Effectiveness and impact of universal prophylaxis with nirsevimab in infants against hospitalisation for respiratory syncytial virus in Galicia, Spain: initial results of a population-based longitudinal study.

BACKGROUND: Galicia (Spain) was one of the first regions worldwide to incorporate nirsevimab for universal respiratory syncytial virus (RSV) prophylaxis in infants into its immunisation programme. The NIRSE-GAL longitudinal population-based study aimed to assess nirsevimab effectiveness in preventing hospitalisations (ie, admittance to hospital). METHODS: The 2023-24 immunisation campaign with nirsevimab in Galicia began on Sept 25, 2023, and concluded on March 31, 2024. The campaign targeted three groups: infants born during the campaign (seasonal group), infants younger than 6 months at the start of the campaign (catch-up group), and infants aged 6-24 months with high-risk factors at the start of the campaign (high-risk group). Infants in the seasonal group were offered immunisation on the first day of life before discharge from hospital. Infants in the catch-up and high-risk groups received electronic appointments to attend a public hospital or health-care centre for nirsevimab administration. For this interim analysis, we used data collected from Sept 25 to Dec 31, 2023, from children born up to Dec 15, 2023. Data were retrieved from public health registries. Nirsevimab effectiveness in preventing RSV-associated lower respiratory tract infection (LRTI) hospitalisations; severe RSV-related LRTI requiring intensive care unit admission, mechanical ventilation, or oxygen support; all-cause LRTI hospitalisations; and all-cause hospitalisations was estimated using adjusted Poisson regression models. Data from five past RSV seasons (2016-17, 2017-18, 2018-19, 2019-20, and 2022-23), excluding the COVID-19 pandemic period, were used to estimate the number of RSV-related LRTI hospitalisations averted along with its IQR. The number needed to immunise to avoid one case in the 2023-24 season was then estimated from the averted cases. Nirsevimab safety was routinely monitored. The NIRSE-GAL study protocol was registered on ClinicalTrials.gov (NCT06180993), and follow-up of participants is ongoing. FINDINGS: 9408 (91·7%) of 10 259 eligible infants in the seasonal and catch-up groups received nirsevimab, including 6220 (89·9%) of 6919 in the seasonal group and 3188 (95·4%) of 3340 in the catch-up group. 360 in the high-risk group were offered nirsevimab, 348 (97%) of whom received it. Only infants in the seasonal and catch-up groups were included in analyses to estimate nirsevimab effectiveness and impact because there were too few events in the high-risk group. In the catch-up and seasonal groups combined, 30 (0·3%) of 9408 infants who received nirsevimab and 16 (1·9%) of 851 who did not receive nirsevimab were hospitalised for RSV-related LRTI, corresponding to an effectiveness of 82·0% (95% CI 65·6-90·2). Effectiveness was 86·9% (69·1-94·2) against severe RSV-related LRTI requiring oxygen support, 69·2% (55·9-78·0) against all-cause LRTI hospitalisations, and 66·2% (56·0-73·7) against all-cause hospitalisations. Nirsevimab effectiveness against other endpoints of severe RSV-related LRTI could not be estimated because of too few events. RSV-related LRTI hospitalisations were reduced by 89·8% (IQR 87·5-90·3), and the number needed to immunise to avoid one RSV-related LRTI hospitalisation was 25 (IQR 24-32). No severe adverse events related to nirsevimab were registered. INTERPRETATION: Nirsevimab substantially reduced infant hospitalisations for RSV-associated LRTI, severe RSV-associated LRTI requiring oxygen, and all-cause LRTI when given in real-world conditions. These findings offer policy makers and health authorities robust, real-world, population-based evidence to guide the development of strategies for RSV prevention. FUNDING: Sanofi and AstraZeneca. TRANSLATION: For the Spanish translation of the abstract see Supplementary Materials section.

Assessment of effectiveness and impact of universal prophylaxis with nirsevimab for prevention of hospitalizations due to respiratory syncytial virus in infants. The NIRSE-GAL study protocol.

Nirsevimab has been recently licensed for universal RSV prophylaxis in infants. NIRSE-GAL is a three-year population-based study initiated in Galicia in September 2023. It aims to evaluate nirsevimab effectiveness against RSV-related hospitalizations lower respiratory tract infections (LRTI), severe RSV, all-cause LRTI, and all-cause hospitalization. NIRSE-GAL also aims to estimate nirsevimab impact on primary healthcare use in the short and mid-term, children's wheezing and asthma, and medical prescriptions for RSV. The immunization campaigns will be scheduled based on the expected start week for the RSV season and will last the whole season. Immunization will be offered to: i) infants born during the campaign (seasonal), ii) infants < 6 months at the start of the campaign (catch-up), and iii) infants with high-risk factors, aged 6-24 months at the start of the campaign (high-risk). The follow-up period will start: i) the immunization date for all immunized infants, ii) the start of the campaign, for the non-immunized catch-up or high-risk groups, or iii) the birthdate for the non-immunized seasonal group. Infants will be followed up until outcome occurrence, death, or end of study. Nirsevimab effectiveness will be estimated using Poisson and Cox regression models. Sensitivity and stratified analyses will be undertaken. The number of averted cases and the number needed to immunize will be estimated. Immunization failure and nirsevimab safety will be monitored. NIRSE-GAL was approved by the ethics committee of Galicia (CEIC 2023-377) and registered in ClinicalTrials.gov (ID: NCT06180993). Findings will be mainly shared via peer-reviewed publications and scientific conferences.

Bullying escolar: associação com possível bruxismo do sono e fatores desencadeantes / School bullying: association with possible sleep bruxism and triggering/precipitant factors

Bullying é um comportamento agressivo que gera consequências emocionais. Indivíduos vulneráveis estão sujeitos a sofrer esta agressão. Bruxismo do sono (BS) é uma atividade muscular mastigatória que está associado a fatores psicossociais. O objetivo do artigo 1 (n=431) foi analisar a associação de possível BS com bullying escolar. O objetivo do artigo 2 (n=425) foi identificar a associação entre fatores desencadeantes de bullying e indivíduos envolvidos em bullying como vítimas e vítimas-intimidadores. O objetivo do artigo 3 foi analisar a acurácia da resposta dada pelos responsáveis em um questionário acerca do BS comparado ao diário do sono. O estudo foi aprovado pelo Comitê de Ética e Pesquisa em Humanos da Universidade Federal de Minas Gerais (protocolo 82839718.4.0000.5149). Participaram da pesquisa escolares com idade entre 8 a 11 anos, matriculados em escolas públicas e privadas de Lavras, e seus responsáveis. Os responsáveis responderam a um questionário, desenvolvido para a pesquisa, com duas perguntas sobre a ocorrência do BS (ranger de dentes [RD]) nos escolares, dados sociodemográficos e um diário do sono de sete dias. Os escolares responderam um questionário, desenvolvido para a pesquisa, sobre dentes, cabelo, cor da pele, altura, peso, boca, nariz e outras características que podem interferir no relacionamento com os pares na escola; e preencheram a versão brasileira do Olweus Bully/Victim Questionnaire. A análise estatística do artigo 1, 2 e 3 incluiu análises descritivas. A regressão de Poisson (RR:Razão das Taxas) foi utilizada no artigo 1 e a regressão Logística Multinomial (OR) no artigo 2 (p≤0,05). No artigo 3 os resultados foram fornecidos com curva ROC e medição de acurácia (área sob a curva ­ AUC). Como resultado para o artigo 1 verificou-se que a frequência de RD entre os escolares vítimas-intimidadores foi 1,57 maior (RR=1,57; IC95%=1,04­2,36; p= 0,030). A frequência de RD entre os escolares que relataram acordar cansados pela manhã pelo menos uma vez por semana foi 1,33 vezes maior (RR=1,33; IC95%=1,00­1,78; p=0,050) e a frequência de RD entre escolares cuja renda familiar mensal é igual ou inferior a um salário mínimo apresentou 1,49 vezes maior (RR=1,49, IC95%=1,04-2,13, p=0,027). No artigo 2 observou-se que escolares vítimas-intimidadores eram mais propensos a serem de escola pública (OR=5,43, IC95%=1,14-25,91; p=0,034) e os escolares vítimas de bullying eram mais propensos a relatarem outras características individuais, como uso de óculos (OR=3,31; IC95%=1,14-9,57; p=0,027) e características dos dentes (OR=3,80; IC95%=1,38-10,41; p=0,010) como fatores que atrapalham seu convívio com os colegas. No artigo 3 verificou-se que a comparação do questionário com o diário do sono, para diagnóstico de BS, demonstrou uma AUC de 87,6% (IC95%=83,2% - 92,1%). Conclui-se que estar envolvido em comportamentos de bullying na escola, cansaço do escolar ao acordar e baixa renda familiar estão associados ao possível BS entre escolares. Os achados mostraram, também, que dentes e outras características individuais estão associados à ser vítima de bullying e estar envolvido em bullying como vítima-intimidador está associado com o tipo de escola. O questionário de diagnóstico de BS mostrou uma acurácia relevante quando comparado ao diário do sono de 7 dias.

Bullying is an aggressive behavior that generates emotional consequences. Vulnerable individuals are more likely to suffer this aggression. Sleep bruxism is a masticatory muscle activity that is associated with psychosocial factors. The objective of article 1 (n=431) was to analyze the association of possible sleep bruxism (SB) with school bullying. The objective of article 2 (n=425) was to identify the association between triggering factors of bullying and individuals involved in bullying as victims and bully-victims. The objective of article 3 was to analyze the accuracy of the response given by guardians in a questionnaire about sleep bruxism (SB) compared to the sleep diary. The study was approved by the Human Research Ethics Committee of the Federal University of Minas Gerais under protocol number CAAE 82839718.4.0000.5149. Schoolchildren aged between 8 and 11 years old, enrolled in public and private schools in Lavras, and their guardians participated in the research. Guardians answered a questionnaire, developed for research, about the occurrence of SB (gnashing teeth [GT]) in schoolchildren, sociodemographic data, and a seven- day sleep diary. The schoolchildren answered a questionnaire, developed for research, about teeth, hair, skin color, height, weight, mouth, nose, and other factors that can interfere with peer relationships at school. They completed the Brazilian version of the Olweus Bully/Victim Questionnaire. Statistical analysis of articles 1, 2 and 3 included descriptive analyses. Poisson regression (RR-Rate Ratio) was used in article 1 and Multinomial Logistic (OR) regression in article 2 (p≤0.05). In article 3 the results were provided with a ROC curve and accuracy measurement (area under the curve ­ AUC). As a result of article 1, it was found that the frequence of GT among schoolchildren were victims-bullies had 1.57 times higher (RR = 1.57; 95%CI=1.04­ 2.36; p= 0.030). The frequence of GT among schoolchildren who reported waking up tired in the morning at least once a week was 1.33 times higher (RR=1.33; 95%CI=1.00­1.78; p=0.050), frequence of GT among schoolchildren whose family monthly income is equal to a minimum wage or less presented 1.49 times higher (RR=1.49, 95% CI=1.04­2.13, p=0.027). In article 2, it was observed that bully-victim schoolchildren were more likely to be from public schools (OR=5.43, 95%CI=1.14- 25.91; p=0.034) and bullied schoolchildren were more likely to report other individual characteristics (example: use of glasses) (OR=3.31; 95%CI=1.14-9.57; p=0.027) and teeth characteristics (PR=3.80; 95%CI=1.38 -10.41; p=0.010) as factors that interfere with his interaction with colleagues. In article 3, it was found that the comparison of the questionnaire with the sleep diary, for the diagnosis of SB, showed an AUC of 87.6% (CI95%=83.2% - 92.1%) It was concluded that being involved in bullying behaviors at school, schoolchildren tiredness upon waking up, and low family income are associated with possible SB among students. The findings also showed that teeth and other individual characteristics are associated with bullying victims and being involved in bullying as a bully-victim is associated with the type of school. The SB diagnostic questionnaire showed relevant accuracy when compared to the 7-day sleep diary.

Recomendações para o enfrentamento da pandemia de COVID-19 em Instituições de Longa Permanência para Idosos: rapid review / Recommendations for managing COVID-19 pandemic in long-term care facilities for the older people: a rapid review

Resumo Introdução O controle da disseminação do coronavírus em Instituições de Longa Permanência para Idosos (ILPI) é considerado um desafio, uma vez que os idosos fazem parte do grupo de risco e apresentam prognóstico bastante desfavorável e também alta letalidade. Objetivo Conduzir uma rapid review para mapear e sintetizar a literatura sobre medidas de enfrentamento de Coronavirus Disease-2019 (COVID-19) em ILPI. Método Foi realizada uma Rapid review, e as buscas foram conduzidas nas bases de dados eletrônicas Biblioteca Cochrane, Web of Science, Scopus, Scielo, Medline/Pubmed e Google Scholar. Foram incluídas publicações a partir de 2019, nos idiomas português, inglês ou espanhol. A seleção das publicações ocorreu em duas etapas: leitura dos títulos/resumos; e leitura na íntegra de todas as publicações selecionadas. As recomendações para enfrentamento da COVID-19 em Instituições de Longa Permanência para Idosos foram extraídas e agrupadas de acordo com o conteúdo. Resultados Foram selecionadas 59 publicações que descreviam recomendações referentes aos temas: controle da disseminação do vírus; formação / educação continuada dos trabalhadores responsáveis pelo cuidado ao idoso; bem como o cuidado no contexto da pandemia: residentes, trabalhadores e familiares, e planejamento e gerenciamento de ações para o enfrentamento. Conclusão As recomendações para o enfrentamento da COVID-19 demandam comportamentos para evitar a disseminação do vírus, adaptações nas dinâmicas de cuidado e de convivência nas instituições, planejamento de ações específicas e suporte familiar, institucional e do Estado para assegurar a proteção da saúde física e psicossocial dos idosos e trabalhadores.

Abstract Background Controlling the spread of the coronavirus in Long-Term Care Facilities for older adults is considered a challenge, since this group have a very unfavorable prognosis and also high lethality. Objective To conduct a rapid review of guidelines to manage COVID-19 in Long-Term Care Facilities for older adults. Method A Rapid review was carried out, searches were conducted in the electronic databases Cochrane Library, Web of Science, Scopus, Scielo and Medline/Pubmed. Publications from 2019 were included, in Portuguese, English, or Spanish. The selection of publications took place in two stages: reading the titles/abstracts and reading in full all selected publications by two independent researchers. Guidelines for managing COVID-19 in LCTFs were extracted and grouped according to content. Results 59 publications were selected describing guidelines regarding control of the spread of the virus; training/continuing education of staff responsible for caring for the elderly residents; care addressing residents, staff and family during the pandemic and planning and management of actions to manage the disease. Conclusion Guidelines for managing COVID-19 demand for behaviors to prevent the spread of the virus and adaptations in the dynamics of care and the coexistence inside facilities. They also require planning for specific actions that include family, institutional and State support so the protection of physical and psychosocial health of the elderly residents and staff is ensured.

Association Between Probable Awake Bruxism and School Bullying in Children and Adolescents: A Case-Control Study.

Purpose: The purpose of this study was to evaluate the association between probable awake bruxism (PAB) and school bullying in children and adolescents. Methods: A total of 380 children and adolescents enrolled in public and private schools in the city of Lavras, Minas Gerais, Brazil, participated in this case-control study. The case group (190 children with PAB) and the control group (190 children without PAB) were matched for sex and age. Data acquisition involved questionnaires administered to the children/adolescents and their parents/caregivers. An oral clinical examination to assess attrition tooth wear was also performed. Descriptive statistics and logistic regression analyses (95 percent confidence interval [95% CI], P<0.05) were conducted. Results: Among the 380 participants, 176 (46.3 percent) were male and 204 (53.7 percent) were female. Children and adolescents who were involved in bullying episodes as victims/bullies (odds ratio [OR] equals 2.92, 95% CI equals 1.07 to 7.95, P=0.036) and victims (OR equals 1.93, 95% CI equals 1.04 to 3.57, P=0.037) were significantly associated with PAB. Children and adolescents who reported sleep problems (OR equals 2.51, 95% CI equals 1.07 to 5.89, P=0.033) were significantly associated with PAB. Conclusion: Based on the results, it was observed that probable awake bruxism is associated with involvement in episodes of school bullying and sleep problems.

Association between the severity of possible sleep bruxism and possible awake bruxism and attrition tooth wear facets in children and adolescents.

OBJECTIVE: To evaluate the association between the severity of possible sleep bruxism (PSB) and possible awake bruxism (PAB) and attrition tooth wear facets (ATWF) in children/adolescents. METHODS: Four hundred-thirty-four children/adolescents enrolled in schools in Lavras, Brazil, participated in this cross-sectional study. Caregivers answered a questionnaire about their childrens' PSB. Children/adolescents answered a questionnaire about the occurrence of PAB. RESULTS: ATWF among individuals without PSB and PAB was lower than those with moderate/severe PSB (p = 0.038) and moderate/severe PAB (p = 0.003). ATWF in anterior teeth was lower among individuals without PSB compared to those with mild (p = 0.015) and moderate/severe PSB (p = 0.032). ATWF in posterior teeth was lower among individuals without PAB compared to those with mild (p = 0.046) and moderate/severe PAB (p = 0.017). CONCLUSION: The number of attrition tooth wear facets is proportional to the severity of PSB and PAB.

Voice and Behavior of Children and Adolescents With Obesity: Integrative Literature Review.

PURPOSE: To verify the relationship between obesity, voice and behavior in childhood and adolescence, through an integrative review. METHODS: The researchers surveyed the articles indexed in the following databases: Embase, Web of Science, Scopus and Pubmed, using uniterms found in the Medical Subject Headings, related to the subject of the study, combined by the Boolean operators "and" and "or", published until January 2022. In the end, three reviewers selected the articles. RESULTS: When searching for studies related to voice, obesity and behavior, 62 articles were found that did not meet the selection criteria and were excluded. Given this result, new searches were carried out with the following crossing strategies: voice and obesity and; Voice, Behavior and Child Behavior Checklist (CBCL). After the evaluation of the reviewers, two articles were selected referring to the intersection "voice and obesity in children and adolescents" and, two studies, in the intersection between "voice, behavior and CBCL". The first study on voice and obesity showed that the greater the abdominal circumference, the greater the maximum expiratory force and sound pressure found. The second study showed high Jitter and NHR values in obese children. Furthermore, studies on voice, behavior and CBCL showed that children with vocal nodules were more sociable than children without vocal nodules, and had behaviors described as "screams a lot" and "teases a lot". On the other hand, another study found potential risks of behavioral changes in the face of vocal complaints. CONCLUSIONS: Although this literature review did not find studies associating obesity with vocal and behavioral disorders, the literature found showed the presence of vocal alteration in some acoustic parameters in obese children. Regarding voice, behavior and CBCL, two studies were found reporting the presence of behavioral changes in children with voice-related complaints, according to the opinion of their parents.

Association between possible awake bruxism and bullying among 8- to 11-year-old children/adolescents.

BACKGROUND: Bruxism is characterized by tooth grinding and/or clenching. AIM: To evaluate the association between possible awake bruxism (PAB) and bullying among individuals aged 8-11 years. DESIGN: A representative cross-sectional study was conducted with 434 eight- to eleven-year-old children/adolescents. Parents/caregivers answered a questionnaire to provide data on sociodemographic characteristics. Children/adolescents answered a questionnaire about the occurrence of PAB. The Olweus Bully/Victim Questionnaire was used. The Poisson regression analysis was performed. RESULTS: Of the 434 children/adolescents, 209 (48.2%) were boys and 225 (51.8%) were girls. The mean age of the children/adolescents was 9.14 years (±1.00). Children/adolescents who were victims of bullying (PR = 1.52, 95% CI = 1.14-2.04, P = .005) and bullies-victims (PR = 2.08, 95% CI = 1.36-3.17, P = .001) presented a higher frequency of PAB than those who were not involved in bullying. CONCLUSION: Children/adolescents who were bullying victims and bullies-victims had a higher frequency of PAB.

Myc stimulates cell cycle progression through the activation of Cdk1 and phosphorylation of p27.

Cell cycle stimulation is a major transforming mechanism of Myc oncoprotein. This is achieved through at least three concomitant mechanisms: upregulation of cyclins and Cdks, downregulation of the Cdk inhibitors p15 and p21 and the degradation of p27. The Myc-p27 antagonism has been shown to be relevant in human cancer. To be degraded, p27 must be phosphorylated at Thr-187 to be recognized by Skp2, a component of the ubiquitination complex. We previously described that Myc induces Skp2 expression. Here we show that not only Cdk2 but Cdk1 phosphorylates p27 at the Thr-187. Moreover, Myc induced p27 degradation in murine fibroblasts through Cdk1 activation, which was achieved by Myc-dependent cyclin A and B induction. In the absence of Cdk2, p27 phosphorylation at Thr-187 was mainly carried out by cyclin A2-Cdk1 and cyclin B1-Cdk1. We also show that Cdk1 inhibition was enough for the synthetic lethal interaction with Myc. This result is relevant because Cdk1 is the only Cdk strictly required for cell cycle and the reported synthetic lethal interaction between Cdk1 and Myc.

CDK contribution to DSB formation and recombination in fission yeast meiosis.

CDKs (cyclin-dependent kinases) associate with different cyclins to form different CDK-complexes that are fundamental for an ordered cell cycle progression, and the coordination of this progression with different aspects of the cellular physiology. During meiosis programmed DNA double-strand breaks (DSBs) initiate recombination that in addition to generating genetic variability are essential for the reductional chromosome segregation during the first meiotic division, and therefore for genome stability and viability of the gametes. However, how meiotic progression and DSB formation are coordinated, and the role CDKs have in the process, is not well understood. We have used single and double cyclin deletion mutants, and chemical inhibition of global CDK activity using the cdc2-asM17 allele, to address the requirement of CDK activity for DSB formation and recombination in fission yeast. We report that several cyclins (Cig1, Cig2, and the meiosis-specific Crs1) control DSB formation and recombination, with a major contribution of Crs1. Moreover, complementation analysis indicates specificity at least for this cyclin, suggesting that different CDK complexes might act in different pathways to promote recombination. Down-regulation of CDK activity impinges on the formation of linear elements (LinEs, protein complexes required for break formation at most DSB hotspot sites). This defect correlates with a reduction in the capability of one structural component (Rec25) to bind chromatin, suggesting a molecular mechanism by which CDK controls break formation. However, reduction in DSB formation in cyclin deletion mutants does not always correspondingly correlate with a proportional reduction in meiotic recombination (crossovers), suggesting that specific CDK complexes might also control downstream events balancing repair pathways. Therefore, our work points to CDK regulation of DSB formation as a key conserved feature in the initiation of meiotic recombination, in addition to provide a view of possible roles CDK might have in other steps of the recombination process.

Associação entre provável bruxismo em vigília e bullying entre escolares / Association between probable awake bruxism and bullying among schoolchildren

O bruxismo é um comportamento caracterizado pelo ranger e/ou apertar de dentes que está fortemente associado a fatores emocionais. O bullying pode afetar o escolar emocionalmente. O objetivo deste estudo foi avaliar a associação entre provável bruxismo em vígila (PBV) e bullying entre escolares. Foi realizado um estudo transversal representativo em Lavras, Minas-Gerais, Brasil. Este estudo foi submetido ao Comitê de Ética e Pesquisa em Humanos da Universidade Federal de Minas Gerais (COEP/UFMG) e aprovado (CAAE 82839718.4.0000.5149). Previamente ao estudo principal foi realizado um estudo piloto com 45 escolares de um escola pública de Lavras. Participaram do estudo escolares com idade entre 8 a 11 anos, matriculados em escolas públicas e privadas, e seus pais/responsáveis. Os pais/responsáveis responderam um questionário com perguntas sociodemográficas e característica do sono das crianças/adolescentes. Os escolares responderam a dois questionários, um com perguntas sobre histórico de dor muscular, dor de cabeça, fatores desencadeadores de bullying e ocorrência do bruxismo em vigília e a versão brasileira do questionário Olweus Bully/Victim Questionnaire (OBVQ) para determinar os escolares que poderiam estar envolvidos em bullying. Uma análise clínica extra e intraoral foi realizada por um examinador para identificar sinais clínicos tais como: linha alba e língua edentada, dor a palpação nos músculos masseter e temporal e desgaste dentário por atrição. Um treinamento e calibração para a avaliação do desgaste dentário por atrição foi realizado. O PBV foi mensurado em uma escala baseada na frequência do relato de bruxismo em vigília das crianças/adolescentes e no número de sintomas e sinais clínicos, onde um maior escore representou uma maior gravidade do PBV. Categorizou-se o PBV em leve, moderado ou grave de acordo com o relato e o número de sintomas e sinais clínicos presentes na avaliação odontológica. A análise estatística incluiu a análise descritiva, teste Mann­Whitney (p<0,05) e regressão de Poisson (p<0,05). Um total de 434 escolares participaram do estudo. A porcentagem das crianças/adolescentes quanto ao gênero foi similiar, com um valor um pouco maior para o feminino (51,8%). A prevalência total de PBV foi de 43,7%, categorizado em provável bruxismo leve em vigília (35,7%), provável bruxismo moderado em vigília (7,8%) e provável bruxismo grave em vigília (0,2%). Na análise bivariada, houve associação entre característica dos dentes como desencadeadores de bullying (p=0,012) e outras características (como hálito ruim, estrabismo, orelha, entre outros) (p=0,006), e o escore do PBV. Vítimas de bullying (RP=1,85; IC95%=1,37-2,50; p<0,001) e vítimas-agressores (RP=1,76, IC95%=1,14-2,72, p=0,010) apresentaram maior gravidade de PBV do que escolares que não estavam envolvidos no bullying. Escolares que acordam cansados pela manhã pelo menos uma vez na semana apresentaram maior gravidade de PBV do que aqueles que não relataram cansaço (RP=1,36, IC95%= 1,03-1,79, p=0,026). Este estudo concluiu que escolares que relataram que seus dentes eram desencadeadores de bullying, tiveram associação significativa com o PBV, escolares que são vítimas de bullying e vítimas-agressores apresentaram maior prevalência de maior gravidade do PBV, bem como aqueles escolares que relataram cansaço ao acordar.

Bruxism is a behavior characterized by the grinding and/or clenching of teeth that is strongly associated with emotional factors. Bullying can affect the student emotionally. The objective of this study was to evaluate the association between probable awake bruxism (PAB) and bullying among schoolchildren. A representative cross-sectional study was conducted in Lavras, Minas Gerais, Brazil. This study was submitted to the Ethics and Research Committee on Human Beings of the Federal University of Minas Gerais (COEP/UFMG) and approved (CAAE 82839718.4.0000.5149). Prior to the main study, a pilot study was conducted with 45 students from a public school in Lavras. Participated in the study schoolchildren aged 8 to 11 years, enrolled in public and private schools, and their parents/caregivers. The parents/caregivers answered a questionnaire with sociodemographic questions and characteristic of their children's/adolescents' sleep. The students answered two questionnaires, one with questions about the history of muscular pain, headache, triggers factors of bullying and the occurrence of awake bruxism and the the Brazilian version of the Olweus Bully/Victim Questionnaire (OBVQ) to determine the students who could be involved in bullying. An extra and intraoral clinical analysis was performed by one examiner to identify clinical signs such as: linea alba and indentations on the tongue, palpation pain in the masseter and temporalis muscles and tooth wear by attrition. A training and calibration for the evaluation of attrition tooth wear was performed. The PAB was measured on a scale based on the frequency of self-reported awake bruxism by child/adolescent and on the number of clinical signs and symptoms, where a larger score represented a greater PAB severity. The PAB was categorized as mild, moderate or severe according to the report and the number of symptoms and clinical signs present in the dental evaluation. Statistical analysis included descriptive analysis, Mann-Whitney test (p <0.05) and Poisson regression (p <0.05). A total of 434 students participated in the study. The percentage of children/adolescents regarding sex was similar, with a slightly higher value for the females (51.8%). The total prevalence of PBV was 43.7%, categorized as probable mild bruxism awake (35.7%), probable moderate bruxism awake (7.8%) and probable severe bruxism awake (0.2%). In the bivariate analysis, there was an association between the characteristics of the teeth as triggers of bullying (p = 0.012) and other characteristics (such as bad breath, squint, ear, among others) (p = 0.006) and the PAB score. Victims of bullying (PR=1.85, 95%CI=1.37-2.50, p<0.001) and victim-aggressors (PR=1.76, 95%CI=1.14-2.72, p=0.010) presented higher PAB severity than students who were not involved in bullying. Schoolchildren who wake up tired in the morning at least once a week presented higher PAB severity than those who did not report tiredness (PR=1.36, 95%CI=1.03-1.79, p=0.026). This study concluded that schoolchildren who reported that their teeth were triggers of bullying were significantly associated with the PAB; schoolchildren who are victims of bullying and victim-aggressors had a higher prevalence of higher severity of PAB, as well as those schoolchildren who reported fatigue upon waking.

Hipofosfatemia asociada a la administración intravenosa de hierro carboximaltosa en pacientes con anemia ferropénica. Un efecto secundario frecuente / Intravenous ferric carboxymaltose-associated hypophosphatemia in patients with iron deficiency anemia. A common side effect

Objetivos: Determinar la frecuencia, gravedad, momento de aparición y variables asociadas al desarrollo de hipofosfatemia (HF) en pacientes con anemia ferropénica tratados con hierro carboximaltosa por vía intravenosa (HCMiv). Material y método: Estudio de cohortes retrospectivo en pacientes que contaran con determinaciones de fosfato previa (normal) y posterior a la administración de HCMiv. Se compara la concentración de fosfato basal y posterior a la administración de HCMiv, y mediante regresión logística binaria se determinan las variables asociadas con la HF. Resultados: Se incluyeron 125 pacientes. La frecuencia de HF fue del 58%. El tiempo medio hasta la aparición de HF fue de 18 d. La edad, las concentraciones basales de ferritina y de fosfato se relacionaron con el desarrollo de HF. El riesgo de HF de los pacientes con fosfato basal ≤ 3,1 mg/dl fue un 67% mayor que en pacientes con fosfato basal ≥ 3,7 mg/dl. Conclusiones: La HF asociada a HCMiv en pacientes con anemia ferropénica es un efecto frecuente, precoz y en ocasiones prolongado. En pacientes mayores, con fosfato y ferritina más bajas, se debe vigilar el fosfato tras la administración de HCMiv (AU)

Objectives: To determine the frequency, severity, time of onset and factors associated with the development of hypophosphatemia (HF) in patients with iron deficiency anemia treated with intravenous ferric carboxymatose (ivFCM). Material and methods: Retrospective cohort study in patients iron deficiency anemia who received ivFCM and had an a prior and subsequent determination of serum phosphate. We carried out a comparative analysis between baseline and post-ivFCM levels of serum phosphate. In order to identify variables independently associated with HF a logistic regression analysis was also performed. Results: One hundred twenty-five patients were included. HF frequency was 58%. The median time to onset of HF was 18 days. Age, baseline ferritin levels and baseline phosphate levels were independently associated with the development of HF. The risk of HF in patients with baseline phosphate levels ≤ 3.1 mg/dl was 67% higher than patients with ≥ 3.7 mg/dl. Conclusions: ivFCM-associated HF is a frequent, early and, sometimes, prolonged effect in patients with iron deficiency anemia. Serum phosphate levels should be monitored after ivFCM administration, especially in older patients and in those with lower baseline phosphate or ferritin levels (AU)

[Intravenous ferric carboxymaltose-associated hypophosphatemia in patients with iron deficiency anemia. A common side effect]. / Hipofosfatemia asociada a la administración intravenosa de hierro carboximaltosa en pacientes con anemia ferropénica. Un efecto secundario frecuente.

OBJECTIVES: To determine the frequency, severity, time of onset and factors associated with the development of hypophosphatemia (HF) in patients with iron deficiency anemia treated with intravenous ferric carboxymatose (ivFCM). MATERIAL AND METHODS: Retrospective cohort study in patients iron deficiency anemia who received ivFCM and had an a prior and subsequent determination of serum phosphate. We carried out a comparative analysis between baseline and post-ivFCM levels of serum phosphate. In order to identify variables independently associated with HF a logistic regression analysis was also performed. RESULTS: One hundred twenty-five patients were included. HF frequency was 58%. The median time to onset of HF was 18 days. Age, baseline ferritin levels and baseline phosphate levels were independently associated with the development of HF. The risk of HF in patients with baseline phosphate levels ≤ 3.1mg/dl was 67% higher than patients with ≥ 3.7 mg/dl. CONCLUSIONS: ivFCM-associated HF is a frequent, early and, sometimes, prolonged effect in patients with iron deficiency anemia. Serum phosphate levels should be monitored after ivFCM administration, especially in older patients and in those with lower baseline phosphate or ferritin levels.

Furfural production by 'acidic steam stripping' of lignocellulose.

Furfural and acetic acid are produced with approximately 60 and 90 mol % yield, respectively, upon stripping bagasse with a gaseous stream of HCl/steam and condensing the effluent to water/furfural/acetic acid. The reaction kinetics is 1(st)  order in furfural and 0.5(th)  order in HCl. A process concept with full recycling of the reaction effluents is proposed to reduce the energy demand to <10 tonsteam tonfurfural (-1) and facilitate the product recovery through a simple liquid/liquid separation of the condensate into a water-rich and a furfural-rich phase.

Dolor en la región isquiopubiana en un paciente con enfermedad de Paget / No disponible

No disponible

Profiling physicochemical changes within catalyst bodies during preparation: new insights from invasive and noninvasive microspectroscopic studies.

Cylindrical or spherical catalyst bodies with sizes ranging from tens of micrometers to a few millimeters have a wide variety of industrial applications. They are crucial in the oil refining industry and in the manufacture of bulk and fine chemicals. Their stability, activity, and selectivity are largely dependent on their preparation; thus, achieving the optimum catalyst requires a perfect understanding of the physicochemical processes occurring in a catalyst body during its synthesis. The ultimate goal of the catalyst researcher is to visualize these physicochemical processes as the catalyst is being prepared and without interfering with the system. In order to understand this chemistry and improve catalyst design, researchers need better, less invasive tools to observe this chemistry as it occurs, from the first stages in contact with a precursor all the way through its synthesis. In this Account, we provide an overview of the recent advances in the development of space- and time-resolved spectroscopic methods, from invasive techniques to noninvasive ones, to image the physicochemical processes taking place during the preparation of catalyst bodies. Although several preparation methods are available to produce catalyst bodies, the most common method used in industry is the incipient wetness impregnation. It is the most common method used in industry because it is simple and cost-effective. This method consists of three main steps each of which has an important role in the design of a catalytic material: pore volume impregnation, drying, and thermal treatment. During the impregnation step, the interface between the support surface and the precursor of the active phase at the solid-liquid interface is where the critical synthetic chemistry occurs. Gas-solid and solid-solid interfaces are critical during the drying and thermal treatment steps. Because of the length scale of these catalyst bodies, the interfacial chemistry that occurs during preparation is space-dependent. Different processes occurring in the core or in the outer rim of the catalytic solid are enhanced by several factors, such as the impregnation solution pH, the metal ion concentration, the presence of organic additives, and the temperature gradients inside the body. Invasive methods for studying the molecular nature of the metal-ion species during the preparation of catalyst bodies include Raman, UV-vis-NIR, and IR microspectroscopies. Noninvasive techniques include magnetic resonance imaging (MRI). Synchrotron-based techniques such as tomographic energy dispersive diffraction imaging (TEDDI) and X-ray microtomography for noninvasive characterization are also evaluated.