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Microorganisms with multiple ecological functions can be a useful biotechnological resource in integrated pest- and disease-management programs. This work aimed to investigate the potential endophytic and virulent effects of a strain of Purpureocillium lilacinum on organic cultivation in Brazil. Specifically, the strain's ability to establish itself as an endophyte in common bean, soybean, and sunflower plants when inoculated via seed was evaluated. Furthermore, its antifungal activity against phytopathogens and its pathogenicity and virulence against insects of the order Lepidoptera, Coleoptera, and Hemiptera were evaluated. Furthermore, the strain was evaluated for its biochemical and physiological characteristics. For virulence bioassays, the experiments were conducted under a factorial scheme (2 × 3), with the following factors: (a) fungal inoculation and control without inoculum and (b) types of inocula (blastospores, aerial conidia, and metabolites). The treatments were sprayed on insect species at different stages of development. In summary, it was found that the SBF054 strain endophytically colonized the common bean, with partial recovery from the root tissues of soybean and sunflower plants, 30 days after inoculation; suppressed 86% of Rhizoctonia solani mycelial growth in an in vitro assay; and controlled eggs, nymphs, and Euschistus heros adults. These multifunctional abilities are mainly attributed to the strain's mechanisms of producing metabolites, such as organic acids, soluble nutrients, and hydrolytic enzymes.

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OBJECTIVE: The focus of this triple-blind randomized study was to evaluate the biocompatibility of a new root canal filling sealer (RCFS) based on tristrontium aluminate and dodecacalcium hepta-aluminate in living tissue. MATERIAL AND METHODS: Forty-five Wistar rats (Rattus norvegicus) were divided into three groups: control (polyethylene), sealer (Bio-C Sealer, Londrina, PR, Brazil), and experimental (tristrontium aluminate and dodecacalcium hepta-aluminate). The tissues were analyzed under an optical microscope to assess different cellular events at different time intervals (7, 15, and 30 days). STATISTICAL ANALYSIS: Data were analyzed using the Kruskal-Wallis and Dunn (p < 0.05) tests. RESULTS: In the initial period, a moderate inflammatory infiltrate was observed, similar between the endodontic cements groups (p = 0.725). The intensity of the infiltrate decreased with time, with no significant difference among the groups (p > 0.05). The number of young fibroblasts was elevated in all groups evaluated at 7 days. The experimental group showed the highest number of cells at all time intervals, but the difference with the sealer group at 7 (p = 0.001) and 15 days (p = 0.002) and the control group at 30 days was not significant (p = 0.001). Regarding tissue repair events, the amount of collagen fibers increased over the experimental intervals, with no significant difference between the sealer and control groups (p > 0.05). CONCLUSION: The experimental RCFS based on calcium and strontium aluminates proved to be biocompatible for use in close contact with periapical tissue, inducing a low inflammatory reaction and favoring rapid tissue repair.

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This study investigated the antimicrobial effects of lactic acid (LA) (3%) and peracetic acid (PA) (300 ppm) on tilapia fillets (Oreochromis niloticus) by fogging (15 min) or by immersion (2 s) in a pool of Escherichia coli (NEWP 0022, ATCC 25922, and a field-isolated strain), Staphylococcus aureus (ATCC 25923 and a field-isolated strain), and Salmonella Typhimurium (ATCC 13311 and ATCC 14028), as well as the effects on the physicochemical characteristics of the fillets. Fogging was effective and the best application method to control S. Typhimurium regardless of the acid used, promoting reductions of 1.66 and 1.23 log CFU/g with PA and LA, respectively. Regarding E. coli, there were significant reductions higher than 1 log CFU/g, regardless of the treatment or acid used. For S. aureus, only immersion in PA showed no significant difference (p < 0.05). For other treatments, significant reductions of 0.98, 1.51, and 1.17 log CFU/g were observed for nebulized PA, immersion, and LA fogging, respectively. Concerning the pH of the samples, neither of the acids used differed from the control. However, treatments with LA, and fogging with PA, reduced the pH compared to immersion in PA. As for color parameters, L* and a* values showed changes regardless of the acid or method used, resulting in an improved perception of fillet quality. These results indicate that fogging and immersion are alternatives for reducing S. Typhimurium, E. coli, and S. aureus in tilapia fillets.

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Aquaculture produces more than 122 million tons of fish globally. Among the several economically important species are the Serrasalmidae, which are valued for their nutritional and sensory characteristics. To meet the growing demand, there is a need for automation and accuracy of processes, at a lower cost. Convolutional neural networks (CNNs) are a viable alternative for automation, reducing human intervention, work time, errors, and production costs. Therefore, the objective of this work is to evaluate the efficacy of convolutional neural networks (CNNs) in counting round fish fingerlings (Serrasalmidae) at different densities using 390 color photographs in an illuminated environment. The photographs were submitted to two convolutional neural networks for object detection: one model was adapted from a pre-trained CNN and the other was an online platform based on AutoML. The metrics used for performance evaluation were precision (P), recall (R), accuracy (A), and F1-Score. In conclusion, convolutional neural networks (CNNs) are effective tools for detecting and counting fish. The pre-trained CNN demonstrated outstanding performance in identifying fish fingerlings, achieving accuracy, precision, and recall rates of 99% or higher, regardless of fish density. On the other hand, the AutoML exhibited reduced accuracy and recall rates as the number of fish increased.

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Laccase is a superfamily of ligninolytic enzymes known to degrade a wide variety of xenobiotics, including synthetic dyes. Congo Red (CR) has a diazo dye function, carcinogenic and mutagenic potential, and is currently applied in clinical analysis. The objective of this work was to produce and characterize the crude extract of Lentinus sp. in semi-solid fermentation (FSS) and perform in vitro and in silico studies to assess the potential of the crude extract to discolor the CR dye. Laccase activity was determined using ABTS as substrate and characterized. The in vitro discoloration was carried out using experimental design 22 at room temperature and monitored at 340 nm for 24h. Molecular docking and molecular dynamics simulations were performed between laccase and CR. The maximum laccase activity production was 29.63 U L-1 with six days of FSS. The optimal temperature and pH were 50 °C and 3.0, respectively. Discoloration of the CR dye was obtained only in tests containing CuSO4. Laccase formed stable complexes with the dye, presenting negative binding energy values ranging from -70.94 to -63.16 kcal mol-1 and the occurrence of seven hydrogen bonds. Molecular dynamics results showed the stability of the system (RMSD ranging from 1.0 to 2.5 Ä) and protein-ligand interaction along simulation. RMSF values pointed residues at the end of chains A (residues 300 to 305, 480 to 500) and B (residues 650 to 655 and 950 to 1000) as the most flexible regions of the laccase. This study highlighted the enzymatic action in the bioremediation of CR in vitro in agreement with the in silico simulations that demonstrate the enzyme potential.Communicated by Ramaswamy H. Sarma.

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RESUMO Self (si mesmo) e identidade são constructos psicossociais que têm sido estudados sob diferentes perspectivas teóricas e metodológicas nos campos da neurologia e da psicologia, sem, no entanto, que sejam evidenciadas as continuidades e convergências que possibilitam uma visão integradora de sua construção e funcionamento. Apesar de muitas vezes esses conceitos serem empregados como sinônimos, diversos estudos têm delimitado suas distinções e definido a identidade como uma configuração madura e mais elaborada do self, que emerge no início da adolescência. O presente estudo, de enfoque teórico, tem como objetivo apresentar uma abordagem integradora dos processos biológicos e psicossociais de construção do self e da identidade. Para tanto, inicia conceituando self e traçando um percurso que explora os componentes biológico, cognitivo-afetivo, sociocultural e moral que interatuam na construção do self e da identidade. Diferentes perspectivas tributárias da epistemologia piagetiana e da teoria da identidade de Erik Erikson (status da identidade e identidade narrativa) são postas em diálogo, evidenciando suas convergências e complementariedades, do que se desdobra uma visão integradora dos processos de construção da identidade.

RESUMEN Self (si mismo) e identidad son constructos psicosociales que han sido estudiados bajo diferentes perspectivas teóricas y metodológicas en los campos de la neurología y la psicología cognitiva, sin destacar, sin embargo, las continuidades y convergencias que permiten una visión integradora de su construcción y funcionamiento. Aunque estos conceptos sean usados a menudo como sinónimos, varios estudios han delimitado sus distinciones y definido la identidad como una configuración madura y más elaborada del yo, que surge en el comienzo de la adolescencia. El presente estudio, de enfoque teórico, tiene como objetivo enseñar un abordaje integrativo de los procesos biológicos y psicosociales de construcción del self y de la identidad. Con este fin, comienza por conceptualizar el yo y trazar un camino que explora los componentes biológico-filogenético, cognitivo-afectivo, sociocultural y moral que interactúan en la construcción del self y la identidad. Diferentes perspectivas tributarias de la epistemología de Piaget y de la teoría de la identidad de Erik Erikson (status de identidad e identidad narrativa) se ponen en diálogo, mostrando sus convergencias y complementariedades, a partir de las cuales se desarrolla una visión integradora de los procesos de construcción de la identidad.

ABSTRACT Self and identity are psychosocial constructs studied under different theoretical and methodological perspectives in the neurology and psychology fields without highlighting the continuities and convergences that enable an integrative view of their construction and functioning. Although these concepts are often used interchangeably, several studies have delimited their distinctions and defined identity as a mature and more elaborate configuration of the self, which emerges in early adolescence. With a theoretical focus, the present study aims to present an integrative approach to the biological and psychosocial processes of self and identity construction. To do so, it begins by conceptualizing the self and tracing a path that explores the biological, cognitive-affective, sociocultural and moral components that interact with self and identity construction. Different perspectives based on Piagetian epistemology and Erik Erikson's theory of identity (status and narrative identity) are put into dialogue, highlighting their convergences and complementarities, resulting in an integrative view of identity construction processes.

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Objetivo: Analisar a relação entre o desmame precoce e o desenvolvimento de alergias alimentares por meio de uma revisão integrativa. Método:Revisão integrativa da literatura realizada através das bases de dados Pubmed, Mesh e Scielo.Resultados:Através da busca pelos descritores determinados, foram selecionados 25 estudos científicos que atenderam aos critérios de inclusão. Devido sua grande composição, o leite humano é responsável pela promoção do crescimento das bactérias com efeito bifidogênico, estando em quantidades superiores nos lactentes em AME. Conclusão: Apesar de alguns dos estudos não mostrarem resultados significativos em relação ao leite materno ser um fator protetor contra as alergias alimentares, nenhum deles deixoude incentivar o AM ou mostrar os seus benefícios já cientificamente comprovados.

Objective: To analyze the relationship between early weaning and the development of food allergies through an integrative review. Method: Integrative literature review performed through the Pubmed, Mesh and Scielo databases. Results: Through the search for the descriptors determined, 25 scientific studies that met the inclusion criteria were selected. Due to its large composition, human milk is responsible for promoting the growth of bacteria with bifidogenic effect, being in higher amounts in infants in EBF. Conclusion: Although some of the studies did not show significant results regarding breast milk being a protective factor against food allergies, none of them failed to encourage BF or show its scientifically proven benefits.

Objetivo: Analizar la relación entre el destete precoz y el desarrollo de alergias alimentarias a través de una revisión integradora. Metodo:Revisión integradora de la literatura realizada a través de las bases de datos Pubmed, Mesh y Scielo. Resultados: A través de la búsqueda de los descriptores determinados, se seleccionaron 25 estudios científicos que cumplieron con los criterios de inclusión. Debido a su gran composición, la leche humana es responsable de promover el crecimiento de bacterias con efecto bifidogénico, estando en mayores cantidades en bebés en LME. Conclusión:Aunque algunos de los estudios no mostraron resultados significativos con respecto a que la leche materna sea un factor protector contra las alergias alimentarias, ninguno de ellos falló en fomentar la BF o mostrar sus beneficios científicamente probados.

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OBJECTIVE: To identify the predictors of self-care behaviors in individuals with heart failure. METHOD: A cross-sectional study including 405 patients with heart failure. Self-care behaviors were assessed by the Self-Care of Heart Failure Index. Sociodemographic and clinical characteristics were investigated as predictors of self-care maintenance, management and confidence through logistic regressions. RESULTS: The predictors of self-care maintenance were number of children (p<0.01), left ventricular ejection fraction (p<0.01), positive feeling about disease (p=0.03), obesity (p=0.02) and dialytic chronic kidney disease (p<0.01). The predictors of self-care management were having married children (p<0.01) and sleep apnea (p<0.01). The predictors of self-care confidence were family income (p<0.01), number of hospitalizations in the previous 12 months (p=0.01), number of daily medication doses (p<0.01) and sedentarism (p<0.01). CONCLUSION: Some predictors related to the self-care behaviors were found, so some intensified education and social aid should be aimed at patients with these specific characteristics.

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This investigation aimed to assess the physiological parameters and quality of milk and fresh cheeses produced by cows that were housed in paddocks, either with or without shade, and supplemented with a phytogenic additive. Sixteen crossbred cows were allocated in a 4 × 4 Latin square design, dividing them into paddocks with or without shade, and providing or not providing a phytogenic additive in their feed. This resulted in a total of four treatment groups and sixteen experimental plots, each containing four animals, over four periods of 21 days. Various parameters were examined, including haematology, rectal and skin temperature, respiratory rate, milk yield and composition, serum parameters, and cheese yield and quality. It is worth noting that the temperature and humidity, as measured by a black globe thermometer, did not display significant variations between the different environments and exhibited minimal fluctuations throughout the day. Additionally, the supplementation of the phytogenic additive led to a reduction in haematocrit levels (p = 0.011). Furthermore, the analysis showed that whey obtained from cheese production had a higher fat content when cows were without access to shade (p = 0.005). Notably, there was an interaction between factors in relation to the total dry extract content, which was lower when cows had access to shade and received the additive (p = 0.010). In summary, the provision of a phytogenic additive and the presence or absence of shade did not bring about significant changes in milk production and quality or in the yield and quality of fresh cheese.

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Resistant hypertension (RH) is characterized by being difficult to control, even with the use of various antihypertensive drugs and is associated with target organ lesions and other comorbidities. Thus, new treatment alternatives such as transcutaneous electrical nerve stimulation (TENS) can offer benefits to resistant hypertensive patients by reducing blood pressure (BP) in a non-invasive way and without the need for the association of more antihypertensive drugs. In this case, a patient with RH was submitted to three weekly applications of TENS on the stellate ganglion lasting 40 min each for 1 month. Peripheral and central hemodynamic assessments were performed by 24-h ambulatory BP monitoring (ABPM) before and after TENS applications. After completion of the TENS applications, significant reductions in office systolic (SBP) and diastolic BP (DBP) were observed. There was also a decrease in peripheral SBP and DBP in the 24-h ABPM and sleep and SBP during wakefulness. Additionally, central parameters including central SBP and pulse wave velocity presented a significant reduction in the 24-h ABPM, during the wakefulness and sleep. TENS is able to attenuate the sympathetic hyperactivity present in RH cases and decrease the peripheral and central hemodynamic parameters of a resistant hypertensive patient.

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Heat stress is one of the most important environmental challenges faced by dairy cattle, with a deleterious effect on animal production and welfare. This research was conducted to evaluate the effects of the thermal environment on the physiological and behavioral responses of dairy cattle in a rotational picket. The research was conducted on an experimental farm, located in the Agreste region of the state of Pernambuco, Brazil. The animals were managed in a rotational picket system of signal grass, with an occupation and a rest period of 7 and 28 days, respectively, for a stocking rate of 3.2 AU ha-1. The determination of the effect of stressors on the animals was performed by recording the dry bulb temperature (°C), and the relative humidity, which allowed the characterization of the thermal environment by the temperature and humidity index and by the specific enthalpy (kJ kg-1). The physiological variables monitored were respiratory rate (mov. min-1), rectal temperature (°C), and skin temperature (°C). The behavioral responses quantified were activities, walking, ruminating, idling and ingestive behaviors, eating, and drinking, with the percentage of time spent on each activity being recorded. According to the canonical multivariate analysis, the chi-square test, and the variation of physiological patterns, the animals, even in a situation of greater thermal challenge, presented physiological responses within conditions considered normal; however, they reduced grazing activity (eating) during the hottest hours and increased the activities of rumination and idling.

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O objetivo da pesquisa foi comparar as características físico-químicas e sensoriais de queijos tipo prato, produzidos no Laboratório de Produtos de Origem Animal do Instituto Federal Goiano ­ Campus Rio Verde com o queijo prato industrial e avaliar a aceitabilidade de embalagens inteligentes preparadas com soro de leite e antocianina da casca de jabuticaba. Os queijos prato industriais foram adquiridos no mercado local. Foram realizadas análises de teor de água, extrato seco, cinza, pH, acidez, proteína, lipídios, gordura extrato seco, cor (L*, a*, b*, Chroma e Hue), textura, perfil do consumidor e intenção de compra. Os queijos tipo prato produzidos no laboratório apresentaram maior teor de umidade e pH em comparação com os queijos industriais; no entanto, na análise de cor por colorimetria, não houve diferença entre os parâmetros analisados. Nas análises de cinzas, proteína, lipídios e acidez, os queijos industriais apresentaram maiores valores em relação aos análogos produzidos no laboratório, enquanto maiores teores de gordura extrato seco foram determinados nos queijos análogos quando comparados aos queijos industriais. Por fim, a análise de textura demonstrou que os queijos industriais são mais firmes que seus análogos.

This research aimed to compare the physico-chemical and sensory characteristics of cheeses type 'prato' produced in the Laboratory of Products of Animal Origin of the Goiano Federal Institute ­ Green River Campus with 'Prato' industrial cheese and evaluate the acceptability of intelligent packings prepared with whey and anthocyanin from jabuticaba peel. Industrial 'prato' cheeses were acquired from the local market. Analyses of water content, dry extract, ash, pH, acidity, protein, lipids, dry extract fat, color (L*, a*, b*, Chroma and Hue), texture, consumer profile, and purchase intention. Cheeses type 'prato' produced in the laboratory presented higher in moisture levels and pH compared to industrial cheeses; however, in the color analysis by colorimetry there was no difference between the analyzed parameters. For analyses of ash, protein, lipids, and acidity, the industrial cheeses showed higher values in relation to the analogs produced in the laboratory, while higher contents of dry extract fat were determined in the analog cheeses when compared to the industrial cheeses. Finally, the texture analysis demonstrated that the industrial cheeses are firmer than their analogs.

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Laccases stand out in the industrial context due to their versatile biotechnological applications. Although these enzymes are frequently investigated, currently, Pleurotus ostreatus laccase structural model is unknown. Therefore, this research aims to predict and validate a P. ostreatus laccase theoretical model by means of comparative homology. The laccase target's primary structure (AOM73725.1) was obtained from the NCBI database, the model was predicted from homologous structures obtained from the PDB (PDB-ID: 5A7E, 2HRG, 4JHU, 1GYC) using the Swiss-Model and Modeller, and was refined in GalaxyRefine. The models were validated using PROCHECK, VERIFY 3D, ERRAT, PROVE and QMEAN Z-score servers. Moreover, molecular docking between the laccase model (Lacc4MN) and ABTS was performed on AutoDock Vina. The models that were generated by the Modeller showed superior stereochemical and structural characteristics to those predicted by the Swiss Model. The refinement made it difficult to stabilize the copper atoms which are typical of laccases. The Lacc4MN model showed the interactions between the amino acids in the active site of the laccase and the copper atoms, thereby hinting the stabilization of the metal through electrostatic interactions with histidine and cysteine. The molecular docking between Lacc4MN and ABTS showed negative free energy and the formation of two hydrogen bonds involving the amino acids ASP 208 and GLY 268, and a Pi-sulfur bond between residue HIS 458 and ABTS, which demonstrates the typical catalytic functionality of laccases. Furthermore, the theoretical model Lacc4MN presented stereochemical and structural characteristics that allow its use in silico tests.Communicated by Ramaswamy H. Sarma.

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Histórico -O tratamento de pacientes com lombalgia crônica (LC) em muitos países, incluindo o Brasil, é um grande desafio no nível de atendimento primário e especializado. Além disso, as informações sobre epidemiologia e tratamento de pacientes com LC são escassas. O objetivo principal desta revisão semi-sistemática foi a construção de evidências locais sobre a prevalência e o padrão de tratamento da LC. Métodos: Esta revisão semi-sistemática utilizou Medline, Embase e Biosis via plataforma Ovid e recursos adicionais (Google, Google Scholar, Banco de dados de incidência e prevalência, Organização Mundial da Saúde, Ministério da Saúde do Brasil e informações anedóticas de especialistas locais) para identificar literatura relevante entre 2002 e 2020 para mapear a jornada do paciente. Artigos de texto completos e originais do Brasil em inglês contendo dados sobre pontos de contato predefinidos na jornada do paciente (conscientização, triagem, diagnóstico, tratamento, adesão e controle) foram selecionados. Os dados foram obtidos usando uma média simples ou ponderada, conforme aplicável para os componentes da jornada do paciente. Resultados: De 297 registros, incluindo os fornecidos por especialistas locais, oito estudos foram incluídos para análise. A conscientização da LC e da LC-NeP foi de 30,4% e 12%, respetivamente. De acordo com estudos publicados, a adesão e o controle dos sintomas dos pacientes foram estimados com percentual semelhante de 38% e 18%, respetivamente para a LC e a LC-NeP. A prevalência de LC-NeP (3,6%) foi menor que a de LC (20,6%). Com exceção de uma porcentagem comparável da população tratada, para LC (39,1%) e LC-NeP (38%), a porcentagem de pontos de contato restantes foi maior no caso de LC do que no LC-NeP, o que implicava uma melhora no trajeto do paciente para a LC. Conclusão: O estudo destaca a necessidade de melhorar os resultados dos pacientes em nível nacional, medindo esses pontos de contato da jornada do paciente. O resultado deste estudo baseado em evidências é importante para preencher a lacuna de conhecimento do paciente com LC. Portanto, recomenda-se garantir a educação médica contínua, a conscientização do paciente e a restruturação do sistema de saúde brasileiro, ao mesmo tempo em que adota novas práticas sobre o gerenciamento da dor. [au]

Background: Managing patients with chronic low back pain (CLBP) in many countries, including Brazil, is a major challenge at the primary and specialty care level. Moreover, the information about epidemiology and patient management with CLBP is sparse. The primary objective of this semi-systematic review was to build local evidence about the prevalence and management pattern of CLBP. Methods: This semi-systematic review used Medline, Embase, and Biosis via Ovid the platform and additional resources (Google, Google Scholar, Incidence and Prevalence Database, World Health Organization, Brazilian Ministry of Health, and anecdotal information from local experts) to identify relevant literature between 2002­2020 to map the patient journey. Original full-text articles from Brazil in English containing data on pre-defined patient journey touchpoints (awareness, screening, diagnosis, treatment, adherence, and control) were screened. Data were synthesized using a simple or weighted mean, as applicable for patient journey components. Results. Of 297 records including those provided by local experts, eight studies were included for analysis. Awareness of CLBP and CLBP-NeP was 30.4% and 12%, respectively. According to published studies, adherence and symptoms control of patients was estimated with a similar percentage of 38% and 18%, respectively for CLBP and CLBP-NeP. CLBP-NeP prevalence (3.6%) was lower than that of CLBP (20.6%). Except for a comparable percentage of the treated population, for CLBP (39.1%) and CLBP-NeP (38%), the percentage of remaining touchpoints are higher in the case of CLBP than in CLBP-NeP, implying an improved patient journey for CLBP. Conclusion: The study highlights the usefulness to improve patient outcomes at the national level by measuring these mapping patient journey touchpoints. The outcome of this evidence-based study was fruitful to bridges the know-do gap in CLBP patients. Therefore, it is recommended to ensure continuing medical education, patient awareness, and health system preparedness while embracing the emerging insights on pain management. [au]

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Objective: This study aimed to describe the demands and costs from chronic pain patients over the private Brazilian healthcare system. Methods: This was a retrospective claim database study to assess the resource utilization of pain patients in the private setting. We used a four-year follow-up period to assess inpatient, outpatient, and procedures reported. Further, we promoted a forum of discussion with five pain experts and healthcare managers to address the management of chronic pain and assistance models.Results: We identified 79,689 patients with chronic pain. The orthopedist was the main medical specialist consulted with a total number of 38,879 visits performed. The ophthalmologist, cardiologist, gynecologist, and general practitioner were also frequently consulted (rheumatologist was seldom consulted). Among non-medical specialists, the physical therapist was consulted 87,574 times by 12,342 patients (15% of the entire cohort), Among chronic pain patients, 96% performed at least one exam and 86% of the patients presented at least one ER visit during the follow-up period. In 4 years, we estimate that pain patients costed more than 3 billion reais to the private health care system. According to the experts' opinions, a fragmented healthcare system and the lack of patient centered interdisciplinary approaches contributes to a high ineffective pain management leading to a high use of resources. Conclusion: There is an urgent need to change the chronic pain care model in the Brazilian private setting. Qualification in pain management, a multidisciplinary patient centered care, integrated approaches, pain centers, and patients' education may help changing this scenario.

Objetivo: O objetivo do estudo foi descrever as demandas e custos dos pacientes com dor crônica no sistema privado de saúde brasileiro. Métodos: Neste estudo retrospectivo do banco de dados administrativo, avaliamos a utilização de recursos de pacientes com dor no ambiente privado. Em um período de quatro anos, avaliamos internações, visitas ambulatoriais e procedimentos. Adicionalmente, promovemos um fórum de discussão com cinco especialistas em dor e gerentes de saúde para abordar o manejo da dor e os modelos de assistência. Resultados: Identificamos 79.689 pacientes com dor crônica. O ortopedista foi o principal especialista médico consultado, com 38.879 visitas realizadas. O oftalmologista, o cardiologista, o ginecologista e o clínico geral também foram consultados com frequência (o reumatologista foi raramente consultado). Entre os especialistas não médicos, o fisioterapeuta foi consultado 87.574 vezes por 12.342 pacientes (15% de toda a coorte). Entre os pacientes, 96% realizaram pelo menos um exame e 86% apresentaram pelo menos uma consulta de emergência durante o período. Em 4 anos, estimamos um custo de mais de 3 bilhões de reais para o sistema privado de saúde. De acordo com as opiniões dos especialistas, um sistema de saúde fragmentado e a falta de abordagens centradas no paciente contribuem para um manejo ineficaz da dor, resultando em um alto uso de recursos. Conclusão: Há necessidade de mudar o modelo de manejo da dor crônica no sistema privado brasileiro. Qualificação dos profissionais, atendimento multidisciplinar centrado no paciente, abordagens integradas, centros de dor e educação dos pacientes podem ajudar a mudar esse cenário.

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BACKGROUND: Blood pressure variability (BPV) and arterial stiffness show an association with increased cardiovascular events. Evidences demonstrated an association between higher short-term systolic BPV and stiffer arteries. There is no previous study assessed the correlation between BPV and arterial stiffness measured by a Mobil-O-Graph device. We issued to evaluate the correlation between short-term BPV parameters and Mobil-O-Graph pulse wave velocity (PWV) among suspected hypertensive individuals under treatment. METHODS: Mobil-O-Graph device estimated arterial stiffness (oscillometric PWV [oPWV]) in 649 individuals, and they recorded 24-h ambulatory BP; 428 had suspected hypertension and 221 under treatment. We analyzed the correlation between oPWV and measures of BPV: SD of 24 h BP (24-h SD), SD of daytime BP (daytime-SD), and SD of nighttime BP (nighttime-SD), weighted SD of 24-h BP (wSD), coefficient of variation of 24-h BP (CV 24-h) and average real variability (ARV). RESULTS: Oscillometric PWV showed a positive correlation with all systolic BPV measures, in both groups. Among suspected hypertensives: 24-h SD, r = 0.30; SD daytime-SD, r = 0.34; nighttime-SD, r = 0.16; wSD, r = 0.30; CV 24-h, r = 0.24; ARV, r = 0.22. In the treated individuals: 24-h SD, r = 0.46; daytime-SD, r = 0.47; nighttime-SD, r = 0.35; wSD, r = 0.50; CV 24-h, r = 0.43; ARV, r = 0.37, all P < 0.001. Diastolic BPV demonstrated association with some measures of BPV. In suspected hypertensive group: nighttime-SD, r = 0.13; wSD, r = 0.10, both P < 0.001. And in treated individuals: daytime-SD, r = 0.23; wSD, r = 0.22; CV 24-h, r = 0.19 (all P < 0.001), ARV, r = 0.15 (P < 0.05). Systolic daytime-SD in suspected and diastolic CV 24-h in treated group independently predicted oPWV. CONCLUSION: We observed a positive and independent correlation between Mobil-O-Graph pulse wave velocity and BPV measures, strong to systolic BPV and weak to diastolic BP.

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INTRODUCTION: Dental undergraduates will access the Internet searching for learning materials to complement their training; however, open access content is not generally recommended by dental schools. This study aimed to evaluate how dental students are using online video content. MATERIALS AND METHODS: Students from eight Universities (Athens, Birmingham, Brescia, Cardiff, Melbourne, Paris, Sao Paulo and Valdivia) representing three continents were invited to complete a survey on their access and learning from online videos. RESULTS: International students behave similarly when studying dental content online. Of 515 respondents, 94.6% use the Internet as a learning tool. It was observed that videos are not frequently recommended during didactic lectures (9.6%). But many students (79.9%) will use YouTube for their learning which includes clinical procedures. Students will check online content before performing procedures for the first time (74.8%), to understand what was explained in class (65.9%) or read in books (59.5%), to relearn clinical techniques (64.7%) and to visualise rare procedures (49.8%). More than half of the students do not fully trust the accuracy or the reliability of online content. This does not prevent students from watching and sharing dental videos with classmates (64.4%). The content watched is not shared with teachers (23.3%) even when it contradicts what was learnt in the school (38.2%). CONCLUSION: This study concludes that students regularly integrate open access digital resources into learning portfolios but are hesitant to inform their teachers about their viewing habits. Students wish to receive critical skills on how to evaluate the material they encounter outside their traditional learning space.

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The chemical composition of Santa Inês sheep colostrum was evaluated, as well as chilled milk (zero to 240 hours) and frozen milk for up to 70 days. Results of chemical composition (fat, protein, casein, lactose, total and degreased dry extract) and colostrum somatic cell count (SCC) were presented descriptively. The results of chemical composition and SCC and total bacterial count (TBC) of chilled and frozen milk were evaluated in a completely randomized design, the repetition of milk collection days and the treatments of the times when the milk was chilled and frozen. The comparison of the quality averages of chilled and frozen milk was performed by Tukey test, with a probability of 5.0 %. Santa Inês sheep colostrum showed high protein and fat content, demonstrating a high source of nutrients for lamb nutrition. Santa Inês sheep's milk can be stored for up to 240 hours without changes in chemical quality. Frozen milk from Santa Inês ewes for up to 70 days minus fat content; however, this form of milk preservation is viable. Refrigeration and freezing are alternatives that add value to the milk of Santa Inês ewes, but studies with previous preservation methods are necessary for greater quality assurance.

Avaliou-se a composição química do colostro de ovinos Santa Inês, leite refrigerado (zero a 240 horas) e leite congelado por até 70 dias. Os resultados de composição química (gordura, proteína, caseína, lactose, extrato seco total e desengordurado) e contagem de células somáticas do colostro (CCS) foram apresentados de forma descritiva. Os resultados da composição química, CCS e da contagem bacteriana total (CBT) do leite refrigerado e congelado foram avaliados em delineamento inteiramente casualizado. As repetições foram os dias de coleta do leite e os tratamentos os tempos em que o leite foi refrigerado e congelado. A comparação das médias de qualidade do leite resfriado e congelado foi realizada pelo teste de Tukey, com probabilidade de 5,0 %. O colostro de ovinos Santa Inês apresentou alto teor de proteína e gordura, demonstrando ser uma grande fonte de nutrientes para a nutrição de cordeiros. O leite de ovelha Santa Inês pode ser armazenado sob refrigeração por até 240 horas sem alterações da composição química. O leite congelado de ovelhas Santa Inês pode ser armazenado por até 70 dias, contudo ocorre alteração da composição química, principalmente nos teores de gordura. A refrigeração e o congelamento são alternativas que agregam valor ao leite de ovelhas Santa Inês, porém, mais estudos com estes métodos de preservação, são necessários para maior garantia de qualidade.

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PURPOSE: Using images in the facial image comparison process poses a challenge for forensic experts due to limitations such as the presence of facial expressions. The aims of this study were to analyze how morphometric changes in the face during a spontaneous smile influence the facial image comparison process and to evaluate the reproducibility of measurements obtained by digital stereophotogrammetry in these situations. MATERIALS AND METHODS: Three examiners used digital stereophotogrammetry to obtain 3-dimensional images of the faces of 10 female participants (aged between 23 and 45 years). Photographs of the participants' faces were captured with their faces at rest (group 1) and with a spontaneous smile (group 2), resulting in a total of 60 3-dimensional images. The digital stereophotogrammetry device obtained the images with a 3.5-ms capture time, which prevented undesirable movements of the participants. Linear measurements between facial landmarks were made, in units of millimeters, and the data were subjected to multivariate and univariate statistical analyses using Pirouette® version 4.5 (InfoMetrix Inc., Woodinville, WA, USA) and Microsoft Excel® (Microsoft Corp., Redmond, WA, USA), respectively. RESULTS: The measurements that most strongly influenced the separation of the groups were related to the labial/buccal region. In general, the data showed low standard deviations, which differed by less than 10% from the measured mean values, demonstrating that the digital stereophotogrammetry technique was reproducible. CONCLUSION: The impact of spontaneous smiles on the facial image comparison process should be considered, and digital stereophotogrammetry provided good reproducibility.

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PURPOSE/OBJECTIVES: To investigate dental students' perceptions and concerns regarding the COVID-19 pandemic, their coping strategies and support resources, and their perceived stress levels. METHODS: A customized 19-item survey and the perceived stress scale (PSS) were applied to undergraduate dental students from the US, Spain, Ireland, Chile, India, and Brazil between April 10 and July 5, 2020. Linear modeling and mediation analysis were used to explore the relationships among demographics, stressors, coping mechanisms, social support, and stress RESULTS: A total of 4475 students responded to the survey. The majority (72.4%) were women, and 52.3% had no COVID-19 training at the time of the survey. The students reported that they had to accommodate to changes in patient care (96.6%) and didactic learning (95.2%) activities, while 88.5% of the respondents indicated at least one of their courses moved online. Transition to online courses went "smoothly with some troubles" for 51.8% of the respondents, and 48.3% perceived the faculty as prepared for the online transition; however, 45.9% reported feeling extremely concerned about the impact of COVID-19 on their education. The average PSS score was 21.9 of 40 (moderate stress). Multivariate models were built for participants with full data (n = 3899). Being male, having completed more dental coursework, and perceiving a smoother transition were associated with lower PSS scores; more concern about academic progress was associated with higher PSS. Faculty support mediated the relationship between a smoothness of transition and concern about academic progress and PSS scores CONCLUSION: Stress caused by the pandemic may be alleviated by smoother transition and good faculty support.

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