Special Considerations for Brazilian Transgender Patients in the United States: A Commentary.

Despite facing many social and structural challenges inside and outside of health systems, transgender and gender diverse (TGD) Brazilian immigrants in the U.S. are understudied, and their barriers to care are largely unnamed. In this commentary, we build on existing literature and our experiences at a safety-net community health system that sees a high volume of Brazilian patients to discuss challenges facing TGD Brazilian immigrant populations. We highlight that while Brazilian TGD populations face discrimination in Brazil, major challenges persist upon immigrating to the U.S., and include: difficulty updating identity documents and changing immigration status, barriers seeking general and specialized health care (including finding bilingual and bicultural providers), challenges navigating complex health and insurance systems, and a lack of community supports. We end by recommending more coordinated efforts between health care and community organizations to help ensure the health and wellness of TGD Brazilian immigrants in the United States.

Maternal nutrition and its effects on fetal neurodevelopment.

Herein, we present a thorough examination of the impact of maternal nutrition on fetal and infant neurodevelopment, focusing on specific nutrients and their critical roles in perinatal and pediatric health. Through a comprehensive narrative review of the literature, this study highlights the importance of a balanced maternal diet rich in nutrients like eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), folic acid, iron, and iodine in shaping children's neurological functions. Key findings underscore the influence of maternal nutrition during pregnancy and the peri-gestational period on children's cognitive, motor, speech, and socio-emotional development. Deficiencies in essential nutrients, such as DHA, are linked to adverse long-lasting outcomes such as premature birth and intrauterine growth restriction, where a suitable intake of iron and folic acid is vital to prevent neural tube defects and promote healthy brain development. We highlight areas requiring further investigation, particularly regarding iodine's impact and the risks associated with alcohol consumption during pregnancy. In conclusion, this research sheds light on our current understanding of maternal nutrition and child neurodevelopment, offering valuable insights for health professionals and researchers.

Advancements in addressing drug dependence: A review of promising therapeutic strategies and interventions.

Substance dependence represents a pervasive global concern within the realm of public health. Presently, it is delineated as a persistent and recurrent neurological disorder stemming from drug-triggered neuroadaptations in the brain's reward circuitry. Despite the availability of various therapeutic modalities, there has been a steady escalation in the mortality rate attributed to drug overdoses. Substantial endeavors have been directed towards the exploration of innovative interventions aimed at mitigating cravings and drug-induced repetitive behaviors. Within this review, we encapsulate the most auspicious contemporary treatment methodologies, accentuating meta-analyses of efficacious pharmacological and non-pharmacological approaches: including gabapentin, topiramate, prazosin, physical exercise regimens, and cerebral stimulation techniques.

Repercussions of the COVID-19 pandemic on the HIV care continuum and related factors in economically disadvantaged nations: an integrated analysis using mixed-methods systematic review.

BACKGROUND: The COVID-19 pandemic affected the self-management and care of people living with HIV, requiring adaptations in the way health services are provided. However, it is unclear how these changes impacted HIV care in low-income countries. METHODS: A systematic review including the current evidence related to changes in HIV care continuum during COVID-19 was conducted through a systematic search in the online databases including CINAHL, OVID-Medline, CAB Direct, and OVID-Embase. A two-step screening process was carried out to include eligible papers and reports according to inclusion criteria. RESULTS: From the searches we identified 21 total studies published between 2021 and 2024, the studies revealed mostly negative impacts on all stages of the HIV care continuum in low-income countries. There were impacts related to the blocking measures due to COVID-19, fear of contracting the disease, difficulties in providing resources such as income, food and transports, reductions in the provision of care from prevention to viral suppression. CONCLUSION: Overall, researchers identified several negative impacts of COVID-19 restrictions on HIV care continuum during pandemic; however, some observations indicated indirect positive impacts on some aspects of HIV care. Decline in HIV care practices during pandemic compared to before pandemic were observed including using preventative methods, counseling and testing, receiving HIV healthcare services, HIV medical appointments, antiretroviral adherence, engagement with treatment, and poor viral suppression. However, in some evidence improvement in ART adherence and PrEP use were observed.

Juvenile language disorders and their interaction with dentistry: a bibliometric analysis.

Language disorders may interfere with social integration and affectpersonal development. Beca-use the balance of the stomatognathic system can interfere with language, it is important for speech therapy and dentistry to work together, providing multidisciplinar y Healthcare. AIM: To analyze the 100 most frequently cited articles on language disorders in children and adolescents and assess the interplay with dentistry by means of a bibliometric analysis. MATERIALS AND METHOD: A search of the 100 most frequently cited articles up to December 2021 on language disorders was performed in the Web of Science Core Collection database. Four researchers extracted the data on number of citations, title, authors, country, year of publication, journals, study design, prevalent clinical conditions, and area of expertise. The analyses were performed using VOSviewer and Excel. RESULTS: The total number of citations ranged from 251 to 1,431. Four articles were cited more than 1,000 times. Bishop DVM (10 articles; 3,653 citations) and Tomblin JD (10 articles; 4,261 citations) were the most frequently cited authors. The institutions with the largest number of publications were the University of Oxford/England (11%) and the University of Kansas/USA (8%). Observational study design was the most frequent (77%). Autism spectrum disorder (18%) and dyslexia (14%) were the most broadly investigated clinical conditions. Speech-language pathology (32%) was the area of expertise with the largest number of articles, and none of the top 100 studies showed interplay with dentistry. CONCLUSION: The 100 most widely cited articles on language disorders are mostly observational, mainly address autism spectrum disorder, and are in the field of speech-language pathology No study reported interplay with dentistry.

Os disturbios de linguagem podem interferir na integrando social e afetar o desenvolvimento dos individuos. O trabalho multidisciplinar entre fonoaudiologia e odontologia é muito importante para a promogdo da saúde. O equilibrio do sistema estomatognático interfere na linguagem. OBJETIVO: Analisar os100 artigos mais citados sobre distúrbios de linguagem em criannas e adolescentes e verificar a interando com a odontologia por meio de análise bibliométrica. MATERIAL E MÉTODO: Foi realizada uma busca pelos 100 artigos mais citados sobre distúrbios de linguagem na base de dados Web of Science Core Collection até dezembro de 2021. Quatro pesquisadores extrairam os dados referentes a número de citanoes, titulo, autores, país, ano de publicando, periódicos, desenho de estudo, condinoes clínicas prevalentes e área de especializando. As análises foram realizadas utilizando VOSviewer e Excel. RESULTADOS: O número total de citanoes variou de 251 a 1.431. Quatro artigos foram citados mais de 1.000 vezes. Bishop DVM (10 artigos; 3.653 citanoes) e Tomblin JD (10 artigos; 4.261 citanoes) foram os autores mais frequentemente citados. As instituinoes com maior número de publicanoes foram a Universidade de Oxford/Inglaterra (11%) e a Universidade de Kansas/EUA (8%). O desenho de estudo observacional foi o mais frequente (77%). O transtorno do espectro autista (18%) e a dislexia (14%) foram as condinoes clínicas mais amplamente investigadas. A Fonoaudiologia (32%) foi a área de atuando com maior número de artigos e nenhum estudo, entre os top100, mostrou interando com a Odontologia. CONCLUSÃO: Os 100 artigos mais citados sobre distúrbios de linguagem sdo em sua maioria observacionais, abordam principalmente transtornos do espectro do autismo e estdo na área de fonoaudiologia. Nenhum estudo apresentou interando com a odontologia.

Anti-Obesity Therapeutic Targets Studied In Silico and In Vivo: A Systematic Review.

In the age of information technology and the additional computational search tools and software available, this systematic review aimed to identify potential therapeutic targets for obesity, evaluated in silico and subsequently validated in vivo. The systematic review was initially guided by the research question "What therapeutic targets have been used in in silico analysis for the treatment of obesity?" and structured based on the acronym PECo (P, problem; E, exposure; Co, context). The systematic review protocol was formulated and registered in PROSPERO (CRD42022353808) in accordance with the Preferred Reporting Items Checklist for Systematic Review and Meta-Analysis Protocols (PRISMA-P), and the PRISMA was followed for the systematic review. The studies were selected according to the eligibility criteria, aligned with PECo, in the following databases: PubMed, ScienceDirect, Scopus, Web of Science, BVS, and EMBASE. The search strategy yielded 1142 articles, from which, based on the evaluation criteria, 12 were included in the systematic review. Only seven these articles allowed the identification of both in silico and in vivo reassessed therapeutic targets. Among these targets, five were exclusively experimental, one was exclusively theoretical, and one of the targets presented an experimental portion and a portion obtained by modeling. The predominant methodology used was molecular docking and the most studied target was Human Pancreatic Lipase (HPL) (n = 4). The lack of methodological details resulted in more than 50% of the papers being categorized with an "unclear risk of bias" across eight out of the eleven evaluated criteria. From the current systematic review, it seems evident that integrating in silico methodologies into studies of potential drug targets for the exploration of new therapeutic agents provides an important tool, given the ongoing challenges in controlling obesity.

Early Childhood Caries and Its Consequences Impact Sleep in Preschool Children.

Purpose: To assess the impact of early childhood caries (ECC) and its clinical conse- quences on preschool children's sleep, as reported by caregivers. Methods: A representative cross-sectional study was carried out with preschoolers aged four to six years in Brazil. Caregivers responded to the Brazilian version of the Early Childhood Oral Health Impact Scale and a specific question from this questionnaire was used to determine sleep-related quality of life: "Has your child had trouble sleeping because of dental problems or dental treatments?" Additionally, a self-administered questionnaire with socioeconomic questions was used. Clinical examinations were performed by two calibrated dentists to diagnose dental caries (International Caries Detection and Assessment System -epi) and its clinical consequences (pulpal involvement, tissue ulceration, fistula and abscesses [pufa] index). Adjusted and unadjusted Poisson regression was used for data analysis (P<0.05). Results: The sample consisted of 533 preschoolers, with 259 girls (51.4 percent) (n=259). The mean age of preschoolers was 4.78±0.6 (standard deviation) years. One-third (n=176) exhibited extensive carious lesions, and 14.1 percent (n=75) had clinical consequences of ECC. Conclusion: Children with clinical consequences of ECC were approximately 3.04 times more likely to have difficulty sleeping than children without them (95 percent confidence interval=1.75 to 5.25). The clinical consequences of ECC were significantly associated with difficulty sleeping among preschool children.

The Impact of the COVID-19 Pandemic on Food Access: Insights from First-Person Accounts in a Safety-Net Health Care System.

The COVID-19 pandemic disproportionately affected populations that were already facing socioeconomic disadvantages and limited access to health care services. The livelihood of millions was further compromised when strict shelter-in-place measures forced them out of their jobs. The way that individuals accessed food during the early stages of the COVID-19 pandemic drastically changed as a result of declines in household income, food chain supply disruptions, and social distance measures. This qualitative study examined the food access experiences of participants enrolled in a safety-net health care system-based, free, monthly fruit and vegetable market in the Metro Boston area during the first six months of the COVID-19 pandemic. The findings offer rich qualitative information to understand the financial repercussions of the pandemic on food access.

Therapeutic potential of psychedelics: History, advancements, and unexplored frontiers.

Psychedelics (serotonergic hallucinogens) are psychoactive substances that can alter perception and mood, and affect cognitive functions. These substances activate 5-HT2A receptors and may exert therapeutic effects. Some of the disorders for which psychedelic-assisted therapy have been studied include depression, addiction, anxiety and post-traumatic stress disorder. Despite the increasing number of studies reporting clinical effectiveness, with fewer negative symptoms and, additionally, minimal side effects, questions remain to be explored in the field of psychedelic medicine. Although progress has been achieved, there is still little understanding of the relationship among human brain and the modulation induced by these drugs. The present article aimed to describe, review and highlight the most promising findings in the literature regarding the (putative) therapeutic effects of psychedelics.

Passive smoking and early childhood caries: when adult addiction affects children's oral health.

DATA SOURCES: Medline via EBSCOhost, PubMed, and Scopus up to February 2023. STUDY SELECTION: Observational studies in the English language published in peer-reviewed journals, encompassing children aged 0 to 6 years exposed to environmental tobacco smoke and passive smoking, with a focus on oral health conditions in deciduous dentition. DATA EXTRACTION AND SYNTHESIS: Data were extracted from 25 papers, encompassing study details, oral health, and smoking exposure. Confounding factors such as parental education, income, diet, fluoride exposure, gender, and oral hygiene practices were also identified. The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). Frequency effect size was calculated for health variables and smoking exposure. RESULTS: Most studies identified a correlation between passive smoking and an increased prevalence of dental caries. Environmental tobacco smoke exposure and dental caries risk were influenced by factors such as low parental education, socioeconomic status, dietary habits, oral hygiene, and gender. CONCLUSIONS: The results of this systematic review strongly indicate a significant association between dental caries in deciduous dentition and passive smoking.

Interest of dental professionals and students in a mobile app for calculating dosages of medicines for use in pediatric dentistry / 9Arq Odontol, Belo Horizonte, 60: e01, 2024Interest of dental professionals and students in a mobile app10.35699/2178-1990.2024.48577Interesse de profissionais e estudantes de odontologia em um aplicativo móvel para cálculo de dosagens de medicamentos para uso em odontopediatria

Aim: This study aimed to assess the interest of dental students, clinicians and professors in a mobile app for calculating dosages of medicines for use in Pediatric Dentistry. Methods: The cross-sectional survey involved a random sample of undergraduate and postgraduate pediatric dental students, clinical pediatric dentists and professors. Initially, participants watched a video about an early version of the app. They then answered a questionnaire about their clinical experience, calculation routine, and interest in the app. Descriptive analyses were carried out. Results: Of the 41 participants (20 students, 10 clinicians and 11 professors), 87.8% recognized the need to adjust doses of medicines used in pediatric dentistry, but only 56.1% felt confident in doing so. Almost a fifth of participants (19.5%) admitted errors in prescribing medicines for pediatric dental patients. After seeing the app's functionalities, 92.7% considered it relevant, and 87.8% were interested in the full version. Conclusion: The app is deemed relevant, necessary, and of significant interest to the target audience, indicating potential for investment and full development.

Objetivo:Este estudo buscou avaliar o interesse de estudantes de odontologia, clínicos e professores em um aplicativo móvel para calcular dosagens de medicamentos para uso em Odontopediatria. Métodos: A pesquisa transversal envolveu uma amostra aleatória de estudantes de odontologia pediátrica de graduação e pós-graduação, odontopediatras clínicos e professores. Inicialmente, os participantes assistiram a um vídeo sobre uma versão inicial do aplicativo. Em seguida, eles responderam a um questionário sobre sua experiência clínica, rotina de cálculos e interesse no aplicativo. Análises descritivas foram realizadas. Resultados:Dos 41 participantes (20 estudantes, 10 clínicos e 11 professores), 87,8% reconheceram a necessidade de ajustar as doses de medicamentos usados em Odontopediatria, mas apenas 56,1% se sentiam confiantes para fazê-lo. Quase um quinto dos participantes (19,5%) admitiu erros na prescrição de medicamentos para pacientes odontopediátricos. Após verem as funcionalidades do aplicativo, 92,7% o consideraram relevante, e 87,8% demonstraram interesse na versão completa. Conclusão: A conclusão é que o aplicativo é relevante, necessário e de interesse para o público-alvo, indicando potencial para investimento e desenvolvimento completo.

The relationship between the clinical severity of chronic venous insufficiency and the calf muscle pump: A cross-sectional study.

PURPOSE: To investigate the connection between the clinical severity of chronic venous insufficiency (CVI) and the biomechanics of the calf muscle pump (CMP). MATERIAL AND METHODS: Through a cross-sectional observational study, we analyzed women on the age range between 30 and 80 years with chronic venous insufficiency, stratified according to the clinical classification. Ninety-nine women were assessed and classified into groups with different levels of severity: C1 (n = 22); C2 (n = 22); C3 (n = 22); C4 (n = 22); C5 (n = 8); C6 (n = 3). The main purpose was to investigate the strength of the calf muscle pump through total work (TW) and peak torque (PT), and the range of motion (ROM) of the ankle joint. For a secondary analysis, the fatigue index was assessed. All results were run through the Humac®/NORMT isokinetic dynamometer to obtain the data. RESULTS: Our findings pointed out that as the clinical severity of CVI increases, there is a reduction on the PT, the TW, the maximum active ROM and the ROM at 120°/sec. As severity increased, there was a reduction of 24Nm in the TW at 30°/sec.and a reduction of 3Nm in the PT at 30°/sec. OUTCOMES: When increased, clinical severity of CVI may trigger downgrading in the strength of the CMP and the ROM in the ankle. These findings are of relevance to the clinician, since through these findings, individuals with venous insufficiency may be treated more precisely for each classification.

Corrigendum to "Metabolic dysfunctions promoted by AIN-93G standard diet compared with three obesity-inducing diets in C57BL/6J mice" [Curr. Res. Physiol. (2022) 436-444].

[This corrects the article DOI: 10.1016/j.crphys.2022.11.001.].

Assessment of acute toxicity of crude extract rich in carotenoids from Cantaloupe melon (Cucumis melo L.) and the gelatin-based nanoparticles using the zebrafish (Danio rerio) model.

Cantaloupe melon is known for its carotenoid-rich orange pulp. However, carotenoids are sensitive to oxygen, light, and heat, potentially reducing their benefits. Nanoencapsulation can preserve these benefits but raises concerns about toxicity. We aimed to assess the safety and bioactive potential of crude extract-rich carotenoids (CE) and nanoparticles based on gelatin loaded with CE (EPG) by investigating parameters such as cardio or neurotoxicity, especially acute toxicity. EPG was obtained by O/W emulsification and characterized by different methods. Zebrafish embryos were exposed to CE and EPG at 12.5 mg/L and 50 mg/L for 96h and were investigated for survival, hatching, malformations, and seven days post fertilization (dpf) larvae's visual motor response. Adult fish underwent behavioral tests after acute exposure of 96h. CE and EPG showed no acute toxicity in zebrafish embryos, and both improved the visual motor response in 7dpf larvae (p = 0.01), suggesting the potential antioxidant and provitamin A effect of carotenoids in cognitive function and response in the evaluated model. Adult fish behavior remained with no signs of anxiety, stress, swimming pattern changes, or sociability that would indicate toxicity. This study highlights the safety and potential benefits of carotenoids in zebrafish. Further research is needed to explore underlying mechanisms and long-term effects.

Effect of oral exposure on chemical, physical, mechanical, and morphologic properties of clear orthodontic aligners

The dental industry is heavily committed to developing more esthetic solutions for orthodontic treatments. Invisalign is a system of transparent orthodontic aligners introduced as an alternative to conventional orthodontic fittings with brackets and metal wires. This study aimed to assess the chemical, physical, mechanical and morphologic changes in these polymeric aligners after exposure to the oral environment. Twenty-four Invisalign orthodontic aligners were equally divided into 2 groups: an in vivo aged group in which patients used aligners for 14 days and the reference group, unexposed to the oral environment. Different experimental techniques were used to study the chemical structure, the color changes and translucency, the density and subsequent volume of the aligners, mechanical properties, surface roughness, morphology and elemental composition. The data were subjected to several statistical analyses. Clear orthodontic aligners exhibit chemical stability but undergo a statistically significant optical change in color and translucency. There was a gradual increase in the water absorption rate and the dimensional variation of the polymer, indicating a strong correlation among these factors. The mechanical properties of the polymer showed a statistically significant decrease in its elastic modulus and hardness. There was a slight tendency toward increased surface roughness of the material, but no statistical differences were found between reference and aged groups. The surface morphology of the used aligners demonstrates microcracks, distortions and biofilm formation. Intraoral aging adversely affected the physical, mechanical, and morphologic properties of the Invisalign appliance.

Which dental and psychosocial factors may predict bullying occurrence in adolescence?

DESIGN: Cohort study. STUDY POPULATION: 639 preschool children at baseline (T1) and 429 adolescents at follow-up (T2). OUTCOME MEASURES: Oral health conditions (untreated dental caries, dental trauma and malocclusion, sense of coherence (SOC), self-perception of dental treatment needs, general and dental bullying. DATA ANALYSIS: Chi-square test, t-test, structural equation modeling, goodness of fit. RESULTS: Untreated dental caries and low socioeconomic status impacted the occurrence of both general and dental bullying. SOC and self-perceived dental treatment need were also important factors in the occurrence of bullying. CONCLUSIONS: The oral health condition that most impacted bullying episodes both directly and indirectly was untreated dental caries. Socioeconomic status was also an important cumulative predictor of the occurrence of episodes of bullying.

Effect of oral exposure on chemical, physical, mechanical, and morphologic properties of clear orthodontic aligners.

INTRODUCTION: The dental industry is heavily committed to developing more esthetic solutions for orthodontic treatments. Invisalign is a system of transparent orthodontic aligners introduced as an alternative to conventional orthodontic fittings with brackets and metal wires. This study aimed to assess the chemical, physical, mechanical and morphologic changes in these polymeric aligners after exposure to the oral environment. METHODS: Twenty-four Invisalign orthodontic aligners were equally divided into 2 groups: an in vivo aged group in which patients used aligners for 14 days and the reference group, unexposed to the oral environment. Different experimental techniques were used to study the chemical structure, the color changes and translucency, the density and subsequent volume of the aligners, mechanical properties, surface roughness, morphology and elemental composition. The data were subjected to several statistical analyses. RESULTS: Clear orthodontic aligners exhibit chemical stability but undergo a statistically significant optical change in color and translucency. There was a gradual increase in the water absorption rate and the dimensional variation of the polymer, indicating a strong correlation among these factors. The mechanical properties of the polymer showed a statistically significant decrease in its elastic modulus and hardness. There was a slight tendency toward increased surface roughness of the material, but no statistical differences were found between reference and aged groups. The surface morphology of the used aligners demonstrates microcracks, distortions and biofilm formation. CONCLUSION: Intraoral aging adversely affected the physical, mechanical, and morphologic properties of the Invisalign appliance.

Interactive gerontechnology for fall prevention in the elderly: a descriptive study.

OBJECTIVES: to develop interactive gerontechnology for the prevention of falls in the elderly at home. METHODS: an exploratory and descriptive study that consisted of gerontechnology development and evaluation by experts and the target audience. For evaluation, researchers used the Agreement Index (AI), considering values greater than 80%. RESULTS: the three-dimensional virtual scale model was elaborated through the SketchUp program, with the distribution of rooms and floors, constituting Prototype 1 (P1). Fifty-four judges evaluated the P1, and all presented agreement above the established, with a minimum AI of 88% and a maximum of 100%, producing Prototype 2 (P2). Thirty elderly participants from a philanthropic institution evaluated Prototype 2. On all items, AI ranged from 83% a 100%, resulting in the final version. CONCLUSIONS: the product of this research reveals itself as an innovative and scientifically based tool aimed at preventing falls in the elderly.

Retention in fissure resin-based sealants in schoolchildren: the etching step importance.

DESIGN: Randomized controlled trial. STUDY POPULATION: Forty-seven schoolchildren aged 9-10 years with fully sound/noncavitated erupted first permanent molars were included and randomly allocated in control and experimental groups in a split-mouth design. CASES: 47 schoolchildren (94 molars) fissure sealants applied using self-etch universal adhesive system. CONTROLS: 47 schoolchildren (94 molars) fissure sealants applied using conventional acid-etching technique. OUTCOME MEASURE: Retention of sealants and secondary caries incidence (ICDAS). DATA ANALYSIS: Chi-square test. RESULTS: Conventional acid-etch sealants retention was superior to self-etch after 6 and 24 months (p < 0.001), but no differences were found in caries incidence after 6 and 24 months (p > 0.05). CONCLUSIONS: Clinical retention of fissure sealants using conventional acid-etch technique is greater than self-etch.