Identifying metabolic features of colorectal cancer liability using Mendelian randomization.

Background: Recognizing the early signs of cancer risk is vital for informing prevention, early detection, and survival. Methods: To investigate whether changes in circulating metabolites characterize the early stages of colorectal cancer (CRC) development, we examined the associations between a genetic risk score (GRS) associated with CRC liability (72 single-nucleotide polymorphisms) and 231 circulating metabolites measured by nuclear magnetic resonance spectroscopy in the Avon Longitudinal Study of Parents and Children (N = 6221). Linear regression models were applied to examine the associations between genetic liability to CRC and circulating metabolites measured in the same individuals at age 8 y, 16 y, 18 y, and 25 y. Results: The GRS for CRC was associated with up to 28% of the circulating metabolites at FDR-P < 0.05 across all time points, particularly with higher fatty acids and very-low- and low-density lipoprotein subclass lipids. Two-sample reverse Mendelian randomization (MR) analyses investigating CRC liability (52,775 cases, 45,940 controls) and metabolites measured in a random subset of UK Biobank participants (N = 118,466, median age 58 y) revealed broadly consistent effect estimates with the GRS analysis. In conventional (forward) MR analyses, genetically predicted polyunsaturated fatty acid concentrations were most strongly associated with higher CRC risk. Conclusions: These analyses suggest that higher genetic liability to CRC can cause early alterations in systemic metabolism and suggest that fatty acids may play an important role in CRC development. Funding: This work was supported by the Elizabeth Blackwell Institute for Health Research, University of Bristol, the Wellcome Trust, the Medical Research Council, Diabetes UK, the University of Bristol NIHR Biomedical Research Centre, and Cancer Research UK. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. This work used the computational facilities of the Advanced Computing Research Centre, University of Bristol - http://www.bristol.ac.uk/acrc/.

Colorectal cancer, or bowel cancer, is the fourth most common cause of death from cancer worldwide. Understanding how the cancer develops and recognizing early signs is essential, as people who receive treatment early on have higher survival rates. One way to boost early detection and disease survival rates is through identifying early colorectal cancer biomarkers. For example, metabolites produced when cells process nutrients have been shown to play a role in the development of colon cancer. Certain metabolites could therefore serve as biomarkers, which can be detected in routine blood tests. But first, scientists need to identify the exact metabolic processes involved in cancer development. Bull, Hazelwood et al. show that fat metabolites during early adulthood may help predict colorectal cancer risk. In the experiments, the team assessed the link between an individual's genetic risk for developing colorectal cancer and metabolites in their blood. By looking at data from over 6,000 individuals living in the UK, followed from early life into adulthood, they found higher fatty acid and low-density lipoprotein levels in young adults at risk of colorectal cancer. However, the results could not be replicated in a separate cohort study of middle-aged adults. Bull, Hazelwood et al. noted that many individuals in this older age group use fat-targeting drugs called statins, which may have obscured this connection. The study of Bull, Hazelwood et al. shows that colorectal cancer risk indicators may be present from adolescence to around 40 years, before most individuals are diagnosed. The results suggest this may be a window for early detection and preventive interventions. It also highlights that differences in fat metabolism, possibly linked to genetic differences, may underlie colorectal cancer risk. More studies are needed to better understand how and whether interventions targeting fat levels may help prevent colorectal cancer development.

Computer vision system using deep learning to predict rib and loin yield in the fish Colossoma macropomum.

Computer vision system (CVSs) are effective tools that enable large-scale phenotyping with a low-cost and non-invasive method, which avoids animal stress. Economically important traits, such as rib and loin yield, are difficult to measure; therefore, the use of CVS is crucial to accurately predict several measures to allow their inclusion in breeding goals by indirect predictors. Therefore, this study aimed (1) to validate CVS by a deep learning approach and to automatically predict morphometric measurements in tambaqui and (2) to estimate genetic parameters for growth traits and body yield. Data from 365 individuals belonging to 11 full-sib families were evaluated. Seven growth traits were measured. After biometrics, each fish was processed in the following body regions: head, rib, loin, R + L (rib + loin). For deep learning image segmentation, we adopted a method based on the instance segmentation of the Mask R-CNN (Region-based Convolutional Neural Networks) model. Pearson's correlation values between measurements predicted manually and automatically by the CVS were high and positive. Regarding the classification performance, visible differences were detected in only about 3% of the images. Heritability estimates for growth and body yield traits ranged from low to high. The genetic correlations between the percentage of body parts and morphometric characteristics were favorable and highly correlated, except for percentage head, whose correlations were unfavorable. In conclusion, the CVS validated in this image dataset proved to be resilient and can be used for large-scale phenotyping in tambaqui. The weight of the rib and loin are traits under moderate genetic control and should respond to selection. In addition, standard length and pelvis length can be used as an efficient and indirect selection criterion for body yield in this tambaqui population.

Association between antibiotic prophylaxis and adverse perinatal outcomes in premature rupture of membranes.

OBJECTIVE: The aim of this study was to evaluate the association between antibiotic prophylaxis and adverse perinatal outcomes in premature rupture of membranes. METHODS: This retrospective cohort included pregnant women with premature rupture of membranes (between 24 and 33+6 weeks) who used or did not use prophylactic antibiotics. Pearson's chi-square (χ²) test, Student's t-test, and binary logistic regression were used for statistical analysis. RESULTS: A significant effect was observed in patients with premature rupture of membranes using prophylactic antibiotics regarding amniotic fluid index (p=0.007), deepest vertical pocket (p=0.049), duration of antibiotic therapy (p≤0.001), C-reactive protein level upon admission (p≤0.001), leukocyte count upon admission (p=0.007), and length of stay in neonatal intensive care (p=0.047). A significant association was observed between the abovementioned patients and surfactant use during the neonatal period (p=0.04). A higher prevalence of surfactant use was noted in these patients (20.0 vs. 8.7%; p=0.04). CONCLUSION: No association was found between antibiotic prophylaxis and the presence of adverse perinatal outcomes in pregnant women with premature rupture of membranes between 24 and 33+6 weeks of gestation.

Association between antibiotic prophylaxis and adverse perinatal outcomes in premature rupture of membranes

SUMMARY OBJECTIVE: The aim of this study was to evaluate the association between antibiotic prophylaxis and adverse perinatal outcomes in premature rupture of membranes. METHODS: This retrospective cohort included pregnant women with premature rupture of membranes (between 24 and 33+6 weeks) who used or did not use prophylactic antibiotics. Pearson's chi-square (χ²) test, Student's t-test, and binary logistic regression were used for statistical analysis. RESULTS: A significant effect was observed in patients with premature rupture of membranes using prophylactic antibiotics regarding amniotic fluid index (p=0.007), deepest vertical pocket (p=0.049), duration of antibiotic therapy (p≤0.001), C-reactive protein level upon admission (p≤0.001), leukocyte count upon admission (p=0.007), and length of stay in neonatal intensive care (p=0.047). A significant association was observed between the abovementioned patients and surfactant use during the neonatal period (p=0.04). A higher prevalence of surfactant use was noted in these patients (20.0 vs. 8.7%; p=0.04). CONCLUSION: No association was found between antibiotic prophylaxis and the presence of adverse perinatal outcomes in pregnant women with premature rupture of membranes between 24 and 33+6 weeks of gestation.

Are We Getting Any Better? A Critical Analysis of Selected Healthy People 2020 Oral Health Indicators in 1999-2004 and 2013-2016, USA.

Oral health disparities are prevalent in the American population and are influenced by various social determinants. This study aimed to analyze oral health disparities in the US between 1999-2004 and 2013-2016 according to sociodemographic characteristics. This analytic cross-sectional study analyzed five oral health indicators from Healthy People 2020. A binomial test was used to compare proportions between baseline and follow-up. Only the indicator for non-treated cavities among children reached its goal. White children had the greatest decrease (-15.4%; p = 0.0428) in dental caries. Higher income determined better outcomes for adolescents (-27.54%; p = 0.00032 dental caries) and adults (-15.96%; p = 0.0143 tooth extractions). However, adults 35-44 years with the highest income had a significant increase (40.74%, p = 0.0258) in decayed teeth. This study provides evidence to suggest that some progress has been made towards reducing oral health disparities in the US, primarily among children. However, trends for certain indicators remain disparate between different racial/ethnic and income groups. Applications for the findings of this study should address the intersectional nature of social determinants of health and should center on improving the equity of services offered by public oral healthcare.

Genomic selection signatures in farmed Colossoma macropomum from tropical and subtropical regions in South America.

Tambaqui or cachama (Colossoma macropomum) is one of the most important neotropical freshwater fish used for aquaculture in South America, and its production is concentrated at low latitudes (close to the Equator, 0°), where the water temperature is warm. Therefore, understanding how selection shapes genetic variations and structure in farmed populations is of paramount importance in evolutionary biology. High-throughput sequencing to generate genome-wide data for fish species allows for elucidating the genomic basis of adaptation to local or farmed conditions and uncovering genes that control the phenotypes of interest. The present study aimed to detect genomic selection signatures and analyze the genetic variability in farmed populations of tambaqui in South America using single-nucleotide polymorphism (SNP) markers obtained with double-digest restriction site-associated DNA sequencing. Initially, 199 samples of tambaqui farmed populations from different locations (located in Brazil, Colombia, and Peru), a wild population (Amazon River, Brazil), and the base population of a breeding program (Aquaculture Center, CAUNESP, Jaboticabal, SP, Brazil) were genotyped. Observed and expected heterozygosity was 0.231-0.350 and 0.288-0.360, respectively. Significant genetic differentiation was observed using global FST analyses of SNP loci (FST = 0.064, p < 0.050). Farmed populations from Colombia and Peru that differentiated from the Brazilian populations formed distinct groups. Several regions, particularly those harboring the genes of significance to aquaculture, were identified to be under positive selection, suggesting local adaptation to stress under different farming conditions and management practices. Studies aimed at improving the knowledge of genomics of tambaqui farmed populations are essential for aquaculture to gain deeper insights into the evolutionary history of these fish and provide resources for the establishment of breeding programs.

Combined Heart and Kidney Transplantation: Initial Clinical Experience.

INTRODUCTION: Combined solid organ transplantation is infrequently performed in Brazil. The objective of this article is to present our initial experience with combined heart and kidney transplantation. METHODS: From January 2007 to December 2019, four patients were submitted to combined heart and kidney transplantation. Their mean age was 55.7±4.4 years, and three (75%) patients were males. All patients had Chagas cardiomyopathy, two were hospitalized and inotrope dependent, and all patients were on preoperative dialysis (median of 12 months prior to transplant). RESULTS: All patients survived and were in New York Heart Association functional class I at the latest follow-up (mean 34.7±17.5 months). Mean retarded kidney graft function was 22.9±9.7 days. One patient lost the kidney graft two years after the transplant due to Polyomavirus infection. CONCLUSION: Our initial experience of combined heart and kidney transplantation was favorable in selected patients with advanced heart failure and end-stage kidney disease. It requires involvement of a dedicated multispecialty team throughout all the diagnostics and treatment steps.

Combined Heart and Kidney Transplantation: Initial Clinical Experience

ABSTRACT Introduction: Combined solid organ transplantation is infrequently performed in Brazil. The objective of this article is to present our initial experience with combined heart and kidney transplantation. Methods: From January 2007 to December 2019, four patients were submitted to combined heart and kidney transplantation. Their mean age was 55.7±4.4 years, and three (75%) patients were males. All patients had Chagas cardiomyopathy, two were hospitalized and inotrope dependent, and all patients were on preoperative dialysis (median of 12 months prior to transplant). Results: All patients survived and were in New York Heart Association functional class I at the latest follow-up (mean 34.7±17.5 months). Mean retarded kidney graft function was 22.9±9.7 days. One patient lost the kidney graft two years after the transplant due to Polyomavirus infection. Conclusion: Our initial experience of combined heart and kidney transplantation was favorable in selected patients with advanced heart failure and end-stage kidney disease. It requires involvement of a dedicated multispecialty team throughout all the diagnostics and treatment steps.

Association between social capital indicators and depressive symptoms among Brazilian university students.

The study aimed to investigate the association between social capital indicators and depressive symptoms among university students from Brazil. The study drew on a sample of 579 randomly selected university students, from a greater crossnational study conducted in 2018. Students completed a self-administered questionnaire assessing depressive symptoms, indicators of social capital and lifestyle behaviors. Data were analyzed using multivariate logistic regression models. Indicators of social capital included trust, group membership and frequency of meeting friends. Four social capital indicators were significantly associated with clinically relevant depressive symptoms. Students who agreed that people are likely to take advantage of one another were more likely to report depressive clinically relevant symptoms (OR: 1.80, 95%CI: 1.00 - 3.23) as well as students who agreed that people are not willing to help in case needed (OR: 2.11, 95%CI: 1.02 - 4.36). Perceived stress, smoking and hazardous alcohol consumption were not associated with clinically relevant depressive symptoms. Social capital plays an important role in explaining depressive symptoms among Brazilian university students. The study suggests that creating trust and enhancing participation in social networks can be an important strategy for promoting mental health among university students investigated in this study.

Association between social capital indicators and depressive symptoms among Brazilian university students / Associação entre indicadores de capital social e sintomas depressivos entre estudantes universitários brasileiros

Abstract The study aimed to investigate the association between social capital indicators and depressive symptoms among university students from Brazil. The study drew on a sample of 579 randomly selected university students, from a greater crossnational study conducted in 2018. Students completed a self-administered questionnaire assessing depressive symptoms, indicators of social capital and lifestyle behaviors. Data were analyzed using multivariate logistic regression models. Indicators of social capital included trust, group membership and frequency of meeting friends. Four social capital indicators were significantly associated with clinically relevant depressive symptoms. Students who agreed that people are likely to take advantage of one another were more likely to report depressive clinically relevant symptoms (OR: 1.80, 95%CI: 1.00 - 3.23) as well as students who agreed that people are not willing to help in case needed (OR: 2.11, 95%CI: 1.02 - 4.36). Perceived stress, smoking and hazardous alcohol consumption were not associated with clinically relevant depressive symptoms. Social capital plays an important role in explaining depressive symptoms among Brazilian university students. The study suggests that creating trust and enhancing participation in social networks can be an important strategy for promoting mental health among university students investigated in this study.

Resumo O estudo investigou a associação entre indicadores de capital social e sintomas depressivos entre estudantes universitários do Brasil. Um estudo transversal foi conduzido com uma amostra de 579 estudantes universitários selecionados randomicamente em 2018. Os estudantes completaram questionários auto-administrados para avaliar sintomas depressivos, indicadores de capital social e comportamentos de estilos de vida. Os dados foram analisados usando modelos de regressão logística multivariada. Indicadores de capital social incluíam confiança, associações em grupos, frequência de encontrar com os amigos, entre outros. Quatro indicadores de capital social se associaram significativamente com relevantes sintomas clínicos de depressão. Estudantes que disseram que as pessoas tendem a tirar mais vantagens umas das outras eram mais propensas a relatar sintomas clínicos relevantes de depressão (OR: 1.80, 95%CI: 1.00 - 3.23), assim como estudantes que relataram que as pessoas não estão dispostas a ajudar caso precise de ajuda (OR: 2.11, 95%CI: 1.02 - 4.36). A autopercepção de estresse, o consumo de álcool e o fumo não se associaram aos sintomas clínicos de depressão. O capital social desempenha um papel importante na explicação dos sintomas depressivos entre os universitários brasileiros. O estudo sugere que promover confiança e aumentar a participação nas redes sociais pode ser uma estratégia importante para a promoção da saúde mental entre os universitários investigados neste estudo.

Comparative analysis of the influence of handgrip strength mobility on the quality of life of institutionalized elderly / Análise comparativa da influência da força e mobilidade da preensão manual na qualidade de vida de idosos institucionalizados

The objective of this study was to carry out a comparative analysis between handgrip strength and mobility in the quality of life (QOL) of older adults living in long-term care facilities. Methods: This was a cross sectional study conducted in Belo Horizonte, Brazil, comprised of a sample population of 127 older adults. Measurements included the World Health Organization Quality of Life-OLD (WHOQOL-BREF) questionnaire, assessment of the handgrip strength by hand dyna- mometer and mobility by Timed Up and Go (TUG). An analysis of variance (ANOVA) was performed to compare the mean values of the WHOQOL-BREF, global and domains, in each stratum of the hand grip strength and mobility values. Our results showed that handgrip dynamometer strength was associated with higher perception of the global WHOQOL-BREF score and two WHOQOL-BREF domains environment (p<0.028) and physical health (p<0.002), that is, the highest QOL values were seen in those older adults with greater handgrip strength. However, no significant association between TUG score and any quality of life domains was found. It can be inferred that handgrip strength seems to influence the quality of life of institutionalized older adults and healthcare providers in LTCs should account for when designing interventions.(AU)

O objetivo desse estudo foi realizar uma análise comparativa entre a força de preensão manual e a mobilidade na qualidade de vida de idosos residentes em Instituições de longa permanência. Este foi um estudo transversal conduzido no município de Belo Hori- zonte, Brasil, envolvendo uma amostra de 127 idosos institucionalizados. As medidas incluíram os questionários de Qualidade de Vida propostos pela Organização Mundial de Saúde (WHOQOL- BREF), avaliação da força de preensão manual pelo dinamômetro manual e a mobilidade pelo Timed Up and Go (TUG). Foi realizada uma análise de variância (ANOVA) para comparar os valores médios do WHOQOL BREF, total e por domínio, em cada estrato dos valores da força de preensão manual e de mobilidade. Os resultados mostraram que foram observados diferenças significativas nos escore global do WHOQOL BREF e nos domínios meio ambiente (p<0.028) e físico (p<0.002) entre os estratos da força de preensão manual, ou seja, os maiores valores da QV foram vistos naqueles idosos com maior força de preensão. Por outro lado, não houve diferença nas médias do WHOQOL, total e por domínio, em nenhum dos estratos do TUG. Pode-se inferir que a força de preensão parece influenciar na qualidade de vida em idosos institucionalizados, devendo, pois, aos gestores das instituições de longa permanência levar em consideração essa informação ao propor intervenções para essa população.(AU)

Development of a multi-species SNP array for serrasalmid fish Colossoma macropomum and Piaractus mesopotamicus.

Scarce genomic resources have limited the development of breeding programs for serrasalmid fish Colossoma macropomum (tambaqui) and Piaractus mesopotamicus (pacu), the key native freshwater fish species produced in South America. The main objectives of this study were to design a dense SNP array for this fish group and to validate its performance on farmed populations from several locations in South America. Using multiple approaches based on different populations of tambaqui and pacu, a final list of 29,575 and 29,612 putative SNPs was selected, respectively, to print an Axiom AFFYMETRIX (THERMOFISHER) SerraSNP array. After validation, 74.17% (n = 21,963) and 71.25% (n = 21,072) of SNPs were classified as polymorphic variants in pacu and tambaqui, respectively. Most of the SNPs segregated within each population ranging from 14,199 to 19,856 in pacu; and from 15,075 to 20,380 in tambaqui. Our results indicate high levels of genetic diversity and clustered samples according to their hatchery origin. The developed SerraSNP array represents a valuable genomic tool approaching in-depth genetic studies for these species.

Social capital or vulnerability: Which has the stronger connection with selected U.S. health outcomes?

We tested associations between social capital or vulnerability and health outcome measures of adult obesity, adult diabetes, and life expectancy at the county level in the United States with data from 2015 to 2018. This ecological cross-sectional study utilized secondary data from four open access databases: The Geography of Social Capital (U.S. Congress, 2018), County Health Rankings (2018), CDC's Behavioral Risk Factor Surveillance System (BRFSS, 2018) and the Kaiser Family Foundation (KFF, 2015). Our dependent variables were adult obesity, adult diabetes, and life expectancy. We identified the highest and lowest states' prevalence for each of three health outcomes in each of the four U.S. regions-Northeast, South, Midwest, and West. Each dependent variable was assessed using a sample of 32 counties (N = 32). Data analysis consisted of bivariate and regression analysis. Our results showed that the most consistent measure of "vulnerability" linked significantly to all three health conditions studied was percent births to unmarried women (Obesity p < .001; Diabetes p = .049; Life Expectancy p = .019). The most consistent measure of "social capital" linked to all three health conditions was recreation establishments per 1,000 inhabitants (Obesity p = .006; Diabetes p = .005; Life Expectancy p = .018). We concluded that measures of vulnerability were strongly associated with obesity, diabetes, and life expectancy when compared with social capital indicators. However, measures of social capital consistently accounted for the second-greatest proportion of the variance. Social and community contexts should be constantly addressed by both public health governmental- and scholarly-research agendas in the United States.

24.0 kyr cal BP stone artefact from Vale da Pedra Furada, Piauí, Brazil: Techno-functional analysis.

Current archaeological paradigm proposes that the first peopling of the Americas does not exceed the Last Glacial Maximum period. In this context, the acceptance of the anthropogenic character of the earliest stone artefacts generally rests on the presence of projectile points considered no more as typocentric but as typognomonic, since it allows, by itself, to certify the human character of the other associated artefacts. In other words, without this presence, nothing is certain. Archaeological research at Piauí (Brazil) attests to a Pleistocene human presence between 41 and 14 cal kyr BP, without any record of lithic projectile points. Here, we report the discovery and interpretation of an unusual stone artefact in the Vale da Pedra Furada site, in a context dating back to 24 cal kyr BP. The knapping stigmata and macroscopic use-wear traces reveal a conception centred on the configuration of double bevels and the production in the same specimen of at least two successive artefacts with probably different functions. This piece unambiguously presents an anthropic character and reveals a technical novelty during the Pleistocene occupation of South America.

Development of a SNP linkage map and genome-wide association study for resistance to Aeromonas hydrophila in pacu (Piaractus mesopotamicus).

BACKGROUND: Pacu (Piaractus mesopotamicus) is one of the most important Neotropical aquaculture species from South America. Disease outbreaks caused by Aeromonas hydrophila infection have been considered significant contributors to the declining levels of pacu production. The current implementation of genomic selection for disease resistance has been adopted as a powerful strategy for improvement in fish species. This study aimed to investigate the genetic architecture of resistance to A. hydrophila in pacu via Genome-Wide Association Study (GWAS), the identification of suggestive Quantitative Trait Loci (QTLs) and putative genes associated with this trait. The genetic data were obtained from 381 juvenile individuals belonging to 14 full-sibling families. An experimental challenge was performed to gain access to the levels of genetic variation for resistance against the bacteria using the following trait definitions: binary test survival (TS) and time of death (TD). RESULTS: The analyses of genetic parameters estimated moderate heritability (h2) for both resistance traits: 0.20 (± 0.09) for TS and 0.35 (± 0.15) for TD. A linkage map for pacu was developed to enable the GWAS, resulting in 27 linkage groups (LGs) with 17,453 mapped Single Nucleotide Polymorphisms (SNPs). The length of the LGs varied from 79.95 (LG14) to 137.01 (LG1) cM, with a total map length of 2755.60 cM. GWAS identified 22 putative QTLs associated to A. hydrophila resistance. They were distributed into 17 LGs, and were considered suggestive genomic regions explaining > 1% of the additive genetic variance (AGV) for the trait. Several candidate genes related to immune response were located close to the suggestive QTLs, such as tbk1, trim16, Il12rb2 and lyz2. CONCLUSION: This study describes the development of the first medium density linkage map for pacu, which will be used as a framework to study relevant traits to the production of this species. In addition, the resistance to A. hydrophila was found to be moderately heritable but with a polygenic architecture suggesting that genomic selection, instead of marker assisted selection, might be useful for efficiently improving resistance to one of the most problematic diseases that affects the South American aquaculture.

The bleaching efficacy of carbamide peroxide gels containing potassium nitrate desensitizer.

BACKGROUND: To evaluate the bleaching efficacy of at-home carbamide peroxide (CP) gels in two concentrations, containing or not a desensitizing agent. MATERIAL AND METHODS: Forty incisors were divided into four groups (n=10), according to gel concentrations (10% or 22%), and presence or not of 3% potassium nitrate in the gel. A thin layer of gel was applied to the buccal surface of each tooth for 2h/day for 4 weeks. Bleaching efficacy was measured using a spectrophotometer, and ∆E*ab, ∆E00 and ∆WID were calculated. Measurements were performed at baseline, 7, 14, 21, 28, and 35 days following the first gel application. Data were analyzed by two-way RM-ANOVA and Tukey's test (α=0.05). RESULTS: Regarding gel concentration or potassium nitrate inclusion, both gels resulted in color change above the perceptibility thresholds, which were similar between gels. Regarding time, significant differences were observed between color change values at 7 days and other time periods. ∆WID ranged from 3.8 to 9.6. Significant moderate to strong positive correlation was observed among the parameters. CONCLUSIONS: Nor the CP concentration, neither the inclusion of potassium nitrate in the gel, had influence on bleaching efficacy. All gels were effective and showed good results from the first weeks' application. Key words:Tooth bleaching, carbamide peroxide, desensitizer, potassium nitrate, color.

Flexural strength and crystalline stability of a monolithic translucent zirconia subjected to grinding, polishing and thermal challenges.

The objective of this study is to investigate the magnitude of structural degradation of a monolithic translucent zirconia caused by clinically relevant grinding and polishing procedures, when associated or not with low temperature degradation (LTD), induced by accelerated hydrothermal aging using autoclave or thermocycling Ninety disks (Ø12 × 1 mm) were prepared from dental zirconia for monolithic restorations (Vipi Block Zirconn Translucent, Vipi). The specimens were divided into 3 groups (n = 30) according to surface treatment: As Sintered (untreated), Grind (diamond bur), Grind + Polish (diamond bur + polish); and then subdivided according to aging method (n = 10): Baseline (no aging), Autoclave (134°C, 2.2 kgf/cm2 pressure for 5 h), and Thermocycling (200,000 cycles, 5°C and 55°C, for 15 s each). Roughness, biaxial flexural strength and percentage of monoclinic phase were evaluated. Regarding surface treatment, the Grind group presented higher roughness and greater flexural strength compared to As Sintered group, while Grind + Polish showed intermediate roughness and flexural strength similar to Grind group. Aging had little effect on roughness, but yielded a significant reduction in flexural strength. Tetragonal to monoclinic phase transformation was observed in all groups, caused by both mechanical stresses (grinding and polishing) and LTD, which was similarly induced by the traditional autoclave method, as well as the thermocycling method The use of diamond burs to grind zirconia surface may result in deleterious effects on the surface quality of monolithic zirconia restorations, yet has a potential toughening effect by phase transformation. However, when zirconia is exposed to LTD, regardless of the surface treatment, degradation of the surface quality and strength are observed.

Association between depression and quality of life among Brazilian older adults in long-term care facilities / Asociación entre depresión y calidad de vida entre adultos mayores brasileños en centros de atención a largo plazo / Associação entre depressão e qualidade de vida entre idosos brasileiros em instituições de longa permanência

This study aims to test the association between geriatric depression and the quality of life of older adults in long-term care facilities in Brazil. Results showed that there was a significant correlation among four of the six domains that were measured in the WHOQOL-OLD questionnaire of those demonstrating symptoms and those without. In conclusion, higher depression scores were reported by participants who had lower quality of life scores. Mental health care should be carefully addressed among institutionalized older adults in long-term facilities.

Lo objectivo es probar la asociación entre la depresión geriátrica y la calidad de vida de los adultos mayores en centros de cuidados a largo plazo en Brasil. Los resultados mostraron que hubo una correlación significativa entre cuatro de los seis domínios que se midieron em el cuestionario WHOQOL-OLD de aquellos que muestram sintomas y los que no. En conclusión, los participantes que tenían puntuaciones de calidad de vida más bajas informaron puntuaciones de depresión más altas. La atención de la salud mental debe abordarse cuidadosamente entre los adultos mayores institucionalizados en instalaciones a largo plazo.

Este estudo tem como objetivo testar a associação entre depressão geriátrica e qualidade de vida de idosos em instituições de longa permanência no Brasil. Os resultados mostraram que houve uma correlação significativa entre quatro dos seis domínios que foram medidos no questionário WHOQOL-OLD daqueles que demonstraram sintomas e aqueles sem. Em conclusão, escores mais altos de depressão foram relatados pelos participantes que apresentaram escores mais baixos de qualidade de vida. Os cuidados de saúde mental devem ser cuidadosamente tratados entre idosos institucionalizados em instalações de longo prazo.

Guarda compartilhada no Brasil e no Uruguai: tensões na instituição da igualdade parental / Shared custody at Brazil and Uruguay: tensions in the institution of parental equality / Custodia compartida en Brasil y Uruguay: tensiones en la institución de la igualdad parental

Este trabalho consiste em um estudo teórico-documental realizado como parte de uma pesquisa mais ampla, ainda em andamento, que investiga as relações parentais na guarda compartilhada no Brasil e no Uruguai. Buscou-se compreender como, histórica e juridicamente, a guarda compartilhada foi instituída nesses países e discutir a relação entre sua instituição e igualdade parental, tendo em conta os processos sociais envolvidos na determinação da igualdade entre homens e mulheres. Os resultados apontaram que, no Uruguai, a instituição da guarda compartilhada derivou de direitos adquiridos pelas mulheres enquanto, no Brasil, foi consequência da mobilização de pais, reivindicando seus direitos frente às mães de seus filhos. Em consequência das diferentes posições ocupadas por homens e mulheres na sociedade, a guarda compartilhada é apreendida por eles como lutas distintas. Concluiu-se que, nos dois países, sua instituição representa avanços em prol da convivência familiar, mas não é suficiente para promover a igualdade parental (AU).

This work consists in a theoretical-documentary study performed as a part of a wider research, still in progress, that investigates the parental relationships in shared custody both in Brazil and in Uruguay. We aimed to comprehend how, historically and legally, shared custody was instituted in these countries and discuss the relationship between their institution and parental equality, taking into account the social processes involved in determining equality between men and women. The results showed that in Uruguay, the institution of shared custody derived from rights acquired by women, while in Brazil it was a consequence of the mobilization of fathers, claiming their rights towards the mothers of their children. Because of the different positions held by men and women in society, they perceive shared custody as distinct struggles. We concluded that, in both countries, their institution represents advances in favor of family acquaintanceship, but is not enough to promote parental equality (AU).

Este trabajo consiste en un estudio teórico y documental realizado como parte de una investigación más amplia, aún en progreso, que investiga las relaciones familiares en custodia compartida tanto en Brasil como en Uruguay. El objetivo fue comprender cómo, histórica y legalmente, se instituyó la custodia compartida en estos países y discutir la relación entre su institución e igualdad parental, teniendo en cuenta los procesos sociales involucrados en la determinación de la igualdad entre hombres y mujeres. Los resultados mostraron que, en Uruguay, la institución de la custodia compartida derivó de los derechos adquiridos por las mujeres, mientras que, en Brasil, fue una consecuencia de la movilización de los padres, reclamando sus derechos hacia las madres de sus hijos. Como resultado de las diferentes posiciones de hombres y mujeres en la sociedad, la custodia compartida es percibida por ellos como luchas distintas. Concluimos que, en ambos países, su institución representa avances a favor de la convivencia familiar, pero no es suficiente para promover la igualdad parental (AU).

Acesso ao tratamento da mulher com câncer de mama / Access to treatment of women with breast cancer

RESUMO O objetivo do estudo foi caracterizar o acesso ao tratamento da mulher com diagnóstico de câncer de mama no estado do Piauí, Brasil. Estudo transversal analítico, desenvolvido em duas instituições hospitalares de referência, no período de janeiro a junho de 2018. A população compreendeu mulheres diagnosticadas com câncer de mama que realizaram tratamento no período de 2016 a 2017. A amostra foi de 155 participantes. A amostragem foi estratificada proporcional. Os dados foram processados no IBM® SPSS®, e calculadas estatísticas uni e bivariadas. Constatou-se que o tempo para o tratamento foi de, em média, 112,7 (±93,6) dias, variando de 12 a 550 dias (≡18,3 meses ou 1,5 anos), sendo que 71,6% das mulheres iniciaram o tratamento em um período superior a 60 dias do diagnóstico do câncer de mama. Foram verificadas associações estatisticamente significativas entre o atraso para início do tratamento e o território estadual de residência (p=0,041) e o estágio da doença (p=0,037). Dessa forma, o acesso ao tratamento do câncer de mama não está acontecendo como preconizado. Ressalta-se, portanto, a necessidade de uma maior organização dos serviços de saúde em rede, levando em conta as necessidades da população, por meio do atendimento em tempo oportuno.

ABSTRACT This study was aimed at characterizing the access to treatment of women diagnosed with breast cancer in the state of Piauí, Brazil. A cross-sectional analytical study was developed in two referral hospital institutions from January/2018 to June/2018. The population comprised women diagnosed with breast cancer who underwent treatment in the period from 2016 to 2017. The sample amounted to 155 participants. Sampling was proportionally stratified. The data was processed in IBM® SPSS®, and uni and bivariate statistics were calculated. It was noted that the average time for treatment was of 112.7 (± 93.6) days, varying from 12 to 550 days (≡18.3 months or 1.5 years), with 71.6 % of the women starting treatment within a period higher than 60 days following breast cancer diagnosis. Statistically significant associations were verified between the delay to start treatment and the state territory of residence (p = 0.041) and the disease stage (p = 0.037). The conclusion is that women are not having access to breast cancer treatment as recommended. Therefore, it is worth noting the need for greater organization in the network of health services, taking into account the needs of the population through timely health care.