Self-Nanoemulsifying Drug Delivery System (SNEDDS) Using Lipophilic Extract of Viscum album subsp. austriacum (Wiesb.) Vollm.

Background and Purpose: Natural products are potential sources of anticancer components. Among various species, the lipophilic extract of the Viscum album subsp. austriacum (Wiesb.) Vollm. (VALE) has shown promising therapeutic potential. The present work aimed to qualify the plant source and characterize the extract's chemical profile. In addition, a self-nanoemulsifying drug delivery system (SNEDDS) containing VALE (SNEDDS-VALE) was developed. Methods: V. album subsp. austriacum histochemistry was performed, and the chemical profile of VALE was analyzed by GC-MS. After the SNEEDS-VALE development, its morphology was visualized by transmission electron microscopy (TEM), while its stability was evaluated by the average droplet size, polydispersity index (PdI) and pH. Lastly, SNEDDS-VALE chemical stability was evaluated by LC-DAD-MS. Results: The histochemical analysis showed the presence of lipophilic compounds in the leaves and stems. The major compound in the VALE was oleanolic acid, followed by lupeol acetate and ursolic acid. SNEDDS was composed of medium chain triglyceride and Kolliphor® RH 40 (PEG-40 hydrogenated castor oil). A homogeneous, isotropic and stable nanoemulsion was obtained, with an average size of 36.87 ± 1.04 nm and PdI of 0.14 ± 0.02, for 14 weeks. Conclusion: This is the first histochemistry analysis of V. album subsp. austriacum growing on Pinus sylvestris L. which provided detailed information regarding its lipophilic compounds. A homogeneous, isotropic and stable SNEDDS-VALE was obtained to improve the low water solubility of VALE. Further, in vitro and in vivo experiments should be performed, in order to evaluate the antitumoral potential of SNEDDS-VALE.

Umbelliferone reduces inflammation and ligature-induced osteoclastic alveolar bone resorption in mice.

AIMS: This study aimed to investigate the effects of Umbelliferone (UMB) on the inflammation underlying alveolar bone resorption in mouse periodontitis. METHODS: Male Swiss mice subjected to a ligature of molars were grouped as non-treated (NT), received UMB (15, 45, or 135 mg/kg) or saline daily for 7 days, respectively, and were compared with naïve mice as control. Gingival tissues were evaluated by myeloperoxidase (MPO) activity and interleukin-1ß level by ELISA. The bone resorption was directly assessed on the region between the cement-enamel junction and the alveolar bone crest. Microscopically, histomorphometry of the furcation region, immunofluorescence for nuclear factor-kappa B (NF-ĸB), and immunohistochemistry for tartrate-resistant acid phosphatase (TRAP), and cathepsin K (CTSK) were performed. Systemically, body mass variation and leukogram were analyzed. RESULTS: Periodontitis significantly increased MPO activity, interleukin-1ß level, and NF-ĸB+ immunofluorescence, and induced severe alveolar bone and furcation resorptions, besides increased TRAP+ and CTSK+ cells compared with naïve. UMB significantly prevented the inflammation by reducing MPO activity, interleukin-1ß level, and NF-ĸB+ intensity, besides reduction of resorption of alveolar bone and furcation area, and TRAP+ and CTSK+ cells compared with the NT group. Periodontitis or UMB treatment did not affect the animals systemically. CONCLUSION: UMB improved periodontitis by reducing inflammation and bone markers.

Suicide prevention in a virtual environment: a roadmap for simulation-based education.

OBJECTIVE: to build and validate a simulation-based education roadmap on suicide prevention in the virtual environment. METHOD: methodological research subdivided into a development and validation stage. The roadmap was built using a previously drafted template based on international guidelines on good clinical simulation practices and scientific literature on suicide prevention in the virtual environment. For validation, the roadmap was validated by experts through self-application of an assessment form with answers based on "adequate, fair, and inadequate", with a field for suggestions. Descriptive statistics and the Content Validity Index (CVI≥0.8) were used. RESULTS: nine experts took part in the study, the majority of whom were nurses (66.7%), female (55.6%), with an average age of 42.22 years. All the items in the roadmap met the acceptance criteria (CVI≥0.8). CONCLUSION: this study provides a useful roadmap for teaching suicide prevention in the virtual environment. BACKGROUND: (1) Innovative study on suicide prevention, simulated teaching, and the virtual environment. (2) Script validated by experts and available in full for simulated teaching. (3) Introduction of a prototype of a fictional virtual social network for simulated practice. (4) Results indicated the appropriateness of the construction, with good agreement in the analyses. (5) The script enhances professional training and development in the mental health context.

Neurofilament light chain as a biomarker for acute hepatic porphyrias.

Background: Acute hepatic porphyrias (AHP) represent a rare group of inherited metabolic disorders of heme biosynthesis pathway. This study aims to determine the diagnostic and prognostic value of serum neurofilament light chain (NfL) as potential biomarker for AHP. Methods: We conducted a cross-sectional observational study to evaluate NfL levels in patients with AHP. They were divided in different groups: normal health individuals; patients with definitive diagnosis of AHP during acute episodes; patients with AHP and infrequent attacks; patients with AHP and recurrent attacks; asymptomatic individuals with positive genetic testing and urinary delta-aminolevulinic acid (ALA) and porphobilinogen (PBG) levels elevated 4 or more times ("high excretors"); asymptomatic individuals with exclusive positive genetic test; control group with Hereditary Amyloidosis related to Transthyretin with Polyneuropathy (ATTRv-PN). Results: During acute attacks, serum NfL levels were 68 times higher compared to normal controls and disclosed a strong correlation with ALA and PBG levels; also exhibited elevated levels in patients with chronic symptoms regardless of the number of disease attacks compared to healthy controls, and at similar levels to patients with ATTRv-PN, which is a model of progressive neuropathy. Conclusion: This study represents the first to establish NfL as a biomarker for AHP, disclosing NfL as a sensitive biomarker for axonal damage and chronic symptom occurrence. This study not only underscores that neurological damage associated with the disease in any patient, irrespective of the number of attacks, but also reinforces the progressive and profoundly debilitating nature of acute and chronic symptoms observed in individuals with AHP.

A 12-Week Ballroom Dance Training Improves Physical Fitness Performance More Than Walking Training in Older Women, Regardless of Vitamin B12 or D Adequacy.

AIM: This study aimed to compare the effects of Ballroom Dancing (BD) versus Walking Training (WT) on the physical fitness performance in physically independent older women with adequate or inadequate levels of vitamins B12 and D. METHODS: Forty-three sedentary women aged 68.5 ± 6.5 years, were allocated to the BD (n = 23) or WT (n = 20) groups. They took part in a 12-week intervention, performed 3 times a week, for about 50 minutes with moderate effort intensity. Data were collected through Short Physical Performance Battery (SPPB), 6 minutes Walk Test (6MWT), Hand Grip Test (HGT), Isokinetic tests for lower limbs and blood tests to detect serum levels of vitamins B12 and D. RESULTS: The BD group performed better after the intervention in relation to the WT in the Sit and Stand Test (SST) (BD pre = 3.1 score vs post = 3.8 score; WT pre = 2.8 score vs post = 3.4 score; P = .02) and in the Peak Torque 180° extension (PKTOQ 180° extension) (BD pre = 56.7 Nm vs post = 61.2 Nm, WT pre = 56.7 Nm vs post = 56.1; P < .01). CONCLUSION: A time effect was observed in all other variables, with the exception of HGT. Both interventions improved physical fitness performance, regardless of the adequacy of vitamins B12 and D, but the older women from BD obtained significant improvements in more variables than the WT.

Clinical and Genetic Aspects of Juvenile Amyotrophic Lateral Sclerosis: A Promising Era Emerges.

Juvenile Amyotrophic Lateral Sclerosis is a genetically heterogeneous neurodegenerative disorder, which is frequently misdiagnosed due to low clinical suspicion and little knowledge about disease characteristics. More than 20 different genetic loci have been associated with both sporadic and familial juvenile Amyotrophic Lateral Sclerosis. Currently, almost 40% of cases have an identifiable monogenic basis; type 6, associated with FUS gene variants, is the most prevalent globally. Despite several upper motor neuron-dominant forms being generally associated with long-standing motor symptoms and slowly progressive course, certain subtypes with lower motor neuron-dominant features and early bulbar compromise lead to rapidly progressive motor handicap. For some monogenic forms, there is a well-established genotypic-phenotypic correlation. There are no specific biochemical and neuroimaging biomarkers for the diagnosis of juvenile Amyotrophic Lateral Sclerosis. There are several inherited neurodegenerative and neurometabolic disorders which can lead to the signs of motor neuron impairment. This review emphasizes the importance of high clinical suspicion, assessment, and proper diagnostic work-up for juvenile Amyotrophic Lateral Sclerosis.

The use of panoramic radiographs to address the oral health needs of vulnerable Canadian populations.

Background: The high demand for oral health care services among vulnerable individuals combined with limited available resources requires a rethinking of the provision of oral health services. This study aimed to determine the usefulness of the dental panoramic radiograph (DPR) as an imaging tool to assess oral health and prioritize dental interventions in vulnerable patients. Methods: This observational and retrospective study evaluated charts of patients who attended Public Health Dental Clinics (PHDC), Alberta Health Services (AHS), in Calgary, Canada, between January 2018 and December 2019. Data collected included sex and age at the time of image acquisition. The following radiographic findings were gathered: the number of missing, present, decayed, restored, and impacted teeth; periapical lesions; retained root; periodontal bone loss; odontogenic and non-odontogenic lesions in the jaws; carotid calcification; and incidental radiographic findings with clinical relevance. Results: Of the 526 DPRs evaluated, 57.4% were from male patients and 42.6% were from female patients, with a mean age of 38.5 years. The average number of present teeth in females and males was 23.7 and 22.6, respectively. The most prevalent dental-related finding was periodontal bone loss (81.5%), followed by periapical lesions (59.6%) and impacted teeth (27%). Among non-dental findings, osseous lesions of the jaws were found in 10.4% of the patients, and carotid atheroma had a frequency of 3.2%. Conclusion: The DPR is a useful adjunct to the clinical exam in this specific population. It provides an opportunistic overview of their oral health and necessary support to establish priorities in oral health care in a public health setting.

Contexte : La forte demande de services de santé buccodentaire chez les personnes vulnérables, combinée aux ressources limitées disponibles, nécessite de repenser la prestation des services de santé buccodentaire. Cette étude vise à déterminer l'utilité de la radiographie panoramique comme outil d'imagerie pour évaluer la santé buccodentaire et prioriser les interventions dentaires chez les patients vulnérables. Méthodes : Cette étude observationnelle et rétrospective a évalué les dossiers des patients qui ont fréquenté les cliniques dentaires de santé publique d'Alberta Health Services (AHS) à Calgary, au Canada, entre janvier 2018 et décembre 2019. Les données recueillies comprenaient le sexe et l'âge au moment de l'acquisition de l'image. Les résultats radiographiques suivants ont été recueillis : nombre de dents manquantes, présentes, cariées, réparées et incluses; lésions périapicales; racine résiduelle; perte osseuse parodontale; lésions odontogéniques et non odontogéniques dans les mâchoires; calcification carotidienne; et résultats radiographiques accessoires pertinents sur le plan clinique. Résultats : Parmi les 526 radiographies panoramiques évaluées, 57,4 % provenaient d'hommes et 42,6 % de femmes, avec un âge moyen de 38,5 ans. Le nombre moyen de dents présentes chez les femmes et les hommes était de 23,7 et 22,6, respectivement. La découverte la plus courante liée aux soins dentaires était la perte osseuse parodontale (81,5 %), suivie des lésions périapicales (59,6 %) et des dents incluses (27 %). En ce qui concerne les résultats non liés aux soins dentaires, des lésions osseuses des mâchoires ont été repérées chez 10,4 % des patients, et l'athérome carotidien avait une fréquence de 3,2 %. Conclusion : La radiographie panoramique est un complément utile à l'examen clinique dans cette population particulière. Elle donne un aperçu de leur santé buccodentaire et le soutien nécessaire pour établir les priorités en matière de soins buccodentaires dans un contexte de santé publique.

Analyzing 14-years of suicide rates in Chile: Impact of alcohol policy, domestic violence, and a suicide prevention program.

Suicide is a major public health problem worldwide with far-reaching effects on families, communities, and societies. Influencing factors range from macro-level interventions like alcohol control policies and suicide prevention programs to individual contributors such as alcohol abuse and domestic violence. This study aimed to examine the relationship between Chile's suicide rate changes from 2002 to 2015 and the Alcohol Act of 2004, a national suicide prevention program implemented in 2007, alcohol abuse, and domestic violence. Assembling a unique longitudinal dataset from Chilean public institutions, the study employed an instrumental variable time-series cross-regional design. Results indicated that the Alcohol Act was not associated with suicide rates, domestic violence exhibited a significant association with increased suicide rates, and the national suicide prevention program was linked to reductions in suicide rates, especially among males. These findings align with research from neighbouring countries, showcasing the efficacy of suicide prevention programs in decreasing suicide rates in Chile. Results highlight the importance of integrating protocols to early-detect domestic violence in suicide prevention programs, as well as the need to further improving alcohol control policies to complement suicide prevention programs.

The effect of the dental follicle volume of palatally impacted canines on the relative position of the adjacent teeth.

OBJECTIVE: To assess if the dental follicle volume of palatally impacted canines (PICs) affects the relative root position of the adjacent lateral incisors (LIs) and first premolars (FPs). MATERIALS AND METHODS: A retrospective cross-sectional study of 49 patients with unilaterally PICs with dental follicles who had CBCT imaging previously taken. Four orthodontic centers in different countries provided the sample. A mean difference of 5° between the angular measurements (mesiodistal tip, buccolingual inclination, or mesiodistal rotation) of the LI and FP adjacent to the PIC and the controls was considered clinically relevant. A value of 0.05 was set for significance level and a power of 80%. The minimum sample size was determined to be 26 patients. These patients were further assigned to an LI sample (n = 49) and an FP sample (n = 23), dependent on the direct contact of the dental follicle to that adjacent tooth. A manual segmentation technique was used to obtain the volumetric measurements of the dental follicle. Angular measurements of adjacent teeth were then compared to the contralateral nonimpacted side, which acted as the control. A multivariant regression analysis was performed using IBM SPSS software, and statistical significance was set at α = 0.05. RESULTS: Adequate intra-rater reliability was accomplished. The multivariant regression analysis implied that there is no difference in the mean change in the tip, torque, and rotation of the LI and FP between the impacted and control sides when dental follicle volumes are considered (P = .509 for the LI sample and P = .804 for the FP sample). LIMITATIONS: CBCT imaging of dental follicle border delimitations, partial volume effect, and scattering are limitations. This is a convenience sample where the FP subsample is small. CONCLUSION: The dental follicle volume of the PICs does not seem to influence the relative position of the adjacent LI and FP mesiodistal tip, buccolingual inclination, and mesiodistal rotation. Early intervention could have been suggested to avoid certain malocclusion traits if significant displacements were demonstrated.

Suicide prevention in a virtual environment: a roadmap for simulation-based education / Prevención del suicidio en un entorno virtual: guion para la enseñanza basada en una simulación / Prevenção do suicídio em ambiente virtual: roteiro para ensino baseado em simulação

Objective: to build and validate a simulation-based education roadmap on suicide prevention in the virtual environment. Method: methodological research subdivided into a development and validation stage. The roadmap was built using a previously drafted template based on international guidelines on good clinical simulation practices and scientific literature on suicide prevention in the virtual environment. For validation, the roadmap was validated by experts through self-application of an assessment form with answers based on "adequate, fair, and inadequate", with a field for suggestions. Descriptive statistics and the Content Validity Index (CVI≥0.8) were used. Results: nine experts took part in the study, the majority of whom were nurses (66.7%), female (55.6%), with an average age of 42.22 years. All the items in the roadmap met the acceptance criteria (CVI≥0.8). Conclusion: this study provides a useful roadmap for teaching suicide prevention in the virtual environment.

Objetivo: elaborar y validar un guion de enseñanza basada en la simulación sobre la prevención del suicidio en el entorno virtual. Método: investigación metodológica subdividida en etapa de elaboración y validación. La elaboración se realizó a partir de un template creado previamente y basado en lineamientos internacionales sobre buenas prácticas de simulación clínica y literatura científica sobre prevención del suicidio en el entorno virtual. Para la validación los especialistas validaron el guion mediante la autoaplicación de un formulario de evaluación cuyas respuestas son: "adecuado, regular e inadecuado", con un campo para sugerencias. Se utilizó estadística descriptiva e Índice de Validez de Contenido (IVC≥0,8). Resultados: participaron nueve especialistas, la mayoría enfermeros (66,7%), mujeres (55,6%), con una edad promedio de 42,22 años. Todos los elementos del guion cumplieron con el criterio de aceptación (IVC≥0,8). Conclusión: este estudio proporciona un guion útil para la enseñanza sobre la prevención del suicidio en el entorno virtual.

Objetivo: construir e validar um roteiro de ensino baseado em simulação sobre a prevenção do suicídio no ambiente virtual. Método: pesquisa metodológica subdividida em etapa de construção e validação. A construção foi realizada a partir de um template previamente elaborado e embasado por diretrizes internacionais em boas práticas de simulação clínica e literatura científica sobre a prevenção do suicídio no ambiente virtual. Para a validação, o roteiro foi validado por especialistas por meio de autoaplicação de formulário de avaliação com respostas baseadas em: "adequado, regular e inadequado", com campo para as sugestões. Foi utilizada a estatística descritiva e o Índice de Validade de Conteúdo (IVC≥0,8). Resultados: participaram nove especialistas, sendo a maioria enfermeiras (66,7%), gênero feminino (55,6%), com média de idade de 42,22 anos. Todos os itens do roteiro alcançaram o critério de aceitação (IVC≥0,8). Conclusão: este estudo disponibiliza um roteiro útil para ser empregado no ensino sobre a prevenção do suicídio no ambiente virtual.

Morphology and phylogeny of Coccomyxa bragantinensis n. sp. (Cnidaria: Myxozoa) found parasitising the Coco Sea catfish, Bagre bagre (Siluriformes: Ariidae), captured off the coast of Northern Brazil.

The present study describes Coccomyxa bragantinensis n. sp., which was found parasitising the gallbladder of the Coco Sea catfish, Bagre bagre, captured off Ajuruteua beach, in the region of Bragança in Pará state, northern Brazil. Most (77.5%) of the 40 fish specimens examined (31/40) had myxospores floating in the bile liquid. These spores are partially ellipsoid, with a tapering anterior extremity and a rounded, elongated posterior extremity with a single piriform polar capsule containing a helicoidal polar filament, with 5-6 coils. A partial sequence of 957 bp of the SSU rDNA gene was obtained from the specimens and deposited in GenBank (xxx). The new species described here - Coccomyxa bragantinensis n. sp. - is phylogenetically similar to Coccomyxa morovi, although it differs from all the other Coccomyxa species and is the first species of this genus to be described from Brazil on the basis of molecular evidence.

Uncovering the Hidden: A Study on Incidental Findings on CBCT Scans Leading to External Referrals.

OBJECTIVES: This project aims to determine the prevalence of cone-beam computed tomography (CBCT) findings requiring referral. Additionally, the goal is to establish a reference standard protocol for incidental findings, outlining indications for further investigation and management protocol. METHODS: Patients records from the Advanced Imaging Centre at the School of Dentistry, University of Alberta, underwent systematic examination to identify CBCT incidental findings. Radiographic findings requiring referral were categorised into 8 anatomic zones. Analysis assessed prevalence and a management protocol was developed for significant findings. Inferential analyses were conducted to determine the frequency and prevalence of specific findings requiring further investigation. RESULTS: A total of 1260 CBCT interpretive reports were analysed. The most prevalent radiographic findings outside the areas of interest were found in the cervical vertebrae (18%), followed by the sinuses (15%), temporomandibular joints (8%), jaw lesions (7%), airway (5%), teeth (5%), soft tissue calcifications (5%), and other (1%). CONCLUSIONS: Findings most commonly requiring external referral included carotid atheroma (2.7%), cervical vertebrae osteoarthritis (0.97%), jaw lesions (0.86%), adenoid and/or tonsillar hypertrophy (0.86%), and paranasal sinus pathology (0.73%). Increased medicolegal awareness and practitioner knowledge contribute to the rising number of CBCT-identified radiographic findings outside the area of concern. The study addresses the debate on reporting all CBCT/radiographic findings by exploring their prevalence and providing protocols. These guidelines assist dentists in identification, decision-making, and referral processes.

Qualification of Prenatal Care and Management in the Context of Primary Health Care

Introduction: Collaboration between different health professionals is essential to ensure safe and quality prenatal care and favorable birth outcomes. Objective: To describe interprofessional prenatal care and management strategies in the context of primary health care. Materials and method: Qualitative research conducted between August and December 2022. Data was collected using an instrument to analyze the content of infographics produced by 26 professionals working in primary health care in southern Brazil, as an evaluation activity for a qualification course. The content of the infographics was analyzed using the coding process proposed by Minayo. Results: The data analyzed enabled three thematic categories to be identified: "The necessary intersectoral and interprofessional coordination;" "Responsibilities built and shared between pregnant women and professionals;" "Planning and qualification of workflows and processes." Conclusions: Interprofessional prenatal care and management strategies in the context of primary health care are associated with overcoming fragmented and dichotomous approaches, as well as the prospect of more participatory, dialogic, and interactive prenatal care and management processes, with the inclusion of various health actors.

Introducción: la colaboración entre diferentes profesionales del área de la salud es esencial para garantizar atención prenatal segura y de calidad, y resultados favorables en el parto. Objetivo: describir estrategias interprofesionales de la gestión y atención prenatal en el contexto de la atención primaria de salud. Materiales y método: investigación cualitativa realizada entre agosto y diciembre de 2022. Los datos se recogieron mediante un instrumento de análisis del contenido de infografías producidas por 26 profesionales que trabajan en la atención primaria de salud en el sur de Brasil, como actividad de evaluación de un curso de cualificación. El contenido de las infografías se analizó mediante el proceso de codificación propuesto por Minayo. Resultados: los datos analizados permitieron identificar tres categorías temáticas: "La necesaria coordinación intersectorial e interprofesional"; "Responsabilidades construidas y compartidas entre gestantes y profesionales"; "Planificación y cualificación de flujos y procesos de trabajo". Conclusiones: las estrategias interprofesionales de gestión y atención prenatal en el contexto de la atención primaria de salud se asocian a la superación de enfoques fragmentados y dicotómicos, así como a la perspectiva de procesos de gestión y atención prenatal más participativos, dialógicos e interactivos con la inclusión de diversos actores de la salud.

Introdução: a colaboração entre os diversos profissionais da saúde é essencial para garantir um pré-natal seguro e de qualidade, bem como desfechos favoráveis no parto. Objetivo: descrever estratégias interprofissionais de gestão e atenção pré-natais no contexto da atenção primária à saúde. Materiais e método: pesquisa qualitativa realizada entre agosto e dezembro de 2022. Os dados foram coletados a partir de um instrumento de análise do conteúdo de infográficos produzidos por 26 profissionais que atuam na atenção primaria à saúde, no sul do Brasil, como atividade avaliativa de um curso de qualificação. O conteúdo dos infográficos foi analisado com base no processo de codificação proposto por Minayo. Resultados: os dados analisados possibilitaram a delimitação de três categorias temáticas: "A necessária articulação intersetorial e interprofissional"; "Responsabilidades construídas e compartilhadas entre gestantes e profissionais"; "Planejamento e qualificação dos fluxos e dos processos de trabalho". Conclusões: as estratégias interprofissionais de gestão e atenção pré-natais no contexto da atenção primária à saúde estão associadas à superação de abordagens fragmentadas e dicotômicas, bem como à prospecção de processos de gestão e atenção pré-natais mais participativos, dialógicos e interativos, com a inclusão dos diversos atores da saúde.

Impact of the COVID-19 Pandemic on Births, Vaginal Deliveries, Cesarian Sections, and Maternal Mortality in a Brazilian Metropolitan Area: A Time-Series Cohort Study.

Purpose: The COVID-19 pandemic posed a worldwide challenge, leading to radical changes in healthcare. The primary objective of the study was to assess the impact of the COVID-19 pandemic on birth, vaginal delivery, and cesarian section (c-section) rates. The secondary objective was to compare the maternal mortality before and after the pandemic. Patients and Methods: Time-series cohort study including data of all women admitted for childbirth (vaginal delivery or c-section) at the maternities in the Public Health System of Federal District, Brazil, between March 2018 and February 2022, using data extracted from the Hospital Information System of Brazilian Ministry of Health (SIH/DATASUS) on September 30, 2022. Causal impact analysis was used to evaluate the impact of COVID-19 on birth, vaginal delivery, and c-section using the CausalImpact R package, and a propensity score matching was used to evaluate the effect on maternal mortality rate using the Easy R (EZR) software. Results: There were 150,617 births, and considering total births, the effect of the COVID-19 pandemic was not statistically significant (absolute effect per week: 5.5, 95% CI: -24.0-33.4). However, there was an increase in c-sections after COVID-19 (absolute effect per week: 18.1; 95% CI: 11.9-23.9). After propensity score matching, the COVID-19 period was associated with increased maternal mortality (OR: 3.22, 95% CI: 1.53-6.81). The e-value of the adjusted OR for the association between the post-COVID-19 period and maternal mortality was 5.89, with a 95% CI: 2.43, suggesting that unmeasured confounders were unlikely to explain the entirety of the effect. Conclusion: Our study revealed a rise in c-sections and maternal mortality during the COVID-19 pandemic, possibly due to disruptions in maternal care. These findings highlight that implementing effective strategies to protect maternal health in times of crisis and improve outcomes for mothers and newborns is crucial.

Thermographic examination of gingival phenotypes: correlation between morphological and thermal parameters.

OBJECTIVES: To evaluate the clinical and thermographic aspects of the gingival phenotype (GP) in healthy subjects. MATERIALS AND METHODS: The study sample examined 264 teeth, upper and lower incisors, comprising 132 central incisors (CI) and 132 lateral incisors (LI), in 33 healthy volunteers. Four periodontal parameters were recorded systematically: ratio of width to length of the dental crown (CW/CL), height of the gingival attachment (KGW), probing depth (PD), and gingival transparency (GT). The temperatures of the attached gingiva (KGW temp) and the free gingival margin (FGM Temp) were also recorded by way of infrared thermography (IRT). RESULTS: The average age of the sample was 30.70 ± 7.65 years. Of the 264 teeth evaluated, 76.1% had a thin GP. There was a significant association between CW/CL (p < 0.001), KGW (p < 0.001), PD (p < 0.007), and FGM Temp (p < 0.006) with the tooth groups. The results show a significant and inversely proportional correlation between clinical parameters and gingival temperature (p < 0.05). A significant association was found between CW/CL (p < 0.026); KGW (p < 0.001); and GP. CONCLUSION: CW/CL, KGW, PD, and FGM Temp vary according to tooth group. The majority of the sample presented with the thin GP, which was more prevalent in the lower LIs and CIs. No significant association could be observed between thermographic parameters and GP. CLINICAL RELEVANCE: Knowledge of the temperature of the gingival tissues can be useful in helping to diagnose and plan periodontal treatments. Moreover, our findings will help future studies evaluate the use of IR as an auxiliary diagnostic method in dentistry, eliminating GP as a confounding factor, since it does not seem to influence the temperature of the gingival tissues.

Suicídio como sintoma social: um estudo sobre os impactos do capitalismo nas subjetividades / Suicide as a social symptom: a study on the impacts of capitalism on subjectivities / El suicidio como síntoma social: un estudio sobre los impactos delcapitalismo enlas subjetividades

O suicídio é um fenômeno multifatorial, considerado um grave problema de saúde pública que atinge, em média, cerca de 700 mil pessoas todos os anos. Diante disso, este artigo tem por objetivo analisar este fenômeno e sua relação com o capitalismo, tendo como base a determinação social da saúde e o cenário individualista deste modelo de sociedade que podem ser causadores da morte autoprovocada. Com isso, foi realizada uma pesquisa bibliográfica que evidenciou a precarização da vida na realidade brasileira e o sofrimento social envolto à população marginalizada, mediado pelas desigualdades do sistema capitalista, dentre elas o desemprego, precarização do trabalho, racismo, sexismo, lgbtfobia e a pobreza como alguns dos elementos envolvidos no suicídio. Verificou-se a importância de considerar os atravessamentos sociais, políticos, econômicos, históricos e culturais no debate sobre a morte voluntária e na promoção e valorização da vida, contrapondo uma visão individualista e reducionista do fenômeno. (AU)

El suicidio es un fenómeno multifactorial, considerado un grave problema de salud pública que afecta, en promedio, a alrededor de 700,000 personas cada año. Ante esto, este artículo tiene como objetivo analizar este fenómeno y su relación con el capitalismo, basándose en la determinación social de la salud y en el escenario individualista de este modelo de sociedad, que pueden ser causantes de la muerte autoprovocada. Con esto, se realizó una investigación bibliográfica que evidenció la precarización de la vida en la realidad brasileña y el sufrimiento social que rodea a la población marginada, mediado por las desigualdades del sistema capitalista, entre las que se encuentran el desempleo, la precarización del trabajo, el racismo, el sexismo, la lgbtfobia y la pobreza como algunos de los elementos del suicidio. Se destacó la importancia de considerar los cruces sociales, políticos, económicos, históricos y culturales en el debate sobre la muerte voluntaria y en la promoción y valoración de la vida, oponiéndose a una visión individualista y reduccionista del fenómeno. (AU)

Suicide is a multifactorial phenomenon, considered a serious public health problem that affects, on average, about 700 thousand people per year. Therefore, this article aims to analyze the phenomenon of suicide and its relationship with capitalism, based on the social determination of the health and the individualistic scenario of this model of society that can be the cause of self-mutilation. With that, a bibliographical research was carried out that evidenced the precariousness of life in the Brazilian reality and the social suffering that surrounds the marginalized population, mediated by the inequalities of the capitalist system, including unemployment, precariousness of employment, racism, sexism, LGBTphobia and poverty as some of the elements involvedin suicide. It was found important to consider the social, political, economic, historical and cultural intersections in the debate on voluntary death and in the promotion and appreciation of life, in opposition to an individualistic and reductionist viewof the phenomenon.

Inhibitory impact of the anticancer drug doxorubicin on anaerobic microbial community.

The inhibitory effect of the anticancer drug doxorubicin (DOX) on biogas production was evaluated in short-term and long-term exposure assays. The short-term assays reached the DOX IC50 value on 648 ± 50 µg·L-1. In addition, it was found that inhibition caused by the exposure of 10×103 µg·L-1 was reversible after removing DOX from the feeding synthetic medium. Furthermore, DOX can be rapidly sorbed by the biomass (despite the low Kow), which might contribute to the inhibitory effect. The results of long-term exposure assays, when the DOX volumetric loading rate was increased from 100 µgDOX·L-1·day-1 to 200 µgDOX·L-1·day-1, showed that biogas production and COD removal decreased rapidly. However, the methanogenic Archaeas could recover from this exposure, corroborating the results on short-term exposure assays. In conclusion, DOX can play a key role in inhibiting biological wastewater treatment processes if its concentration in hospital wastewater treatment plants increases abruptly.

Genomic inbreeding estimation, runs of homozygosity, and heterozygosity-enriched regions uncover signals of selection in the Quarter Horse racing line.

With the advent of genomics, significant progress has been made in the genetic improvement of livestock species, particularly through increased accuracy in predicting breeding values for selecting superior animals and the possibility of performing a high-resolution genetic scan throughout the genome of an individual. The main objectives of this study were to estimate the individual genomic inbreeding coefficient based on runs of homozygosity (FROH ), to identify and characterize runs of homozygosity and heterozygosity (ROH and ROHet, respectively; length and distribution) throughout the genome, and to map selection signatures in relevant chromosomal regions in the Quarter Horse racing line. A total of 336 animals registered with the Brazilian Association of Quarter Horse Breeders (ABQM) were genotyped. One hundred and twelve animals were genotyped using the Equine SNP50 BeadChip (Illumina, USA), with 54,602 single nucleotide polymorphisms (SNPs; 54K). The remaining 224 samples were genotyped using the Equine SNP70 BeadChip (Illumina, USA) with 65,157 SNPs (65K). To ensure data quality, we excluded animals with a call rate below 0.9. We also excluded SNPs located on non-autosomal chromosomes, as well as those with a call rate below 0.9 or a p-value below 1 × 10-5 for Hardy-Weinberg equilibrium. The results indicate moderate to high genomic inbreeding, with 46,594 ROH and 16,101 ROHet detected. In total, 30 and 14 candidate genes overlap with ROH and ROHet regions, respectively. The ROH islands showed genes linked to crucial biological processes, such as cell differentiation (CTBP1, WNT5B, and TMEM120B), regulation of glucose metabolic process (MAEA and NKX1-1), heme transport (PGRMC2), and negative regulation of calcium ion import (VDAC1). In ROHet, the islands showed genes related to respiratory capacity (OR7D19, OR7D4G, OR7D4E, and OR7D4J) and muscle repair (EGFR and BCL9). These findings could aid in selecting animals with greater regenerative capacity and developing treatments for muscle disorders in the QH breed. This study serves as a foundation for future research on equine breeds. It can contribute to developing reproductive strategies in animal breeding programs to improve and preserve the Quarter Horse breed.

Percepções de familiares sobre uma rede de cuidados de saúde mental infantojuvenil / Family perceptions about a children's mental health network / Percepciones familiares sobre una red de atención de salud mental infantojuvenil

Este artigo pretende conhecer como a rede de cuidados em saúde tem se operacionalizado a partir da percepção de familiares de crianças com demanda de cuidado em saúde mental (SM). Foram realizados dois grupos focais, um com familiares da Atenção Básica (AB) e outro com familiares do Centro de Atenção Psicossocial Infantojuvenil (CAPSij), totalizando 15 participantes. Seguiu-se com a análise lexical do tipo classificação hierárquica descendente, com o auxílio do software R Interface, a fim de análises multidimensionais de textos e questionários (IRaMuTeQ), resultando em cinco classes: A Pílula Mágica; Forças e Fraquezas dos serviços; Procurando por ajuda; Aceitando o diagnóstico da criança e Onde procurei ajuda. Os resultados apontam para dificuldades presentes na AB em identificar e manejar situações de Saúde Mental Infantojuvenil (SMIJ), por meio de uma lógica ainda medicalizante. Ressalta-se que a escola é apresentada como lugar de destaque na produção da demanda por cuidado e a família ainda é pouco convocada à construção das ações. Conclui-se, então, que avanços ainda são necessários para operacionalização de um cuidado pautado nas diretrizes da política de SMIJ.(AU)

This article aims to know how the healthcare network has been operationalized from the perception of family members of children with demand for mental health care (MH). Two focus groups were held, one with family members from Primary Care (PC) and the other with family members from the Child Psychosocial Care Center (CAPSij), totaling 15 participants. A lexical analysis of the descending hierarchical classification type was performed with the help of the software R Interface for multidimensional analyzes of texts and questionnaires (IRAMUTEQ), resulting in five classes: The Magic Pill; Strengths and Weaknesses of services; Looking for help; Accepting the child's diagnosis; and Where did I look for help. The results point to difficulties present in PC in identifying and managing situations of mental health in children and adolescents (MHCA), with a medicalization logic. Note that the school is presented as a prominent place in producing the demand for care, and the family is still not very much involved in the actions. It is, thus, concluded that advances are still needed for operationalization of care guided by MHCA policy guidelines.(AU)

Este artículo tuvo por objetivo conocer cómo opera una red asistencial a partir de la percepción de familiares de niños con demanda de atención en salud mental (SM). Se realizaron dos grupos focales, uno con familiares de Atención Primaria (AP) y otro con familiares del Centro de Atención Psicosocial Infantojuvenil (CAPSij), totalizando 15 participantes. Se realizó análisis léxico del tipo clasificación jerárquica descendente con la ayuda del software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (IRAMUTEQ), lo que resultó en cinco clases: "La píldora mágica"; "Fortalezas y debilidades de los servicios"; "En busca de ayuda"; "Aceptar el diagnóstico del niño" y "¿Dónde busqué ayuda?". Los resultados apuntan las dificultades presentes en AP para identificar y manejar situaciones de salud mental infantojuvenil (SMIJ) mediante una lógica aún medicalizante. La escuela tiene un lugar destacado en la producción de la demanda de cuidados y la familia aún no está muy involucrada en la construcción de acciones. Se concluye que se necesitan avances para ofertar una atención guiada por lineamientos de la política del SMIJ.(AU)

Prenatal qualification course: interprofessional constructions and reconstructions / Curso de calificación prenatal: construcciones y reconstrucciones interprofesionales / Curso de qualificação pré-natal: construções e reconstruções interprofissionais

ABSTRACT Objective: to understand the perception of health professionals regarding the implementation of a prenatal qualification course from an interprofessional perspective. Method: action research conducted from August to November 2022, with the participation of 47 professionals from Primary Health Care and hospital institutions from 33 cities that make up a Regional Health Coordination in southern Brazil. Results: data analysis allowed the delimitation of two thematic categories: Training: professional constructions and reconstructions; and Network articulation: weaknesses and perspectives. The prenatal course, with an interprofessional focus, was a driving tool for integration, dialogue and enhancement of initiatives aimed at qualifying prenatal care. Conclusion: the implementation of the prenatal qualification course enabled the expansion of knowledge and the (re)construction of interprofessional practices capable of inferring in the maternal and child health care network.

RESUMEN Objetivo: comprender la percepción de los profesionales de la salud sobre la implementación de un curso de capacitación prenatal desde una perspectiva interprofesional. Método: investigación-acción realizada entre agosto y noviembre de 2022, con la participación de 47 profesionales de la Atención Primaria de Salud e instituciones hospitalarias de los 33 municipios que integran una Coordinación Regional de Salud en el sur de Brasil. Resultados: el análisis de los datos permitió delimitar dos categorías temáticas: Formación: construcciones y reconstrucciones profesionales; y Articulación de redes: debilidades y perspectivas. El curso prenatal, con enfoque interprofesional, fue una herramienta impulsora de integración, diálogo y potenciación de iniciativas encaminadas a calificar la atención prenatal. Conclusión: la implementación del curso de calificación prenatal permitió la ampliación de conocimientos y la (re)construcción de prácticas interprofesionales capaces de inferir en la red de atención a la salud maternoinfantil.

RESUMO Objetivo: conhecer a percepção de profissionais de saúde acerca da implementação de um curso de qualificação pré-natal na perspectiva interprofissional. Método: pesquisa-ação conduzida entre agosto e novembro de 2022, com a participação de 47 profissionais da Atenção Primária à Saúde e de instituições hospitalares dos 33 municípios que integram uma Coordenadoria Regional de Saúde do sul do Brasil. Resultados: a análise dos dados possibilitou a delimitação de duas categorias temáticas: Formação: construções e reconstruções profissionais; e Articulação em rede: fragilidades e perspectivas. O curso pré-natal, com enfoque interprofissional, constituiu-se em ferramenta propulsora de integração, interlocução e potencialização de iniciativas voltadas à qualificação da assistência pré-natal. Conclusão: a implementação do curso de qualificação pré-natal possibilitou a ampliação de saberes e a (re)construção de práticas interprofissionais capazes de inferir na rede de atenção em saúde materno-infantil.