Nevin Manimala

Braz Oral Res. 2021 Apr 26;35:e040. doi: 10.1590/1807-3107bor-2021.vol35.0040. eCollection 2021.

ABSTRACT

This study aimed to evaluate the influence of choosing different socioeconomic status indicators in research regarding older adults’ oral health. This is a cross-sectional study that analyzed baseline data from the Brazilian Longitudinal Study on Aging (ELSI-Brazil). The outcomes were edentulism (n = 9,073) and self-reported oral health (n = 9,365). The following socioeconomic indicators were assessed: individual income, per capita household income, and wealth index. Poisson regression analysis with robust variance was performed to estimate prevalence ratios (PR), with their respective 95% confidence intervals (CI), after adjusting for socioeconomic and oral health behavior variables. Absolute inequality measures were also estimated. The individual income indicator was not statistically associated with the results after adjustments. When using per capita household income indicator, individuals in the richest quintile showed a 12% lower prevalence of poor self-reported oral health [PR: 0.88 (CI: 0.78-0.98)], relative to the poorest, and there was no association with edentulism. When the wealth index was chosen, there was a 22% lower prevalence of edentulism [PR: 0.78 (CI: 0.64-0.94)] and 15% lower prevalence of self-reported poor oral health [PR: 0.85 (CI: 0.78-0.93)] in individuals of the richest quintile, both relative to the poorest quintile. Regarding absolute inequality measures, for edentulism, the wealth index showed the highest absolute inequality. When considering self-reported oral health, per capita household income showed the greatest absolute inequality. Despite scientific challenges and the difficulty of socioeconomic indicator metrics, further investments in its development are critical to measure, promote, and improve population oral health.

PMID:33909862 | DOI:10.1590/1807-3107bor-2021.vol35.0040

Braz Oral Res. 2021 Apr 26;35:e038. doi: 10.1590/1807-3107bor-2021.vol35.0038. eCollection 2021.

ABSTRACT

A randomized controlled parallel clinical trial was conducted to evaluate the efficacy of the association of 1.23% topical professional acidulated phosphate fluoride (APF) gel with oral hygiene and dietary instructions on the arrest of active non-cavitated lesions in permanent, mixed, and temporary dentition in children between 3 and 12 years of age. Ninety-eight caries-active children were randomly divided into two groups: a fluoride gel group (n = 49) and a non-fluoridated gel group (n = 49). Each group received up to eight weekly applications of gel, weekly professional toothbrushing with oral hygiene instructions and dietary counselling. Caries lesions were assessed qualitatively through visual-tactile criteria performed in three stages: initial, intermediate, and final. Regression models were applied to identify risk indicators for caries control. Between-group comparison regarding the time taken to arrest the lesions was performed using Chi-squared and Fisher’s exact tests. Seventeen children did not receive the allocated intervention, and one was lost to follow-up (n = 80). There was no difference between the control and placebo groups regarding the time to the arrest of the lesion (p >.05). The treatments showed similar results without significant statistical difference (p = 0.33; 95%CI: 0.32-1.48). No adverse effects were observed. It can be concluded that no additional effect of the association of 1.23% APF gel with oral hygiene using fluoride dentifrice and dietary instructions on the arrest of active non-cavitated lesions could be established. We can also confirm the importance of toothbrushing frequency and, consequently, the visible plaque reduction in the control of caries activity. RBR-37V5S3.

PMID:33909860 | DOI:10.1590/1807-3107bor-2021.vol35.0038

Braz J Med Biol Res. 2021 Apr 26;54(6):e10317. doi: 10.1590/1414-431X202010317. eCollection 2021.

ABSTRACT

Physical performance is a multifactorial and complex trait influenced by environmental and hereditary factors. Environmental factors alone have been insufficient to characterize all outstanding phenotypes. Recent advances in genomic technologies have enabled the investigation of whole nuclear and mitochondrial genome sequences, increasing our ability to understand interindividual variability in physical performance. Our objective was to evaluate the association of mitochondrial polymorphic loci with physical performance in Brazilian elite military personnel. Eighty-eight male military personnel who participated in the Command Actions Course of the Army were selected. Total DNA was obtained from blood samples and a complete mitochondrial genome (mtDNA) was sequenced using Illumina MiSeq platform. Twenty-nine subjects completed the training program (FINISHED, ‘F’), and fifty-nine failed to complete (NOT_FINISHED, ‘NF’). The mtDNA from NF was slightly more similar to genomes from African countries frequently related to endurance level. Twenty-two distinct mtDNA haplogroups were identified corroborating the intense genetic admixture of the Brazilian population, but their distribution was similar between the two groups (FST=0.0009). Of 745 polymorphisms detected in the mtDNA, the position G11914A within the NADPH gene component of the electron transport chain, was statistically different between F and NF groups (P=0.011; OR: 4.286; 95%CI: 1.198-16.719), with a higher frequency of the G allele in group F individuals). The high performance of military personnel may be mediated by performance-related genomic traits. Thus, mitochondrial genetic markers such as the ND4 gene may play an important role on physical performance variability.

PMID:33909855 | DOI:10.1590/1414-431X202010317

Codas. 2021 Apr 12;33(1):e20190285. doi: 10.1590/2317-1782/20202019285. eCollection 2021.

ABSTRACT

PURPOSE: To verify the validity evidence based on response processes of a vocabulary-screening tool.

METHODS: This is a descriptive, cross-sectional and quantitative study, applied in a sample of 133 children between 3 and 7 years of age, divided into five groups, according to their age range. This research evaluates the instrument TRILHAR, which is a screening of receptive and expressive vocabulary, composed by ten activities for each age range. The collected data were the application time in minutes and seconds, screening instructions comprehension and behavior during the screening. The data were analyzed descriptively as mean, standard deviation and percentage using the IBM SPSS Statistics.

RESULTS: The application time was short, with less time for the greater ages. The mean time of application was 05m19s for G1, 04m29s for G2, 04m11s for G3, 03m40s for G4 and 02m13s for G5. Only one child (4.8%) from G2 required repetition of the instructions for the receptive vocabulary, and two children (6.3%) from G4 for the expressive vocabulary. We observed little occurrence of behaviors like disinterest, inattention and agitation.

CONCLUSION: The application of the instrument required a short period, with a longer time for the group of 3-years children. The little necessity of repetition of the instructions indicates that children can easily comprehend the instrument.

PMID:33909843 | DOI:10.1590/2317-1782/20202019285

Codas. 2021 Apr 21;33(1):e20190190. doi: 10.1590/2317-1782/20202019190. eCollection 2021.

ABSTRACT

PURPOSE: To verify the immediate effect of the Excitomotor Electrical Current, called Functional Electrical Stimulation (FES), on vocal quality, Maximum Phonation Time (MPT) and possible discomfort, in women without vocal alteration, with application at Maximum Supported Intensity (MSI) and associated with phonation.

METHODS: Experimental study with 20 normophonic adult women. They emitted the sustained vowel / a / and then it was applied to FES during emission of the same vowel. There were five series with three minutes of emission each, interspersed with passive rest. The electrical stimulus was at the MSI by the participant, adjusted by series. Before and after the emissions the voices were recorded and the MPT and the intensity of the stimuli were collected. The vocal quality was rated by judges. Statistical analysis made it possible to compare pre and post emission / electrostimulation data in each phase. Qualitative analysis was performed based on self-reported symptoms.

RESULTS: There was no difference in vocal quality and MPT between pre and post moments in both phases. The difference between MSI and stimulus perception intensity was greater in series 1 than in series 2. There was an increase in MSI in series 5 compared to series 1. No significant negative symptoms or within 48h after procedures were reported.

CONCLUSION: The FES at MSI, associated with phonation, did not generate an immediate change in vocal quality, in the MPT or self-reported discomforts by women without vocal alteration, even with a gradual increase in the stimulus, series by series.

PMID:33909842 | DOI:10.1590/2317-1782/20202019190

Codas. 2021 Apr 26;33(1):e20190112. doi: 10.1590/2317-1782/20202019112. eCollection 2021.

ABSTRACT

PURPOSE: To propose the Dysphonia Risk Screening Protocol for Musical Theatre Actors (DRSP-MTA), to verify its applicability in association with the General Dysphonia Risk Screening Protocol (G-DRSP), to correlate the final scores of both, and these with the total risk score, and to compare the risk of dysphonia measured in musical theater actors with and without vocal complaint.

METHODS: An observational cross-sectional study with 34 musical theater actors, adults, of both genders, with and without vocal complaints and regardless of whether they are professionals or students. The questionnaires were applied individually. Statistical analysis made it possible to verify the correlation between the dysphonia risk scores and to compare the groups with and without vocal complaint.

RESULTS: Most of the participants were male, young adults, professional actors and without vocal complaint. There was a high risk of dysphonia, evidenced by the application of G-DRSP, with means scores compatible with values found in individuals with dysphonia, and reinforced by the indices found with DRSP-MTA application. There was a moderate and directly proportional correlation between the two questionnaire scores; and a correlation of both with the total risk score. Higher G-DRSP scores were observed in the vocal complaint group.

CONCLUSION: DRSP-MTA was feasible and easy to apply and was positively correlated with the total score and G-DRSP score. A high risk of dysphonia was evidenced in individuals with vocal complaints. Although the specific DRSP-MTA score did not differentiate musical theatre actors with and without vocal complaints, the G-DRSP score and the total risk score performed such differentiation.

PMID:33909841 | DOI:10.1590/2317-1782/20202019112

Clinics (Sao Paulo). 2021 Apr 26;76:e2515. doi: 10.6061/clinics/2021/e2515. eCollection 2021.

ABSTRACT

OBJECTIVES: We compared the diagnostic potential of cancer ratio (CR, serum lactate dehydrogenase [LDH]/pleural fluid adenosine deaminase [pfADA]), cancer ratio plus (CR plus, cancer ratio/pleural lymphocyte percentage), and age/pfADA ratio with pfADA in malignant pleural effusion.

METHODS: Data from 100 patients with malignant pleural effusion (MPE) and 119 patients with tuberculous pleural effusion (TPE) were retrospectively collected. PfADA, age/pfADA ratio, CR, and CR plus were compared between patients with MPE and those with TPE in two age groups (≤50 and >50 years). The best cut-off value was determined, and the diagnostic performance was evaluated according to the receiver operating characteristic curve.

RESULTS: PfADA was statistically significantly lower while age/pfADA ratio, CR, and CR plus were significantly higher in the MPE group than in the TPE group in both age groups (p<0.05). For patients aged ≤50 years, the differential diagnostic value of pfADA for MPE was better than those of age/pfADA ratio, CR, and CR plus. At a cut-off value of 13.0 U/L, the sensitivity, specificity, and accuracy were 88.9%, 100.0%, and 98.9%, respectively. For patients aged >50 years, the diagnostic performance of CR plus was superior to those of pfADA, age/pfADA ratio, and CR. At a cut-off value of 22.6, the sensitivity, specificity, and accuracy of CR plus for the diagnosis of MPE were 86.8%, 84.6%, and 86.2%, respectively.

CONCLUSIONS: The best parameter for diagnosing MPE was different for patients aged ≤50 years and >50 years. For patients aged >50 years, CR plus was a good parameter for the differential diagnosis of MPE. For patients aged ≤50 years, pfADA was better.

PMID:33909825 | DOI:10.6061/clinics/2021/e2515

Arq Gastroenterol. 2021 Jan-Mar;58(1):82-86. doi: 10.1590/S0004-2803.202100000-14.

ABSTRACT

BACKGROUND: Hepatocellular carcinoma (HCC) is the most frequent primary cancer of the liver and cirrhosis is considered a pre-malignant disease. In this context, the evolutionary sequence from low grade dysplastic nodule and high grade dysplastic nodule (HGDN) to early HCC and advanced HCC has been studied. The differential diagnosis between HGDN and early HCC is still a challenge, especially in needle biopsies.

OBJECTIVE: To evaluate an immunohistochemistry panel to differentiate dysplastic nodules and HCC.

METHODS: Patients with cirrhosis who underwent surgical resection or liver transplantation were included. The sensitivity, specificity and accuracy for the diagnosis of neoplasia were analyzed by evaluating five markers: heat shock protein 70, glypican 3, glutamine synthetase, clathrin heavy chain and beta-catenin. P≤0.05 was considered statistically significant.

RESULTS: One hundred and fifty-six nodules were included; of these, 57 were HCC, 14 HGDN, 18 low grade dysplastic nodules and 67 regenerative macronodules. Sensitivity of HCC diagnosis was 64.9% for glypican 3 and 77.2% for glutamine syntetase, while specificity was 96.0% and 96.0% respectively. When the panel of four markers was considered (excluding beta catenin), the specificity ranged from 87.9% for one positive marker to 100% for at least three markers. The best accuracy for HCC diagnosis was obtained with at least two positive markers, which was associated with a sensitivity of 82.5% and specificity of 99%.

CONCLUSION: Differential diagnosis of dysplastic nodules and HCC by morphological criteria can be challenging. Immunomarkers are useful and should be used for the differential diagnosis between HCC and HGDN.

PMID:33909802 | DOI:10.1590/S0004-2803.202100000-14

Breast Cancer Res Treat. 2021 Apr 28. doi: 10.1007/s10549-021-06217-4. Online ahead of print.

ABSTRACT

PURPOSE: To characterize health-related quality of life (HRQoL) in patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC) from the NALA phase 3 study.

METHODS: In NALA (NCT01808573), patients were randomized 1:1 to neratinib + capecitabine (N + C) or lapatinib + capecitabine (L + C). HRQoL was assessed using seven prespecified scores from the European Organisation for Research and Treatment of Cancer Quality Of Life Questionnaire core module (QLQ-C30) and breast cancer-specific questionnaire (QLQ-BR23) at baseline and every 6 weeks. Descriptive statistics summarized scores over time, mixed models evaluated differences between treatment arms, and Kaplan-Meier methods were used to assess time to deterioration in HRQoL scores of ≥ 10 points.

RESULTS: Of the 621 patients randomized in NALA, patients were included in the HRQoL analysis if they completed baseline and at least one follow-up questionnaire. The summary, global health status, physical functioning, fatigue, constipation, and systemic therapy side effects scores were stable over time with no persistent differences between treatment groups. There were no differences in time to deterioration (TTD) for the QLQ-C30 summary score between treatment arms; the hazard ratio (HR) for N + C vs. L + C was 0.94 (95% CI 0.63-1.40). Only the diarrhea score worsened significantly more in the N + C arm as compared to the L + C arm, and this remained over time (HR for TTD for N + C vs. L + C was 1.71 [95% CI 1.32-2.23]).

CONCLUSION: In NALA, patients treated with N + C maintained their global HRQoL over time, despite a worsening of the diarrhea-related scores. These results may help guide optimal treatment selection for HER2-positive MBC.

PMID:33909203 | DOI:10.1007/s10549-021-06217-4

Brain Topogr. 2021 Apr 28. doi: 10.1007/s10548-021-00840-6. Online ahead of print.

ABSTRACT

Nowadays, the brain-computer interface (BCI) systems attract much more attention than before, yet they have not found their ways into our lives since their accuracy is not satisfying. Error Related Potential (ErRP) is a potential that occurs in human brain signals when an unintended event happens, against ones’ will and thoughts. An example is the occurrence of an error in BCI systems. Investigation of the ErRP could enable researchers to increase the accuracy of BCI systems by detecting instances of inaccuracy in the system. In this research the effects of two parameters on the ErRP are studied: (1) The Motor Imagery Time, also known as Inter-Stimulus Interval (ISI) and (2) different types of feedback (Visual and Tactile). The statistical analysis of the ErRP characteristics showed that feedback type meaningfully affects the ErRP in a cue-paced BCI system and it will affect the time of occurrence of this potential. To validate the proposed idea, different feature extraction, and classification techniques were used for the classification of the BCI system responses. It was shown that by proper selection of the parameters and features, the accuracy of the system could be improved. Tactile feedback together with higher ISI could increase the accuracy of finding erroneous trials up to 90%. The proposed method’s accuracy was significantly higher (p-value < 0.05) compared to other methods of feature extraction.

PMID:33909193 | DOI:10.1007/s10548-021-00840-6