Osteoinductive effects of preoperative dexamethasone in human dental pulp stem cells primary culture

Aim: The use of dexamethasone (DEX) in mesenchymal cell culture induces osteoblastic differentiation and, consequently, formation of mineralized tissues. Tissue engineering proposes the development of therapeutic strategies aimed at structural and functional regeneration of biological tissues. In this sense, cell characterization in vitro is critical to ensure the development of such techniques. Our objective was to evaluate the osteoinductive effect of DEX administered as a preoperative medication in primary cell culture of human dental pulp stem cell. Methodology: Cells from the third molar pulp were divided into two experimental groups, each with two preoperative medication protocols used in dental practice and differentiated by the intake of DEX in one of them. The assessment of proliferation, differentiation and viability through trypan blue, methylthiazol tetrazolium, and von Kossa and alizarin red assays, respectively, were held within fixed intervals: 7, 14, 21 and 28 days. Conclusion: This study has shown that DEX may influence in vitro human dental pulp stem cell behavior. Lay abstract: Dexamethasone (DEX) is often used as a preoperative drug in dental surgeries because it reduces pain and has favorable effects on other symptoms caused by the surgery. Additionally, when used in cell culture, its osteoinductor effect is observed. In vitro cell characterization is critical to ensure the development of therapeutic strategies used in tissue engineering. In this sense, this study used two preoperative medication protocols regularly used in dental practice. In Protocol A, patients did not intake DEXin Protocol B, patients took in tablets of DEX. It was possible to assess in vitro behavior of human dental pulp stem cells by applying those protocols.UNIFESP Univ Fed São Paulo, Escola Paulista Med, CTCMol, Ctr Cellular & Mol Therapy, São Paulo, BrazilUNIFESP Univ Fed São Paulo, Escola Paulista Med, Translat Surg, Dept Surg, São Paulo, BrazilBIOFABRIS, Natl Inst Sci & Technol, Biofabricat Inst, São Paulo, BrazilHosp Ipiranga, Oral & Maxillofacial Surg Dept, São Paulo, BrazilUNIFESP Univ Fed São Paulo, Escola Paulista Med, CTCMol, Ctr Cellular & Mol Therapy, São Paulo, BrazilUNIFESP Univ Fed São Paulo, Escola Paulista Med, Translat Surg, Dept Surg, São Paulo, BrazilWeb of Scienc

Impact of Stretching Exercises on Work-Related Musculoskeletal Disorders: A Systematic Review

Objective: This study aims to compile the latest information concerning workplace stretching regimens and to give a panoramic view of their effectiveness in reducing work-related Musculoskeletal disorders (MSDs). Methods: Searching MEDLINE, Embase, CINAHL, PEDro, Web of Science, Scopus, Google Scholar, SPORTDiscus and PubMed databases from 2010 to 2022 found 723 eligible studies, based on predefined inclusion criteria. Results: In the review, 14 included studies recruited subjects aged 18 years, with males (n=813), females (n=5141), and some research did not identify gender (n=3). The included studies were of both high (n=6) and low quality (n=8). Seven studies revealed stretching exercises to be an effective and safe non-pharmacological intervention for MSDs, and one study included an active control group observed better improvement in the treatment group. Four trials showed a significant effect from stretching exercises as a stand-alone treatment. Three studies revealed that stretching exercises had a meaningful and major effect on MSDs complaints, while two studies reported no significant results when utilizing Anti-fatigue mats in addition to stretching. Conclusion: The current study indicated that stretching exercises are a crucial and useful technique for preventing and treating pain and function in Work-related MSDs affecting the neck, shoulder, back, etc. Workplace/ergonomic changes can enhance the results of stretching exercises

Cross validation of bi-modal health-related stress assessment

This study explores the feasibility of objective and ubiquitous stress assessment. 25 post-traumatic stress disorder patients participated in a controlled storytelling (ST) study and an ecologically valid reliving (RL) study. The two studies were meant to represent an early and a late therapy session, and each consisted of a "happy" and a "stress triggering" part. Two instruments were chosen to assess the stress level of the patients at various point in time during therapy: (i) speech, used as an objective and ubiquitous stress indicator and (ii) the subjective unit of distress (SUD), a clinically validated Likert scale. In total, 13 statistical parameters were derived from each of five speech features: amplitude, zero-crossings, power, high-frequency power, and pitch. To model the emotional state of the patients, 28 parameters were selected from this set by means of a linear regression model and, subsequently, compressed into 11 principal components. The SUD and speech model were cross-validated, using 3 machine learning algorithms. Between 90% (2 SUD levels) and 39% (10 SUD levels) correct classification was achieved. The two sessions could be discriminated in 89% (for ST) and 77% (for RL) of the cases. This report fills a gap between laboratory and clinical studies, and its results emphasize the usefulness of Computer Aided Diagnostics (CAD) for mental health care

O que nos Disse a Comunidade? A construção de uma agenda pública de demandas coletivas no Alto do Moura-PE

Embora o artesanato seja reconhecido como elemento de grande importância cultural e econômica na comunidade do Alto do Moura, em Caruaru-PE, observa-se uma carência de ações governamentais e políticas públicas que dialoguem efetivamente com o contexto local. O objetivo deste trabalho foi mapear as principais problemáticas apontadas por entrevistados, e por nós observadas, a fim de contribuir para formação de uma agenda pública referente à valorização e ao desenvolvimento do artesanato como negócio, bem como ao atendimento de outras necessidades coletivas da comunidade. Dentre as intervenções realizadas, estiveram a elaboração de um relatório-técnico discutido junto à comunidade e ao poder público municipal. As demandas identificadas geraram recomendações apresentadas aos públicos envolvidos. Acreditamos que sua partilha possa inspirar reflexão sobre formas alternativas de pensar a construção de agendas públicas localizadas de modo participativo e sobre o potencial da pesquisa social de suportar iniciativas em torno de interesses comuns em microcosmos sociais específicos

An appraisal of students' awareness of "self-reflection" in a first-year pathology course of undergraduate medical/dental education

<p>Abstract</p> <p>Background</p> <p>Self-reflection and reflective practice are increasingly considered as essential attributes of competent professionals functioning in complex and ever-changing healthcare systems of the 21^stcentury. The aim of this study was to determine the extent of students' awareness and understanding of the reflective process and the meaning of 'self-reflection' within the contextual framework of their learning environment in the first-year of their medical/dental education. We endorse that the introduction of such explicit educational tasks at this early stage enhances and promotes students' awareness, understanding, and proficiency of this skill in their continuing life-long health professional learning.</p> <p>Methods</p> <p>Over two years, students registered in first-year pathology at the University of Saskatchewan were introduced to a self-reflection assignment which comprised in the submission of a one-page reflective document to a template of reflective questions provided in the given context of their learning environment. This was a mandatory but ungraded component at the midterm and final examinations. These documents were individually analyzed and thematically categorized to a "5 levels-of-reflection-awareness" scale using a specially-designed rubric based on the accepted major theories of reflection that included students' identification of: 1) personal abilities, 2) personal learning styles 3) relationships between course material and student history 4) emotional responses and 5) future applications.</p> <p>Results</p> <p>410 self-reflection documents were analyzed. The student self-awareness on personal learning style (72.7% level 3+) and course content (55.2% level 3+) were well-reflected. Reflections at a level 1 awareness included identification of a) specific teaching strategies utilized to enhance learning (58.4%), b) personal strengths/weaknesses (53%), and c) emotional responses, values, and beliefs (71.5%). Students' abilities to connect information to life experiences and to future events with understanding were more evenly distributed across all 5 levels of reflection-awareness.</p> <p>Conclusions</p> <p>Exposure to self-reflection assignments in the early years of undergraduate medical education increases student awareness and promotes the creation of personal meaning of one's reactions, values, and premises in the context of student learning environments. Early introduction with repetition to such cognitive processes as practice tools increases engagement in reflection that may facilitate proficiency in mastering this competency leading to the creation of future reflective health professionals.</p

Líquen plano oral: relato de caso com diferentes aspectos clínicos / Liquen oral plan: case report with different clinical aspects

Introdução: O Líquen Plano é uma doença mucocutânea imunomediada, de natureza crônica inflamatória e etiologia desconhecida, onde a cavidade oral é um dos locais mais comumente afetados, sendo assim denominado de Líquen Plano Oral (LPO). O LPO, geralmente, acomete mulheres com idade entre 30 e 60 anos, e pode se apresentar como uma lesão semelhante a placa, ou com aspecto reticular, erosivo, atrófico, papular ou bolhoso. Objetivo: Relatar um caso de LPO, com presença de múltiplas lesões que apresentam diferentes aspectos clínicos. Relato de caso: Paciente do sexo feminino, feoderma, de 50 anos de idade, procurou o serviço de diagnóstico oral da UFRN se queixando de ardência no céu da boca. Durante a anamnese a paciente relatou ser ex-tabagista e ter problemas de ansiedade. No exame intraoral observou-se uma lesão ulcerada em palato duro, como também a presença de lesões bilaterais em mucosa jugal que apresentavam aspecto reticular, entretanto essas não exibiam sintomatologia. O diagnóstico clínico de LPO foi emitido. A biópsia excisional da lesão em palato foi realizada, onde o diagnóstico histopatológico corroborou com o clínico. A paciente se encontra sob acompanhamento clínico. Conclusão: O paciente com LPO deve ser acompanhado rotineiramente, visto que muitas vezes as lesões orais antecedem às manifestações extraorais, sendo o cirurgiões-dentistas um agente importante no diagnóstico dessa doença, o que possibilita a realização de um tratamento adequado.Liquen oral plan: case report with different clinical aspect

Educação internacional: um relato de experiência com alunos latino-americanos na pós-graduação em odontologia / International education: a report of experience with latin american students in graduate degree in dentistry

A busca por metodologias que atraiam o interesse dos alunos de Odontologia e cirurgiões dentistas, em processo de especialização, devem ser uma das preocupações no ensino superior. Estudantes estrangeiros tem peculiaridades em relação a língua e cultura diversa, fazendo com que os docentes se empenhem em adaptar melhor suas metodologias. Nesse sentido, as experiencias práticas no ensino podem contribuir significativamente para isto, pois estas tendências servem de base para que as instituições procurem flexibilizar seu currículo. OBJETIVO: este relato de experiência pretende discorrer sobre a formação dos cirurgiões dentistas especialistas, oriundos de diversas nacionalidades (da américa latina), enfatizando os pontos mais relevantes da experiência do ensino. METODOLOGIA: Trata-se de um estudo descritivo, retrospectivo, transversal e qualitativo, do tipo relato de experiência, realizados com os alunos estrangeiros da Equipe Quixadaense de Pesquisa e Pós-Graduação [EQUIP] (Quixadá-CE) e os docentes sobre a reflexão acerca do trabalho desenvolvido na formação dos estudantes e seu aproveitamento. Os resultados evidenciam que o espaço da EQUIP permite aos alunos o aprendizado prático, baseado na diversidade de atividades, nas reflexões sobre a importância do curso, nos atendimentos e no uso das quatro habilidades do ensino que são ler, ouvir, falar e fazer durante a formação. Além disso, a instituição de ensino possui um histórico de trabalho com o público estrangeiro em outras áreas, facilitando dessa forma a interdisciplinaridade, promovendo grande envolvimento dos profissionais deste estabelecimento de ensino. Os resultados obtidos são percebidos no dia-a-dia dos alunos

Outcomes and resource usage of infants born at ≤ 25 weeks gestation in Canada

Objectives: To determine the outcomes and resource usage of infants born at ≤ 25 weeks gestational age (GA). Methods: Retrospective study of infants born between April 2009 and September 2011 at ≤ 25 weeks\u27 GA in all neonatal intensive care units in Canada with follow-up in the neonatal follow-up clinics. Short-term morbidities, neurodevelopmental impairment, significant neurodevelopmental impairment, and resource utilization of infants born at ≤ 24 weeks were compared with neonates born at 25 weeks. Results: Of 803 neonates discharged alive, 636 (80.4%) infants born at ≤ 25 weeks\u27 GA were assessed at 18 to 24 months. Caesarean delivery, lower birth weight, and less antenatal steroid exposure were more common in infants born ≤ 24 weeks as compared with 25 weeks. They had significantly higher incidences of ductus arteriosus ligation, severe intracranial hemorrhage, retinopathy of prematurity as well as longer length of stay, central line days, days on respiratory support, days on total parenteral nutrition, days on antibiotics, and need for postnatal steroids. Neurodevelopmental impairment rates were 68.9, 64.5, and 55.6% (P=0.01) and significant neurodevelopmental impairment rates were 39.3, 29.6, and 20.9% (P\u3c0.01) for infants ≤ 23, 24, and 25 weeks GA, respectively. Postdischarge service referrals were higher for those ≤ 23 weeks. Nonsurviving infants born at 25 weeks GA had higher resource utilization during admission than infants born less than 25 weeks. Conclusions: Adverse outcomes and resource usage were significantly higher among infants born ≤ 24 weeks GA as compared with 25 weeks GA