Spatial Variation and Environmental Parameters Affecting the Abundant and Rare Communities of Bacteria and Archaea in the Sediments of Tropical Urban Reservoirs.

Microbial communities in freshwater sediments play an important role in organic matter remineralization, contributing to biogeochemical cycles, nutrient release, and greenhouse gases emissions. Bacterial and archaeal communities might show spatial or seasonal patterns and were shown to be influenced by distinct environmental parameters and anthropogenic activities, including pollution and damming. Here, we determined the spatial variation and the environmental variables influencing the abundant and rare bacterial and archaeal communities in the sediments of eutrophic-hypereutrophic reservoirs from a tropical urban area in Brazil. The most abundant microbes included mainly Anaerolineae and Deltaproteobacteria genera from the Bacteria domain, and Methanomicrobia genera from the Archaea domain. Microbial communities differed spatially in each reservoir, reflecting the establishment of specific environmental conditions. Locations with better or worst water quality, or close to a dam, showed more distinct microbial communities. Besides the water column depth, microbial communities were affected by some pollution indicators, including total phosphorus, orthophosphate, electrical conductivity, and biochemical oxygen demand. Distinct proportions of variation were explained by spatial and environmental parameters for each microbial community. Furthermore, spatial variations in environmental parameters affecting these communities, especially the most distinct ones, contributed to microbial variations mediated by spatial and environmental properties together. Finally, our study showed that different pressures in each reservoir affected the sediment microbiota, promoting different responses and possible adaptations of abundant and rare bacterial and archaeal communities.

Thrombotic microangiopathy caused by methionine synthase deficiency: diagnosis and treatment pitfalls.

BACKGROUND: Inborn errors of cobalamin (Cbl) metabolism form a large group of rare diseases. One of these, Cbl deficiency type C (CblC), is a well-known cause of thrombotic microangiopathy (TMA), especially in infants. However, there has only been a single published case of TMA associated to Cbl deficiency type G (CblG), also known as methionine synthase deficiency (MSD). CASE DIAGNOSIS/TREATMENT: A 21-month-old boy presented with pallor and oral ulcers during episodes of upper respiratory infection (URI). Further examination revealed signs of TMA, and the patient progressed to acute renal failure (ARF). Renal biopsy showed TMA. Evaluation for infection and autoantibodies were negative. The C3 and C4 complement fractions were normal. Analysis of the bone marrow aspirate suggested megaloblastic anemia and signs of hematopoiesis activation (secondary to peripheral hemolysis). Although the serum vitamin B12 level was normal, the patient was treated with cyanocobalamin, with no improvement. The ARF and hematologic parameters improved with conservative treatment. A severe relapse occurred during the follow-up, with normal ADAMTS13 activity. The presumed diagnosis was atypical hemolytic uremic syndrome, and the patient was started on eculizumab, but his response was poor, even when the dosage was increased. At this point it was also recognized that his developmental speech was delayed. Based on these findings, whole exome sequencing was performed, leading to the detection of two novel deleterious variants in the gene coding for methionine synthase, confirming the diagnosis of MSD. Subsequent treatment consisted of elevating the patient's serum homocysteine level and starting him on hydroxicobalamin, with normalization of all hematologic parameters although the microalbuminuria remained. CONCLUSIONS: Methionine synthase deficiency is very rare and characterized by megaloblastic anemia and neurological symptoms. We report the second case of MSD associated to TMA previously diagnosed as aHUS in which the patient had a poor response to eculizumab.

Student's perspectives of inclusive practices in anatomy education.

There is a drive to implement inclusive practices in anatomy by adapting curricula and utilizing inclusive language and resources that negate biases. However, to date there is no data regarding student's perception of inclusivity. Therefore, the study aims to investigate anatomy student's opinions on inclusive practices in anatomy education based on the protected characteristics of age, disability, ethnicity, gender affirmation and sex. One hundred and forty-five students completed a questionnaire with 21 Likert-scale and two open-ended questions. Kruskal-Wallis tests compared responses by groups defined by the protected characteristics of the Equality Act (2010). Most students (71.2%; n = 84) agreed or strongly agreed that "improving inclusivity in anatomy education should be educator's priority". In terms of representation, there was a statistically different response rate from students from different ethnic backgrounds to the statements "there are anatomy educators" (p < 0.001), "images in textbooks" (p < 0.001) and "models in the dissection room" (p < 0.001) "that look like me". Most students agreed or strongly agreed to statements relating to the protected characteristics of age (70.4%; n = 68), disability (78.6%; n = 77), ethnicity (59.8%; n = 64), gender affirmation (46.3%; n = 46) and sex (51.5%; n = 62). Themes identified relating to improving inclusivity included "reflecting reality", "teaching the truth", "the invisibility of women" and the "learning environment". Students have confirmed that anatomists, as gatekeepers of the knowledge of the human body, should foster inclusive teaching practices that will benefit all students and potentially future patient care.

Gambling advertising on Twitter before, during and after the initial Australian COVID-19 lockdown.

Background and aims: COVID-19 resulted in the shutdown of almost all sporting competitions and most venue-based gambling opportunities. This study examines how wagering operators in Australia responded, by examining their advertising. Methods: The study compared Twitter activity during lockdown (March-May 2020) to the previous year for four major wagering operators. Results: Wagering operators continued to advertise in earnest, changing their marketing mix to include more race betting content, as races continued to operate. Most also promoted the only sports available, such as table tennis or esports. When sports resumed, sports betting advertising quickly returned to normal, or exceeded previous levels. Despite more content being available in the case of two operators, engagement from the public during lockdown was similar to or lower than previously. Discussion and conclusion: These results indicate that gambling operators can adjust quickly to major changes. These shifts appear to have been successful, with the increase in race betting during this period almost completely offsetting the decreases in sports betting. This is likely due in part to changes in advertising, which have been associated with increased betting activity, particularly amongst vulnerable people. Responsible gambling messages were virtually non-existent on Twitter, which contrasts with mandatory requirements in other media. The study highlights that regulatory changes to advertising, e.g., banning some content, are likely to be met with substitution of content, rather than reduction, unless advertising volume is also capped. The study also highlights the adaptive capacity of the gambling industry in the face of major disruption to supply.

Effects of metal contamination with physicochemical properties on the sediment microbial communities in a tropical eutrophic-hypereutrophic urban reservoir in Brazil.

We investigated the effects of metals and physicochemical variables on the microbes and their metabolisms in the sediments of Guarapiranga reservoir, a tropical eutrophic-hypereutrophic freshwater reservoir located in a highly urbanized and industrialized area in Brazil. The metals cadmium, copper, and chromium showed minor contribution to changes in the structure, composition, and richness of sediment microbial communities and functions. However, the effects of metals on the microbiota are increased when taken together with physicochemical properties, including the sediment carbon and sulfur, the bottom water electrical conductivity, and the depth of the water column. Clearly, diverse anthropic activities, such as sewage discharge, copper sulfate application to control algal growth, water transfer, urbanization, and industrialization, contribute to increase these parameters and the metals spatially in the reservoir. Microbes found especially in metal-contaminated sites encompassed Bathyarchaeia, MBG-D and DHVEG-1, Halosiccatus, Candidatus Methanoperedens, Anaeromyxobacter, Sva0485, Thermodesulfovibrionia, Acidobacteria, and SJA-15, possibly showing metal resistance or acting in metal bioremediation. Knallgas bacteria, nitrate ammonification, sulfate respiration, and methanotrophy were inferred to occur in metal-contaminated sites and may also contribute to metal removal. This knowledge about the sediment microbiota and metabolisms in a freshwater reservoir impacted by anthropic activities allows new insights about their potential for metal bioremediation in these environments.

Subnodal Correspondence of PSMA Expression and USPIO-MRI in Metastatic Pelvic Lymph Nodes in Prostate Cancer.

OBJECTIVES: Two advanced imaging modalities used to detect lymph node (LN) metastases in prostate cancer patients are prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography and ultrasmall superparamagnetic iron oxide (USPIO)-enhanced magnetic resonance imaging (MRI). As these modalities use different targets, a subnodal comparison is needed to interpret both their correspondence and their differences. The aim of this explorative study was to compare ex vivo 111In-PSMA µSPECT images with high-resolution 7 T USPIO µMR images and histopathology of resected LN specimens from prostate cancer patients to assess the degree of correspondence at subnodal level. MATERIALS AND METHODS: Twenty primary prostate cancer patients who underwent pelvic LN dissection were included and received USPIO contrast and 111In-PSMA. A total of 41 LNs of interest (LNOIs) were selected for ex vivo imaging based on γ-probe detection or palpation. µSPECT and µMRI acquisition were performed immediately after resection. Overlay of µSPECT images on MR images was performed, and the level of correspondence (LoC) between µSPECT and µMR findings was assessed according to a 4-point Likert classification scheme. RESULTS: Forty-one LNOIs could be matched to an LN on ex vivo µMRI. Coregistration of µSPECT and USPIO-enhanced water-selective multigradient echo MR images was successful for all 41 LNOIs. Ninety percent of the lesions showed excellent correspondence regarding the presence of metastatic tissue and affected subnodal site (LoC 4; 37/41). In only 1 of 41 LNOIs, a small metastasis was misclassified by both techniques. Three LNOIs were classified as LoC 3 (7%) and 1 LNOI as LoC 2. All LoC 2 and LoC 3 lesions had PSMA-expressing metastases on final histopathology. CONCLUSIONS: Coregistration of µSPECT and USPIO-µMRI showed excellent subnodal correspondence in the majority (90%) of LNs. Ex vivo imaging may thus help localize small cancer deposits within resected LNs and could contribute to improved interpretation of in vivo imaging of LNs.

Nursing workload associated with neonatal mortality risk: a cross-sectional study.

OBJECTIVES: to analyze the association between nursing workload and neonatal mortality risk in newborns admitted to the Neonatal Intensive Care Unit. METHODS: this is an observational, cross-sectional study conducted from January 2019 to January 2020. RESULTS: the sample consisted of 399 newborns, 55.4% male, Nursing Activities Score mean of 67.5%, and Score for Neonatal Acute Physiology Perinatal Extension mean of 17.7, revealed itself as a predictor of the risk of death, while gestational age, length of hospitalization, and the first-minute Apgar established a protective relationship. The correlation between workload and neonatal mortality was low (r= 0.23, p=0.0009). CONCLUSIONS: the workload of the nursing team is not associated with the risk of mortality in the Neonatal Intensive Care Unit, as measured by the Nursing Activities Score.

Strengthening the clinical academic pathway: a systematic review of interventions to support clinical academic careers for doctors and dentists.

OBJECTIVE: Evaluate existing evidence on interventions intended to increase recruitment, retention and career progression within clinical academic (CA) careers, including a focus on addressing inequalities. DESIGN: Systematic review. DATA SOURCES: Medline, Embase, Cochrane Controlled Register of Trials, PsycINFO and Education Resource Information Center searched October 2019. STUDY SELECTION: Eligible studies included qualified doctors, dentists and/or those with a supervisory role. Outcomes were defined by studies and related to success rates of joining or continuing within a CA career. DATA EXTRACTION AND SYNTHESIS: Abstract screening was supported by machine learning software. Full-text screening was performed in duplicate, and study quality was assessed. Narrative synthesis of quantitative data was performed. Qualitative data were thematically analysed. RESULTS: 148 studies examined interventions; of which 28 were included in the quantitative synthesis, 17 in the qualitative synthesis and 2 in both. Studies lacked methodological rigour and/or were hindered by incomplete reporting. Most were from North America. No study included in the syntheses evaluated interventions aimed at CA dentists.Most quantitative evidence was from multifaceted training programmes. These may increase recruitment, but findings were less clear for retention and other outcomes. Qualitative studies reported benefits of supportive relationships, including peers and senior mentors. Protected time for research helped manage competing demands on CAs. Committed and experienced staff were seen as key facilitators of programme success. Respondents identified several other factors at a programme, organisational or national level which acted as facilitators or barriers to success. Few studies reported on the effects of interventions specific to women or minority groups. CONCLUSIONS: Existing research is limited by rigour and reporting. Better evaluation of future interventions, particularly those intended to address inequalities, is required. Within the limits of the evidence, comprehensive multifaceted programmes of training, including protected time, relational and support aspects, appear most successful in promoting CA careers. SYSTEMATIC REVIEW REGISTRATION: Open Science Framework: https://osf.io/mfy7a.

Higher Abundance of Sediment Methanogens and Methanotrophs Do Not Predict the Atmospheric Methane and Carbon Dioxide Flows in Eutrophic Tropical Freshwater Reservoirs.

Freshwater reservoirs emit greenhouse gases (GHGs) such as methane (CH4) and carbon dioxide (CO2), contributing to global warming, mainly when impacted by untreated sewage and other anthropogenic sources. These gases can be produced by microbial organic carbon decomposition, but little is known about the microbiota and its participation in GHG production and consumption in these environments. In this paper we analyzed the sediment microbiota of three eutrophic tropical urban freshwater reservoirs, in different seasons and evaluated the correlations between microorganisms and the atmospheric CH4 and CO2 flows, also correlating them to limnological variables. Our results showed that deeper water columns promote high methanogen abundance, with predominance of acetoclastic Methanosaeta spp. and hydrogenotrophs Methanoregula spp. and Methanolinea spp. The aerobic methanotrophic community was affected by dissolved total carbon (DTC) and was dominated by Crenothrix spp. However, both relative abundance of the total methanogenic and aerobic methanotrophic communities in sediments were uncoupled to CH4 and CO2 flows. Network based approach showed that fermentative microbiota, including Leptolinea spp. and Longilinea spp., which produces substrates for methanogenesis, influence CH4 flows and was favored by anthropogenic pollution, such as untreated sewage loads. Additionally, less polluted conditions favored probable anaerobic methanotrophs such as Candidatus Bathyarchaeota, Sva0485, NC10, and MBG-D/DHVEG-1, which promoted lower gaseous flows, confirming the importance of sanitation improvement to reduce these flows in tropical urban freshwater reservoirs and their local and global warming impact.

Disease Progression and Obstetric Outcomes of Women with Multiple Sclerosis at a Reference Center in Northeastern Brazil.

OBJECTIVE: To describe the obstetric outcomes of patients with multiple sclerosis (MS) and the impact of pregnancy and the postpartum period on the progression of the disease. METHODS: A case series study performed between December 2019 and February 2020, reporting pregnancies occurred between 1996 and 2019. The subjects included were women with MS undergoing follow-up at an MS referral center in Northeastern Brazil, and who had at least one pregnancy after the onset of MS symptoms, or who had their first relapse in the first year after delivery. RESULTS: In total, 26 women and 38 pregnancies were analyzed - 32 of them resulted in delivery, and the remaining 6, in miscarriages. There was a significant increase in the prevalence of relapse during the postpartum period when compared with the gestational period. In 16 (42.1%) of the pregnancies, there was exposure to disease-modifying therapies (DMTs) - 14 (36.8%), to interferon ß, and 2 (5.3%), to fingolimod. Higher rates of abortion, prematurity and low birth weight were reported in the group was exposed to DMT when compared with the one who was not. CONCLUSION: In the sample of the present study, there was a significant increase in the rate of MS relapse during the postpartum period when compared with the gestational period. Additionally, it seems that exposure to DMTs during pregnancy may affect the obstetric outcomes of the patients.

OBJETIVO: Descrever os desfechos obstétricos de pacientes com esclerose múltipla (EM) e o impacto da gravidez e do período pós-parto na progressão da doença. MéTODOS: Uma série de casos realizada entre dezembro de 2019 e fevereiro de 2020, que retrata gestações ocorridas entre 1996 e 2019. As pacientes incluídas neste estudo foram mulheres com EM, que realizam acompanhamento em um centro de referência em EM no Nordeste do Brasil, e que tiveram ao menos uma gestação após o início dos sintomas da EM, ou tiveram o primeiro surto da doença no ano posterior ao parto. RESULTADOS: No total, 26 mulheres e 38 gestações foram avaliadas ­ dentre as quais, 32 resultaram em partos, e 6, em abortamentos. Houve um aumento significativo na prevalência de surtos durante o pós-parto quando comparado com o período gestacional. Em 16 (42,1%) das gravidezes, houve exposição a terapias modificadoras da doença (TMDs) ­ 14 (36,8%) a ß-interferona, e 2 (5,3%) a fingolimode. As taxas de abortamento, prematuridade e baixo peso ao nascer foram mais elevadas no grupo exposto às TMDs quando comparado com o não exposto. CONCLUSãO: Na amostra deste estudo, houve um aumento significativo na taxa de surtos da EM durante o período pós-parto quando comparado com o período gestacional. Além disso, a exposição às TMDs durante a gestação pode afetar os desfechos obstétricos das pacientes.

Corrigendum: Higher Abundance of Sediment Methanogens and Methanotrophs Do Not Predict the Atmospheric Methane and Carbon Dioxide Flows in Eutrophic Tropical Freshwater Reservoirs.

[This corrects the article DOI: 10.3389/fmicb.2021.647921.].

Twelve tips for running a successful body painting teaching session.

Body painting in the medical education context is the painting of internal structures on the surface of the body with high verisimilitude. Body painting has many educational benefits, from the obvious acquisition of anatomical knowledge, to the less obvious benefits of improved communication skills and greater body awareness. As with any activity, which involves physical examination and undressing, sensitive delivery is imperative. The 12 tips given in this article offer advice on the practicalities of running a successful body painting session in a supportive environment, thus promoting maximum student participation.

The impact of wearing scrubs on contextual learning.

BACKGROUND: Godden and Baddeley ( 1975 ) suggested strong contextual influence on recall, suggesting learning in an educational context might not transfer well to practice. AIM: To explore the impact of an authentic context (wearing hospital scrubs) on learning and recall. METHODS: 82 first year medical students sat a pre-test on renal gross anatomy and imaging, to establish prior knowledge, wearing their own clothes. Students wore either scrubs or their own clothes for the first teaching session on renal gross anatomy. A mid-test on this topic was completed immediately after the teaching session. Students then changed into opposite clothing and attended a self-directed session on renal imaging. An imaging specific mid-test was completed. 5 weeks later students completed two post-tests (gross anatomy and imaging) in their own clothes. Tests were online. RESULTS: Data were analysed using paired t-tests. Results showed no significant difference between test performance immediately after the teaching session, but a significant improvement (p = 0.04) on recall between groups tested in the same clothing versus testing in different clothing. The effect size of the teaching intervention was 0.27, a 'moderate' effect in teaching terms. CONCLUSIONS: Students examined in the same context as they were taught recalled significantly more information.

Nursing workload associated with neonatal mortality risk: a cross-sectional study / Carga de trabajo de enfermería relacionada al riesgo de mortalidad neonatal: un estudio transversal / Carga de trabalho de enfermagem associada ao risco de mortalidade neonatal: um estudo transversal

ABSTRACT Objectives: to analyze the association between nursing workload and neonatal mortality risk in newborns admitted to the Neonatal Intensive Care Unit. Methods: this is an observational, cross-sectional study conducted from January 2019 to January 2020. Results: the sample consisted of 399 newborns, 55.4% male, Nursing Activities Score mean of 67.5%, and Score for Neonatal Acute Physiology Perinatal Extension mean of 17.7, revealed itself as a predictor of the risk of death, while gestational age, length of hospitalization, and the first-minute Apgar established a protective relationship. The correlation between workload and neonatal mortality was low (r= 0.23, p=0.0009). Conclusions: the workload of the nursing team is not associated with the risk of mortality in the Neonatal Intensive Care Unit, as measured by the Nursing Activities Score.

RESUMEN Objetivos: analizar la relación entre la carga de trabajo de enfermería y el riesgo de mortalidad neonatal en recién nacidos internados en Unidad de Cuidados Intensivos Neonatal. Métodos: estudio observacional, del tipo transversal, realizado en el período de enero de 2019 a enero de 2020. Resultados: la muestra se constituyó de 399 recién nacidos, siendo 55,4% del sexo masculino, Nursing Activities Score mediano de 67,5% y Score for Neonatal Acute Physiology Perinatal Extension mediano de 17,7, se mostró como pronosticador para riesgo de óbito, mientras la edad gestacional, tiempo de internación y Apgar del primero minuto establecieron una relación protectora. La correlación entre carga de trabajo y el riesgo de mortalidad neonatal fue baja (r= 0,23, p=0.0009). Conclusiones: la carga de trabajo del equipo de enfermería, mensurada por el Nursing Activities Score, no está relacionada al riesgo de mortalidad en el ámbito de la Unidad de Cuidados Intensivos Neonatal.

RESUMO Objetivos: analisar a associação entre a carga de trabalho de enfermagem e o risco de mortalidade neonatal em recém-nascidos internados em Unidade de Terapia Intensiva Neonatal. Métodos: trata-se de um estudo observacional, do tipo transversal, realizado no período de janeiro de 2019 a janeiro de 2020. Resultados: a amostra constituiu-se de 399 recém-nascidos, sendo 55,4% do sexo masculino, Nursing Activities Score médio de 67,5%, Score for Neonatal Acute Physiology Perinatal Extension médio de 17,7 e mostrou se como preditor para risco de óbito, enquanto a idade gestacional, tempo de internação e Apgar do primeiro minuto estabeleceram uma relação protetora. A correlação entre carga de trabalho e o risco de mortalidade neonatal, foi baixa (r= 0,23, p=0.0009). Conclusões: a carga de trabalho da equipe de enfermagem, mensurada pelo "Nursing Activities Score", não está associada ao risco de mortalidade no âmbito da Unidade de Terapia Intensiva Neonatal.

Espaços Formativos e de Sensibilização Quanto às Práticas Integrativas e Complementares em uma Unidade de Saúde da Família: Potencialidades e Desafios

Diante do contexto do Sistema Único de Saúde e das Diretrizes Curriculares Nacionais para os Cursos de Medicina, o Módulo Horizontal A-2 traz uma proposta de conectar os aprendizados teóricos e a prática na rede de saúde. Com objetivos de construção de conhecimentos em práticas educativas em saúde, foram realizados dois cursos de Práticas Integrativas centrados em princípios da educação popular e em uma construção horizontal do conhecimento. Esses cursos foram realizados na Unidade de Saúde da Família - Vila Saúde e a sua construção deu-se em conjunto com a equipe e usuários da mesma. Os participantes entraram em contato com diversas práticas como a fitoterapia, terapia floral, biodança e vivências teatrais. Nesse contexto, foi possível identificar muitas potencialidades e dificuldades no desenvolvimento desses cursos, como a importância do interesse dos participantes e os problemas de infraestrutura na Unidade. Durante os cursos, o conhecimento construído permitiu um contato maior dos participantes com as práticas integrativas e uma visão ampliada sobre o cuidado. Além disso, os profissionais puderam se capacitar e conhecer novas práticas, o que possibilita uma melhoria no atendimento realizado. Para os estudantes, o curso trouxe uma visão ampla do sistema e da importância da educação em saúde no Sistema Único de Saúde.

Introduction of nickel titanium rotary instruments to undergraduate students: afour-yearclinical experience / Introdução de instrumentos rotários de níquel titânio para alunos de graduação: quatro anos de experiência clínica

Many studies address the quality of root canal treatments, but few refer to endodontics usingrotatory techniques performed by noviceoperators. This study evaluatedthe performance of undergraduates in their first contact with rotary root canal instrumentation concerningthe findings of the final periapical radiograph, and thepostendodontic treatment pain.A longitudinal observational studywas performed on periapical radiographs of 491teethfrom 450 patientssubmitted toroot canal treatmentby undergraduate students from 2015 to 2018. The analysis of the length of root canal filling followed the criteria: (i) acceptable, ifperiapical radiograph presentsroot filling ending 0 -1 mm short of radiographic apex; (ii) over, if periapical radiograph presentsroot filling ending beyond the radiographic apex; and (iii) under, ifperiapical radiograph presentsroot filling ending > 1 mm short of radiographic apex. Evaluation of postendodontic treatment painwas categorized into either absence or presenceof pain. Adequate length root canal filling was observed in 65.9% of the cases (324 teeth). Periapical lesions presenceand dimensions did not interfere to the obturation quality.Statistical relation was found between the pulp condition and postendodontic treatment pain. Thepresence of pain was observed in 4.7% of the vital teeth and 0.3% of non-vital teeth. The presence of periapical lesion did not influence postoperative pain.AdequatelengthrootcanalfillingwasobservedinmostcasesandNitTi rotary instrumentation hadapplicability in undergraduate programs, even with novice operators. Besides that, pulp condition had an effect on post endodontic pain (AU).

Muitos estudos abordam a qualidade dos tratamentos de canal radicular, mas poucos se referem à endodontia por meio de técnicas rotatórias realizada por operadores novatos. Este estudo avaliou o desempenho de graduandos no primeiro contato com a instrumentação endodôntica em relação aos achados da radiografia periapical final e à dor pós-tratamento endodôntico. Um estudo observacional longitudinal foi realizado em radiografias periapicais de 491 dentes de 450pacientes submetidos a tratamento endodôntico por estudantes de graduação no período de 2015 a 2018. A análise do comprimento da obturação de canais radiculares obedeceu aos critérios: (i) aceitável, se a radiografia periapical apresentasse término de obturação 0 -1 mm aquém do ápice radiográfico; (ii) acima, se a radiografia periapical apresentasse obturação que termina além do ápice radiográfico; e (iii) abaixo, se a radiografia periapicalapresentasse obturação, terminando > 1 mm aquém do ápice radiográfico. A avaliação da dor pós-operatória foi categorizada em ausência ou presença de dor. A obturação de canais radiculares de comprimento adequado foi observada em 65,9% dos casos (324 dentes). A presença e as dimensões das lesões periapicais não interferiram na qualidade da obturação. Foi encontrada relação estatística entre a condição pulpar e a dor pós-tratamento endodôntico. Presença de dor foi observada em 4,7% dos dentes vitais e 0,3% dos não vitais. A presença de lesão periapical não influenciou na dor pós-operatória. O comprimento de trabalho adequado foi observado na maioria dos casos e a instrumentação rotatória NitTi teve aplicabilidade em programas de graduação, mesmo com operadores iniciantes. Além disso, a condição pulpar afetou a dor pós-operatória (AU).

Disease progression and obstetric outcomes of women with multiple sclerosis at a reference center in northeastern Brazil / Progressão da doença e desfechos obstétricos em mulheres portadoras de esclerose múltipla em um centro de referência no Nordeste brasileiro

Abstract Objective To describe the obstetric outcomes of patients withmultiple sclerosis (MS) and the impact of pregnancy and the postpartum period on the progression of the disease. Methods A case series study performed between December 2019 and February 2020, reporting pregnancies occurred between 1996 and 2019. The subjects included were women with MS undergoing follow-up at an MS referral center in Northeastern Brazil, and who had at least one pregnancy after the onset of MS symptoms, or who had their first relapse in the first year after delivery. Results In total, 26 women and 38 pregnancies were analyzed - 32 of them resulted in delivery, and the remaining 6, in miscarriages. There was a significant increase in the prevalence of relapse during the postpartum period when compared with the gestational period. In 16 (42.1%) of the pregnancies, there was exposure to diseasemodifying therapies (DMTs) - 14 (36.8%), to interferon β, and 2 (5.3%), to fingolimod. Higher rates of abortion, prematurity and low birth weight were reported in the group was exposed to DMT when compared with the one who was not. Conclusion In the sample of the present study, there was a significant increase in the rate of MS relapse during the postpartum period when compared with the gestational period. Additionally, it seems that exposure to DMTs during pregnancy may affect the obstetric outcomes of the patients.

Resumo Objetivo Descrever os desfechos obstétricos de pacientes com esclerose múltipla (EM) e o impacto da gravidez e do período pós-parto na progressão da doença. Métodos Uma série de casos realizada entre dezembro de 2019 e fevereiro de 2020, que retrata gestações ocorridas entre 1996 e 2019. As pacientes incluídas neste estudo foram mulheres com EM, que realizam acompanhamento em um centro de referência em EM no Nordeste do Brasil, e que tiveram ao menos uma gestação após o início dos sintomas da EM, ou tiveram o primeiro surto da doença no ano posterior ao parto. Resultados No total, 26 mulheres e 38 gestações foram avaliadas - dentre as quais, 32 resultaram em partos, e 6, em abortamentos. Houve um aumento significativo na prevalência de surtos durante o pós-parto quando comparado com o período gestacional. Em 16 (42,1%) das gravidezes, houve exposição a terapias modificadoras da doença (TMDs) - 14 (36,8%) a β-interferona, e 2 (5,3%) a fingolimode. As taxas de abortamento, prematuridade e baixo peso ao nascer foram mais elevadas no grupo exposto às TMDs quando comparado com o não exposto. Conclusão Na amostra deste estudo, houve um aumento significativo na taxa de surtos da EM durante o período pós-parto quando comparado com o período gestacional. Além disso, a exposição às TMDs durante a gestação pode afetar os desfechos obstétricos das pacientes.

Protective behavioral strategies as a mediator and moderator of the relationship between self-regulation and alcohol-related consequences in first-year college students.

This study examined protective behavioral strategies (PBS) as a potential mediator and moderator of the relationship between self-regulation and alcohol-related consequences. Participants were 249 first-year undergraduate men and women. The use of PBS partially mediated the relationship between self-regulation and alcohol-related problems (i.e., supporting the "self-control equals drinking control" hypothesis). However, use of PBS appeared more important for those with poorer self-regulation abilities (supporting the "PBS protect the impaired" hypothesis). Because both mediation and moderation were supported, a moderated mediation model was tested. The moderated mediation model demonstrated that the negative relationship between self-regulation and alcohol-related consequences could be explained by use of PBS for individuals with poor-to-average self-regulation but not for individuals with above-average, self-regulation abilities. Implications of the study's findings are discussed.

Aspectos ecológicos de mosquitos (Diptera: Culicidae) em fragmentoflorestal urbano e suas implicações vetoriais no município de Taubaté,Estado de São Paulo, Brasil / Ecological Aspects of Mosquitoes (Diptera: Culicidae) in urban forest fragment and its vector implications in the municipality of Taubaté, State of São Paulo, Brazil

Introdução:Fragmentos de mata inseridos no cenário urbano podem reunircondições favoráveis à reprodução de espécies de culicideos de importânciaepidemiológica, constituindo aspecto ecológico extraordinário na discussãode processos adaptativos e suas implicações para a saúde pública.Objetivo:Identificar a composição de espécies de mosquitos adultos, frequência,diversidade, dominância e constância. Pretendeu-se ainda verificar aassociação dos mosquitos com temperatura e pluviosidade e discutir suaimportância em saúde pública. Verificar o dimorfismo sexual e descrever avariação morfológica temporal alar de fêmeas da espécie de importânciaepidemiológica mais frequente. Métodos: Foram realizadas duascoletas/mês, em parque ecológico inserido em ambiente urbano domunicípio de Taubaté-SP, entre agosto de 2008 e agosto de 2009,utilizando-se as técnicas de aspiração, CDC e puçá. Foram empregados osíndices de diversidade, dominância e constância. Analisou-se a associaçãoentre temperatura e pluviosidade e abundância de mosquitos, além dasvariações morfológicas da espécie mais frequente com base na morfometriageométrica alar. Resultados: Foram coletados 2.733 exemplares adultos,sendo 1.412 fêmeas e 1.321 machos, distribuídos em seis gêneros e 23espécies. As mais frequentes e abundantes foram: Aedes scapularis(n=1063), Culex bidens (n=728), Culex nigripalpus (n=408), Ae. albopictus(n=130), Psorophora ferox (n=97) e Culex chidesteri (n=82),perfazendoaproximadamente 90% do total de espécimes coletados. Nove espéciesclassificaram-se como constantes, 5 acessórias e as demais acidentais. Os...

Introduction: Fragments of forest embedded in the urban scenario cancreate favorable conditions to the reproduction of culicidae species ofepidemiological importance, constituting an extraordinary ecological aspect inthe discussion of adaptable processes and its implications to the publichealth. Objective: Identify the composition of specimens of adultmosquitoes, analyzing its frequency, diversity, dominance, constancy, anddiscuss those ones of importance in public health. Verify association of theabundance of mosquitoes with abiotic factors, sexual dimorphism and thewing temporal morphological variation of females of the most frequentspecies of epidemiological importance. Methods: Two samples a monthwere collected, in an ecological park inserted in urban environment in themunicipality of Taubaté-SP, from August, 2008 to August 2009, usingtechniques of aspiration, CDC e insect net to capture. Indexes of diversity,dominance and constancy were used. The association of mosquitoabundance with temperature and rainfall was analyzed, besides themorphological variations of the most frequent species with basis in the winggeometric morphometrics. Results: 2.733 adult individuals were collected,being 1.412 females and 1.321 males, distributed in six genders and 23specimens. The most frequent and abundant were: Aedes scapularis(n=1063), Culex bidens (n=728), Cx. nigripalpus (n=408), Ae. albopictus(n=130), Psorophora ferox (n=97) e Cx. chidesteri (n=82), totalizingapproximately 90% of the total of specimens collected. Nine species wereclassified as constant, 5 as accessory and the other ones as accidental. The...