Accuracy of guided dental implant surgery using a fully digital workflow: A case series.

STATEMENT OF PROBLEM: Computer-guided implant surgery facilitated by intraoral scanning may enhance the efficiency of the digital workflow. However, it is necessary to assess technique accuracy to evaluate the accuracy of implant placement. PURPOSE: The purpose of this clinical study was to evaluate the accuracy of a virtual computer-aided design and computer-aided manufacturing (CAD-CAM) static guided surgery technique associated with intraoral scanning in partially edentulous participants by analyzing the overlap among preoperative and postoperative cone beam computed tomography (CBCT) scans, virtual planning, and the guided surgery performed. MATERIAL AND METHODS: Eleven partially edentulous participants underwent CBCT and intraoral scanning (TRIOS3). Data were integrated into a software program (ImplantViewer 3.5) for the virtual planning of implants and 3-dimensional (3D) printing of the prototype CAD-CAM surgical guide. A total of 18 implants were placed using the CAD-CAM static computer-aided implant surgery technique (Strong SW). After 15 days, postoperative CBCT scans were made and 4 variables (angular, coronal, apical, and vertical deviation) were measured to compare the virtually planned implants and the implants placed by analyzing the overlap between preoperative and postoperative of the virtual planning and guided surgery performed using the ImplantViewer 3.5 and Rhino 6 software programs. RESULTS: Deviations were found in all parameters analyzed. The mean angular deviation was 2.68 ±1.62 degrees; mean coronal deviation, 0.82 ±0.44 mm; mean apical deviation, 1.14 ±0.44 mm; and mean vertical deviation, 0.62 ±0.44 mm. CONCLUSIONS: The implants placed using the CAD-CAM static guided surgery technique associated with intraoral scanning in partially edentulous participants exhibited angular and linear deviations when compared with virtual planning implants. However, these deviations were not clinically significant.

Pectinases Secretion by Saccharomyces cerevisiae: Optimization in Solid-State Fermentation and Identification by a Shotgun Proteomics Approach.

A sequential design strategy was applied to optimize the secretion of pectinases by a Saccharomyces cerevisiae strain, from Brazilian sugarcane liquor vat, on passion fruit residue flour (PFRF), through solid-state fermentation (SSF). A factorial design was performed to determine the influence variables and two rotational central composite designs were executed. The validated experimental result was of 7.1 U mL-1 using 50% PFRF (w/w), pH 5, 30 °C for 24 h, under static SSF. Polygalacturonase, pectin methyl esterase, pectin-lyase and pectate-lyase activities were 3.5; 0.08; 3.1 and 0.8 U mL-1, respectively. Shotgun proteomics analysis of the crude extract enabled the identification of two pectin-lyases, one pectate-lyase and a glucosidase. The crude enzymatic extract maintained at least 80% of its original activity at pH values and temperatures ranging from 2 to 8 and 30 to 80 °C, respectively, over 60 min incubation. Results revealed that PFRF might be a cost-effective and eco-friendly substrate to produce pectinases. Statistical optimization led to fermentation conditions wherein pectin active proteins predominated. To the extent of our knowledge, this is the first study reporting the synthesis of pectate lyase by S. cerevisiae.

Autofluorescence-spectral imaging as an innovative method for rapid, non-destructive and reliable assessing of soybean seed quality.

In the agricultural industry, advances in optical imaging technologies based on rapid and non-destructive approaches have contributed to increase food production for the growing population. The present study employed autofluorescence-spectral imaging and machine learning algorithms to develop distinct models for classification of soybean seeds differing in physiological quality after artificial aging. Autofluorescence signals from the 365/400 nm excitation-emission combination (that exhibited a perfect correlation with the total phenols in the embryo) were efficiently able to segregate treatments. Furthermore, it was also possible to demonstrate a strong correlation between autofluorescence-spectral data and several quality indicators, such as early germination and seed tolerance to stressful conditions. The machine learning models developed based on artificial neural network, support vector machine or linear discriminant analysis showed high performance (0.99 accuracy) for classifying seeds with different quality levels. Taken together, our study shows that the physiological potential of soybean seeds is reduced accompanied by changes in the concentration and, probably in the structure of autofluorescent compounds. In addition, altering the autofluorescent properties in seeds impact the photosynthesis apparatus in seedlings. From the practical point of view, autofluorescence-based imaging can be used to check modifications in the optical properties of soybean seed tissues and to consistently discriminate high-and low-vigor seeds.

Correction: Sociodemographic characteristics and risk factors related to SARS-CoV-2 infection in Luanda, Angola.

[This corrects the article DOI: 10.1371/journal.pone.0249249.].

Sociodemographic characteristics and risk factors related to SARS-CoV-2 infection in Luanda, Angola.

This study aimed to investigate the characteristics related to SARS-CoV-2 in Luanda, Angola. A total of 622 individuals were screened for SARS-CoV-2 from January to September 2020. Chi-square and logistic regression were used to identify the relationship between sociodemographic characteristics and SARS-CoV-2. Of the 622 tested, 14.3% tested positive. The infection rate was the same for both genders (14.3%). Individuals ≥40 years old, from non-urbanized areas, and healthcare professionals had a higher frequency of infection. The risk of infection was very high in individuals ≥60 years old (AOR: 23.3, 95% CI: 4.83-112), in women (AOR: 1.24, 95% CI: 0.76-2.04), in Luanda (AOR: 7.40, 95% CI: 1.64-33.4), and healthcare professionals (AOR: 1.27, 95% CI: 0.60-2.71), whereas a low risk was observed in individuals from urbanized areas (AOR: 0.44, 95% CI: 0.26-0.75). Our results suggest that Angolan authorities should implement a greater effort in non-urbanized areas and among healthcare professionals since when these individuals presented any indication for a COVID-19 test, such as fever/cough/myalgia, they were more likely to test positive for SARS-CoV-2 than having some other cause for symptoms.

O princípio da solidariedade no enfrentamento da COVID-19 no Brasil / The principle of solidarity in facing COVID-19 in Brazil / El principio de solidaridad frente al COVID-19 en Brasil

Objetivo: analisar o princípio da solidariedade como vetor interpretativo para as políticas públicas emergenciais e outras ações de enfrentamento da pandemia COVID-19. Metodologia: utilizou-se o método dedutivo como abordagem; o método descritivo-exploratório como procedimento; e como técnicas de pesquisa a bibliográfica e documental. Resultados: verificou-se que, apesar do avanço das políticas públicas de saúde, notadamente por meio do Sistema Único de Saúde (SUS), o princípio da solidariedade ainda está sendo desconsiderado no enfrentamento da pandemia no Brasil, como se vê, por exemplo, pela estocagem de testes RT-qPCR prestes a vencer e subutilização do orçamento destinado à pandemia. Embora já demonstrado que medidas orientadas por esse princípio salvam vidas, como revelam experiências exitosas de outros países, sendo um instrumento eficaz e pouco oneroso, muito há a avançar na aplicação de tal princípio no Brasil. Conclusão: inspirados pelo princípio da solidariedade, os governos federal, estaduais e municipais, e demais poderes, devem conjugar esforços para oferecer políticas públicas e outras ações adequadas e eficazes ao combate da COVID-19 no Brasil.

Objective: analyzing the principle of solidarity as an interpretive vector for urgent public policies and other actions to combat the COVID-19 pandemic. Methodology: the deductive approach, the descriptive-exploratory method of procedure and the bibliographic and documentary research techniques were used. Results: it was found that, despite the advancement of public health policies, notably through SUS (Unified Health System), the principle of solidarity is still being disregarded in the face of the pandemic in Brazil, as seen, for example, by the storage of RT-qPCR tests (about to expire) and underutilization of the budget for the pandemic. Thus, although it has already been demonstrated that measures informed by this principle save lives, as revealed by successful experiences in other countries, being, therefore, an effective and inexpensive instrument, much remains to be done in the application of this principle in Brazil. Conclusion: inspired by the principle of solidarity, the federal, state and municipal governments, and other powers, must combine efforts to offer public policies and other appropriate and effective actions to combat COVID-19 in Brazil.

Objetivo: analizar el principio de solidaridad como vector interpretativo de políticas públicas de emergencia y otras acciones para combatir la pandemia COVID-19. Metodología: se utilizó el enfoque deductivo, el método de procedimiento descriptivo-exploratorio y las técnicas de investigación bibliográfica y documental. Resultados: se encontró que, a pesar del avance de las políticas públicas de salud, en particular a través del SUS (Sistema Único de Salud), el principio de solidaridad sigue siendo desatendido frente a la pandemia en Brasil, como lo ha visto, por ejemplo, el almacenamiento de pruebas RT-qPCR (a punto de expirar) y subutilización del presupuesto para la pandemia. Así, si bien ya se ha demostrado que las medidas fundamentadas en este principio salvan vidas, como lo revelan experiencias exitosas en otros países, siendo, por tanto, un instrumento eficaz y económico, queda mucho por hacer en la aplicación de este principio en Brasil. Conclusión: inspirados en el principio de solidaridad, los gobiernos federal, estatal y municipal, y otros poderes, deben aunar esfuerzos para ofrecer políticas públicas y otras acciones adecuadas y efectivas para combatir el COVID-19 en Brasil.

Differentiation of periapical granuloma from radicular cyst using cone beam computed tomography images texture analysis.

OBJECTIVE: This study aimed to investigate the use of texture analysis for characterization of radicular cysts and periapical granulomas and to assess its efficacy to differentiate between both lesions with histological diagnosis. METHODS: Cone beam computed tomography (CBCT) images were obtained from 19 patients with 25 periapical lesions (14 radicular cysts and 11 periapical granulomas) confirmed by biopsy. Regions of interest were created in the lesions from which 11 texture parameters were calculated. Spearman's correlation analysis was performed and adjusted with Benjamini-Hochberg false discovery rate procedure (FDR <0.005). RESULTS: The texture parameters used to differentiate the lesions were assessed by using a receiver operating characteristic analysis. Five texture parameters were predictive of lesion differentiation for eight positions: angular second moment; sum of squares; sum of average; contrast; correlation. CONCLUSION: Texture analysis of CBCT scans distinguishes radicular cysts from periapical granulomas and can be a promising diagnostic tool for periapical lesions. CLINICAL SIGNIFICANCE: Texture analysis can be used in diagnostic and treatment monitoring to provide supplementary information.

[Socio-ecological super-determination of health in rural areas in Humaitá, State of Amazonas, Brazil]. / Sobredeterminação socioecológica da saúde da ruralidade em Humaitá, AM, Brasil.

The scope of this article is to apply a trans-disciplinary socio-ecological approach to discuss the super-determination of health in rural areas of the southern Amazon region from a case study developed in Humaitá in the State of Amazonas in Brazil. Field data were collected using ethnographic techniques applied during three expeditions in Humaitá's rural area between 2012 and 2014. Based on the 'socio-ecological metabolism' analytical category, a descriptive and theoretical analysis of four crucial components in the process of super-determination of local health are presented: (1) the composition of the local rural population; (2) fixed and changing territorial aspects; (3) construction of socio-ecological identities; (4) ethnic conflict between Indians and non-Indians. The conclusion reached is that the incorporation of a socio-ecological approach in territorial-based health research provides input for analyses of the local health situation through the systematization of information related to the process of super-determination of health. It also helps in the construction of trans-disciplinarity, which is a necessary epistemological condition for addressing the complex reality at the interfaces of social production, the environment and health.

Trauma and the negative narcissism in borderline cases / Trauma y el narcisismo negativo en los casos límite

Abstract This work emphasizes the deadly repetition as a psychic violence revealed by the issue of trauma. This theme is particularly important for the clinic of borderline cases. The Freudian idea that combines trauma and sexuality has existed since the beginnings of psychoanalysis. But are there different focuses along its work? How they can be related to borderline cases clinic? We are guided by the Freudian text called Beyond the Pleasure Principle (1920) and by Andre Green's propositions on the subject, which concern: The Neutral, objectifying and deobjectfying functions and negative narcissism. From the moment Freud complexifies the notion of trauma so it evidences an excess of external stimuli and instinctual that cannot be part of the chain of psychic representation, Freud also reveals a particular mode of objectual-love: the pair sadismmasochism. But while this pair is still expression of Eros, Green's Neutral concept is the expression of what he calls negative narcissism. In both cases, the traumatic is a requirement of presentification.

Resumen Este trabajo hace énfasis en la repetición de cómo la violencia psíquica revela el trauma. Este tema es particularmente importante para la clínica de los casos límite. La idea freudiana de que combina el trauma y la sexualidad ha existido desde los comienzos del psicoanálisis. Pero ¿existen diferentes enfoques a lo largo de su trabajo? ¿Cómo pueden estar relacionados con la clínica de los casos límite? Nos guiamos por el texto freudiano llamado Más allá del principio del placer (1920) y por las proposiciones de Andre Green en el tema, que se refieren a la objetivación y deobjetivación, funciones neutrales y narcisismo negativo. Desde el momento en que Freud complejiza la noción de trauma por lo que evidencia un exceso de estímulos externos e instintivos que no pueden ser parte de la cadena de la representación psíquica, Freud también revela un modo particular de amor objetual: el par sadismo-masoquismo. Pero mientras este par sigue siendo expresión de Eros, el concepto Neutral de Green es la expresión de lo que él llama narcisismo negativo. En ambos casos, el trauma es un requisito.

MBL2 gene polymorphisms and susceptibility to tuberculosis in a northeastern Brazilian population.

The innate immune system represents the first line of host defense against pathogens. Genetics factors regulating the immune responses play a role in the susceptibility to infectious diseases, such as tuberculosis (TB). We analyzed MBL2 promoter and exon 1 functional single nucleotide polymorphisms (SNPs) in a group of 155TB patients and 148 healthy controls in order to evaluate their influence on the onset of infection and TB development. There was no association between MBL2 -550 HL promoter polymorphisms and susceptibility to develop TB, but heterozygous -221 Y/X genotype was significantly more frequent in pulmonary TB patients than controls. Moreover, MBL2 exon 1 O allele, was significantly associated with susceptibility to TB development in general (p=0.023, OR=1.61, 95% CI 1.05-2.49) and pulmonary TB (p=0.0008, OR=2.16, 95% CI 1.35-3.46); C allele at codon 57, as well as A/C genotype, were significantly more frequent in TB patients than in controls. Our results indicate that MBL2 polymorphisms, especially at codon 57, could be considered as risk factors for TB development.

Comparison of the RIFLE, AKIN and KDIGO criteria to predict mortality in critically ill patients.

OBJECTIVE: Acute kidney injury is a common complication in critically ill patients, and the RIFLE, AKIN and KDIGO criteria are used to classify these patients. The present study's aim was to compare these criteria as predictors of mortality in critically ill patients. METHODS: Prospective cohort study using medical records as the source of data. All patients admitted to the intensive care unit were included. The exclusion criteria were hospitalization for less than 24 hours and death. Patients were followed until discharge or death. Student's t test, chi-squared analysis, a multivariate logistic regression and ROC curves were used for the data analysis. RESULTS: The mean patient age was 64 years old, and the majority of patients were women of African descent. According to RIFLE, the mortality rates were 17.74%, 22.58%, 24.19% and 35.48% for patients without acute kidney injury (AKI) in stages of Risk, Injury and Failure, respectively. For AKIN, the mortality rates were 17.74%, 29.03%, 12.90% and 40.32% for patients without AKI and at stage I, stage II and stage III, respectively. For KDIGO 2012, the mortality rates were 17.74%, 29.03%, 11.29% and 41.94% for patients without AKI and at stage I, stage II and stage III, respectively. All three classification systems showed similar ROC curves for mortality. CONCLUSION: The RIFLE, AKIN and KDIGO criteria were good tools for predicting mortality in critically ill patients with no significant difference between them.

O papel do aleitamento materno na redução das hospitalizações por pneumonia em crianças brasileiras menores de 1 ano / Breastfeeding can prevent hospitalization for pneumonia among children under 1 year old

Objetivo: Avaliar a relação entre o aleitamento materno e as internações hospitalares por pneumonia entre crianças com menos de 1 ano de vida. Métodos: Estudo epidemiológico ecológico que utilizou dados secundários de internação por pneumonia (desfecho) e de prevalência de aleitamento materno (exposição) na população de crianças com menos de 1 ano de vida nas capitais brasileiras e no Distrito Federal em 2008. A razão de taxas (RT) de internação hospitalar foi estimada por modelo estatístico binomial negativo (intervalo de confiança de 95%), ajustado pelo índice de Gini da população e pela prevalência de fumantes na população em geral e de baixo peso ao nascer na população estudada. Resultados: A prevalência de aleitamento materno em crianças de 9 a 12 meses incompletos de vida e a prevalência do aleitamento materno exclusivo entre crianças menores de 6 meses mostraram-se associadas a uma menor taxa de internação hospitalar por pneumonia (RT = 0,62; IC95% 0,51-0,74, e RT = 0,52; IC95% 0,39-0,69, respectivamente). Conclusão: O aumento das prevalências de aleitamento materno no 1º ano de vida e de aleitamento materno exclusivo nos primeiros 6 meses de uma população podem reduzir as internações hospitalares por pneumonias.

Objective: To evaluate the relationship between breastfeeding and hospitalization for pneumonia among children under 1 year old. Methods: Ecological study using secondary data of hospitalizations for pneumonia (outcome) and breastfeeding prevalence data (exposure) among children under 1 year old living in the Brazilian state capital cities and the Federal District in 2008. A negative binomial model of hospitalization was used to estimate the rate ratio (95% confidence interval), adjusted according to the Gini Index, and the prevalence rates of smokers in the general population and low birth weight individuals in the population investigated. Results: Breastfeeding prevalence among children between 9 and 12 months old and exclusive breastfeeding prevalence among children under 6 months old were associated with a lower rate ratio of hospitalization for pneumonia (RR = 0.62; 95%CI 0.51-0.74 and RR = 0.52; 95%CI 0.39-0.69, respectively). Conclusion: Increased prevalence rates of breastfeeding during the first year of life and exclusive breastfeeding during the first 6 months of life can reduce the number of hospitalizations for pneumonia.

[Exclusive breastfeeding and diarrhea hospitalization patterns between 1999 and 2008 in Brazilian State Capitals]. / Padrões de aleitamento materno exclusivo e internação por diarréia entre 1999 e 2008 em capitais brasileiras.

The prevalence of breastfeeding has increased over the past two decades in Brazil, as a result of public breastfeeding policies. The scope of this paper is to analyze the correlation between the increase in the prevalence of breastfeeding and hospitalization rates due to diarrhea. It is an epidemiological ecological study, based on secondary data from Brazilian Capital Cities and the Federal District. The prevalence of breastfeeding, the number of live births, and cases of hospitalization due to diarrhea were compared for the years 1999 and 2008 and the Spearman non-parametric test was used to correlate the variables. During the period, 1,329,618 children under one year of age in 1999 and 2008 were studied. The increase in the prevalence of exclusive breastfeeding among children under 4 months old had a negative correlation with hospitalization rates due to diarrhea (Rho=-0.483, p=0.014). This correlation was stronger for girls (Rho=-0.521, p=0.008) than for boys (Rho=-0.476, p=0.016). The increase in the prevalence of breastfeeding between 1999 and 2008 appears to be correlated to a reduction in hospitalization rates due to diarrhea over the same period, corroborating the importance of public policies to protect, support and promote breastfeeding.

Heavy metal tolerance (Cr, Ag AND Hg) in bacteria isolated from sewage.

Samples of sewage from a university hospital and a chemistry technical school were analysed for the percentage of bacterial tolerance to chromium (Cr), silver (Ag) and mercury (Hg). Additionally, we investigated the effect of these metals on pigmentation and on some enzymatic activities of the metal tolerant strains isolated, as well as antimicrobial resistance in some metal tolerant Enterobacteriaceae strains. Tolerance to Cr was observed mainly in Gram positive bacteria while in the case of Ag and Hg the tolerant bacteria were predominately Gram negative. Hg was the metal for which the percentage of tolerance was significantly higher, especially in samples from the hospital sewage (4.1%). Mercury also had the most discernible effect on color of the colonies. Considering the effect of metals on the respiratory enzymes, one strain of Ag-tolerant Bacillus sp. and one of Hg-tolerant P. aeruginosa were unable to produce oxidase in the presence of Ag and Hg, respectively, while the expression of gelatinase was largely inhibited in various Gram negative strains (66% by Cr). Drug resistance in Hg-tolerant Enterobacteriaceae strains isolated from the university hospital sewage was greater than 80%, with prevalence of multiple resistance, while the Ag-tolerant strains from the same source showed about 34% of resistance, with the predominance of mono-resistance. Our results showed that, despite the ability of metal tolerant strains to survive and grow in the presence of these elements, the interactions with these metals may result in metabolic or phisiological changes in this group of bacteria.

Evaluation of calcium excretion in Brazilian infantile and young population environmentally exposed to lead.

Lead exposure is an important issue in the research of several toxic effects resulting from the biochemical interaction between this metal and the organism. Calcium is a fundamental mineral for the maintenance of the organism homeostasis where there is interaction between lead and calcium in metabolic pathways. Environmental lead exposure by verifying the usefulness and applicability of urinary calcium/creatinine ratio (UCa/Cr) in this context was evaluated. This was an extensive socio-demographic study of the nutritional profile, lead exposure biomarkers in blood and the urine and UCa/Cr ratio. The children studied were from a low socio-economic group characterized by unsatisfactory nutritional diet. Lead environmental exposure was shown by biomarkers, with UCa/Cr ratio having positive and significant correlations with both lead and delta-aminolevulinic acid in urine (ALA-U), without colinearity diagnosis. There was a strong association between calcium excretion and lead exposure as a result of linear regression construction models. In children, lead increases calcium excretion which is an additional risk to infantile health. Urinary calcium/creatinine ratio may be a useful tool in the biological monitoring of lead exposure and health promotion programs.

Low-dose transdermal hormone therapy does not interfere with the blood pressure of hypertensive menopausal women: a pilot study.

OBJECTIVES: To determine the effects of low-dose transdermal hormone therapy (HT) on systolic (SBP) and diastolic (DBP) blood pressure (BP) evaluated by 24-h ambulatory blood pressure monitoring (ABPM) in hypertensive postmenopausal women. METHODS: The study was conducted on 24 hypertensive postmenopausal women aged, on average, 54 years and under treatment with enalapril maleate (10-20 mg/day) combined or not with hydrochlorothiazide (25 mg/day). Thirteen women used a transdermal adhesive containing estradiol and norethisterone (25 and 125 mug active substance/day, respectively) and 11 did not receive HT. ABPM, lipid profile, and climacteric symptoms were evaluated before and 3 and 6 months after treatment. RESULTS: After 3 and 6 months of follow-up, there was a statistically significant reduction of the Blatt-Kupperman menopausal index in the treated group (19.6+/-8.3 vs. 9.6+/-5.9 vs. 9.7+/-7.0; P=0.01). No significant difference in any of the ABPM variables (areas under the systolic and diastolic curves, mean SBP and DBP, SBP and DBP loads and wakefulness-sleep variation) or in the lipid profile was observed between or within groups at the three time points studied. CONCLUSION: Low-dose transdermal HT administered for 6 months was effective in improving climacteric symptoms and did not change BP values or circadian pattern in postmenopausal women with mild-to-moderate arterial hypertension taking antihypertensive medications.