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Introduction: The World Health Organization (WHO) strategy for leprosy control from 2021 to 2030 focuses on interrupting transmission, reducing autochthonous cases to zero, and using a safe and effective vaccine and chemoprophylaxis. In 2020, 127,396 new cases were registered in the world, 19,195 new cases in the Americas, and, of these, 17,979 cases in Brazil, about 93.66% of the total in the Americas. Brazil is classified as a country with a high burden of the disease, occupying the 2nd place in the world, behind only India (WHO, 2020). Análise do período de 2010-2015 em publicação recente9, apresenta as seguintes cidades no estado do Pará nas quais se observou maiores taxas de incidência (detecção): Marituba, Belém, Marabá, Parauapebas e Altamira [9]. Material and method: This is an analytical retrospective study carried out in a database - Epi-Info resulting from records of Surveillance and Seroprevalence actions in five endemic municipalities for leprosy located in the Southeast and West of Pará. The following variables were analyzed: age, sex, Clinical Classification, vaccination status with BCG, and the result of the search for IgM antibodies against PGL-1 of Mycobacterium leprae by the “In house” ELISA technique. Results: We evaluated 1551 records examined in the laboratory from 2014 to 2016, which were classified into 123 Multibacillary -MB patients (123/1551 = 7.93%); 71 Paucibacillary-PB patients (71/1551 = 4.57%); 451 Intradomicilliary Consanguineous Contacts - CCOSI (451/1551 = 29.07%) and 906 Non Consanguineous Contacts - CNCOS (906/1551 = 58.41%). 57 MB patients (13.47%), 13 PB patients (3.07%), 133 CCOSI (31.44%) and 220 CNCOS (52.00%) were positive for PGL-1. The correlation of the Classification with the vaccination status showed 57 MB patients without any BCG (57/125 = 45.6%) and only 3 patients with two doses of BCG (3/125 = 2.4%); 17 PB patients without any dose of BCG (17/69 = 24.63%); 80 CCOSI without any BCG (80/455 = 17.58%) and 171 CNCOS (171/906 = 18.87%). The odds ratio (OR) in the analysis between unvaccinated MB patients compared to CCOSI was statistically significant (OR = 14.25; p ˂ 0.0001). The study shows the importance of using the BCG vaccine in healthy contacts of patients with leprosy, as it shows the probability of unvaccinated individuals being 14.25 times more likely to become ill with Multibacillary forms compared to CCOSI. In addition, the BCG vaccine has been in use for 80 years and is the only vaccine that we can use in leprosy control programs. Conclusion: Although the leprosy epidemiological data analyzed recently (2010 - 2015) show a downward trend in the main indicators in Pará, such as the detection of new cases and prevalence, the endemic municipalities are still classified as hyperendemic for the population under 15 years of age and This proves that Surveillance is essential, as well as BCG vaccination according to the Ministry of Health Standards.

The emergence of Porphyromonas gingivalis biofilm is a hallmark of risky burden diseases including Alzheimer's disease and atherosclerosis. The current study aims to screen some natural essential oil compounds and coumarin derivatives to interfere with quorum sensing of the bacterium and thus biofilm formation. A total of 20 ligands (10 essential oil molecules and 10 coumarin derivatives) were docked to P.gingivalis  heme-binding protein HmuY using UCSF Chimera built-in AutoDock interface. Alongside, ADMET properties were also predicted via ADMETsar 2.0 and ProTox-II webservers. All of the selected ligands had higher free energy values than the reference inhibitor MES and native coumarin as well. Moreover, ADME parameters are in good agreement with Lipinski's rule of five. Nevertheless, the best molecules with top binding energy exhibited slight immunogenicity as well as carcinogenicity issues requiring in vitro confirmation. In conclusion, the tested ligands had better efficacy against P.gingivalis quorum sensing and biofilm.

Over the past 20 years, there has been a surge of clinical investigations and useful trials on heart failure (HF) with preserved ejection fraction (HFpEF). HFpEF represents the largest phenotype of HF, a public health concern for its link with high mortality and rates of morbidity.

Background and aim of the study: Sutureless aortic valves are used to reduce operation time. However, the stent implantation might cause postoperative ECG alterations and a higher risk of paravalvular leakage. In literature, some cases of thrombocytopenia are described after implantation. We investigated the Sorin Perceval S Sutureless Valve and the Edwards Intuity Sutureless Valve.Material and methods: Seventy-nine patients underwent aortic valve replacement using a sutureless valve in a single center between 2015 - 2018. Thirty-seven patients received Sorin Perceval S (Group A) and 42 Edwards Intuity (Group B). Simultaneous bypass surgery was performed in 23 patients in Group A and 22 patients in Group B. We compared the groups regarding postoperative TTE and paravalvular leakage, postoperative ECG alterations, need for pacemaker implantation, postoperative platelet count, and 30-day mortalityResults: Only in Group B 2 patients had paravalvular leakage, and one was reoperated within the same hospital stay. In Group A, nine patients suffered from postoperative atrial fibrillation, and in Group B, 16 patients. Left bundle branch block (LBBB) was observed in 5 patients in Group A, and 13 patients in Group B. Two patients in Group A needed a definite pacemaker, and five patients in Group B. Tachy-Brady Syndrome and LBBB were observed more frequently in Group B as well as ECG alterations. One patient died within 30 days in Group A due to multiorgan failure. This patient was older and multimorbid compared to the average. Regarding platelet count, we saw a statistically significant decrease in both groups. There were no major bleeding complications or reoperations due to hemorrhage.Conclusion: Our data shows that sutureless aortic valve replacement is associated with new postoperative ECG alterations, which are self-limiting in most cases. Compared to the literature pacemaker implantation rate in Group B is higher.

Introduction: Dead Sea Salt, rich in minerals and ionic compositions and low in Sodium Chloride (NaCl) has many reported unique properties that set it apart from other salts. Objectives: To evaluate the composition of Dead Sea Salt and assess its in vitro cytotoxicity, and efficacy against oral bacterial leukotoxins, oral endotoxins and oral glucan sucrase. Methods: The cytotoxicity was evaluated in an established cell line (solution at 5000 µg/mL of culture medium) using positive and negative control groups. The effect on oral bacterial leukotoxin (LtxA) and different concentrations of lipopolysaccharide and glucan sucrase was established at 24, 36, 48, 60, 72, 84, and 96 hours using the HPLC method (high-performance liquid chromatography). Results: The most predominant elements detected were the water of crystallization (H2O, water that is found in the crystalline framework of salt and which is not directly bonded ), magnesium chloride (MgCl2), potassium chloride (KCl), sodium chloride (NaCl), calcium chloride (CaCl2), bromide (Br -) and sulfates (SO4). In vitro, Dead Sea Salt presented no cytotoxicity and was highly effective against leukotoxin, endotoxin, and glucan sucrase enzyme. Conclusion and clinical significance: We believe that rinsing with Dead Sea Salt has the potential to contribute to the prevention of periodontal, peri-implant and dental disease and merits clinical research.

Case report: This case report aimed to evaluate temporomandibular joint activity in a patient with the temporomandibular disorder before and after disclusion time reduction (DTR) therapy.Results: Positive changes in joint health were observed in the patient after the DTR treatment. Conclusion: The joint vibration analysis objectively showed significant results with the disclusion-time reduction therapy. The measured parameters were closer to the reference values. Thus, DTR is an effective method to treat TMJ disorders, based on Piper’s classification.

Periodontal suturing beyond the surgical elements it provides precedes the selection of the type of suture versus the fact that it is manipulated with periodontal soft tissue. This fact is the basic element in the selection of the type of suture indicated for use and the way of suturing, which in the periodontal surgeon with experience is performed instinctively without thinking.The article is of the review type, bringing a summary of the published data about the suturing method needed for the periodontal application.Conclusion: The type of suture indicated as a primary indication has a clinical case that is indicated based on clinical diagnosis, but the selection of suture type depending on the material or needle is performed based on the clinical area conditioned by minimal manipulation space and the possibility of laceration of periodontal tissue.

Cancer metastasis to the pituitary gland is rare, but in most cases, it originates from a late-stage breast tumor or lung cancer. The most common symptoms of metastasis to the pituitary gland are diabetes insipidus and visual disturbance. The common site of metastasis is the posterior portion of the pituitary gland because it is highly vascularized. Metastases to this site represent 1% of all tumors [1]. Metastasis to the pituitary gland is difficult to diagnose by hormonal analysis and magnetic resonance imaging of the brain and requires biopsy for confirmation [2].

Introduction: Even after surgical resection and adjuvant chemotherapy in pancreatic cancer the 5-year disease-free survival times (DFS), as well as overall survival rates (OS), are still low and median survival times are below 2 years. Here we retrospectively analyzed the outcome of immunotherapy in the additional adjuvant treatment of pancreatic cancer with long antigen exposition dendritic cell therapy (LANEX-DC®) in 28 patients who were treated at our institution. Patients: Data were available from 28 patients. Dendritic cells (LAEX-DC®) were produced according to a recently published protocol.Results: Therapy was well tolerated and no serious side effects were observed. The median disease-free survival times and the median survival times were 16,9 months and 29,4 months respectively. Five-year DFS and OS were 14,3% and 17,9%. Conclusion: We were able to show in a small cohort of patients that additional treatment with dendritic cells (LANEX-DC®) is highly effective and extends the median disease-free survival times as well as the median survival in the adjuvant treatment of pancreatic cancer, whereas the five-year overall survival still remains unsatisfactory.

Cancer is a serious disease that affects deeply and painfully not only the child who has cancer but also their parents. Through this study, we describe the different aspects of the impact of pediatric cancer on parents: the psychological, social, and family impact to offer optimal care to these parents. Results: mothers represent 82.5% of the participants in our survey. More than sixty percent were of urban origin. The average time from diagnosis to parents’ assessment was 7.3 months. This announcement was made by doctors in 87.5% of cases. Conscious denial of cancer when it was announced was reported in 75% of parents. The social impact of pediatric cancer on parents was significant. The child’s illness was experienced as a very significant psychological distress; all of the parents said they had given up on important projects after their children’s illness. The psycho-emotional impact was represented by feelings of guilt in 37.5% and incapacity for illness in 30%. Forty-two percent felt tensions on the marital level with significant repercussions on the couple with a type of destabilization in 60% of cases. The parent’s relationship with the rest of the family, especially siblings, was marked by neglect and anxiety in 35% and 26% respectively.Conclusion: The discovery of pediatric cancer induces various feelings that will inevitably have an impact on the parents of the affected child. Understanding the different aspects of this impact on the parents’ psycho-social, emotional and family experiences will make it possible to offer optimal care.

In the 17th century, Robert Hooke, an English physicist, proposed Hooke’s law. Since then, the theory of elastic deformation in metals has been restricted to a macroscopic frame that is normalized by Hooke’s law. From the start of the 21st century, Xu has established a microscopic theory of elastic deformation based on Hooke’s law to describe the reaction and movement of vacancy and solute atom in metals under elastic tensile stress [1,2].

Atherosclerosis is the most important factor that leads to the high risk of atherothrombotic cases in patients with diabetes mellitus (DM). High morbidity and mortality in these patients are firstly caused by cardiovascular disease, mostly coronary artery disease (CAD) along with acute coronary syndrome (ACS) [1].

In this short opinion piece, we discuss the appropriate use of the term ‘invasion’ for woody plant expansion and refer to the various ways in which the term is being used in the literature. We point out the present confusion and make suggestions for the use of a more appropriate term (i.e., ‘woody plant encroachment’). We continue with an overview of the various definitions of ‘woody plant encroachment in the literature, we mention associated alternative terms, and we explain the circumstances in which each of these are used. With this piece, we hope to provide more clarity on the use of correct terminology related to woody plant expansion research.

The wheat production (Triticum aestivum L.) in Argentina is the third in importance after soybeans and corn (source: BCR). 

Most parents in affluent countries receive information about neonatal jaundice from instructional pamphlets and/or verbally from nurses before discharge. Predischarge protocols, content and delivery of information for parents, and screening for jaundice vary among hospitals. Newborns are usually screened either visually or with a transcutaneous monitor to estimate the intensity of jaundice. The timing of follow-up is guided by the newborn’s clinical status, age at discharge and risk of developing significant hyperbilirubinemia based on an hour-specific bilirubin level [1,2].

Neonatal sepsis is a systemic infection that causes high morbidity and mortality rates in newborns during the first month of life. Although there is abundant literature on the subject, it remains a fundamental public health problem due to its high prevalence in underdeveloped countries. This article aims to highlight the importance of the approach in investigating neonatal sepsis using causality research questions, which generate knowledge to promote better care and reduce the complications associated with neonatal sepsis in newborns.

Different methods for calculating and estimating a safe face pressure were proposed by researchers, which have some advantages and disadvantages. In each of these methods, some related parameters such as soil geotechnical parameters, dimensions of the tunnel, and geological conditions are used. In these methods, using a series of mathematical or empirical functions, the face pressure is calculated. In this study, the face displacements were obtained using the finite difference numerical FLAC3D, the COB (Netherlands Underground Science Center) empirical, and the Leca and Dormieux (1990) analytical methods. The impact of the COB method on different ground stiffnesses is studied and evaluated. The reference case of this research is the Tehran Metro Line 6 tunnel (excavation radius: 4.6 m).

Buildings are demolished, when they outlived their service life, become structurally/functionally unfit, or have been built illegally. In India, an RCC framed, 40-storied high-rise building, with a built-up area of about 75,000 sqm, built without relevant approvals along with lots of violations of building bye-laws, has been demolished. There is nothing new in this demolition process, but its effect on the environment is unavailable. A study has been conducted to understand the environmental impact of this demolition. Based on the main primary construction materials, the embodied energy of this demolished building has been computed as 7.07 GJ/sqm.The civil construction cost of the building was found to be about INR 200 Crores (USD 27 million, assuming a conversion rate of 1 USD 75 INR in the year 2022). Expected GHGs emissions corresponding to this embodied energy were estimated as 42.42 × 103 MT. Energy in the demolition of the building has been computed to be about 8.7 GJ/sqm. The situation, in which this building can be retrofitted and made compliant with local building bye-laws, has been analyzed for its environmental impact. 

Carbonic anhydrase VI (CA VI) catalyzes the reversible hydration of carbon dioxide in saliva with possible pH regulation, taste perception, and tooth formation effects. Objective: The aim of this work was to undertake a systematic review regarding the relationship between the expression/activity of CA VI in saliva and in dental biofilm and caries experience. Study design: Five databases were searched until February 2020. The composition was based on the PRISMA statement and on the PICOS model. First author, year, subject characteristics, analysis performed, outcome, measures & variables were extracted. The used terms were “carbonic anhydrase VI”, “saliva”, “dental biofilm” and “dental caries”.Results: Five studies in the English language were selected for this systematic review and the main discussed topics were the expression/activity of CA VI in saliva and/or in the dental biofilm of children, and its relationship with dental caries. Conclusion: Salivary carbonic anhydrase plays an important role in the caries dynamics process since there is an association between the expression/activity of CA VI in saliva and the experience of caries. Thus, this protein can predict the risk of dental caries in young patients.

Due to the global pandemic spread of COVID-19, the medical field has experienced many changes [1]. One of the main changes is the attention to Telemedicine (Digital Medicine), which is a part of Digital Health. The combination of ‘Digital’ and ‘Dentistry’ can be awkward because dental treatment is often conducted face-to-face with clinical treatment, but it is planned to proceed with the inevitable flow of the times [2,3]. In addition, Digital therapeutics (DTx), a part of digital dentistry, is a narrower concept and has an evidence-based effect on diseases. This article contains opinions on the concept and current status of Teledentistry and the application of DTx [4].