients and how this translates into functional strategies. Here we tested four scenarios describing the shape of the niche breadth-niche position relationship, including one neutral scenario and three scenarios proposing different relative influences of abiotic and biotic factors on community assembly along a soil resource gradient. To do so, we used soil concentration data for five key nutrients (N, P, Ca, Mg, and K), along with accurate measurements of 14 leaf, stem, and root traits for 246 tree species inventoried in 101 plots located across Eastern (French Guiana) and Western (Peru) Amazonia. We found that species niche breadth increased linearly with species niche position along each soil nutrient gradient. This increase was associated with more resource acquisitive traits in the leaves and the roots for soil N, Ca, Mg, and K concentration, while it was negatively associated with wood density for soil P concentration. These observations agreed with one of our hypothetical scenarios in which species with resource conservation traits are confined to the most nutrient-depleted soils (abiotic filter), but they are outperformed by faster-growing species in more fertile conditions (biotic filter). Our results refine and strengthen support for niche theories of species assembly while providing an integrated approach to improving forest management policies.

Complicaciones postoperatorias en fractura de órbita: experiencia en el Hospital del Trabajador de Santiago

Objetivo: Describir la experiencia del equipo de cirugía maxilofacial del Hospital del Trabajador en el manejo de las fracturas de órbita. Materiales y Método: Estudio retrospectivo de 42 pacientes consecutivos operados por fractura de órbita en el Servicio de Cirugía Maxilofacial del Hospital del Trabajador entre enero de 2016 y diciembre de 2017. Se tabularon datos demográficos, información del trauma, tipo de fractura, fracturas asociadas, tratamiento y seguimiento. Resultado: De los 42 pacientes, la mayoría eran hombres (73,8%) con edad promedio de 40 ± 12,24 años. Los principales síntomas al ingreso fueron equimosis (64,3%), edema periocular (54,8%), hemorragia subconjuntival (33,3%) y diplopía (26,2%). La pared orbitaria más frecuentemente afectada fue el piso de la órbita (85,7%). Las fracturas se presentaron de forma aislada en 35,7% de los casos y asociada a otra fractura de la cara en 64,3%. Post cirugía, la tasa de complicación fue de 16,7%, producto de diplopía y enoftalmos leves que solo requirieron tratamientos conservadores para su resolución. Discusión: La baja tasa de complicaciones se debe a la experiencia del equipo médico con un seguimiento a largo plazo, la medición de volúmenes orbitarios, imagenología intraoperatoria, utilización de malla prefabricada y asistencia endoscópica. Conclusiones: Un adecuado diagnóstico y evaluación son fundamentales para el tratamiento de la fractura de órbita. Los datos demográficos, las características de las fracturas y las complicaciones descritas fueron muy similares a lo reportado por otras experiencias, mientras que la tasa de complicaciones fue menor.

Aim: To describe the experience of the Maxillofacial Surgical team of Hospital del Trabajador de Santiago in the management of orbital fractures. Materials and Methods: Retrospective study of 42 patients operated consecutively between January of 2016 and November of 2017 at Hospital del Trabajador de Santiago by the Maxillofacial Surgery team due to orbital fracture. The demographic data was tabulated and then a comparison between isolated and combined orbital fractures was made. Results: Of 42 patients most were men (73.8%) with an average age of 40±12.24 years. At admission the main symptoms were ecchymosis (64.3%), periorbital edema (54.8%), subconjunctival hemorrhage (33.3%) and diplopia (26.2%). The most frequently affected orbital wall was the floor (85.7%). Isolated fractures accounted for 35.7% of the cases and those associated with other facial fractures for 64.3%. The postoperative complication rate was 16.7% due to diplopia and enophthalmos. Both complications were mild and only required conservative management. Discussion: The low complication rate might be due to the experience of the surgical team in the management of orbital fractures, long-term following, orbital volume measurements, intraoperative imaging, the use of prefabricated mesh and endoscopic guidance. Conclusión: An adequate diagnosis and evaluation are fundamental for orbital fracture treatment. Demographic data, fracture characteristics and the complications described were similar to those reported by other studies, while the rate of complications was lower than those experiences.

Current status of cone-beam computed tomography teaching in Brazilian undergraduate endodontic programs - A web-based survey.

PURPOSES: This study aimed to assess the current status of cone-beam computed tomography (CBCT) education in Brazilian undergraduate Endodontic programs. METHODS: One hundred program directors were emailed. The questionnaire asked whether the CBCT topic was included in the program, the availability of a CBCT machine, and, the total length of the dental program. For the group that does not teach, seven questions discussed the reasons for not teaching and whether another subject included this topic. For the programs that included CBCT, seven questions discussed the number of hours included, and the impression of the program directors with the quality of the teaching. The chi-square test was used for the correlation between the availability of the CBCT machine and the length of the dental program with the inclusion of the topic. RESULTS: Thirty-five program directors replied to the questionnaire. Twenty-six (74.3%) reported that the topic of CBCT is not included in their programs. There was no impact of the availability of a CBCT machine on the inclusion of the topic (p > 0.05). The increased length of the dental program decreased the inclusion of the topic (p < 0.05). Fifty percent of the directors replied that lack of time is the reason for not including the topic. Among the programs that include CBCT, the majority (55.6%) deliver 3-5 h of lectures. The practical activities range from 1 to 5 h or more. The majority (77.8%) of the directors are satisfied with the content delivered and 44.4% understand that the students are competent in the interpretation of CBCT images. CONCLUSIONS: The majority of the Endodontic undergraduate programs in Brazil do not include CBCT in the program. The availability of a CBCT machine does not impact the inclusion of the topic, the increased duration of the dental program decreases the inclusion of the CBCT topic.

Obesity induces resistance to central action of BMP8B through a mechanism involving the BBSome.

OBJECTIVE: Bone morphogenetic protein 8B (BMP8B) plays a major role in the regulation of energy homeostasis by modulating brown adipose tissue (BAT) thermogenesis and white adipose tissue (WAT) browning. Here, we investigated whether BMP8B's role in metabolism is affected by obesity and the possible molecular mechanisms underlying that action. METHODS: Central treatments with BMP8B were performed in rats fed a standard (SD) and high-fat diet (HFD), as well as in genetically modified mice. Energy balance studies, infrared thermographic analysis of BAT and molecular analysis of the hypothalamus, BAT and WAT were carried out. RESULTS: We show for the first time that HFD-induced obesity elicits resistance to the central actions of BMP8B on energy balance. This obesity-induced BMP8B resistance is explained by i) lack of effects on AMP-activated protein kinase (AMPK) signaling, ii) decreased BMP receptors signaling and iii) reduced expression of Bardet-Biedl Syndrome 1 (BBS1) protein, a key component of the protein complex BBSome in the ventromedial nucleus of the hypothalamus (VMH). The possible mechanistic involvement of BBS1 in this process is demonstrated by lack of a central response to BMP8B in mice carrying a single missense disease-causing mutation in the Bbs1 gene. CONCLUSIONS: Overall, our data uncover a new mechanism of central resistance to hormonal action that may be of relevance in the pathophysiology of obesity.

Activation of Hypothalamic AMP-Activated Protein Kinase Ameliorates Metabolic Complications of Experimental Arthritis.

OBJECTIVE: To investigate whether thermogenesis and the hypothalamus may be involved in the physiopathology of experimental arthritis (EA). METHODS: EA was induced in male Lewis rats by intradermal injection of Freund's complete adjuvant (CFA). Food intake, body weight, plasma cytokines, thermographic analysis, gene and protein expression of thermogenic markers in brown adipose tissue (BAT) and white adipose tissue (WAT), and hypothalamic AMP-activated protein kinase (AMPK) were analyzed. Virogenetic activation of hypothalamic AMPK was performed. RESULTS: We first demonstrated that EA was associated with increased BAT thermogenesis and browning of subcutaneous WAT leading to elevated energy expenditure. Moreover, rats experiencing EA showed inhibition of hypothalamic AMPK, a canonical energy sensor modulating energy homeostasis at the central level. Notably, specific genetic activation of AMPK in the ventromedial nucleus of the hypothalamus (a key site modulating energy metabolism) reversed the effect of EA on energy balance, brown fat, and browning, as well as promoting amelioration of synovial inflammation in experimental arthritis. CONCLUSION: Overall, these data indicate that EA promotes a central catabolic state that can be targeted and reversed by the activation of hypothalamic AMPK. This might provide new therapeutic alternatives to treat rheumatoid arthritis (RA)-associated metabolic comorbidities, improving the overall prognosis in patients with RA.

Fracture incidence of Reciproc instruments during root canal retreatment performed by postgraduate students: a cross-sectional retrospective clinical study.

OBJECTIVES: To evaluate the fracture incidence of Reciproc R25 instruments (VDW) used during non-surgical root canal retreatments performed by students in a postgraduate endodontic program. MATERIALS AND METHODS: From the analysis of clinical record cards and periapical radiographs of root canal retreatments performed by postgraduate students using the Reciproc R25, a total of 1,016 teeth (2,544 root canals) were selected. The instruments were discarded after a single use. The general incidence of instrument fractures and its frequency was analyzed considering the group of teeth and the root thirds where the fractures occurred. Statistical analysis was performed using the χ2 test (p < 0.01). RESULTS: Seven instruments were separated during the procedures. The percentage of fracture in relation to the number of instrumented canals was 0.27% and 0.68% in relation to the number of instrumented teeth. Four fractures occurred in maxillary molars, 1 in a mandibular molar, 1 in a mandibular premolar and 1 in a maxillary incisor. A greater number of fractures was observed in molars when compared with the number of fractures observed in the other dental groups (p < 0.01). Considering all of the instrument fractures, 71.43% were located in the apical third and 28.57% in the middle third (p < 0.01). One instrument fragment was removed, one bypassed, while in 5 cases, the instrument fragment remained inside the root canal. CONCLUSIONS: The use of Reciproc R25 instruments in root canal retreatments carried out by postgraduate students was associated with a low incidence of fractures.

A Low-Cost Assistive Robot for Children with Neurodevelopmental Disorders to Aid in Daily Living Activities.

In this paper, we present a new low-cost robotic platform that has been explicitly developed to increase children with neurodevelopmental disorders' involvement in the environment during everyday living activities. In order to support the children and youth with both the sequencing and learning of everyday living tasks, our robotic platform incorporates a sophisticated online action detection module that is capable of monitoring the acts performed by users. We explain all the technical details that allow many applications to be introduced to support individuals with functional diversity. We present this work as a proof of concept, which will enable an assessment of the impact that the developed technology may have on the collective of children and youth with neurodevelopmental disorders in the near future.

Intraoperative Fluoroscopy Reduces Complication and Reoperation Rate in Facial Fractures.

Purpose: The purpose of this study is to evaluate surgical outcomes of facial fractures after the introduction of intraoperative radiology. Methods: An historic cohort of patients without intraoperative fluoroscopy (IOF) was compared with a prospective cohort of patients with IOF. Main outcomes were postoperative complications and reoperation rate. Results: There were 51 in the non-IOF group and 49 in the IOF group. In the group with IOF 10 patients required intraoperative revisions (20.46%). Overall postoperative complication rate was higher in the non-IOF group (25.49% vs. 6.12%) due to the significantly higher bone-related complication rate (15.69% vs. 2.04%). Reoperation rate was also higher in the non-IOF group (11.76% vs. 0%). Conclusion: This study demonstrates that IOF reduces bone-related complication and reoperation rate by allowing correction of surgical errors immediately during surgery.

Behaviour of cerium(III) in the presence of components of soils and its humate complex.

The behaviour of cerium, as a prototype of the lanthanide group, against the inorganic components of two types of soils (one from an Abisreligiosa forest (IM-F) and the other from a semiarid zone (IM-S)) was investigated. The pseudo-second order model applied to the kinetics adsorption data for both soils indicated chemical adsorption; the equilibrium was reached in less than 4 h, the adsorption of Ce(III) in these conditions were 15.6 and 3.5 mg g-1 for IM-F and IM-S respectively. The adsorbents showed a buffer effect in alkali conditions, the adsorption was highest at 5 > pHeq < 6 for both adsorbents. The adsorption isotherms showed that the IM-F surface is homogeneous with a maximum adsorption capacity of 15.7 mg g-1 and that of IM-S is heterogeneous. IM-F is more efficient at low adsorbent dosage, whereas this parameter virtually does not affect the IM-S efficiency but the adsorption percentage increases as the dosage increases. The thermodynamic parameters showed an exothermic and chemical adsorption process using IM-F (ΔH0 = -96.6 KJ mol-1) and an endothermic and physicochemical process using IM-S (ΔH0 = 29 KJ mol-1). Finally, the competition of the adsorption by IM-F and the formation of the complex with humic acids showed the complex formation of Ce:(HA)n, (1:1) with a log ßCe,HAapp=5.2.

Unsupervised Action Proposals Using Support Vector Classifiers for Online Video Processing.

In this work, we introduce an intelligent video sensor for the problem of Action Proposals (AP). AP consists of localizing temporal segments in untrimmed videos that are likely to contain actions. Solving this problem can accelerate several video action understanding tasks, such as detection, retrieval, or indexing. All previous AP approaches are supervised and offline, i.e. they need both the temporal annotations of the datasets during training and access to the whole video to effectively cast the proposals. We propose here a new approach which, unlike the rest of the state-of-the-art models, is unsupervised. This implies that we do not allow it to see any labeled data during learning nor to work with any pre-trained feature on the used dataset. Moreover, our approach also operates in an online manner, which can be beneficial for many real-world applications where the video has to be processed as soon as it arrives at the sensor, e.g., robotics or video monitoring. The core of our method is based on a Support Vector Classifier (SVC) module which produces candidate segments for AP by distinguishing between sets of contiguous video frames. We further propose a mechanism to refine and filter those candidate segments. This filter optimizes a learning-to-rank formulation over the dynamics of the segments. An extensive experimental evaluation is conducted on Thumos'14 and ActivityNet datasets, and, to the best of our knowledge, this work supposes the first unsupervised approach on these main AP benchmarks. Finally, we also provide a thorough comparison to the current state-of-the-art supervised AP approaches. We achieve 41% and 59% of the performance of the best-supervised model on ActivityNet and Thumos'14, respectively, confirming our unsupervised solution as a correct option to tackle the AP problem. The code to reproduce all our results will be publicly released upon acceptance of the paper.

The impact of intensive care unit diaries on patients' and relatives' outcomes: a systematic review and meta-analysis.

BACKGROUND: Memory gaps in intensive care unit (ICU) survivors are associated with psychiatric disorders. The ICU diaries improve the patient's factual memory of the ICU, but it is not clear if they reduce the incidence of psychiatric disorders in patients and relatives after hospital discharge. The aim of this study is to evaluate the literature on the effect of ICU diaries for patients admitted in ICU and their relatives. METHODS: Two authors independently searched the online databases PubMed, OVID, Embase, EBSCO host, and PsycINFO from inception to July 2019. Studies were included if the intervention group (ICU diary) was compared with a group with no diaries and the sample was comprised patients ≥ 18 years old admitted in the ICU for more than 24 h and their relatives. Randomized clinical trials, observational studies, letter with original data, and abstracts were included, irrespective of the language. The search was not limited by any specific outcome. Review articles, commentaries, editorials, and studies without a control group were excluded. Structured tools were used to assess the methodological quality ("Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I)" for cohort studies and the "Cochrane Risk of Bias tool" for included RCTs and before/after studies). A random-effects model was employed considering the anticipated variability between the studies. RESULTS: Seven hundred eighty-five titles were identified for screening. Two additional studies were selected after a reference search, and after a full-text review, a total of 12 studies were included. When pooling the results, ICU diary was associated with lower risk of depression (RR 0.41, 95% CI 0.23-0.75) and better quality of life (10.3 points higher in SF-36 general health score, 95% CI 0.79-19.8), without a decrease in anxiety or post-traumatic stress disorder (PTSD). For the relatives receiving an ICU diary, there was no difference in the incidence of PTSD, anxiety, or depression. CONCLUSION AND RELEVANCE: This systematic review and meta-analysis supports the use of ICU diaries to reduce the risk of depression and preserve the quality of life of patients after ICU admission. ICU diaries do not seem to have any beneficial effect on the relatives of the patients. TRIAL REGISTRATION: PROSPERO, CRD42019136639.

Study of organochlorine pesticides and heavy metals in soils of the Juarez valley: an important agricultural region between Mexico and the USA.

The Juarez Valley is an important agricultural region in northern Mexico, conveniently organized into three modules (I to III). For decades, their soils have been exposed to organochlorine pesticides (OCPs) and also have been irrigated with wastewaters, which may contain heavy metals. Nowadays, there is very limited information regarding the presence of OCPs and heavy metals in these soils. Thus, the aim of this study was to diagnose these soils for OCPs and heavy metal content by using gas chromatography coupled with electron micro-capture detector and atomic absorption spectrometry, respectively. The results indicated that 4,4'-dichlorodiphenyldichloroethylene and 4,4'-dichlorodiphenyltrichloroethane were primarily disseminated across the three modules since they were found in 100% and 97% of the analyzed soils, respectively. According to international regulations, none of the determined OCP concentrations are out of the limits. Additionally, the Cu, Zn, Fe, Pb, and Mn were found in all sampled soils from the three modules. The highest concentration of Fe was found in module II (1902.7 ± 332.2 mg kg-1), followed by Mn in module III (392.43 ± 74.43 mg kg-1), Zn in module I (38.36 ± 26.57 mg kg-1), Pb in module II (23.48 ± 6.48 mg kg-1), and Cu in module I (11.04 ± 3.83 mg kg-1) (p ≤ 0.05). These values did not exceed the limits proposed by international standards. The Cd was detected in most of the analyzed soils and all their values, with an average of 2 mg kg-1, surpassed the Mexican standards (0.35 mg kg-1). This study has mapped the main OCPs and heavy metals in the Juarez Valley and can serve as a starting point to further monitor the behave of xenobiotics. Since these recalcitrant compounds might be bio-accumulated in biological systems, further analytical methods, as well as remediation techniques, should be developed.

Removal of inorganic chemical species and organic matter from slaughterhouse wastewater via calcium acetate synthesized from eggshell.

The physicochemical treatment (PT) of slaughterhouse wastewater (SWW) was investigated. In the first stage, calcium acetate (Ca(Ac)2) was synthesized in five different ways: (1) acetic acid (HAc) and chicken eggshell (CaAc1), (2) lime (CaAc2), (3) a 1:1 eggshell and lime mixture (CaAc3), (4) a 1:2 eggshell and lime mixture (CaAc4), and (5) calcium oxide via the calcination of eggshell (CaAc5). The synthesized Ca(Ac)2 samples were characterized by IR, SEM, XRD, and EDS. Subsequently, the samples were used to precipitate oxyanions and organic matter. The experiments were carried out at pH 4 and 12. For the treatment with CaAc1 at pH 4, an acid (HCl, H2SO4, or HAc) was also added. The best results for CaAc1 in acid media were attained with HCl, where removal efficiencies of 82.23% total suspended solids, 76% turbidity, 81.43% color, 53.86% Fe, 69.74% Cu, and 14.64% Na were observed. This treatment also removed ∼99% fecal and total coliforms, 26.49% COD, and 78.39% TOC. The experiments were also performed at pH 12 using CaAc1. These afforded removal efficiencies of 92.7% turbidity, 84.7% color, 40.5% phosphates (PO43-), and 64.7% sulfates (SO42-). In addition, this method removed metals, 35.37% COD and 99% fecal and total coliforms.

Learning to Exploit the Prior Network Knowledge for Weakly-Supervised Semantic Segmentation.

Training a Convolutional Neural Network (CNN) for semantic segmentation typically requires to collect a large amount of accurate pixel-level annotations, a hard and expensive task. In contrast, simple image tags are easier to gather. With this paper we introduce a novel weakly-supervised semantic segmentation model able to learn from image labels, and just image labels. Our model uses the prior knowledge of a network trained for image recognition, employing these image annotations as an attention mechanism to identify semantic regions in the images. We then present a methodology that builds accurate class-specific segmentation masks from these regions, where neither external objectness nor saliency algorithms are required. We describe how to incorporate this mask generation strategy into a fully end-to-end trainable process where the network jointly learns to classify and segment images. Our experiments on PASCAL VOC 2012 dataset show that exploiting these generated class-specific masks in conjunction with our novel end-to-end learning process outperforms several recent weakly-supervised semantic segmentation methods that use image tags only, and even some models that leverage additional supervision or training data.

Chemical activity relation of phosphorus and nitrogen presence in trace elements incorporation into underground water.

Anthropogenic activities can deteriorate the quality of groundwater destined for human use and consumption due to the fact that human activities cause changes in groundwater chemistry. The changes are induced by chemical species coming from industrial waste, which interacts with rocks and minerals. These trigger agents (phosphorus and nitrogen nutrients) which can incorporate trace elements (As, Fe, Mn, Pb, Cd, Ni, Zn). The main objective of the present work was to study the phosphate ions' and nitrogenous species' effects on the incorporation of trace elements into groundwater used for human consumption and to determine the physicochemical processes that participate in the incorporation of trace elements. The physicochemical analysis and elemental analysis by ICP of the groundwater that supplies the study area showed that the phosphorus (P) activity contributes in the incorporation of trace elements into the water. Significant correlations between the activities of P and Fe (0.516), Mn (0.553), Pb (0.756), and As (- 0.747) as well as the correlation of NH4+ with As indicate that the presence of chemical species such as PO43- (2.50-32.20 mg L-1), NO3- (0.89-30.80 mg L-1), and NH4+ (0.2-12.70 mg L-1) are triggering agents that favor the dissolution and mobility of As (0.014-0.020 mg L-1), Fe (0.020-1.14 mg L-1), Mn (0.007-0.254 mg L-1), Ni (0.002-0.0141 mg L-1), Zn (0.009-0.459 mg L-1), and Pb (0.009-0.0170 mg L-1), species with adverse health effects because they are considered carcinogenic. Adequate control of the nitrogenous and phosphated material prevents the dissolution and mobility of trace elements into the water.

A comparative metagenomic and spectroscopic analysis of soils from an international point of entry between the US and Mexico.

The Paso del Norte region is characterized by its dynamic industries and active agriculture. Throughout the years, urban and agricultural soils from this region have been exposed to xenobiotics, heavy metals, and excess of hydrocarbons. In this study, samples of urban [domestic workshops (DW)] and agricultural-intended (AI) soils from different sites of Ciudad Juárez, Mexico were evaluated for their fertility, element content, and microbial diversity. Chemical analyses showed that nitrites, nitrates, P, K, Mg, and Mn were predominantly higher in AI soils, compared to DW soils (p ≤ 0.05). The composition of soil microbial communities showed that Proteobacteria phylum was the most abundant in both soils (67%, p ≤ 0.05). In AI soils, Paracoccus denitrificans was reduced (p ≤ 0.05), concurring with an increment in nitrates, while the content of nitrogen was negatively correlated with the rhizobium group (r2 = -0.65, p ≤ 0.05). In DW soils, the Firmicutes phylum represented up to ~25%, and the relative abundance of Proteobacteria strongly correlated with a higher Cu content (r2 = 0.99, p ≤ 0.0001). The monotypic genus Sulfuricurvum was found only in oil-contaminated soil samples. Finally, all samples showed the presence of the recently created phylum Candidatus saccharibacteria. These results describe the productivity parameters of AI soils and its correlation to the microbial diversity, which are very important to understand and potentiate the productivity of soils. The data also suggest that soils impacted with hydrocarbons and metal(oid)s allow the reproduction of microorganisms with the potential to alleviate contaminated sites.

Separation of Nickel-Titanium Rotary and Reciprocating Instruments: A Mini-Review of Clinical Studies.

OBJECTIVE: This review aimed to evaluate clinical studies that assessed separated NiTi rotary and reciprocating instruments. DESIGN AND METHODS: This review assessed clinical studies involving treatments performed by undergraduate students, graduate students, and endodontic specialists. This review evaluated studies using rotary instruments, reciprocating instruments, and hybrid techniques. The number of uses of the different NiTi rotary and reciprocating systems was also assessed. RESULTS: The incidence of separation for rotary instruments ranged from 0% to 23%. Rotary instruments were used from 1 to 50 times depending on the instrument and tooth type. The lowest rate of incidence separation for rotary instruments was obtained by undergraduate students, using a hybrid technique. The separation incidence for reciprocating instruments ranged from 0% to 1.71%. Reciprocating instruments were mostly single-used; one study reported their use up to 3 times. Separation rate in reciprocating instruments was similar in single-use or in multiple uses 0.2%. CONCLUSIONS: Separation of instruments has dropped recently and seems to be a minor problem in current Endodontics. Multiple uses of NiTi rotary instruments are a possibility without significantly increasing the risk of instrument separation. Single and multiple uses of NiTi reciprocating instruments are also associated with low incidence of separation. Attempting to remove separated instruments should be carefully evaluated.

Locating the second mesiobuccal canal in maxillary molars: challenges and solutions.

The second mesiobuccal canal in mesiobuccal roots in maxillary molars is a common finding in root canal treatments. Failure on the location of these canals is associated with a high rate of unsuccessful treatments of maxillary molars. Its prevalence has been assessed in several in vitro and in vivo studies, presenting variations according to the methodology applied, along with the population of interest. While the anatomy of these teeth is well defined in micro-computed tomography studies, the clinical management is a great challenge for the practitioner. The use of a dental operating microscope has rendered a better clinical outcome when considering the location and treatment of this canal. On the other hand, cone-beam computed tomography use is still controversial in the efficacy of MB2 canal location. The association of a dental operating microscope with troughing performed with ultrasonic tips is an essential step in this location. Moreover, sodium fluorescein might be applied for root canal location. Due to the high rate of unsuccessful cases when the MB2 canal is not initially found, several cases are performed aiming to address the cases of missed MB2 canals. Therefore, the clinician should discuss the best possible approach, whether surgical or clinical. This article presents an overview of the importance of the MB2 canal on the outcomes of root canal treatments of maxillary molars. Solutions based in current literature will be presented accordingly.