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Aprotic organic solvents such as acetonitrile offer a potential solution to promote electrochemical CO2 reduction over the competing hydrogen evolution reaction. Tetraalkylammonium cations (TAA+) are widely used as supporting electrolytes in organic media due to their high solubility and conductivity. The alkyl chain length of TAA+ cations is known to influence electron transfer processes in electrochemical systems by the adsorption of TAA+, causing modifications of the double layer. In this work, we elucidate the influence of the cation chain length on the mechanism and selectivity of the CO2RR reaction under controlled dry and wet acetonitrile conditions on copper cathodes. We find that the hydrophobic hydration character of the cation, which can be tuned by the chain length, has an effect on product distribution, altering the reaction pathway. Under dry conditions, smaller cations (TEA+) preferentially promote oxalate production via dimerization of the CO2 ·- intermediate, whereas formate is favored in the presence of water via protonation reaction. Larger cations (TBA+ > TPA+ > TEA+) favor the generation of CO regardless of water content. In situ FTIR analysis showed that TBA+ cations are able to stabilize adsorbed CO more effectively than TEA+, explaining why larger cations generate a higher proportion of CO. Our findings also suggest that higher cation concentrations suppress hydrogen evolution, particularly with larger cations, highlighting the role of cation chain length size and hydrophobic hydration shell.

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Electrochemical CO2 reduction in non-aqueous solvents is promising due to the increased CO2 solubility of organic-based electrolytes compared to aqueous electrolytes. Here the effect of nine different salts in propylene carbonate (PC) on the CO2 reduction product distribution of polycrystalline Cu is investigated. Three different cations (tetraethylammonium (TEA), tetrabutylammonium (TBA), and tetrahexylammonium (THA)) and three different anions (chloride (Cl), tetrafluoroborate (BF4), and hexafluorophosphate (PF6)) were used. Chronoamperometry and in-situ FTIR measurements show that the size of the cation has a crucial role in the selectivity. A more hydrophobic surface is obtained when employing a larger cation with a weaker hydration shell. This stabilizes the CO2-· radical and promotes the formation of ethylene. CO2 reduction in 0.7 M THACl/PC shows the highest hydrocarbon formation. Lastly, we hypothesize that the hydrocarbon formation pathway is not through C-C coupling, as the CO solubility in PC is very high, but through the dimerization of the COH intermediate.

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PURPOSE  : To assess gender differences in COVID-19 related changes in home and work responsibilities longitudinally, and determine whether these differences, together with other potential risk and protective factors, are associated with depression, anxiety, and post-traumatic stress disorder (PTSD) symptomatology. METHOD: Symptoms of depression, anxiety, and PTSD were measured using an online survey instrument, between May 2020 and April 2021, in four waves completed at 3-monthly intervals. Analyses were based on data from the COvid MEntal healTh (COMET) survey which investigated the mental health effects of the COVID-19 outbreak spanning 13 countries on five continents in N = 7,909 participants. RESULTS: From the first to the last wave, women reported a greater increase in home and work responsibilities, and had higher depression, anxiety and PTSD scores compared to men. Women who reported a reduction in income due to the pandemic had higher depression scores. Working harder and experiencing a reduction in income were also associated with higher anxiety scores in women but not in men. Women were more likely to score above the cut-off for depression (32.5% vs 23.6%, p < .001), anxiety (21.2% vs 14.4%, p < .001) and PTSD (21.2% vs 14.4%, p < .001) than men during the first wave. Stronger reliance on socially supported coping mechanisms was a risk factor for depression, anxiety and PTSD in men and women. CONCLUSION: Women were more likely to report mental health problems which may be related to the gender disproportionate increase in home and work responsibilities but not necessarily due to COVID-19 stressors.

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Introduction: Emotional disorders (ED) (mood and anxiety disorders) are very prevalent and disabling, and often appear in comorbid presentations. Although there are effective treatments for these disorders, there is still a large gap between the number of people who need them and those who actually receive them. The combination of three strategies may help in this regard, facilitating the dissemination and accessibility of treatment: the transdiagnostic perspective of ED, the group format, and the use of technologies in a blended format (i.e., the combination of online and face-to-face therapy elements). This study intends to compare the efficacy of a new ED intervention, a transdiagnostic group treatment protocol administered in a blended format, with that of a face-to-face treatment. This article describes the study protocol for the randomized controlled trial. Method and analyses: A two-arm, parallel-group, randomized controlled clinical trial (RCT) will be conducted. Participants (N = 144) will be adult volunteers suffering from DSM-5 anxiety and/or depressive disorders and will be randomly assigned to one of two conditions: Face-to-face Group Transdiagnostic Protocol or Blended Group Transdiagnostic Protocol. The face-to-face condition will consist of a total of 16 weekly face-to-face group sessions, while the blended condition will consist of 8 biweekly face-to-face group sessions in combination with self-applied work through a web platform. Clinical and acceptability measures will be included in both groups. Assessments will be performed at baseline, during the treatment, at post-treatment, and at 3-, 6- and 12-month follow-ups. This study received the approval of the Ethics Committee of Universitat Jaume I in October 2021 (CD/91/2021). Intention-to-treat analyses will be performed. Statistical analyses will be carried out using SPSS version 28.0. The results will be reported in accordance with CONSORT recommendations. Discussion: This is the first RCT to compare the effectiveness of an ED treatment protocol based on the transdiagnostic perspective and applied in group and blended format. It will offer relevant data to continue moving forward towards treatment alternatives that are cost-effective and more accessible, so that all patients with ED who require them can benefit. Trial registration: ClinicalTrials.gov Identifier: NCT05569018. Registered 06 October 2022, https://clinicaltrials.gov/study/NCT05569018.

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A technique is outlined for utilising a polymeric composite reinforced with glass fibres in a three-dimensional mesh as a post-core in aesthetic cases. The clinical procedure involves obtaining an impression of the root canal space, scanning the definitive cast, and milling a fibre-reinforced composite post-core. Subsequently, the intra-radicular post-core is cemented using an adhesive resin cement. The use of custom-made computer-aided design-computer-aided manufacturing (CAD-CAM) fibre-reinforced composite post-core facilitates repairability, provides better adaptation to the root canal space, avoids uneven cement thickness, ensures chemical adhesion to resin cement, and promotes favourable aesthetics when combined with all-ceramic crowns.

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Polyamine (PA) spermidine (SPD) plays a crucial role in aging. Since SPD accumulates in glial cells, particularly in Müller retinal cells (MCs), the expression of the SPD-synthesizing enzyme spermidine synthase (SpdS) in Müller glia and age-dependent SpdS activity are not known. We used immunocytochemistry, Western blot (WB), and image analysis on rat retinae at postnatal days 3, 21, and 120. The anti-glutamine synthetase (GS) antibody was used to identify glial cells. In the neonatal retina (postnatal day 3 (P3)), SpdS was expressed in almost all progenitor cells in the neuroblast. However, by day 21 (P21), the SpdS label was pronouncedly expressed in multiple neurons, while GS labels were observed only in radial Müller glial cells. During early cell adulthood, at postnatal day 120 (P120), SpdS was observed solely in ganglion cells and a few other neurons. Western blot and semi-quantitative analyses of SpdS labeling showed a dramatic decrease in SpdS at P21 and P120 compared to P3. In conclusion, the redistribution of SpdS with aging indicates that SPD is first synthesized in all progenitor cells and then later in neurons, but not in glia. However, MCs take up and accumulate SPD, regardless of the age-associated decrease in SPD synthesis in neurons.

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Life depends on a conserved set of chemical energy currencies that are relics of early biochemistry. One of these is ATP, a molecule that, when paired with a divalent metal ion such as Mg2+, can be hydrolyzed to support numerous cellular and molecular processes. Despite its centrality to extant biochemistry, it is unclear whether ATP supported the function of ancient enzymes. We investigate the evolutionary necessity of ATP by experimentally reconstructing an ancestral variant of the N2-reducing enzyme nitrogenase. The Proterozoic ancestor is predicted to be ~540-2,300 million years old, post-dating the Great Oxidation Event. Growth rates under nitrogen-fixing conditions are ~80% of those of wild type in Azotobacter vinelandii. In the extant enzyme, the hydrolysis of two MgATP is coupled to electron transfer to support substrate reduction. The ancestor has a strict requirement for ATP with no other nucleotide triphosphate analogs (GTP, ITP, and UTP) supporting activity. Alternative divalent metal ions (Fe2+, Co2+, and Mn2+) support activity with ATP but with diminished activities compared to Mg2+, similar to the extant enzyme. Additionally, it is shown that the ancestor has an identical efficiency in ATP hydrolyzed per electron transferred to the extant of two. Our results provide direct laboratory evidence of ATP usage by an ancient enzyme.IMPORTANCELife depends on energy-carrying molecules to power many sustaining processes. There is evidence that these molecules may predate the rise of life on Earth, but how and when these dependencies formed is unknown. The resurrection of ancient enzymes provides a unique tool to probe the enzyme's function and usage of energy-carrying molecules, shedding light on their biochemical origins. Through experimental reconstruction, this research investigates the ancestral dependence of a nitrogen-fixing enzyme on the energy carrier ATP, a requirement for function in the modern enzyme. We show that the resurrected ancestor does not have generalist nucleotide specificity. Rather, the ancestor has a strict requirement for ATP, like the modern enzyme, with similar function and efficiency. The findings elucidate the early-evolved necessity of energy-yielding molecules, delineating their role in ancient biochemical processes. Ultimately, these insights contribute to unraveling the intricate tapestry of evolutionary biology and the origins of life-sustaining dependencies.

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The extent to which the neural systems underlying semantic processes degrade with advanced age remains unresolved, which motivated the current study of neural activation on functional magnetic resonance imaging (fMRI) during semantic judgments of associated vs. unassociated, semantic vs. rhyme, and abstract vs. rhyme word pairs. Thirty-eight older adults, 55-85 years of age, performed semantic association decision tasks in a mixed event-related block fMRI paradigm involving binary judgments as to whether word pairs were related (i.e., semantically associated). As hypothesized, significantly greater activation was evident during processing of associated (vs. unassociated) word pairs in cortical areas implicated in semantic processing, including the angular gyrus, temporal cortex, and inferior frontal cortex. Cortical areas showed greater activation to unassociated (vs. associated) word pairs, primarily within a large occipital cluster. Greater activation was evident in cortical areas when response to semantic vs. phonemic word pairs. Contrasting activation during abstract vs. concrete semantic processing revealed areas of co-activation to both semantic classes, and areas that had greater response to either abstract or concrete word pairs. Neural activation across conditions did not vary as a function of greater age, indicating only minimal age-associated perturbation in neural activation during semantic processing. Therefore, the response of the semantic hubs, semantic control, and secondary association areas appear to be largely preserved with advanced age among older adults exhibiting successful cognitive aging. These findings may provide a useful clinical contrast if compared to activation among adults experiencing cognitive decline due Alzheimer's, frontal-temporal dementia, and other neurodegenerative diseases.

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Parent-led cognitive behavioral therapy (CBT) is an efficient, promising form of therapy that may be well suited for autistic youth with anxiety disorders, though to date it has been minimally tested. In this study, 87 autistic youth (7 to 13 years old) with anxiety disorders and their parents were randomized to two forms of parent-led CBT in which parents led their child through a guided CBT workbook across 12 weeks: one with low therapist contact (four 30-minute telehealth calls), and one with standard therapist contact (ten 60-minute telehealth calls). Anxiety, functional impairment, and autism features significantly declined across therapy, without differences between groups. High satisfaction was reported in both groups, though significantly higher satisfaction ratings were reported in standard-contact CBT. Responder rates were 69% of completers at posttreatment (70% in standard contact, 68% in low contact) and 86% at 3-month follow-up (86% in standard contact, 87% in low contact). Low-contact CBT was estimated to incur an average cost of $755.70 per family compared with $1,978.34 in standard-contact CBT. Parent-led CBT with minimal or standard therapist contact both appear to be effective CBT delivery formats for autistic youth with anxiety disorders, with significant cost savings for low-contact CBT.

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The Astrobiology Primer 3.0 (ABP3.0) is a concise introduction to the field of astrobiology for students and others who are new to the field of astrobiology. It provides an entry into the broader materials in this supplementary issue of Astrobiology and an overview of the investigations and driving hypotheses that make up this interdisciplinary field. The content of this chapter was adapted from the other 10 articles in this supplementary issue and thus represents the contribution of all the authors who worked on these introductory articles. The content of this chapter is not exhaustive and represents the topics that the authors found to be the most important and compelling in a dynamic and changing field.

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OBJECTIVES: This systematic review and meta-analysis aimed to evaluate the clinical and mycological effectiveness of mucoadhesives as vehicles for drugs or natural products in the treatment of oral candidiasis. MATERIALS AND METHODS: The search for articles was carried out in the Medline/PubMed, SCOPUS, EMBASE, Web of Science, Cochrane Library, and SciELO databases before August 2023. We selected the studies, extracted the data, evaluated the study quality, graded the evidence, performed the risk of bias, and carried out meta-analysis. RESULTS: A total of 389 potentially relevant articles were identified, and 11 studies (1869 participants) met the inclusion criteria of the systematic review. The overall risk of bias was considered low. The most common presentation of mucoadhesives was tablets, with miconazole being the most frequently drug used in the delivery system. Mucoadhesives demonstrated comparable efficacy with topical or systemic antifungal agents, with no significant differences between treatments in terms of clinical (RR = 0.907; 95CI = 0.3-1.297; p = 0.591; I2 = 64.648) or mycological (RR = 0.95; 95CI = 0.667-1.360; p = 0.789; I2 = 73.271) efficacy. CONCLUSIONS: Mucoadhesives may be a suitable alternative to conventional treatments, with the advantage of reducing the frequency of application by up to 5 times and the daily dosage by up to 20 times.

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BACKGROUND: Denture biofilm acts as a potential reservoir for respiratory pathogens, considerably increasing the risk of lung infections, specifically aspiration pneumonia, mainly 48h after hospital admission. The establishment of a straightforward, affordable, and applicable hygiene protocol in a hospital environment for the effective control of denture biofilm can be particularly useful to prevent respiratory infections or reduce the course of established lung disease. OBJECTIVES: To evaluate the anti-biofilm effectiveness of denture cleaning protocols in hospitalized patients. METHODOLOGY: The maxillary complete dentures (MCDs) of 340 hospitalized participants were randomly cleaned once using one of the following 17 protocols (n=20): brushing with distilled water, toothpaste, or neutral liquid soap (controls); immersion in chemical solutions (1% sodium hypochlorite, alkaline peroxide, 0.12% or 2% chlorhexidine digluconate), or microwave irradiation (650 W for 3 min) combined or not with brushing. Before and after the application of the protocols, the biofilm of the intaglio surface of the MCDs was evaluated using two methods: denture biofilm coverage area (%) and microbiological quantitative cultures on blood agar and Sabouraud Dextrose Agar (CFU/mL). Data were subjected to the Wilcoxon and Kruskal-Wallis tests (α=0.05). RESULTS: All 17 protocols significantly reduced the percentage area of denture biofilm and microbial and fungal load (P<0.05). The highest percentage reductions in the area of denture biofilm were observed for 1% hypochlorite solution with or without brushing and for 2% chlorhexidine solution and microwave irradiation only in association with brushing (P<0.05). The greatest reductions in microbial and fungal load were found for the groups that used solutions of 2% chlorhexidine and 1% hypochlorite and microwave irradiation, regardless of the association with brushing (P<0.05). CONCLUSIONS: A single immersion for 10 min in 1% sodium hypochlorite, even in the absence of brushing, proved to be a straightforward, rapid, low-cost, and effective protocol for cleaning the dentures of hospitalized patients.

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Molecular innovations within key metabolisms can have profound impacts on element cycling and ecological distribution. Yet, much of the molecular foundations of early evolved enzymes and metabolisms are unknown. Here, we bring one such mystery to relief by probing the birth and evolution of the G-subunit protein, an integral component of certain members of the nitrogenase family, the only enzymes capable of biological nitrogen fixation. The G-subunit is a Paleoproterozoic-age orphan protein that appears more than 1 billion years after the origin of nitrogenases. We show that the G-subunit arose with novel nitrogenase metal dependence and the ecological expansion of nitrogen-fixing microbes following the transition in environmental metal availabilities and atmospheric oxygenation that began ∼2.5 billion years ago. We identify molecular features that suggest early G-subunit proteins mediated cofactor or protein interactions required for novel metal dependency, priming ancient nitrogenases and their hosts to exploit these newly diversified geochemical environments. We further examined the degree of functional specialization in G-subunit evolution with extant and ancestral homologs using laboratory reconstruction experiments. Our results indicate that permanent recruitment of the orphan protein depended on the prior establishment of conserved molecular features and showcase how contingent evolutionary novelties might shape ecologically important microbial innovations.

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All organisms living on Earth descended from a single, common ancestral population of cells, known as LUCA-the last universal common ancestor. Since its emergence, the diversity and complexity of life have increased dramatically. This chapter focuses on four key biological innovations throughout Earth's history that had a significant impact on the expansion of phylogenetic diversity, organismal complexity, and ecospace habitation. First is the emergence of the last universal common ancestor, LUCA, which laid the foundation for all life-forms on Earth. Second is the evolution of oxygenic photosynthesis, which resulted in global geochemical and biological transformations. Third is the appearance of a new type of cell-the eukaryotic cell-which led to the origin of a new domain of life and the basis for complex multicellularity. Fourth is the multiple independent origins of multicellularity, resulting in the emergence of a new level of complex individuality. A discussion of these four key events will improve our understanding of the intertwined history of our planet and its inhabitants and better inform the extent to which we can expect life at different degrees of diversity and complexity elsewhere.

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Introduction: Adjustment disorder (AjD) is a maladaptive response to one or more psychosocial stressors. In many cases, the symptomatology of this disorder disappears once the stressor or its consequences are no longer present. However, in some cases, if left untreated, the symptoms may worsen and develop into a more severe mental disorder. In this regard, different authors propose that a low-intensity intervention may be suitable for this disorder. Previous studies with other mental disorders and with patients with AjD found that blended interventions can be a viable and effective option. The aim of this study is to analyze the feasibility (the participants' expectations and preferences, the satisfaction and acceptance, the appropriateness of different methods of recruitment and data collection, and the reasons for dropping out) of a blended cognitive-behavioral intervention (CBT) for AjD that combines the use of a self-applied Internet-based program with videoconference sessions with a therapist. As a secondary objective, the potential efficacy of this intervention will be tested. Method and analysis: A feasibility trial with a single-group and open-trial design will be conducted. A total of 41 participants will be assigned to the single treatment group. All the participants will be assessed for eligibility and respond at four measurement points: pre-treatment, post-treatment, and 3- and 12-month follow-ups. The treatment combines the use of an Internet-based intervention through a web platform with videoconference sessions with a therapist every 10-12 days. The intervention contains seven modules and is based on CBT. The main outcome measures are related to the feasibility of the intervention (adherence, treatment satisfaction and expectations, participants' opinions, preferences, therapeutic alliance, and usability). Clinical measures will also be assessed. Discussion: To the best of our knowledge, this is the first study to test a blended intervention for AjD in the Spanish language. We expect this intervention to be feasible, and that a future Randomized Controlled Trial will be able to show its efficacy. Potential limitations include difficulties in recruiting the sample, failures in the computer systems, or a high dropout rate. Measures have been taken to try to reduce the impact of these limitations. This study received the approval of the Ethics committee of Universitat Jaume I in March 2022 (CD/42/2022). Trial registration: ClinicalTrials.gov Identifier: NCT05464121. Registered 19 July 2022, https://clinicaltrials.gov/ct2/show/NCT05464121.

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A grand challenge for the next century is in facing a changing climate through bioengineering solutions. Biological nitrogen fixation, the globally consequential, nitrogenase-catalyzed reduction of atmospheric nitrogen to bioavailable ammonia, is a vital area of focus. Nitrogen fixation engineering relies upon extensive understanding of underlying genetics in microbial models, including the broadly utilized gammaproteobacterium, Azotobacter vinelandii (A. vinelandii). Here, we report the first CRISPR interference (CRISPRi) system for targeted gene silencing in A. vinelandii that integrates genomically via site-specific transposon insertion. We demonstrate that CRISPRi can repress transcription of an essential nitrogen fixation gene by ~60%. Further, we show that nitrogenase genes are suitably expressed from the transposon insertion site, indicating that CRISPRi and engineered nitrogen fixation genes can be co-integrated for combinatorial studies of gene expression and engineering. Our established CRISPRi system fills an important gap for engineering microbial nitrogen fixation for desired purposes.IMPORTANCEAll life on Earth requires nitrogen to survive. About 78% of the atmosphere alone is nitrogen, yet humans cannot use it directly. Instead, we obtain the nitrogen we need for our survival through the food we eat. For more than 100 years, a substantial portion of agricultural productivity has relied on industrial methods for nitrogen fertilizer synthesis, which consumes significant amounts of nonrenewable energy resources and exacerbates environmental degradation and human-induced climate change. Promising alternatives to these industrial methods rely on engineering the only biological pathway for generating bioaccessible nitrogen: microbial nitrogen fixation. Bioengineering strategies require an extensive understanding of underlying genetics in nitrogen-fixing microbes, but genetic tools for this critical goal remain lacking. The CRISPRi gene silencing system that we report, developed in the broadly utilized nitrogen-fixing bacterial model, Azotobacter vinelandii, is an important step toward elucidating the complexity of nitrogen fixation genetics and enabling their manipulation.

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BACKGROUND: Care plans documented by nurses in electronic health records (EHR) are a rich source of data to generate knowledge and measure the impact of nursing care. Unfortunately, there is a lack of integration of these data in clinical data research networks (CDRN) data trusts, due in large part to nursing care being documented with local vocabulary, resulting in non-standardized data. The absence of high-quality nursing care plan data in data trusts limits the investigation of interdisciplinary care aimed at improving patient outcomes. OBJECTIVE: To map local nursing care plan terms for patients' problems and goals in the EHR of one large health system to the standardized nursing terminologies (SNTs), NANDA International (NANDA-I), and Nursing Outcomes Classification (NOC). METHODS: We extracted local problems and goals used by nurses to document care plans from two hospitals. After removing duplicates, the terms were independently mapped to NANDA-I and NOC by five mappers. Four nurses who regularly use the local vocabulary validated the mapping. RESULTS: 83% of local problem terms were mapped to NANDA-I labels and 93% of local goal terms were mapped to NOC labels. The nurses agreed with 95% of the mapping. Local terms not mapped to labels were mapped to the domains or classes of the respective terminologies. CONCLUSION: Mapping local vocabularies used by nurses in EHRs to SNTs is a foundational step to making interoperable nursing data available for research and other secondary purposes in large data trusts. This study is the first phase of a larger project building, for the first time, a pipeline to standardize, harmonize, and integrate nursing care plan data from multiple Florida hospitals into the statewide CDRN OneFlorida+ Clinical Research Network data trust.

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Circulating sexual stages of Plasmodium falciparum (Pf) can be transmitted from humans to mosquitoes, thereby furthering the spread of malaria in the population. It is well established that antibodies (Abs) can efficiently block parasite transmission. In search for naturally acquired Ab targets on sexual stages, we established an efficient method for target-agnostic single B cell activation followed by high-throughput selection of human monoclonal antibodies (mAbs) reactive to sexual stages of Pf in the form of gamete and gametocyte extract. We isolated mAbs reactive against a range of Pf proteins including well-established targets Pfs48/45 and Pfs230. One mAb, B1E11K, was cross-reactive to various proteins containing glutamate-rich repetitive elements expressed at different stages of the parasite life cycle. A crystal structure of two B1E11K Fab domains in complex with its main antigen, RESA, expressed on asexual blood stages, showed binding of B1E11K to a repeating epitope motif in a head-to-head conformation engaging in affinity-matured homotypic interactions. Thus, this mode of recognition of Pf proteins, previously described only for PfCSP, extends to other repeats expressed across various stages. The findings augment our understanding of immune-pathogen interactions to repeating elements of the Plasmodium parasite proteome and underscore the potential of the novel mAb identification method used to provide new insights into the natural humoral immune response against Pf . Impact Statement: A naturally acquired human monoclonal antibody recognizes proteins expressed at different stages of the Plasmodium falciparum lifecycle through affinity-matured homotypic interactions with glutamate-rich repeats.

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Abstract Denture biofilm acts as a potential reservoir for respiratory pathogens, considerably increasing the risk of lung infections, specifically aspiration pneumonia, mainly 48h after hospital admission. The establishment of a straightforward, affordable, and applicable hygiene protocol in a hospital environment for the effective control of denture biofilm can be particularly useful to prevent respiratory infections or reduce the course of established lung disease. Objectives To evaluate the anti-biofilm effectiveness of denture cleaning protocols in hospitalized patients. Methodology The maxillary complete dentures (MCDs) of 340 hospitalized participants were randomly cleaned once using one of the following 17 protocols (n=20): brushing with distilled water, toothpaste, or neutral liquid soap (controls); immersion in chemical solutions (1% sodium hypochlorite, alkaline peroxide, 0.12% or 2% chlorhexidine digluconate), or microwave irradiation (650 W for 3 min) combined or not with brushing. Before and after the application of the protocols, the biofilm of the intaglio surface of the MCDs was evaluated using two methods: denture biofilm coverage area (%) and microbiological quantitative cultures on blood agar and Sabouraud Dextrose Agar (CFU/mL). Data were subjected to the Wilcoxon and Kruskal-Wallis tests (α=0.05). Results All 17 protocols significantly reduced the percentage area of denture biofilm and microbial and fungal load (P<0.05). The highest percentage reductions in the area of denture biofilm were observed for 1% hypochlorite solution with or without brushing and for 2% chlorhexidine solution and microwave irradiation only in association with brushing (P<0.05). The greatest reductions in microbial and fungal load were found for the groups that used solutions of 2% chlorhexidine and 1% hypochlorite and microwave irradiation, regardless of the association with brushing (P<0.05). Conclusions A single immersion for 10 min in 1% sodium hypochlorite, even in the absence of brushing, proved to be a straightforward, rapid, low-cost, and effective protocol for cleaning the dentures of hospitalized patients.

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Introduction: Cleft lip and palate rank third among congenital defects, demanding early intervention for correction. Aim: To describe the results obtained with the use of nasoalveolar molding (NAM) and lip adhesion in patients with complete cleft lip-alveolus-palate, treated in the Maxillofacial Surgery service of the Pediatric Hospital of Matanzas between 2010 and 2020. Methods: An observational, descriptive, prospective research was carried out, in a universe of 16 patients with a diagnosis of complete cleft lip-alveolus-palate, treated in the Maxillofacial Surgery Service of Matanzas pediatric hospital during the period from January 2010 to December 2020, determining reference points to perform linear measurements that represented the study variables, both in patients treated only with nasoalveolar molding and in those in whom the nasoalveolar molding-lip adhesion binomial was used. Results: With the exclusive use of nasoalveolar molding, there was a significant reduction of the palatal cleft in all patients under study, with increase in maxillary and hemi-maxillary transverse dimension, as well as a significant reduction of the alveolar cleft. The total reduction of the alveolar cleft was only achieved by combining lip adhesion with nasoalveolar molding. Conclusion: The nasoalveolar molding-lip adhesion combination constitutes an effective binomial in the treatment of complete cleft lip-alveolus-palate.

Introducción: Las fisuras de labio y paladar ocupan el tercer lugar entre los defectos congénitos, demandando una temprana intervención para su corrección. Objetivo: Describir los resultados del empleo del moldeo nasoalveolar y la adhesión labial en pacientes con fisura labio-alveolo-palatina completa, atendidos en el Servicio de Cirugía Maxilofacial del hospital pediátrico de Matanzas, entre 2010 y 2020. Métodos: Se realizó una investigación observacional, descriptiva, prospectiva, en un universo de 16 pacientes con diagnóstico de fisura labio-alveolo-palatina completa, atendidos en el Servicio de Cirugía Maxilofacial del hospital pediátrico de Matanzas, durante el período comprendido de enero de 2010 a diciembre de 2020, determinándose puntos de referencia para realizar mediciones lineales que representaron las variables de estudio, tanto en pacientes atendidos solo con moldeo nasoalveolar como en los que se empleó el binomio moldeo nasoalveolar-adhesión labial. Resultados: Con el empleo exclusivo del moldeo nasoalveolar, existió una significativa reducción de la hendidura palatina en los pacientes estudiados, con incremento de la dimensión transversal maxilar y hemimaxilar, así como una significativa reducción de la hendidura alveolar. La reducción total de la hendidura alveolar solo se logró al combinar la adhesión labial con el moldeo nasoalveolar. Conclusión: La combinación moldeo nasoalveolar-adhesión labial constituye un binomio efectivo en el tratamiento de la fisura labio-alveolo-palatina completa.