Effect of Surface Treatment with Zirconium Dioxide Slurry on the Bond Strength of Resin Cement to Ultratranslucent Zirconia.

This laboratory study aimed to evaluate the effects of zirconium dioxide (ZrO2) slurry surface treatment on the bond strength of ultratranslucent zirconia to resin cement using different ceramic primers. The surface morphology was evaluated by scanning electron microscopy (SEM) and atomic force microscopy (AFM), and the interface was evaluated by SEM. Additionally, the phase composition was analyzed by X-ray diffraction (XRD). Specimens of zirconia (n=120) were obtained and divided into two groups according to the surface treatment: (1) airborne particle abrasion with 50-µm aluminum oxide (n=60) and (2) ZrO2 slurry (n=60). The 60 specimens were then further divided into three groups (n=20) according to the ceramic primer application: no primer (NP), Monobond N (MB), and Clearfil ceramic primer (CP). Four resin cement cylinders were built on each ceramic specimen. Half of the specimens (n=10) were subjected to a microshear bond strength (µSBS) test after 24 hours of storage in distilled water, and the other half (n=10) were subjected to a µSBS test after thermocycling. Additional specimens were prepared for SEM, AFM, and XRD analyses. According to the Kruskal-Wallis and Student-Newman-Keuls post hoc tests, the µSBS values were significantly higher for MB and CP than for NP (p<0.05), and there were no significant differences in µSBS for both surface treatments associated with MB and CP after 24 hours of storage (p>0.05). Thermocycling significantly decreased the µSBS values for all specimens, especially for the NP groups and ZrO2 slurry treatment groups, and gaps at the interface were observed by SEM. SEM and AFM analyses showed agglomerate-type irregularities on the ceramic surface for ZrO2 slurry treatment. XRD spectra showed that ZrO2 slurry did not cause phase transformation. It was concluded that ZrO2 slurry promoted irregularities on the ultratranslucent zirconia surface, not causing phase transformation; moreover, the values of µSBS were comparable to those of airborne particle abrasion with aluminum oxide. However, neither surface treatment nor ceramic primer prevented the degradation of the interface.

Barriers to patient recruitment in a poststroke neurorehabilitation multicenter trial in Brazil.

There is a high demand for stroke rehabilitation in the Brazilian public health system, but most studies that have addressed rehabilitation for unilateral spatial neglect (USN) after stroke have been performed in high-income countries. Therefore, the aim of this study was to analyze USN patient recruitment in a multicenter noninvasive brain stimulation clinical trial performed in Brazil and to provide study design recommendations for future studies. We evaluated the reasons for exclusion of patients from a multicenter, randomized, double-blinded clinical trial of rehabilitation of USN patients after stroke. Clinical and demographic variables were compared between the included and excluded patients. A descriptive statistical analysis was performed. Only 173 of the 1953 potential neglect patients (8.8%) passed the initial screening. After screening evaluation, 87/173 patients (50.3%) were excluded for clinical reasons. Cognitive impairment led to the exclusion of 21/87 patients (24.1%). Low socioeconomic status led to the exclusion of 37/173 patients (21.4%). Difficulty obtaining transportation to access treatment was the most common reason for their exclusion (16/37 patients, 43.3%). The analyzed Brazilian institutions have potential for conducting studies of USN. The recruitment of stroke survivors with USN was restricted by the study design and limited financial support. A history of cognitive impairment, intracranial stenting or craniectomy, and lack of transportation were the most common barriers to participating in a multicenter noninvasive brain stimulation trial among patients with USN after stroke.

Pharmacological PI3K inhibition in head and neck squamous cell carcinoma: A systematic review.

BACKGROUND: This systematic review aimed to investigate the in vitro and in vivo effects of phosphatidylinositol-3-kinase (PI3K) inhibitors on head and neck squamous cell carcinoma (HNSCC). Considering the role of PI3K and its downstream effectors in cell proliferation, invasion, and survival, it is reasonable to expect that treatment with PI3K inhibitors could control HNSCC onset and progression. Thus, the research question for our review was whether pharmacological inhibition of PI3K affects HNSCC progression. METHODS: In vitro and in vivo studies were selected from six databases. We collected data regarding cell viability, apoptosis, and the regulation of protein expression levels from in vitro studies. For the in vivo studies, we analyzed the reduction in tumor size or gene and protein expression. RESULTS: The included studies showed reduced cell proliferation and apoptosis after treatment with PI3K inhibitors. PI3K inhibitors in combination with other drugs had an enhanced anticancer effects compared to those of single-drug treatments. CONCLUSIONS: The results support the potential of PI3K inhibitors as candidates for clinical trials in HNSCC.

Barriers to patient recruitment in a poststroke neurorehabilitation multicenter trial in Brazil

There is a high demand for stroke rehabilitation in the Brazilian public health system, but most studies that have addressed rehabilitation for unilateral spatial neglect (USN) after stroke have been performed in high-income countries. Therefore, the aim of this study was to analyze USN patient recruitment in a multicenter noninvasive brain stimulation clinical trial performed in Brazil and to provide study design recommendations for future studies. We evaluated the reasons for exclusion of patients from a multicenter, randomized, double-blinded clinical trial of rehabilitation of USN patients after stroke. Clinical and demographic variables were compared between the included and excluded patients. A descriptive statistical analysis was performed. Only 173 of the 1953 potential neglect patients (8.8%) passed the initial screening. After screening evaluation, 87/173 patients (50.3%) were excluded for clinical reasons. Cognitive impairment led to the exclusion of 21/87 patients (24.1%). Low socioeconomic status led to the exclusion of 37/173 patients (21.4%). Difficulty obtaining transportation to access treatment was the most common reason for their exclusion (16/37 patients, 43.3%). The analyzed Brazilian institutions have potential for conducting studies of USN. The recruitment of stroke survivors with USN was restricted by the study design and limited financial support. A history of cognitive impairment, intracranial stenting or craniectomy, and lack of transportation were the most common barriers to participating in a multicenter noninvasive brain stimulation trial among patients with USN after stroke.

Marandu grass pastures with the same average height and different horizontal structures change the feeding behavior of grazing sheep? / Pastos de capim-marandu com mesma altura média e diferentes estruturas horizontais alteram o comportamento ingestivo de ovinos em pastejo?

The objective was to investigate the feeding behavior of sheep in marandu grass (Brachiaria brizantha cv. Marandu) pastures under continuous stocking with the same average height and different horizontal structures. The treatments were composed of less heterogeneous pastures (P-H, 24% coefficient of variation of plant heights and more heterogeneous pastures (P+H, 46% coefficient of variation of plant heights) and the locations of the picket, front and back, were also evaluated. A randomized block design was used, with split plots in space and four replications in two years. Crossbred lambs were used, managed under continuous stocking and variable stocking rate, to maintain average height of pastures at 30 cm. Greater masses of total forage, live leaf, live stem and dead material, and greater time of sheep in rumination, occurred in the front, in relation to the paddock background. In P-H, grazing time (GT) did not vary between regions. In P+H, GT was lower at the front than at the background. Idle time (IT) was similar between P-H and P+H. However, the animals remained more IT in the front than in the background. The feeding behavior of grazing sheep is modified in marandu grass pastures under continuous stocking with the same average height, but with different spatial variability of the vegetation.

Objetivou-se investigar o comportamento ingestivo de ovinos em pastos de capim-marandu (Brachiaria brizantha cv. Marandu) sob lotação contínua com mesma altura média e diferentes estruturas horizontais. Os tratamentos foram compostos de pastos menos heterogêneo (P-H, 24% de coeficiente de variação das alturas das plantas) e pastos mais heterogêneo (P+H, 46% de coeficiente de variação das alturas das plantas), também foi avaliado os locais do piquete, frente e fundo. O delineamento utilizado foi de blocos ao acaso, com parcelas subdivididas no espaço e quatro repetições em dois anos. Foram utilizadas borregas mestiças, manejadas sob lotação continua e com taxa de lotação variável, para manter altura média dos pastos em 30cm. Maiores massas de forragem total, folha viva, colmo vivo e material morto, e maior tempo dos ovinos em ruminação, ocorreram na frente, em relação ao fundo do piquete. No P-H, o tempo em pastejo (TP) não variou entre as regiões. No P+H, o TP foi menor na frente do que no fundo. O tempo em ócio (TO) foi semelhante entre os P-H e P+H. Porém, os animais permaneceram mais TO na frente que no fundo. O comportamento ingestivo de ovinos em pastejo é modificado em pastos de capim-marandu sob lotação contínua com mesma altura média, porém com diferentes variabilidades espaciais da vegetação.

Retention of Manually or CAD/CAM-customized Fiberglass Posts Luted to Enlarged Root Canals with Different Resin Cements.

The aim of this laboratory study was to evaluate the pull-out force of a prefabricated fiberglass post (PP), relined fiberglass post (RP), or milled fiberglass post (MP) luted with Multilink N (MN), RelyX Unicem 2 (RXU2) or RelyX Ultimate (RU) to enlarged root canals. The thickness of the resin cements and the presence of voids in the resin cement film were observed. The root canals of 90 bovine incisors were enlarged, endodontically treated, and randomly divided into 9 groups (n=10) according to the post type and resin cement. The specimens were scanned using micro-CT to analyze the thickness of the resin cement and the presence of voids. The specimens were submitted to mechanical cyclic loading (500,000 cycles at 50 N load) and subjected to pull-out force testing. Two-way ANOVA and Tukey's test analyzed the pull-out force and resin cement thickness data. Kruskal-Wallis and Bonferroni tests analyzed the void scores. The interaction between factors (post × resin cement) was significant (p=0.0001) for the pull-out force. Higher pull-out forces were obtained for RP and MP compared to PP. The post factor was significant (p=0.0001) for resin cement thickness, which was higher for PP (1054 µm), followed by MP (301 µm) and RP (194 µm). More void formation occurred for PP, being less for RP, differing significantly among the posts. Post customization (RP and MP) decreased resin cement thickness and void formation, favoring a higher pull-out force. Resin cements requiring an adhesive application (MN and RU) favored higher pull-out force than self-adhesive resin cement (RXU2).

A state level analyses of suicide and the COVID-19 pandemic in Mexico.

BACKGROUND: While suicide rates in high- and middle-income countries appeared stable in the early stages of the pandemic, we know little about within-country variations. We sought to investigate the impact of COVID-19 on suicide in Mexico's 32 states and to identify factors that may have contributed to observed variations between states. METHODS: Interrupted time-series analysis to model the trend in monthly suicides before COVID-19 (from Jan 1, 2010, to March 31, 2020), comparing the expected number of suicides derived from the model with the observed number for the remainder of the year (April 1 to December 31, 2020) for each of Mexico's 32 states. Next, we modeled state-level trends using linear regression to study likely contributing factors at ecological level. RESULTS: Suicide increased slightly across Mexico during the first nine months of the pandemic (RR 1.03; 95%CI 1.01-1.05). Suicides remained stable in 19 states, increase in seven states (RR range: 1.12-2.04) and a decrease in six states (RR range: 0.46-0.88). Suicide RR at the state level was positively associated with population density in 2020 and state level suicide death rate in 2019. CONCLUSIONS: The COVID-19 pandemic had a differential effect on suicide death within the 32 states of Mexico. Higher population density and higher suicide rates in 2019 were associated with increased suicide. As the country struggles to cope with the ongoing pandemic, efforts to improve access to primary care and mental health care services (including suicide crisis intervention services) in these settings should be given priority.

Tillering dynamics in spring and summer of marandu palisade grass pastures previously used under deferred grazing / [Dinâmica de perfilhamento na primavera e no verão de pastagens de capim-marandu previamente utilizadas sob pastejo diferido]

This work was conducted to evaluate the effect of deferred pasture condition of Brachiaria brizantha cv. Marandu in the late winter on tillering during the growing season. The treatments were three pasture conditions at late winter: short pasture, tall pasture and tall/mown pasture. In September and October, tiller appearance rate (TApR) and tiller mortality rate (TMoR) were greater in the tall/mown pasture. In November and December, tall pasture presented greater TApR. From November to January the TMoR was greater in the tall pasture. The tiller stability index of short and tall/mown pastures were greater in October. The short pasture presented a greater tiller number than the tall and tall/mown pastures during the entire experimental period. Deferred and short pasture of marandu palisade grass at late winter presents in general lower tiller mortality and higher population density of tillers from the early spring onwards, in comparison to tall pasture. The mowing of marandu palisade grass with high forage mass at the late winter, although it only temporarily compromises the population stability of tillers, also stimulates its fast tillering from spring on.(AU)

Este trabalho foi conduzido com o objetivo de avaliar o efeito da condição da pastagem diferida de Brachiaria brizantha cv. Marandu ao final do inverno sobre o perfilhamento durante a estação de crescimento. Os tratamentos foram três condições de pastagem no final do inverno: pasto baixo, pasto alto e pasto alto/roçado. Nos meses de setembro e outubro, a taxa de aparecimento de perfilhos (TApP) e a taxa de mortalidade de perfilhos (TMoP) foram maiores na pastagem alta/roçada. Nos meses de novembro e dezembro, a pastagem alta apresentou maior TApP. De novembro a janeiro, a TMoP foi maior na pastagem alta. Os índices de estabilidade de perfilhos das pastagens baixas e altas/roçadas foram maiores em outubro. A pastagem baixa apresentou maior número de perfilhos do que as pastagens altas e altas/roçadas durante todo o período experimental. A pastagem diferida e baixa de capim-marandu no final do inverno apresenta, em geral, menor mortalidade de perfilhos e maior densidade populacional de perfilhos no início da primavera, em comparação com a pastagem alta. A roçada do capim-marandu com alta massa de forragem ao final do inverno, embora comprometa apenas temporariamente a estabilidade populacional dos perfilhos, também estimula o perfilhamento rápido a partir da primavera.(AU)

Morphogenesis of stockpiled Marandu, Piatã, Xaraés and Paiaguás brachiaria grass cultivars / [Morfogênese de cultivares de capins marandu piatã, xaraés e paiaguás diferidos]

The objective this study was to identify differences in the morphogenic patterns of four Urochloa brizantha cultivars (marandu, piatã, xaraés and paiaguás grasses) during the stockpiling period. A completely randomized design was used, with three replications, in experimental plots of 9m². The evaluations took place over 2 years. The grasses were stockpiled for 92 (Year 1) and 95 (Year 2) days. The leaf appearance rate of paiaguás grass was higher, compared to other grasses. In Year 1, the stem elongation rate of xaraés grass was higher than other grasses. At the end of stockpiling period of Year 1, the tiller population density (TPD) was higher in the paiaguás grass, intermediate in the xaraés and marandu grasses and lower in the piatã grass. At the end of the stockpiling period in Year 2, TPD was higher in the paiaguás grass canopy, intermediate in the marandu and piatã grasses canopies, and lower in the xaraés grass canopy. Paiaguás grass has greater leaf growth during the stockpiling period and is therefore suitable for use under stockpiled grazing. Xaraés grass has high stem elongation during the stockpiling period, which is why its use under stockpiled grazing must be accompanied by adjustments in pasture management.(AU)

O objetivo deste estudo foi identificar diferenças nos padrões morfogênicos de quatro cultivares de Urochloa brizantha (marandu, piatã, xaraés e paiaguás) durante o período de diferimento. Foi utilizado o delineamento inteiramente ao acaso, com três repetições, em parcelas experimentais de 9m². As avaliações ocorreram por dois anos. Os capins foram diferidos por 92 (Ano 1) e 95 (Ano 2) dias. A taxa de aparecimento foliar do capim-paiaguás foi maior, em comparação aos demais capins. No Ano 1, a taxa de alongamento do colmo do capim-xaraés foi superior aos demais capins. No final do diferimento do Ano 1, a densidade populacional de perfilho (DPP) foi maior no capim-paiaguás, intermediária nos capins xaraés e marandu e inferior no capim-piatã. No fim do período de diferimento do Ano 2, a DPP foi superior no dossel de capim-paiaguás, intermediária nos dosséis dos capins marandu e piatã, e menor no dossel de capim-xaraés. O capim-paiaguás tem maior crescimento foliar durante o período de diferimento, sendo, portanto, apropriado para uso sob pastejo diferido. O capim-xaraés apresenta elevado alongamento de colmo durante o período de diferimento, razão pela qual seu uso sob pastejo diferido deve vir acompanhado de ajustes no manejo da pastagem.(AU)

Does the lowering strategy before the stockpiling period modify the marandu palisade grass production and structure? / [A estratégia de desfolhação prévia ao período de diferimento modifica a produção e a estrutura do capim-marandu?]

The objective was to identify lowering strategies for Urochloa brizantha cv. Marandu in the beginning of the stockpiling period that increase forage production and improve the structure of stockpiled canopies. Three lowering strategies were evaluated: maintenance of marandu palisade grass with 15cm four months before the stockpiling period; maintenance of palisade grass with 30cm for four months, and lowering to 15cm before the stockpiling period; and maintaining of palisade grass at 45cm for four months, and lowering to 15cm before the stockpiling period. The experimental design was completely randomized, with four replications. At the end of stockpiling, the number of reproductive tillers and forage mass were higher in the canopy under 15/15cm than in the others; the percentage of live leaf was higher in the canopy under 45/15cm than under 15/15cm. Forage production during the stockpiling period was higher in the canopy under 15/15cm and lower in the under 45/15cm. Maintaining 15cm marandu palisadegrass for four months before the stockpiling period increases forage production during this period. The lowering of the marandu palisadegrass from 45 to 15cm at the beginning of the stockpiling period improves the structure of the stockpiled canopy.(AU)

Objetivou-se identificar estratégias de rebaixamento da Urochloa brizantha cv. Marandu no início do diferimento, as quais resultem em aumento da produção e em melhoria da estrutura do dossel diferido. Foram avaliadas três estratégias de rebaixamento no início do diferimento: manutenção do capim-marandu com 15cm por quatro meses antes do início do diferimento; manutenção do capim-marandu com 30cm por quatro mese, e rebaixamento para 15cm no início do diferimento; e manutenção do capim com 45cm por quatro meses e rebaixamento para 15cm no início do diferimento. O delineamento foi inteiramente ao acaso, com quatro repetições. No fim do diferimento, o número de perfilho reprodutivo e a massa de forragem foram superiores no dossel sob 15/15cm do que nos demais; a percentagem de folha viva foi maior no dossel sob 45/15cm do que sob 15/15cm. A produção de forragem durante o diferimento foi superior no dossel sob 15/15cm e inferior no sob 45/15cm. A manutenção do capim-marandu com 15cm por quatro meses antes do período de diferimento aumenta a produção de forragem neste período. O rebaixamento do capim-marandu de 45 para 15cm no início do diferimento melhora a estrutura do dossel diferido.(AU)

Associação entre eficiência alimentar e ganho em acabamento de carcaça de bovinos da raça Nelore / Association between feed efficiency and carcass finishinging gain of Nellore cattle

Objetivou-se estimar a associação fenotípica entre a eficiência alimentar e o ganho em acabamento de carcaça de touros jovens da raça Nelore. Utilizaram-se informações de 98 touros jovens da raça Nelore, participantes de duas provas de eficiência alimentar que empregaram o sistema de cochos eletrônicos Growsafe®, as quais foram realizadas nos anos de 2015 e 2016, na fazenda Capim Branco, da Universidade Federal de Uberlândia. As provas de eficiência alimentar tiveram duração de 91 dias, sendo 21 dias de adaptação e 70 dias de avaliação. Os animais apresentavam idade média ao início e ao término do confinamento de 19,98 e 22,16 meses e peso inicial e final médio de 428,17 e 542,27kg, respectivamente. Verificou-se que os animais mais eficientes depositaram menos gordura, e os animais menos eficientes depositaram mais gordura durante o período de avaliação em confinamento. Observou-se que há uma associação fenotípica de baixa magnitude (0,29) entre o consumo alimentar residual (CAR) e o ganho em acabamento de carcaça (GACAB). Assim, pode-se inferir que, ao serem selecionados menores valores de CAR, haverá alguma interferência negativa em GACAB. Concluiu-se que animais mais eficientes (CAR negativo) podem apresentar menor deposição de gordura subcutânea, influenciando na qualidade de carcaça de bovinos da raça Nelore.(AU)

This study aimed to estimate the phenotypic association between feed efficiency and gain in carcass finishing of young Nelore bulls. Information from 98 young Nelore bulls participating in two feed efficiency tests using the Growsafe® electronic trough system, carried out in the years 2015 and 2016, at the Capim Branco farm of the Universidade Federal de Uberlândia was used .The feed efficiency tests lasted for 91 days, with 21 days of adaptation and 70 days of evaluation. The animals had a mean age at the beginning and end of the confinement of 19.98 and 22.16 months, and mean weight initial and end of 428.17 and 542.27kg, respectively. It was verified that most efficient animals deposited less fat, and the efficient animals deposited more fat during the evaluation period at the confinement. It was observed that there is a low magnitude phenotypic association (0.29) between the residual feed intake (RFI) and the gain in carcass finishing (GACAB). Thus, it can be inferred that by selecting lower values of residual feed intake there will be some negative interference in GACAB. It was concluded that the most efficient animals (negative RFI) may present lower deposition of subcutaneous fat, influencing the carcass quality of Nelore cattle.(AU)

Associação entre eficiência alimentar e ganho em acabamento de carcaça de bovinos da raça Nelore / Association between feed efficiency and carcass finishinging gain of Nellore cattle

Objetivou-se estimar a associação fenotípica entre a eficiência alimentar e o ganho em acabamento de carcaça de touros jovens da raça Nelore. Utilizaram-se informações de 98 touros jovens da raça Nelore, participantes de duas provas de eficiência alimentar que empregaram o sistema de cochos eletrônicos Growsafe®, as quais foram realizadas nos anos de 2015 e 2016, na fazenda Capim Branco, da Universidade Federal de Uberlândia. As provas de eficiência alimentar tiveram duração de 91 dias, sendo 21 dias de adaptação e 70 dias de avaliação. Os animais apresentavam idade média ao início e ao término do confinamento de 19,98 e 22,16 meses e peso inicial e final médio de 428,17 e 542,27kg, respectivamente. Verificou-se que os animais mais eficientes depositaram menos gordura, e os animais menos eficientes depositaram mais gordura durante o período de avaliação em confinamento. Observou-se que há uma associação fenotípica de baixa magnitude (0,29) entre o consumo alimentar residual (CAR) e o ganho em acabamento de carcaça (GACAB). Assim, pode-se inferir que, ao serem selecionados menores valores de CAR, haverá alguma interferência negativa em GACAB. Concluiu-se que animais mais eficientes (CAR negativo) podem apresentar menor deposição de gordura subcutânea, influenciando na qualidade de carcaça de bovinos da raça Nelore.(AU)

This study aimed to estimate the phenotypic association between feed efficiency and gain in carcass finishing of young Nelore bulls. Information from 98 young Nelore bulls participating in two feed efficiency tests using the Growsafe® electronic trough system, carried out in the years 2015 and 2016, at the Capim Branco farm of the Universidade Federal de Uberlândia was used .The feed efficiency tests lasted for 91 days, with 21 days of adaptation and 70 days of evaluation. The animals had a mean age at the beginning and end of the confinement of 19.98 and 22.16 months, and mean weight initial and end of 428.17 and 542.27kg, respectively. It was verified that most efficient animals deposited less fat, and the efficient animals deposited more fat during the evaluation period at the confinement. It was observed that there is a low magnitude phenotypic association (0.29) between the residual feed intake (RFI) and the gain in carcass finishing (GACAB). Thus, it can be inferred that by selecting lower values of residual feed intake there will be some negative interference in GACAB. It was concluded that the most efficient animals (negative RFI) may present lower deposition of subcutaneous fat, influencing the carcass quality of Nelore cattle.(AU)

Twelve-month mental health service use in six countries of the Americas: A regional report from the World Mental Health Surveys.

AIMS: To provide cross-national data for selected countries of the Americas on service utilization for psychiatric and substance use disorders, the distribution of these services among treatment sectors, treatment adequacy and factors associated with mental health treatment and adequacy of treatment. METHODS: Data come from data collected from 6710 adults with 12 month mental disorder surveys across seven surveys in six countries in North (USA), Central (Mexico) and South (Argentina, Brazil, Colombia, Peru) America who were interviewed 2001-2015 as part of the World Health Organization (WHO) World Mental Health (WMH) Surveys. DSM-IV diagnoses were made with the WHO Composite International Diagnostic Interview (CIDI). Interviews also assessed service utilization by the treatment sector, adequacy of treatment received and socio-demographic correlates of treatment. RESULTS: Little over one in four of respondents with any 12 month DSM-IV/CIDI disorder received any treatment. Although the vast majority (87.1%) of this treatment was minimally adequate, only 35.3% of cases received treatment that met acceptable quality guidelines. Indicators of social-advantage (high education and income) were associated with higher rates of service use and adequacy, but a number of other correlates varied across survey sites. CONCLUSIONS: These results shed light on an enormous public health problem involving under-treatment of common mental disorders, although the problem is most extreme among people with social disadvantage. Promoting services that are more accessible, especially for those with few resources, is urgently needed.

Propuesta de protocolo diagnóstico, estadificador y quirúrgico para el cáncer de endometrio / Proposal for a diagnostic, staging and surgical protocol for endometrial carcinoma

El carcinoma de endometrio es la neoplasia más frecuente del tracto genital de la mujer en el mundo occidental es una patología que va en ascenso en los países en vías de desarrollo. En general, el pronóstico de carcinoma endometrial es bueno, con una supervivencia global de alrededor del 80 %. Se pueden definir tres grupos de acuerdo al riesgo de recurrencia, en alto, medio y bajo. Se realiza revisión bibliográfica y casuística para proponer protocolo de manejo quirúrgico en pacientes con cáncer de endometrio. Se definen tres etapas durante el protocolo: clínica, patológica y quirúrgica. Se realizan recomendaciones basados en la vía de abordaje, tipo de histerectomía, lavado peritoneal, linfadenectomía, omentectomía, y cito-reducción. Se plantean situaciones especiales y la importancia del ganglio centinela. La realización de protocolos quirúrgicos para el manejo de carcinoma endometrial permite la unificación de criterios, mejora la evaluación de respuesta rapéutica y facilita revisiones y mejoras a futuro.(AU)

The endometrial carcinoma is the most common neoplasia in the genital tract of women in the western world and is a condition that is increasing in the developing countries. In general, the rognosis of endometrial carcinoma is good, with an overall survival of about 80 %. It can define three groups according to the risk of the recurrence in high, medium and low. The literature review and case mix is performed to propose the surgical management protocol in patients with endometrial cancer. Three stage the clinical, the pathological and the surgical defined for the protocol. The recommendations based on the approach, type of the ysterectomy, te peritoneal washing, the lymphadenectomy, the omentectomy, and the debulking are made. The special situations and the importance of sentinel node arise. Performing the surgical protocol for the management of endometrial carcinoma allows the unification of criteria, the improved therapeutic response assessment and facilitates future revisions and improvements.(AU)

Hazardous drinking and exposure to interpersonal and community violence on both sides of the U.S. -Mexico border.

Objective: Different patterns of heavy drinking occur by country and proximity to the U.S. Mexico border. Few studies describe the impact of violence on drinking between countries and along the border. Methods: Survey data is from U.S. Mexican origin adults living in Texas and Mexican border and non-border cities, N=4,796. Participants were asked about alcohol consumption, interpersonal physical violence (IPV) and exposure to community violence. Monthly hazardous drinking (5+/4+ for men/women) was the primary outcome. Multivariate logistic regression model comparisons identified best predictors. Results: In the U.S. hazardous drinking was associated with past year IPV (ORadj=2.5; 1.8-3.5) and community violence (ORadj=1.4; 1.1-1.8). In Mexico, IPV (ORadj=3.9; 2.0-7.4) and border proximity (ORadj=0.5; 0.4-0.8) were associated with hazardous drinking but not community violence. Conclusion: Hazardous drinking is associated with IPV in both countries, but violence did not explain border hazardous drinking differences where they existed in Mexico.

A meta-analysis of acute use of alcohol and the risk of suicide attempt.

BACKGROUND: No review has used a meta-analytic approach to estimate common odds ratios (ORs) for the effect of acute use of alcohol (AUA) on suicide attempts. We aim to report the results of the first meta-analysis of controlled epidemiological studies on AUA and suicide attempt. METHOD: The English-language literature on Medline, PsycINFO and Google Scholar was searched for original articles and critical review on AUA and suicide attempt (period 1996-2015). Studies had to report an OR estimate for this association. Common ORs and 95% confidence intervals (CIs) from random effects in meta-analyses for any AUA and two levels of alcohol use on suicide attempt were calculated. RESULTS: In all, seven studies provided OR estimates for the likelihood of suicide attempt by AUA, compared with those who did not drink alcohol. Studies used case-control (n 3) and case-crossover designs (n 4). Meta-analysis revealed a common OR of 6.97 (95% CI 4.77-10.17) for any AUA. Using four studies, 'low levels of acute drinking' resulted in an OR of 2.71 (95% CI 1.56-4.71) and 'high levels' had an OR of 37.18 (95% CI 17.38-79.53). CONCLUSIONS: AUA is associated with increased likelihood of a suicide attempt, particularly at high doses. Such data should be incorporated into estimates of the burden of disease associated with alcohol use, which are currently limited by a consideration of only alcohol's chronic effects. Future research should focus on the mechanisms through which AUA confers risk for attempt.

The growth of suicide ideation, plan and attempt among young adults in the Mexico City metropolitan area.

AIMS: Low and middle income countries share a heavy burden of suicide with about three in every four suicides occurring in these countries. Mexico has witnessed a growing trend in suicide deaths; if this trend is not simply a reflection of better reporting of suicide on death certificates, then this increase should logically be accompanied by an increasing trend in suicide ideation, plan and attempts, but we lack information on the trends for suicide ideation, plan and attempt for this period. We therefore aim to report changes for suicidal behaviour for the period 2001-2013 in the Mexico City Metropolitan Area. METHOD: Using two cross-sectional surveys conducted in Mexico in 2001 and 2013, we report the lifetime and 12-month prevalence of suicide ideation, plan and attempt and changes in treatment for these problems among respondents aged 19-26 living in the Mexico City Metropolitan Area 12 years apart. To estimate the changes in prevalence for each outcome, we used generalised linear models to calculate prevalence ratios (PR; the prevalence rate in the exposed (year 2013) divided by the prevalence rate in the unexposed (year 2001-2002), adjusting for sociodemographic variables. RESULTS: While increases in the prevalence are noted everywhere, statistical comparisons only found differences for lifetime ideation (PR = 3.1; 95% CI = 1.7-5.8) and a borderline difference for suicide attempt (PR = 2.2; 95% CI = 1.0-4.9). No attempt within the last 12-months was reported in 2001, but the prevalence in 2013 reached 1.5% (18 cases). While PRs for 12-month prevalence were all above the null, none reached statistically significant differences. During this 12-year period, the distribution of mental disorders and the use of services for mental disorders among suicide ideators, planners and attempters did not change in any noticeable way. CONCLUSIONS: The limitations of our data are the small number of participants in the 2001 survey, the low follow-up rate for the survey in 2013 and that while representative from one city it does not represent the whole country. These findings suggest that suicide ideation and attempt may have increased during this 12-year period in the Mexico City metropolitan area, but this increase did not lead to more use of mental health care services. This information, coupled with the long-term trend of increasing suicide death rates in the country, draw a worrisome and neglected scenario for our youth in this region. Urgent measures, following the recent WHO guidelines for suicide prevention, must not be postponed.

Chemoreflex control of the cardiovascular system remains altered after recovery from low protein diet early in life.

This study aimed to evaluate the cardiovascular component of the arterial chemoreflex in rats recovered from low protein diet. Male Fischer rats were randomly divided into control and recovered (R-PR) groups after weaning. R-PR rats were fed with low protein diet for 35days and recovered under normal protein diet for 70days. Control rats received normal protein diet for 105days. Arterial chemoreflex was elicited by intravenous injection of KCN. Results showed that pressor response of the chemoreflex was increased in R-PR. Data suggest that protein restriction may alter cardiovascular response to chemical activation of the chemoreflex after recovery.

Barriers to mental health treatment: results from the WHO World Mental Health surveys.

BACKGROUND: To examine barriers to initiation and continuation of mental health treatment among individuals with common mental disorders. METHOD: Data were from the World Health Organization (WHO) World Mental Health (WMH) surveys. Representative household samples were interviewed face to face in 24 countries. Reasons to initiate and continue treatment were examined in a subsample (n = 63,678) and analyzed at different levels of clinical severity. RESULTS: Among those with a DSM-IV disorder in the past 12 months, low perceived need was the most common reason for not initiating treatment and more common among moderate and mild than severe cases. Women and younger people with disorders were more likely to recognize a need for treatment. A desire to handle the problem on one's own was the most common barrier among respondents with a disorder who perceived a need for treatment (63.8%). Attitudinal barriers were much more important than structural barriers to both initiating and continuing treatment. However, attitudinal barriers dominated for mild-moderate cases and structural barriers for severe cases. Perceived ineffectiveness of treatment was the most commonly reported reason for treatment drop-out (39.3%), followed by negative experiences with treatment providers (26.9% of respondents with severe disorders). CONCLUSIONS: Low perceived need and attitudinal barriers are the major barriers to seeking and staying in treatment among individuals with common mental disorders worldwide. Apart from targeting structural barriers, mainly in countries with poor resources, increasing population mental health literacy is an important endeavor worldwide.

Effects of surface treatments, thermocycling, and cyclic loading on the bond strength of a resin cement bonded to a lithium disilicate glass ceramic.

SUMMARY Objectives : The aim of this present study was to investigate the effect of two surface treatments, fatigue and thermocycling, on the microtensile bond strength of a newly introduced lithium disilicate glass ceramic (IPS e.max Press, Ivoclar Vivadent) and a dual-cured resin cement. Methods : A total of 18 ceramic blocks (10 mm long × 7 mm wide × 3.0 mm thick) were fabricated and divided into six groups (n=3): groups 1, 2, and 3-air particle abraded for five seconds with 50-µm aluminum oxide particles; groups 4, 5, and 6-acid etched with 10% hydrofluoric acid for 20 seconds. A silane coupling agent was applied onto all specimens and allowed to dry for five seconds, and the ceramic blocks were bonded to a block of composite Tetric N-Ceram (Ivoclar Vivadent) with RelyX ARC (3M ESPE) resin cement and placed under a 500-g static load for two minutes. The cement excess was removed with a disposable microbrush, and four periods of light activation for 40 seconds each were performed at right angles using an LED curing unit (UltraLume LED 5, Ultradent) with a final 40 second light exposure from the top surface. All of the specimens were stored in distilled water at 37°C for 24 hours. Groups 2 and 5 were submitted to 3,000 thermal cycles between 5°C and 55°C, and groups 3 and 6 were submitted to a fatigue test of 100,000 cycles at 2 Hz. Specimens were sectioned perpendicular to the bonding area to obtain beams with a cross-sectional area of 1 mm(2) (30 beams per group) and submitted to a microtensile bond strength test in a testing machine (EZ Test) at a crosshead speed of 0.5 mm/min. Data were submitted to analysis of variance and Tukey post hoc test (p≤0.05). Results : The microtensile bond strength values (MPa) were 26.9 ± 6.9, 22.2 ± 7.8, and 21.2 ± 9.1 for groups 1-3 and 35.0 ± 9.6, 24.3 ± 8.9, and 23.9 ± 6.3 for groups 4-6. For the control group, fatigue testing and thermocycling produced a predominance of adhesive failures. Fatigue and thermocycling significantly decreased the microtensile bond strength for both ceramic surface treatments when compared with the control groups. Etching with 10% hydrofluoric acid significantly increased the microtensile bond strength for the control group.