Demographic, socioeconomic, and health structure factors associated with the use of HIV pre-exposure prophylaxis in Brazil: A nationwide ecological study.

Aims: To assess the cumulative rate of HIV Pre-Exposure Prophylaxis (PrEP) users in Brazil since its 2018 implementation and to analyze the association between PrEP usage and state-level structural factors. Methods: A nationwide ecological study from 2018 to 2022 was conducted, examining the 5-year cumulative rate of PrEP users in relation to demographic, socioeconomic, and healthcare infrastructure variables. Multiple linear regression analysis identified significant predictors of PrEP utilization. Results: Between 2018 and 2022, 124,796 individuals used PrEP, with a cumulative rate of 61.5 per 100,000 population. The highest usage was in Minas Gerais, São Paulo, and Santa Catarina, while the lowest was in Distrito Federal, Maranhão, and Alagoas. Regression analysis showed that higher PrEP usage was associated with lower population density, a younger median age, a lower male to female ratio, and reduced social vulnerability. Additionally, PrEP usage was positively associated with the density of medical doctors and the number of dispensing units. Conclusions: The study reveals significant regional disparities in PrEP usage across Brazil, influenced by socioeconomic and healthcare factors. It highlights the need for targeted public health strategies to enhance PrEP access and uptake, especially in socially vulnerable regions.

The relationship among disordered eating behavior, power of food scale and sensitization of the reinforcing value of food.

INTRODUCTION: Disordered eating behaviors are a current public health concern since their progression can lead to the development of a full criteria eating disorder. Sensitization to repeated intake of high energy density (HED) foods is associated with excess weight gain over time, but less is known about relationships with assessments of disordered eating. Thus, this study aims to understand how disordered eating behaviors refunlate to the influence of the food environment and sensitization. METHOD: 163 adolescents - 50 % female and 13.2 mean age - were followed for 24 months. Sensitization was assessed by comparing the relative reinforcing value (RRV) of HED food at baseline and after two weeks of daily intake; sensitization was defined as RRV of food after repeated intake. Study participants also completed the EDE-Q, and Power of Food Scale (PFS). We conducted multivariate general linear models to examine these associations. RESULTS: Sensitization status and PFS scores at baseline were positively associated with EDE-Q subscale scores cross-sectionally, but not longitudinally, at baseline and 24 months. We found that sensitization to HED food and higher susceptibility to food cues relates to increased disordered eating behaviors and both at baseline and at 24-months. DISCUSSION: These findings suggest that sensitization to repeated HED food intake and the food environment might be a risk factor for later engagement in disordered eating behaviors. Future studies should address the temporal relationships among these factors and the role that social norms around body weight and weight stigma may play in the development of these behaviors.

Association between childhood trauma and postpartum depression among Brazilian puerperal women.

OBJECTIVE: to evaluate the association between different forms of childhood trauma and postpartum depression in Brazilian puerperal women. METHOD: this cross-sectional survey included 253 puerperal women who were evaluated using the Edinburgh Postnatal Depression Scale and the Childhood Trauma Questionnaire. Multivariate logistic regression analyses were performed to verify the association of different types of trauma and the co-occurrence of forms of abuse and neglect with postpartum depression. RESULTS: postpartum depression was identified in 93 women (36.8%; 95% Confidence Interval: 30.8-42.7). All forms of childhood trauma assessed (emotional abuse, emotional neglect, physical abuse, physical neglect and sexual abuse) were independently associated with postpartum depression after adjusting for confounding variables. Emotional abuse remained associated with postpartum depression when the co-occurrence of all forms of childhood trauma was analyzed. CONCLUSION: the results suggest an association between the different forms of childhood trauma and postpartum depression. In this sense, childhood trauma is an indicator for Nursing professionals to screen for risk factors of postpartum depression during obstetric_follow-up.

ELMO2 biallelic pathogenic variants in a patient with gingival hypertrophy and cherubism phenotype: Case report and molecular review.

Ramon syndrome (OMIM #266270) was first described in a patient with cherubism, gingival fibromatosis, epilepsy, intellectual disability, hypertrichosis, and stunted growth. In 2018, Mehawej et al. described a patient with Ramon syndrome in whom a homozygous variant in ELMO2 was identified, suggesting that this gene may be the causative for this syndrome. ELMO2 biallelic pathogenic variants were also described in patients with a primary intraosseous vascular malformation (PIVM; OMIM #606893). These patients presented gingival bleeding and cherubism phenotype. Herein, a patient with gingival hypertrophy, neurodevelopmental delay, and cherubism phenotype with a novel homozygous predicted loss-of-function (LOF) variant in the ELMO2 gene and family recurrence was reported. A surgical approach to treat gingival bleeding and mandible vascular malformation was also described. Furthermore, this study includes a comprehensive literature review of molecular data regarding the ELMO2 gene. All the variants, except one described in the ELMO2, were predicted as LOF, including our patient's variant. There is an overlapping between PIVM, also caused by LOF biallelic variants in the ELMO2 gene, and Ramon syndrome, which can suggest that they are not different entities. However, due to a limited number of cases described with molecular evaluation, it is hard to establish a genotype-phenotype correlation. Our study supports that LOF pathogenic biallelic variants in the ELMO2 gene cause a phenotype that has cherubism and gingival hypertrophy as main characteristics.

Resources for health literacy among caregivers of prematurely born children: a scoping review.

OBJECTIVES: to map the available evidence on resources used to promote health literacy among caregivers of prematurely born children during outpatient follow-up. METHODS: the Joanna Briggs Institute's scope review protocol was utilized. The search encompassed six databases, incorporating studies from 2012 to 2022. RESULTS: the three included publications revealed that the resources employed are: mobile applications, phone calls, individual counseling, videos, educational pamphlets, and group discussions. Implementing an education protocol during the transition home enhances scientifically grounded health promotion rates. CONCLUSIONS: there is limited literature addressing the health literacy of these caregivers. The nursing team plays a crucial role in health education and in developing resources applicable to these families.

Plasma Jet versus Electrocarbonization in the Treatment of Wrinkles of the Upper Palpebral Region.

Background: The plasma jet is a non-surgical and minimally invasive procedure that acts by heating the superficial region of the skin, providing rejuvenation of the region. Objective: We sought to compare the clinical and histological effects of direct plasma jet versus electrocarbonization without plasma in the treatment of wrinkles in the upper palpebral region. Methods: This is a clinical trial in which 20 volunteers participated and divided into two groups: electrocarbonization (EG) and plasma jet (JPG), which were clinically evaluated before and after treatment through evaluation protocols, photographs, and questionnaires. Three treatment sessions were performed in the upper eyelid region with an interval of 30 days. After the treatment, a surgical procedure of upper blepharoplasty was performed on two volunteers to remove a skin fragment and later histological analysis. Results: The JPG showed better clinical responses in rejuvenation. The EG promoted an increase in the number of fibroblasts, the number of blood vessels and the amount of inflammation. The JPG showed an increase in the number of fibroblasts and blood vessels. It was observed that the JPG generated activation of T lymphocytes (CD3), macrophages (CD68), and plasmocytes (CD138); in addition to reducing the number of positive cells for CD57 (NK cells). The satisfaction analysis shows that 100 percent in the JPG considered themselves satisfied with the treatment. Conclusion: We verified that in comparison with electrocarbonization, the use of a direct plasma jet promoted tissue improvement at the histological level, in addition to fewer adverse reactions.

SARS-CoV-2 rapidly evolves lineage-specific phenotypic differences when passaged repeatedly in immune-naïve mice.

The persistence of SARS-CoV-2 despite the development of vaccines and a degree of herd immunity is partly due to viral evolution reducing vaccine and treatment efficacy. Serial infections of wild-type (WT) SARS-CoV-2 in Balb/c mice yield mouse-adapted strains with greater infectivity and mortality. We investigate if passaging unmodified B.1.351 (Beta) and B.1.617.2 (Delta) 20 times in K18-ACE2 mice, expressing the human ACE2 receptor, in a BSL-3 laboratory without selective pressures, drives human health-relevant evolution and if evolution is lineage-dependent. Late-passage virus causes more severe disease, at organism and lung tissue scales, with late-passage Delta demonstrating antibody resistance and interferon suppression. This resistance co-occurs with a de novo spike S371F mutation, linked with both traits. S371F, an Omicron-characteristic mutation, is co-inherited at times with spike E1182G per Nanopore sequencing, existing in different within-sample viral variants at others. Both S371F and E1182G are linked to mammalian GOLGA7 and ZDHHC5 interactions, which mediate viral-cell entry and antiviral response. This study demonstrates SARS-CoV-2's tendency to evolve with phenotypic consequences, its evolution varying by lineage, and suggests non-dominant quasi-species contribution.

Anti-migratory and cytotoxic effect of indole derivative in C6 glioma cells.

Gliomas are among the most common primary malignant brain tumors. Despite advances in cancer treatment, survival is very low, so the discovery of new therapeutic agents is essential. In this context, indole is an important source for the development of new bioactive molecules. A pharmacological screening of ten indole derivatives was carried out to evaluate the cytotoxic capacity against three tumor cell lines. After pharmacological screening, three compounds were selected, based on their high capacity to reduce cell proliferation, and their IC50 values were determined. Compound 9 exhibited the highest cytotoxic activity (IC50 = 0.4 µg/mL) in gliomas (C6 cell line), and were selected for further experiments. C6 cells were treated with compound 9 to evaluate cellular mechanisms such as colony formation and cell migration capacity and morphological alterations. Compound 9 decreased clone formation (0.4 and 0.8 µg/mL), and inhibited migration (0.2-0.8 µg/mL) in C6 cells. Morphological changes in cells treated with the compound 9 were also observed, such as chromatin condensation, and disorganization in cellular stress beams. Indole derivatives had a cytotoxic effect on tumor cells, and compound 9 showed the best anti-proliferative and anti-migratory activity in glioma cells.

In vitro susceptibility to fosfomycin in clinical and environmental extended-spectrum beta-lactamase producing and/or ciprofloxacin-non-susceptible Escherichia coli isolates.

Extended-spectrum beta-lactamase producing and ciprofloxacin-non-susceptible Escherichia coli are clinical and environmental issues. We evaluated the susceptibility profile of fosfomycin in non-susceptible E. coli isolated from urine and the environment. We measured the activity of fosfomycin against 319 and 36 E. coli strains from urine and environmental isolates, respectively, collected from rivers. Fosfomycin resistance profiles were investigated using the minimal inhibitory concentration (MIC), according to the Clinical and Laboratory Standards Institute (CLSI) and the European Committee for Antimicrobial Susceptibility Testing (EUCAST) guidelines. Antibiotic susceptibility testing revealed that 5% and 6.6% of urine samples were non-susceptible to fosfomycin according to CLSI and EUCAST guidelines, respectively. The fosfomycin MIC50/90 was 0.5/4 mg/L. Of the 36 E. coli isolates from river water, 11.1% and 13,8% were non-susceptible to fosfomycin according to CLSI and EUCAST, respectively (range ≤0.25 ≥512 mg/L). All the isolates with MIC ≥512 mg/L for fosfomycin showed the fosA3 gene. Fosfomycin resistance was more frequent in the environment than in clinical samples.

The Nostrum to Exercise: How Self-Selected and Imposed Exercise Intensity Prescription Relates to Affective, Cognitive, and Behavioral Outcomes-A Systematic Review / El Nostrum al Ejercicio: Cómo la Prescripción de Intensidad de Ejercicio Autoseleccionada e Impuesta se Relaciona con Resultados Afectivos, Cognitivos y Conductuales-Una Revisión Sistemática / A Panaceia do Exercício: Como a Prescrição de Intensidade de Exercício Autoselecionada e Imposta se Relaciona com Resultados Afetivos, Cognitivos e Comportamentais-Uma Revisão Sistemática

Permitir seleccionar la intensidad del ejercicio se ha propuesto como un método para apoyar la adherencia al ejercicio, pero no se encontró ninguna exploración extensa que contrastara este enfoque con un método de intensidad impuesta. Esta revisión sistemática explora la relación entre la intensidad del ejercicio seleccionada por el usuario y los resultados afectivos, cognitivos y conductuales en contextos de actividad física. La búsqueda se realizó en las bases de datos PubMed, SPORTDiscus y PsycINFO con los criterios de inclusión: (1) experimentales y no experimentales; (2) publicados en una revista revisada por pares; (3) escritos en inglés; (4) que exploraran la autoselección de intensidad y/o la autorregulación en contextosde ejercicio; (5) muestras con individuos de entre 18 y 64 años; y (6) centrados en individuos aparentemente sanos. Veintinueve estudios (N=749 participantes) fueron incluidos para revisión, 25 explorando el ejercicio aeróbico y cuatro de resistencia. En general, la intensidad de ejercicio autoseleccionada mostró mejores resultados afectivos, cognitivos y conductuales positivos en comparación con la prescripción de intensidad de ejercicio impuesta, pero la alta heterogeneidad en los métodos y resultados justifica la precaución al interpretar los resultados. La autoselección de la intensidad puede promover la mejora de las respuestas afectivas, las percepciones de autonomía, la autoeficacia, la intención de ser físicamente activo, y más minutos de participación en el ejercicio. Las discrepancias en los métodos de autoselección de la intensidad, las diferencias en los protocolos de ejercicio y las características de las muestras ponen de manifiesto la necesidad de realizar más estudios.(AU)

Allowing to select the exercise intensity has been proposed as a method to support exercise adherence, but no extensive exploration was found contrasting this approach to an imposed intensity method. For this matter, this systematic review aimed to explore the relationship between self-selected exercise intensity and affective, cognitive, and behaviouraloutcomes in physical activity settings, and whenever possible, compare this approach to other forms of exercise intensity prescription. Search wasconductedin the PubMed, SPORTDiscus, and PsycINFO databases (last search date July 2022) with the following inclusion criteria: (1) experimental and non-experimental; (2) published in a peer-reviewed journal; (3) written in English; (4) exploring intensity self-selection and/or self-regulation in exercise settings; (5) samples with individuals aged between 18 and 64 years; and (6) focused on apparently healthy individuals. Twenty-nine studies (N=749 participants) were included in this review, 25 exploring aerobic exercise and four resistance training activities. Overall, self-selected exercise intensity showed better positive affective, cognitive, and behaviouraloutcomes compared to imposed exercise intensity prescription, but high heterogeneity on the methods and outcomes warrant caution when interpreting the results. Self-selected intensity may promote improved affective responses, autonomy perceptions, self-efficacy, intention to be physically active,and more minutes of exercise participation. However, discrepancy on the intensity self-selection methods, exercise protocol differences, and samples characteristics, highlight the need for further studies on the topic to better understand the possible magnitude of this effect.(AU)

Permitir a seleção da intensidade do exercício tem sido proposto como um método para apoiar a adesão ao exercício, mas não foi encontrada nenhuma exploraçãoextensiva que contrastasse esta abordagem com um método de intensidade imposta. Por esta razão, esta revisão sistemática teve como objetivo explorar a relação entre a intensidade do exercício autosselecionada e os resultados afetivos, cognitivos e comportamentais em contextos de atividade física e, sempre que possível, comparar esta abordagem comoutrasformas de prescrição da intensidade do exercício. A pesquisa foi realizada nas bases de dados PubMed, SPORTDiscus e PsycINFO (última data de pesquisa em julho de 2022) com os seguintes critérios de inclusão:(1) experimentais e não-experimentais; (2) publicados numa revista com revisão por pares; (3) escritos em inglês; (4) que explorassem a autosseleção da intensidade e/ou a autorregulação em contextos de exercício; (5) amostras com indivíduos com idades compreendidas entre os 18 e os 64 anos; e (6) focados em indivíduos aparentemente saudáveis. Vinte e nove estudos (N=749 participantes) foram incluídos nesta revisão, 25 explorando o exercício aeróbico e quatro atividades de treino de resistência. Em geral,a intensidade de exercício autosselecionada mostrou melhores resultados positivos a nível afetivo, cognitivo e comportamental em comparação com a prescrição de intensidade de exercício imposta, mas a elevada heterogeneidade dos métodos e dos resultados justifica cautela na interpretação dos resultados. Aintensidade autosselecionada pode promover melhores respostas afetivas, perceções de autonomia, autoeficácia, intenção de ser fisicamente ativo e mais minutos de participação no exercício. No entanto, a discrepância entre os métodos de autosseleção da intensidade, as diferenças entre os protocolos de exercício e as características das amostras, realçam a necessidade de mais estudos sobre o tema para melhor compreender a possível magnitude deste efeito.(AU)

Consistent patterns of common species across tropical tree communities.

Trees structure the Earth's most biodiverse ecosystem, tropical forests. The vast number of tree species presents a formidable challenge to understanding these forests, including their response to environmental change, as very little is known about most tropical tree species. A focus on the common species may circumvent this challenge. Here we investigate abundance patterns of common tree species using inventory data on 1,003,805 trees with trunk diameters of at least 10 cm across 1,568 locations1-6 in closed-canopy, structurally intact old-growth tropical forests in Africa, Amazonia and Southeast Asia. We estimate that 2.2%, 2.2% and 2.3% of species comprise 50% of the tropical trees in these regions, respectively. Extrapolating across all closed-canopy tropical forests, we estimate that just 1,053 species comprise half of Earth's 800 billion tropical trees with trunk diameters of at least 10 cm. Despite differing biogeographic, climatic and anthropogenic histories7, we find notably consistent patterns of common species and species abundance distributions across the continents. This suggests that fundamental mechanisms of tree community assembly may apply to all tropical forests. Resampling analyses show that the most common species are likely to belong to a manageable list of known species, enabling targeted efforts to understand their ecology. Although they do not detract from the importance of rare species, our results open new opportunities to understand the world's most diverse forests, including modelling their response to environmental change, by focusing on the common species that constitute the majority of their trees.

Scoping review: Effect of surface treatments on bond strength of resin composite repair.

OBJECTIVE: to evaluate the existing evidence on surface treatment techniques employed in resin composite repair and their effect on the repair short- and long-term bond strength. DATA AND SOURCE: This scoping review was performed under the PRISMA-ScR guidelines for scoping reviews and registered on the Open Science Framework platform. STUDY SELECTION: A systematic search was conducted in PubMed, Embase, and Scopus and grey literature up to September 2022 without language or date restriction. In vitro studies comparing mechanical surface and/or chemical treatments on repair bond strength of resin composite were included. Studies evaluating experimental adhesive systems or resin composites were excluded. Selection of studies and data extraction were performed. Data from selected studies was qualitatively analyzed. RESULTS: A total of 76 studies were included in the qualitative analysis. Among the mechanical treatments, alumina blasting was the most frequently used, followed by silica coating and diamond bur. As for chemical treatments, dentin bonding systems were the most frequently evaluated, followed by universal adhesive systems and silane/ceramic primer. The combination of mechanical and chemical pre-treatments increased the repair bond strength of resin composite in both short- and long-term simulated aging scenarios. The evidence obtained from the included studies was classified as moderate quality, mainly due to the medium risk of bias observed across most of the studies. CONCLUSION: The techniques used to treat the surface of resin composites for repair are diverse. Incorporating a combination of mechanical and chemical pre-treatments resulted in superior repair bond strength of resin composite materials under both short- and long-term simulated aging conditions. CLINICAL SIGNIFICANCE: The analysis of evidence revealed significant variability among protocols for repairing resin composites. Utilizing both mechanical and chemical pre-treatment methods is important for enhancing the bond strength of resin composites during both short- and long-term simulated aging situations.

Peeling with retinoic acid in microemulsion for treatment of melasma: A double-blind randomized controlled clinical study.

OBJECTIVE: To evaluate the clinical efficacy of peeling with a microemulsion formulation containing 1% retinoic acid. MATERIALS AND METHODS: After development of the product, 60 patients with melasma were randomly divided into three groups (n = 20): Group 1-application of conventional 1% retinoic acid peeling (RA 1%). Group 2-application of 1% retinoic acid peeling in microemulsion (RA 1%M). Group 3-Application of placebo. The groups were submitted to four peeling sessions, fortnightly on Days 0, 15, 30, and 45, and analyzed at the time intervals of 0, 15, 30, 45, and 60 days. Evaluation was made by using the Melasma Area and Severity Index (MASI) and Melasma Quality of Life (MelasquoL) instrument. Hemato-biochemical parameters were also evaluated at Days 0 and 60. After obtaining the results, normality was evaluated by means of the Kolmogorov-Smirnov test and afterwards, the following tests were applied: Friedman statistical (to test the effect of the treatments on the MASI index); Wilcoxon, (for comparison between pairs to test the effect of treatments on the MelasQoL index); Kruskal-Wallis, (to test the differences between the groups); and Mann-Whitney, (comparisons between treatments). The level of significance adopted was 5% (α = 0.05). RESULTS: The three groups presented a significant reduction in the MASI index, indicating the effect of all the treatments on reducing the melasma (p < 0.001). A significant reduction in the stains was observed with the use of retinoic acid peeling delivered in microemulsion (62%) when compared with the conventional peeling with 1% retinoic acid in a conventional vehicle (26%) and the placebo (12%). There was also a significant reduction in the MelasQoL index (sum of all the aspects) in the three groups, indicating the effect of all the treatments, including the placebo, on the overall quality of life of those with melasma. However, RA 1%M the treatment that promoted the greatest effect on the quality of life of individuals. In percentage terms, the RA 1%M provided a mean reduction of 30% in the MelasQoL index, against 13% of the conventional treatment and only 4% of the placebo. When the hemato-biochemical parameters were compared on Days 0 and 60, there were no significant changes in the results. CONCLUSION: The chemical peeling performed with RA 1%M was effective for the treatment of melasma, and was shown to be superior to the peeling performed with retinoic acid in a conventional vehicle, in reducing the stains and improving the quality of life of patients.

Outcomes and factors associated with tolerance in infants with non-IgE-mediated cow's milk allergy with gastrointestinal manifestations.

OBJECTIVES: To evaluate outcomes of oral food challenge (OFC) test to assess tolerance in infants with non-IgE-mediated cow's milk allergy (CMA) with gastrointestinal manifestations and explore clinical data predictive of these outcomes. METHODS: Single-center retrospective study including infants (age < 12 months) who were referred for CMA between 2000 and 2018 and underwent OFC on follow-up. A univariate logistic regression test was performed to evaluate variables associated with the outcomes of the follow-up OFC test. RESULTS: Eighty-two patients were included, 50% were male. Eighteen patients had a positive OFC test (22%). Most patients had presented with hematochezia (77%). The median age of symptom onset was 30 days. Two-thirds of the patients were on appropriate infant formula (extensively hydrolyzed or amino acid-based formula), exclusively or in association with breastfeeding. The median time on an elimination diet before the OFC test was 8 months (Q1 6 - Q3 11 months). All cases with positive follow-up OFC tests (n = 18) had been exposed to cow's milk-based formula before the first clinical manifestation of CMA. Five out of eight cases with Food Protein-Induced Enterocolitis Syndrome (FPIES) had positive OFC tests. Exposure to cow's milk-based formula before diagnosis, a history of other food allergies, hematochezia and diarrhea were predictors of a positive OFC test. CONCLUSIONS: In infants with non-IgE-mediated CMPA with gastrointestinal manifestations, the use of cow's milk-based formula, a history of other food allergies, and hematochezia and diarrhea upon initial presentation were associated factors for the later achievement of tolerance.

Innovation of the protocol for the application of cryolipolysis: Effects and mechanisms of action.

BACKGROUND: In recent years, aesthetic procedures aiming at body remodeling and have grown exponentially. Cryolipolysis (CLL) has stood out as a noninvasive resource that acts directly on the subcutaneous adipose tissue promoting a significant reduction of adipose tissue through of cooling that could lead to the crystallization cytoplasmic lipids, loss of cellular integrity, apoptosis/necrosis of adipocytes, and local inflammation, producing selective loss of adipose tissue. Thus, the objective of the present study was to evaluate the effects of a specific technique of CLL application on the inflammatory reactions of the target tissue in different post-application times. METHODS: This is a randomized, blind clinical study that evaluated the tissue sample of six patients after 45, 60, and 90 days of an innovative protocol for the application of CLL, with samples collected through abdominoplasty surgeries. The samples were evaluated by immunohistochemical analyses of several markers. RESULTS: A significantly greater increase in fibroblasts was observed at 45 days and greater phagocytic action at 60 days. Regarding the apoptosis process, the expression of caspase 3 and cleaved caspase 3 markers varied at different times, with cleaved caspase 3 being higher at 45 and 90 days after CLL application. CONCLUSION: The protocol of the CLL presented in this study was able to induce inflammatory responses in addition to confirming the selective apoptotic action at the different times studied.

Resources for health literacy among caregivers of prematurely born children: a scoping review / Recursos para el alfabetismo en salud de cuidadores de niños nacidos prematuramente: revisión de alcance / Recursos para o letramento em saúde de cuidadores de crianças nascidas prematuras: revisão de escopo

ABSTRACT Objectives: to map the available evidence on resources used to promote health literacy among caregivers of prematurely born children during outpatient follow-up. Methods: the Joanna Briggs Institute's scope review protocol was utilized. The search encompassed six databases, incorporating studies from 2012 to 2022. Results: the three included publications revealed that the resources employed are: mobile applications, phone calls, individual counseling, videos, educational pamphlets, and group discussions. Implementing an education protocol during the transition home enhances scientifically grounded health promotion rates. Conclusions: there is limited literature addressing the health literacy of these caregivers. The nursing team plays a crucial role in health education and in developing resources applicable to these families.

RESUMEN Objetivos: mapear las evidencias disponibles sobre los recursos utilizados para la promoción del alfabetismo en salud de cuidadores de niños nacidos prematuramente en el seguimiento ambulatorio. Métodos: se utilizó el protocolo de revisión de alcance del Joanna Briggs Institute. La búsqueda se realizó en seis bases de datos, incluyendo estudios entre 2012 y 2022. Resultados: las tres publicaciones incluidas evidenciaron que los recursos utilizados son: aplicaciones para teléfonos móviles, llamadas telefónicas, asesoramiento individual, videos y folletos educativos, y discusiones en grupos. Implementar un protocolo educativo en la transición al hogar aumenta los índices de promoción de la salud respaldada científicamente. Conclusiones: hay poca información en la literatura sobre el alfabetismo en salud de estos cuidadores. El equipo de enfermería juega un papel fundamental en la educación en salud y en la creación de recursos que pueden aplicarse a estas familias.

RESUMO Objetivos: mapear as evidências disponíveis sobre os recursos utilizados para a promoção do letramento em saúde de cuidadores de crianças nascidas prematuras no seguimento ambulatorial. Métodos: utilizou-se o protocolo de revisão de escopo do Joanna Briggs Institute. A busca foi realizada em seis bases de dados, incluindo estudos entre 2012 e 2022. Resultados: as três publicações incluídas evidenciaram que os recursos utilizados são: aplicativos para celulares, ligações telefônicas, aconselhamento individual, vídeos e folhetos educativos e discussões em grupos. Efetivar um protocolo de educação na transição para casa aumenta os índices de promoção da saúde cientificamente embasada. Conclusões: pouco se aborda na literatura sobre o letramento em saúde desses cuidadores. A equipe de enfermagem desempenha um papel fundamental na educação em saúde e na construção de recursos que podem ser aplicados a essas famílias.

Color and surface roughness alterations of bulk-fill resin composites submitted to simulated toothbrushing with whitening dentifrices

Aim: To evaluate the surface roughness and color stability of bulk-fill resin composites after simulated toothbrushing with whitening dentifrices. The radioactive/relative dentin abrasion (RDA) and radioactive/relative enamel abrasion (REA) of dentifrices were also assessed. Methods: Specimens (n=10) of Tetric N Ceram Bulk Fill (TNCB), Filtek One Bulk Fill (FOB) resin composites, and Z100(Control) were prepared using a cylindrical Teflon matrix. Surface roughness (Ra, µm) was assessed by a roughness meter and the color evaluations (ΔEab , ΔE00 , WID ) were performed using a digital spectrophotometer based on the CIELAB system. Three measurements were performed per sample, before and after simulated toothbrushing with 3D Oral-B White Perfection (3DW) and Black is White (BW) dentifrices. The abrasivity (REA and RDA values) of the used dentifrices was also determined by the Hefferren abrasivity test. Results: The Ra values increased significantly in all resin composites after 3DW and BW toothbrushing. The acceptable threshold color varied among resin composites, and TNCB and Z100 presented the highest ΔEab and ΔE00 for BW dentifrice. The 3DW dentifrice was significantly more abrasive than BW dentifrice on enamel and dentin. Conclusions: simulated toothbrushing with tested whitening dentifrices increased the surface roughness at acceptable levels. The Tetric N Ceram Bulk-fill and Z100 composite showed the highest color alteration in BW. 3D White Perfection dentifrice was more abrasive on dentin and enamel than Black is White.

Outcomes and factors associated with tolerance in infants with non-IgE-mediated cow's milk allergy with gastrointestinal manifestations

Abstract Objectives To evaluate outcomes of oral food challenge (OFC) test to assess tolerance in infants with non-IgE-mediated cow's milk allergy (CMA) with gastrointestinal manifestations and explore clinical data predictive of these outcomes. Methods Single-center retrospective study including infants (age < 12 months) who were referred for CMA between 2000 and 2018 and underwent OFC on follow-up. A univariate logistic regression test was performed to evaluate variables associated with the outcomes of the follow-up OFC test. Results Eighty-two patients were included, 50% were male. Eighteen patients had a positive OFC test (22%). Most patients had presented with hematochezia (77%). The median age of symptom onset was 30 days. Two-thirds of the patients were on appropriate infant formula (extensively hydrolyzed or amino acid-based formula), exclusively or in association with breastfeeding. The median time on an elimination diet before the OFC test was 8 months (Q1 6 - Q3 11 months). All cases with positive follow-up OFC tests (n= 18) had been exposed to cow's milk-based formula before the first clinical manifestation of CMA. Five out of eight cases with Food Protein-Induced Enterocolitis Syndrome (FPIES) had positive OFC tests. Exposure to cow's milk-based formula before diagnosis, a history of other food allergies, hematochezia and diarrhea were predictors of a positive OFC test. Conclusions In infants with non-IgE-mediated CMPA with gastrointestinal manifestations, the use of cow's milk-based formula, a history of other food allergies, and hematochezia and diarrhea upon initial presentation were associated factors for the later achievement of tolerance.

In vitro susceptibility to fosfomycin in clinical and environmental extended-spectrum beta-lactamase producing and/or ciprofloxacin-non-susceptible Escherichia coli isolates

ABSTRACT Extended-spectrum beta-lactamase producing and ciprofloxacin-non-susceptible Escherichia coli are clinical and environmental issues. We evaluated the susceptibility profile of fosfomycin in non-susceptible E. coli isolated from urine and the environment. We measured the activity of fosfomycin against 319 and 36 E. coli strains from urine and environmental isolates, respectively, collected from rivers. Fosfomycin resistance profiles were investigated using the minimal inhibitory concentration (MIC), according to the Clinical and Laboratory Standards Institute (CLSI) and the European Committee for Antimicrobial Susceptibility Testing (EUCAST) guidelines. Antibiotic susceptibility testing revealed that 5% and 6.6% of urine samples were non-susceptible to fosfomycin according to CLSI and EUCAST guidelines, respectively. The fosfomycin MIC50/90 was 0.5/4 mg/L. Of the 36 E. coli isolates from river water, 11.1% and 13,8% were non-susceptible to fosfomycin according to CLSI and EUCAST, respectively (range ≤0.25 ≥512 mg/L). All the isolates with MIC ≥512 mg/L for fosfomycin showed the fosA3 gene. Fosfomycin resistance was more frequent in the environment than in clinical samples.