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Overcrowding is a worldwide problem, and long waiting times are associated with increased morbidity and even mortality of patients regardless of triage classification. Although there are many tools published in the literature that contribute to the reduction of overcrowding, for the Colombian population there are not many tools evaluated to reduce the length of stay of patients in the emergency department. This is a retrospective analytical study that compared whether there was a difference in patient definition time and ED length of stay between a group attended under an early care protocol (PAT) versus the usual protocol. Of the total of 969 patients included it was found that the group attended under the PAT protocol had a shorter definition time than the usual protocol, also the Emergency department length of stay (EDLOS) was significantly lower in the PAT group compared to the usual protocol. The implementation of the PAT protocol performed by emergency physicians allows a faster contact with the patient by the physician, and leads to a significant reduction of EDLOS, contributing to the reduction of overcrowding in the emergency department.

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Osmotic stress conditions occur at multiple stages of plant life. Changes in water availability caused by osmotic stress induce alterations in the mechanical properties of the plasma membrane, its interaction with the cell wall, and the concentration of macromolecules in the cytoplasm. We summarize the reported players involved in the sensing mechanisms of osmotic stress in plants. We discuss how changes in macromolecular crowding are perceived intracellularly by intrinsically disordered regions (IDRs) in proteins. Finally, we review methods for dynamically monitoring macromolecular crowding in living cells and discuss why their implementation is required for the discovery of new plant osmosensors. Elucidating the osmosensing mechanisms will be essential for designing strategies to improve plant productivity in the face of climate change.

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Under macromolecular crowding (MC) conditions such as cellular, extracellular, food and other environments of biotechnological interest, the thermodynamic activity of the different macromolecules present in the system is several orders of magnitude higher than in dilute solutions. In this state, the diffusion rates are affected by the volume exclusion induced by the crowders. Immiscible liquid phases, which may arise in MC by liquid-liquid phase separation, may induce a dynamic confinement of reactants, products and/or enzymes, tuning reaction rates. In cellular environments and other crowding conditions, membranes and macromolecules provide, on the whole, large surfaces that can perturb the solvent, causing its immobilisation by adsorption in the short range and also affecting the solvent viscosity in the long range. The latter phenomenon can affect the conformation of a protein and/or the degree of association of its protomers and, consequently, its activity. Changes in the water structure can also alter the enzyme-substrate interaction, and, in the case of hydrolytic enzymes, where water is one of the substrates, it also affects the reaction mechanism. Here, we review the evidence for how macromolecular crowding affects the catalysis induced by hydrolytic enzymes, focusing on the structure and dynamics of water.

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Most crowding measures in public transportation are usually aggregated at a service level. This type of aggregation does not help to analyze microscopic behavior such as exposure risk to viruses. To bridge such a gap, our paper proposes four novel crowding measures that might be well suited to proxy virus exposure risk at public transport. In addition, we conduct a case study in Santiago, Chile, using smart card data of the buses system to compute the proposed measures for three different and relevant periods of the COVID-19 pandemic: before, during, and after Santiago's lockdown. We find that the governmental policies diminished public transport crowding considerably for the lockdown phase. The average exposure time when social distancing is not possible passes from 6.39 min before lockdown to 0.03 min during the lockdown, while the average number of encountered persons passes from 43.33 to 5.89. We shed light on how the pandemic impacts differ across various population groups in society. Our findings suggest that poorer municipalities returned faster to crowding levels similar to those before the pandemic.

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OBJECTIVE: The aim of this 2-arm parallel study was to evaluate the alignment efficiency of heat-activated nickel-titanium (NiTi-TE) and superelastic nickel titanium (NiTi-PSE) archwires over the first 3 months of orthodontic treatment and compare these groups. SETTING AND SAMPLE POPULATION: Randomized, double-blind, controlled, single-center trial in 52 patients with fixed orthodontic appliances from an orthodontic graduate program in the permanent dentition and moderate crowding in the lower arch. MATERIAL AND METHODS: Patients were randomly allocated to one of two interventions: NiTi-TE and NiTi-PSE archwires, 0.014-inch (3M Unitek™, CA, USA) with a follow-up period of 3 months. The primary outcome was the alignment efficiency determined by the reduction in Little's irregularity index (mm), measured in three points, T0: before the start of orthodontic treatment, T1: 1 month later, T2: 2 months later, T3: 3 months later. Data were analyzed using independent sample t tests and repeated measures ANOVA. RESULTS: 52 patients (NiTi-TE n = 26; NiTi-PSE n = 26) were randomized and analyzed (average age: 21.73; standard deviation (SD): 6.07; average lower anterior irregularity: 5.20; SD: 0.76) for intention-to-treat (ITT) analysis. No statistically significant differences between the groups were found (mean of the differences: T1: 0.20; 95% CI: -0.558; 0.958; T2: 0.49: 95% CI: -0.339; 1.319; T3: 0.33; 95% CI: -0.308; 0.968). The resolution of crowding with each of the wires was significant (P < 0.0001) at all times. Twelve participants (2 treated with NiTi-TE and 10 treated with NiTi-PSE) lost follow-up due to face-to-face dental-procedures restrictions during the COVID-19 pandemic, the missing data was imputed. CONCLUSIONS: NiTi-TE and NiTi-PSE wires of 0.014-inch were similar in their clinical efficiency for the resolution of crowding during the first 3 months of orthodontic treatment. REGISTRATION: Clinical Trials NCT03256279.

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INTRODUCTION: Dental crowding is the most prevalent malocclusion in the mixed and permanent detitions and can have a major impact on dentofacial esthetics. However, adjustments to the development and growth of the dentition can potentiate self-correction of dental crowding during childhood. OBJECTIVE: To evaluate the physiological behavior of mandibular incisor crowding in the transition from mixed to permanent dentition. METHODOLOGY: Five electronic databases (PubMed, Scopus, Web of Science, LILACS and LIVIVO) and part of the gray literature (Proquest and Google Scholar) were investigated, based on the eligibility criteria associated with the acronym PECO, until June 2022. The risk of bias was assessed using the ROBINS-E tool and the certainty of evidence, the GRADE tool. RESULTS: Among the 2.663 studies identified, five were selected for qualitative analysis, of which one have a low risk of bias, and four, a moderate risk. A total of 243 patients were evaluated. Evidence with a high level of certainty was generated indicating a tendency for improvement in mandibular incisor crowding from mixed to permanent dentition, with mandibular incisor crowding decreasing from 0.17 to 4.62 mm on average. The mandibular incisor crowding reduction seems to be associated with the amount of initial crowding and spontaneous dental arch dimensional changes that occur in the mixed dentition and culminate in the increase in arch perimeter, leeway space, incisor protrusion and transverse growth of the maxillary and mandibular arch. CONCLUSION: Based on moderate scientific evidence, spontaneous longitudinal changes in dental arch in the transition from the mixed to the permanent dentition demonstrate a spontaneous improvement in mandibular incisor crowding by up to 4.62 mm. These evidence provide a scientific basis for planning only longitudinal follow-up in patients with mild to borderline moderate mandibular incisor crowding in the mixed dentition avoiding overtreatment.

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ABSTRACT Objective: The objective of this study was to determine how arch form and interproximal contact size displace mandibular teeth subjected to an anterior component of force (ACF). Methods: Nine finite element models (FEM) of the mandibular arch were developed using Ansys® v. 16.0 software. They were designed to evaluate the effects of three arch forms (triangular, oval, and square) and three contact sizes (point-to-point, 1 mm diameter, and 2 mm diameter). All nine models were subjected to an ACF of 53.8 N (5486 gm). Three-dimensional tooth rotations and displacements of the mandibular teeth were evaluated, from the right first molar to the left first molar. Results: Arch form had a greater effect on tooth movements than contact size. Triangular arches and point-to-point contacts produced the greatest displacements and rotations of teeth. Oval arches with 2 mm wide interproximal contact points showed the greatest stability. The right first premolar showed the greatest displacements in all of the models. Conclusions: Arch form and contact size affect interproximal tooth stability. Teeth are least stable in narrow arches with point-to-point interproximal contacts, and most stable in wider arches with larger contacts.

RESUMO Objetivo: O objetivo deste estudo foi determinar como o formato da arcada e o tamanho do contato interproximal deslocam os dentes inferiores submetidos a um componente anterior de força (CAF). Métodos: Nove modelos de elementos finitos (MEF) da arcada inferior foram desenvolvidos utilizando o software Ansys® v. 16.0. Eles foram projetados para avaliar os efeitos de três formatos de arcada (triangular, oval e quadrado) e três tamanhos de contato interproximal (ponto a ponto, 1 mm de diâmetro e 2 mm de diâmetro). Todos os nove modelos foram submetidos a um CAF de 53,8 N (5486 gm). Foram avaliados tridimensionalmente as rotações dentárias e os deslocamentos dos dentes inferiores, do primeiro molar direito ao primeiro molar esquerdo. Resultados: A forma da arcada teve um efeito maior no movimento dos dentes do que o tamanho do contato interproximal. Arcadas triangulares e contatos ponto a ponto produziram os maiores deslocamentos e rotações dos dentes. Arcadas ovais com pontos de contato interproximal de 2 mm de largura apresentaram maior estabilidade. O primeiro pré-molar direito apresentou os maiores deslocamentos em todos os modelos. Conclusões: O formato da arcada e o tamanho do contato interproximal afetam a estabilidade dos dentes. Os dentes foram menos estáveis nas arcadas estreitas com contatos interproximais ponto a ponto, e mais estáveis nas arcadas mais largas com contatos maiores.

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El apiñamiento dental es una maloclusión frecuen-te y junto con los requerimientos de estética dental son una causa habitual de la solicitud de tratamien-to ortodóncico. El tiempo que demanda y las moles-tias que pudiera ocasionar el tratamiento produce inquietud en los pacientes y un esfuerzo de los or-todoncistas para optimizar el tiempo y prevenir los efectos adversos. Los tratamientos odontológicos multidisciplinarios permiten una mejor respuesta estética, funcional y de estabilidad post tratamiento. El tiempo de alineación dentaria y finalización, en los pacientes tratados con láser de baja intensidad po-dría mejorar tanto los índices gingivales como la res-puesta al dolor. Adicionalmente, las corticales óseas de los pacientes con ortodoncia tratados con láser, podrían verse menos afectadas en comparación con las de los pacientes no tratados. Se presenta un caso de fotobioestimulación con láser de baja intensidad aplicado en un paciente en fase de alineación, que forma parte de un estudio prospectivo aleatorizado que se desarrolla en la FOUBA y fue aprobado por el comité de Ética de la institución. El paciente aceptó y firmó el consentimiento informado. Finalizada la etapa de alineación, se evaluó la efectividad de la te-rapia con láser de baja intensidad actualmente de-nominada fotobiomodulación en incisivos superiores en la fase de alineación para acelerar el movimiento dentario, la respuesta gingival, el dolor, el estado de la cortical alveolar vestibular y la estética del perfil (AU)

Dental crowding, which is a frequent malocclusion, and dental aesthetic requirements are a common cause for requesting orthodontic treatment. The time that the treatment requires and the inconvenience that it could cause worries the patient and makes orthodontists strive to optimize time and prevent adverse effects. Multidisciplinary treatments would allow a better aesthetic, functional and post-treatment stability response. The dental alignment and completion time in patients treated with low-intensity laser could improve both gingival indices and response to pain. Additionally, the bone cortical of orthodontic patients treated with laser could be less affected compared to those of untreated patients. A case of low-intensity laser photobiostimulation applied to a patient in the alignment phase is presented, which is part of a prospective randomized study carried out at FOUBA and was approved by the institution's Ethics Committee. The patient accepted and signed the informed consent. After the alignment phase, the effectiveness of low-level laser therapy actually called photobiomodulation in upper incisors in the alignment phase is evaluated to accelerate tooth movement; the gingival response; the pain; the vestibular alveolar cortical and the aesthetics of the profile (AU)

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ABSTRACT Introduction: Medical planning for mass gathering events is founded on the structuring of assistance to the population involved and the preservation of the response capacities of the local healthcare system. Large sporting events attended by crowds are increasingly common in society. These events have been shown to be dangerous, generating higher incidences of injuries and illnesses than usual. Thus, planning and the interaction among various public and private sectors are required for the prevention of and response to emergencies and incidents involving multiple victims. Methods: Recently published studies on medical planning for large sports events and current federal agency legislation were selected to conduct an updated review on the subject. Results: After reading titles and abstracts, 159 papers were chosen for a full reading, 50 of which met the eligibility criteria and were included as the basis for this review. The size of the audience, the weather, and the behavior of the crowd seem to contribute significantly to the estimated need for resources in sporting events. Conclusion: Mass events require planning for prevention and to strengthen the resilience of host communities. There is a still a lack of evidence that these events increase the risk of the mass spreading of disease. Level of Evidence: V; Expert opinion .

RESUMEN Introducción: La planificación médica de eventos masivos tiene como pilares la estructuración de la atención a la población involucrada y la preservación de las capacidades de respuesta del sistema local de salud. Los grandes eventos deportivos a los que asisten multitudes son cada vez más comunes en la sociedad. Estos eventos han demostrado ser peligrosos, generando una mayor incidencia de lesiones y enfermedades de lo habitual. Por lo tanto, es necesaria la planificación y la interacción de diversos sectores, públicos y privados, para la prevención y respuesta a emergencias o incidentes con múltiples víctimas. Métodos: Se seleccionaron estudios recientes publicados sobre la planificación médica de grandes eventos deportivos y la legislación vigente en organismos federales con el objetivo de realizar una revisión actualizada sobre el tema. Resultados: Después de leer los títulos y resúmenes, se eligieron 159 artículos para lectura completa y 50 cumplieron los criterios de elegibilidad y se utilizaron como base para esta revisión. El tamaño del público, las condiciones climáticas y el comportamiento de la multitud parecen contribuir significativamente a la estimación de los requisitos de recursos en los eventos deportivos. Conclusión: Los eventos masivos requieren una planificación para la prevención y el fortalecimiento de la resiliencia de las comunidades anfitrionas. Todavía no hay pruebas de que estos eventos aumenten el riesgo de propagación masiva de enfermedades. Nivel de Evidencia: V; Opinión experta .

RESUMO Introdução: O planejamento médico para eventos de massa tem como pilares a estruturação dos atendimentos à população envolvida e a preservação da capacidade de resposta do sistema de saúde local. Grandes eventos esportivos frequentados por multidões são cada vez mais comuns na sociedade. Esses eventos têm se mostrado perigosos, gerando maiores incidências de lesões e doenças do que o habitual. Dessa forma, é necessário planejamento e interação de diversos setores, públicos e privados, para prevenção e resposta à ocorrência de emergências ou incidentes com múltiplas vítimas. Métodos: Foram selecionados trabalhos recentes publicados sobre o planejamento médico para grandes eventos esportivos e a legislação vigente em órgãos federais com o objetivo de realizar uma revisão atualizada sobre o assunto. Resultados: Após a leitura de títulos e resumos, 159 trabalhos foram escolhidos para leitura integral e 50 preencheram os critérios de elegibilidade e foram usados como base para esta revisão. O tamanho do público, as condições climáticas e o comportamento da multidão parecem contribuir significativamente para a estimativa da necessidade de recursos em eventos esportivos. Conclusão: Eventos de massa exigem planejamento para prevenção e fortalecimento da resiliência das comunidades anfitriãs. Ainda faltam evidências de que esses eventos aumentem o risco de propagação maciça de doenças. Nível de evidência: V; Opinião do especialista .

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This article reviews the use of the 6-acetyl-2-(dimethylamino)naphthalene (ACDAN) fluorophore to study dipolar relaxation in cells, tissues, and biomimetic systems. As the most hydrophilic member of the 6-acyl-2-(dimethylamino)naphthalene series, ACDAN markedly partitions to aqueous environments. In contrast to 6-lauroyl-2-(dimethylamino)naphthalene (LAURDAN), the hydrophobic and best-known member of the series used to explore relaxation phenomena in biological (or biomimetic) membranes, ACDAN allows mapping of spatial and temporal water dipolar relaxation in cytosolic and intra-organelle environments of the cell. This is also true for the 6-propionyl-2-(dimethylamino)naphthalene (PRODAN) derivative which, unlike LAURDAN, partitions to both hydrophobic and aqueous environments. We will (i) summarize the mechanism which underlies the solvatochromic properties of the DAN probes, (ii) expound on the importance of water relaxation to understand the intracellular environment, (iii) discuss technical aspects of the use of ACDAN in eukaryotic cells and some specialized structures, including liquid condensates arising from processes leading to liquid immiscibility and, (iv) present some novel studies in plant cells and tissues which demonstrate the kinds of information that can be uncovered using this approach to study dipolar relaxation in living systems.

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BACKGROUND: Emergency Department (ED) boarding is related to in-hospital patients' discharge since no beds will be available for receiving ED patients if there is a delay for patients in the yard leaving the hospital. New techniques implemented in hospital institutions, such as digital signatures to facilitate clerical work improve these processes. We evaluated the impact of expediting patients' discharge after medical orders with the number of patients with an unplanned hospital admission from the Hospital Out Clinic directed to ED for waiting for an available bed in a public tertiary hospital in Brazil. METHODS: We conducted a quasi-experimental study before and after an intervention. It consisted of an encrypted digital signature to reduce clerical work and expedite the patient's release from the institution after medical discharge. We used an interrupted time-series analysis based on administrative data (number of hospital discharges, bed turnover, the time between medical discharge, and the time the patient effectively left the hospital) from 2011 to 2020. RESULTS: We enrolled 210,496 patients admitted to the hospital from January 2011 to December 2020. Of those, 69,897(33%) composed the group after the intervention. There was no difference between the groups' gender, age distribution, the proportion of surgical patients, or in-hospital stay (≤ 7 or > 7 days). The interrupted time series analysis for the time from medical order to effectively hospital discharge showed an immediate change in level (Coefficient ß2 -3.6 h-95% confidence interval -3.9;-3.4), but no a difference in the slope of the behavior of the post-intervention curve (ß3 0.0005 coefficient-95% confidence interval -0.0040;0.0050). For the number of patients directed to ED, we observed no immediate change in level (Coefficient ß2 -0.84 patients-95% confidence interval -0.33;0.16), but a difference in the slope of the behavior of the post-intervention curve (ß3 0.0005 coefficient-95% confidence interval -0.0040;0.0050). CONCLUSION: Reducing clerical work and expediting patient discharge was associated with decreased potential boarders to ED.

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While theory suggests that at conception the sex ratio should be balanced (1:1), this can be variable across space and time in wild populations. Currently, studies of the environmental factors that regulate adult sex ratio (ASR) in species with different life history traits are scarce. Using capture-recapture over a year, we analyzed the influence of habitat type (forest and nonforest) and season (rainy and dry) on variation in ASR, male aggregation and the trajectory movement of 2 dung beetle species with different life history traits: Deltochilum mexicanum (a hornless roller species) and Dichotomius satanas (a tunneler species with horns on its head and thorax). We found opposite tendencies. The D. mexicanum population tends to be female-biased, but the population of D. satanas tends to be predominantly male, and observed values were not related to habitat type or season. However, the 95% confidence intervals estimated were highly variable between seasons depending on habitat. On examining the monthly variation in ASR for both habitats, we found that it depends on the species. In addition, male aggregation differed between species depending on habitat type and season, and species movement patterns were closely related to their habitat preferences. Based on our results, we argue that comparative population studies of species with different life history traits are necessary to understand the variation in demographic parameters as well as its ecological and evolutionary implications in the face of spatial and climatic environmental variation.

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Background: This study aimed to investigate whether the alignment of the teeth while smiling alters the visual perception by laypeople using eye tracking. Methods: Facial images (two males and two females) were digitally edited to show a smile pattern with aligned teeth and one with crowded teeth. Sixty laypeople were selected to observe the images. The number of fixations, fixation duration, and time until the first fixation were recorded using an eye-tracking system. The results were qualitatively calculated with dot maps. Numerical data were analyzed using an independent Student's t test. Results: There were no significant differences in fixation duration and the number of fixations in the crowded smile, mainly that of the male. The fixation times for the teeth were significantly different when the participants viewed the male subjects with a crowded smile (P<0.05). Dot maps showed greater attention to the smile with crowded teeth in both genders. Conclusion: The crowded maxillary incisor smile attracted more visual attention to males from laypeople.

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Introducción: La conexión entre la lepra y los factores sociales, tienen implicación tanto para el paciente, como para la operatividad de los programas de control de esta enfermedad. Objetivo: Caracterizar factores antropológicos socio-demográficos en la incidencia de lepra en el municipio Camagüey. Métodos: Se realizó un estudio observacional, descriptivo, transversal retrospectivo. El universo lo conformaron los pacientes con diagnósticos de lepra incluidos en el periodo que abarcó el estudio y pertenecientes al municipio Camagüey. Las variables estudiadas fueron: formas clínicas según clasificación sanitaria, edad, sexo, área de salud, procedencia geográfica (rural o urbana), ingreso económico familiar e índice de hacinamiento. La información obtenida fue procesada mediante el paquete estadístico SPSS v21. Los métodos empleados fueron estadística descriptiva de distribución de frecuencias absolutas y relativas. Los resultados del estudio se expusieron en tablas y gráficos. Resultados: La lepra multibacilar fue la de mayor incidencia, predominó el grupo de edad entre los 20 y 59 años, el sexo masculino fue el más afectado, el mayor por ciento de casos se observó en las áreas de salud Norte y Previsora, más de las cuatro quintas parte de los pacientes pertenecían a la zona urbana, la mayoría de ellos tenían un ingreso económico familiar malo y predominó el índice sin hacinamiento. Conclusiones: Se hace necesario profundizar en el estudio de los factores antropológicos sociales que pudieran favorecer la adquisición de esta enfermedad.

Introduction: The connection between leprosy and social factors has implications both for the patient and for the operation of the control programs for this disease. Objective: To characterize socio-demographic anthropological factors in the incidence of leprosy in the Camagüey municipality. Methods: A retrospective cross-sectional descriptive observational study was conducted. The universe was made up of patients diagnosed with leprosy included in the period covered by the study and belonging to the municipality of Camagüey. The variables studied were: clinical forms according to health classification, age, sex, health area, geographical origin (rural or urban), family economic income and overcrowding index. The information obtained was processed using the statistical package SPSS v21. The methods used were descriptive statistics of absolute and relative frequency distribution. The results of the study were presented in tables and graphs. Results: Multibacillary leprosy was the one with the highest incidence, the age group between 20 and 59 years old prevailed, with a predominance of males, the highest percentage of cases was observed in the North and Previsory health areas, more than four fifths parts of the patients belonged to urban areas, most of them had a poor family income and the index without overcrowding prevailed. Conclusions: It is necessary to deepen the study of the social anthropological factors that could favor the acquisition of this disease.

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Using LAURDAN fluorescence we observed that water dynamics measured at the interface of DOPC bilayers can be differentially regulated by the presence of crowded suspensions of different proteins (HSA, IgG, Gelatin) and PEG, under conditions where the polymers are not in direct molecular contact with the lipid interface. Specifically, we found that the decrease in water dipolar relaxation at the membrane interface correlates with an increased fraction of randomly oriented (or random coil) configurations in the polymers, as Gelatin > PEG > IgG > HSA. By using the same experimental strategy, we also demonstrated that structural transitions from globular to extended conformations in proteins can induce transitions between lamellar and non-lamellar phases in mixtures of DOPC and monoolein. Independent experiments using Raman spectroscopy showed that aqueous suspensions of polymers exhibiting high proportions of randomly oriented conformations display increased fractions of tetracoordinated water, a configuration that is dominant in ice. This indicates a greater capacity of this type of structure for polarizing water and consequently reducing its chemical activity. This effect is in line with one of the tenets of the Association Induction Hypothesis, which predicts a long-range dynamic structuring of water molecules via their interactions with proteins (or other polymers) showing extended conformations. Overall, our results suggest a crucial role of water in promoting couplings between structural changes in macromolecules and supramolecular arrangements of lipids. This mechanism may be of relevance to cell structure/function when the crowded nature of the intracellular milieu is considered.

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This study investigated protection against Eimeria tenella following the vaccination of chicks with 5.3 × 106 E. tenella whole-sporozoites emulsified in the nanoparticle adjuvant IMS 1313 N VG Montanide™ (EtSz-IMS1313). One-day-old specific pathogen-free (SPF) chicks were subcutaneously injected in the neck with EtSz-IMS1313 on the 1st and 10th days of age. Acquired immunity was assayed through a challenge with 3 × 104 homologous sporulated oocysts at 21 days of age. The anticoccidial index (ACI) calculated for every group showed the effectiveness of EtSz-IMS1313 as a vaccine with an ACI of 186; the mock-injected control showed an ACI of 18 and the unimmunized, challenged control showed an ACI of -28. In a comparison assay, antibodies from rabbits and SPF birds immunized with EtSz-IMS1313 recognized almost the same polypeptides in the blotting of E. tenella sporozoites and merozoites. However, rabbit antisera showed the clearest recognition pattern. Polypeptides of 120, 105, 94, 70, 38, and 19 kDa from both E. tenella life cycle stages were the most strongly recognized by both animal species. The E. tenella zoite-specific IgG antibodies from the rabbits demonstrated the feasibility for successful B cell antigen identification.

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ABSTRACT BACKGROUND: Patients with low back pain frequently undergo a variety of diagnostic and therapeutic interventions, but some of these have uncertain effectiveness. This highlights the importance of the association of healthcare services and therapeutic measures relating to disability. OBJECTIVE: To analyze the use of healthcare services and therapeutic measures among Brazilian older adults with disability-related low back pain. DESIGN AND SETTING: Observational cross-sectional study on baseline assessment data from the Back Complaints in the Elders - Brazil (BACE-B) cohort. METHODS: The main analyses were based on a consecutive sample of 602 older adult participants in BACE-B (60 years of age and over). The main outcome measurement for disability-related low back pain was defined as a score of 14 points or more in the Roland Morris Questionnaire. RESULTS: Visits to doctors in the previous six weeks (odds ratio, OR = 1.82; 95% confidence interval, CI 1.22-2.71) and use of analgesics in the previous three months (OR = 1.57; 95% CI 1.07-2.31) showed statistically significant associations with disability-related low back pain. The probability of disability-related low back pain had an additive effect to the combination of use of healthcare services and therapeutic measures (OR = 2.57; 95% CI 1.52-4.36). The analyses showed that this association was significant among women, but not among men. CONCLUSIONS: Occurrence of the combined of consultations and medication use was correlated with higher chance of severe disability among these elderly people with nonspecific low back pain. This suggested that overuse and "crowding-in" effects were present in medical services for elderly people.

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Abstract INTRODUCTION: Household crowding deserves attention when evaluating the transmission intensity of SARS-CoV-2 in Brazil. We aimed to evaluate the association between household crowding and COVID-19 incidence. METHODS: Linear and Poisson regression analyses were used to assess the associations between indices of household crowding (high, average, low) and COVID-19 incidence estimates. RESULTS: Cities with a high index of household crowding were linked with a significantly higher COVID-19 incidence estimate (excess of 461 per 100,000; 95% confidence interval: 371-558 per 100,000). CONCLUSIONS: Crowding typically promotes virus transmission. Considering urban and housing structures is essential in designing mitigation strategies during a pandemic.

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ABSTRACT Introduction: Due to the anatomical constraints of the mandible, mandibular dental arch usually serves as a guideline to determine the required changes in the maxillary transverse dimension. The Schwarz appliance and the Lip Bumper are the traditional orthodontic appliances for mandibular arch expansion in patients with borderline amounts of crowding, and/or transverse discrepancy. However, they often require patient cooperation, which may be a concern for orthodontists in daily practice. Objectives: This article illustrates a simple fixed orthodontic device as an alternative to achieve mandibular arch expansion in patients with moderate tooth-size/arch-length discrepancy. The four reported cases refer to 8 to 10-year-old patients in the mixed dentition, with an Angle Class I or Class II malocclusion, transverse deficiency in both arches, moderate crowding and/or posterior crossbite, combined with compromised smile aesthetics. The patients were treated with rapid maxillary expansion (RME) using Hass expander appliance and the modified Arnold expander (MAE). Conclusion: This low-cost compliance-free orthodontic appliance provided dentoalveolar decompensation by means of uprighting the posterior teeth, with minimal or no adjustments during treatment. The final results were achieved in only three to four months, and fulfilled all treatment objectives, such as an increase in the arch perimeter and width, and a better teeth alignment.

RESUMO Introdução: Devido aos limites anatômicos da mandíbula, a arcada dentária inferior geralmente serve como guia para determinar as alterações necessárias na dimensão transversal da maxila. O aparelho de Schwarz e o Lip Bumper são os aparelhos usados tradicionalmente para expansão da arcada inferior em pacientes com quantidades limítrofes de apinhamento e/ou discrepância transversal. No entanto, eles requerem a cooperação do paciente, o que pode ser uma preocupação para os ortodontistas na prática diária. Objetivos: O presente artigo ilustra uma alternativa diferente de aparelho fixo para se obter a expansão da arcada inferior em pacientes com discrepância moderada de tamanho dentário e/ou comprimento da arcada. Os quatro casos relatados referem-se a pacientes com 8 a 10 anos de idade, na dentição mista, com má oclusão de Classe I ou II de Angle, deficiência transversal em ambas as arcadas, apinhamento moderado e/ou mordida cruzada posterior, apresentando comprometimento da estética do sorriso. Os pacientes foram tratados com expansão rápida da maxila (ERM), usando aparelho expansor de Hass, e expansor Arnold modificado (EAM). Conclusão: O EAM, que é um aparelho de baixo custo e não depende da colaboração do paciente, promoveu uma descompensação dentoalveolar por meio da verticalização dos dentes posteriores, necessitando de mínimo ou nenhum ajuste durante o tratamento. Os resultados pretendidos foram alcançados em três a quatro meses e cumpriram todos os objetivos do tratamento, como aumento do perímetro e largura da arcada, assim como o melhor alinhamento dos dentes.

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ABSTRACT Objective: to verify the conformity of the time interval between the end of the risk classification and the beginning of medical care with that recommended by the Manchester protocol and to relate the times of care and the risk categories with the outcome. Method: Cross-sectional, retrospective, and analytical study. The t test, the analysis of variance and the generalized linear model were used. Results: The average time for medical care in the red and orange categories was 3 and 39.5 minutes, respectively. Death outcome was associated with the red category, with an average time to start the classification of 5.5 minutes and an average length of stay of 2.3 hours. Conclusion: The waiting time for medical care in the high priority categories was longer than recommended, which suggests the need to continuously monitor the system. Shorter waiting times for classification and permanence were related to the red category and the outcome of death.

RESUMEN Objetivo: Verificar el cumplimiento del intervalo de tiempo entre el final de la clasificación de riesgo y el inicio de la atención médica con el recomendado por el protocolo de Manchester y relacionar los tiempos de atención y las categorías de riesgo con el resultado. Método: Estudio transversal, retrospectivo y analítico. Se utilizó la prueba t, el análisis de varianza y el modelo lineal generalizado. Resultados: El tiempo promedio de atención médica en las categorías rojo y naranja fue de 3 y 39,5 minutos, respectivamente. El resultado de la muerte se asoció con la categoría roja, con un tiempo promedio para iniciar la clasificación de 5,5 minutos y una estancia promedio de 2,3 horas. Conclusión: El tiempo de espera para la atención médica en las categorías de alta prioridad fue mayor al recomendado, lo que sugiere la necesidad de monitorear continuamente el sistema. Los tiempos de espera más cortos para la clasificación y la permanencia se relacionaron con la categoría roja y el resultado de la muerte.

RESUMO Objetivo: Verificar a conformidade do intervalo de tempo entre o término da classificação de risco e o início do atendimento médico com o recomendado pelo protocolo de Manchester e relacionar os tempos de atendimento e as categorias de risco com o desfecho. Método: Estudo transversal, retrospectivo e analítico. Foram utilizados o testet, a análise de variância e o modelo linear generalizado. Resultados: O tempo médio para atendimento médico nas categorias vermelha e laranja foi de 3 e 39,5 minutos, respectivamente. Desfecho óbito associou-se à categoria vermelha, com tempo médio para início da classificação de 5,5 minutos e tempo médio de permanência de 2,3 horas. Conclusão: O tempo de espera para atendimento médico nas categorias de alta prioridade foi maior que recomendado, o que sugere a necessidade de monitorar continuamente o sistema. Menores tempos de espera para a classificação e de permanência relacionaram-se à categoria vermelha e ao desfecho óbito.