Clinical Relevance of Studies on the Accuracy of Visual Inspection for Detecting Caries Lesions: A Systematic Review

Although visual inspection is the most commonly used method for caries detection, and consequently the most investigated, studies have not been concerned about the clinical relevance of this procedure. Therefore, we conducted a systematic review in order to perform a critical evaluation considering the clinical relevance and methodological quality of studies on the accuracy of visual inspection for assessing caries lesions. Two independent reviewers searched several databases through July 2013 to identify papers/articles published in English. Other sources were checked to identify unpublished literature. The eligible studies were those which (1) assessed the accuracy of the visual method for detecting caries lesions on occlusal, approximal or smooth surfaces, in primary or permanent teeth, (2) used a reference standard, and (3) reported data about sample size and accuracy of the methods. Aspects related to clinical relevance and the methodological quality of the studies were evaluated. 96 of the 5,578 articles initially identified met the inclusion criteria. In general, most studies failed in considering some clinically relevant aspects: only 1 included study validated activity status of lesions, no study considered its prognosis, 79 studies did not consider a clinically relevant outcome, and only 1 evaluated a patient-centred outcome. Concerning methodological quality, the majority of the studies presented a high risk of bias in sample selection. In conclusion, studies on the accuracy of the visual method for caries detection should consider clinically relevant outcomes besides accuracy; moreover, they should be conducted with higher methodological quality, mainly regarding sample selection

Bouncing pre-big bang on the brane

A regular bouncing universe is obtained in the context of a dilaton-gravity brane world scenario. The scale factor starts in a contracting inflationary phase both in the Einstein and in the string frame, it then undergoes a bounce (due to interaction with the bulk Weyl tensor), and subsequently enters into a decelerated expanding era. This graceful exit is obtained at low curvature and low coupling, and without violating the Null Energy Condition.Comment: 16 pages, 3 figures; final version to be published on PRD. General improvement of section II (better specification of the matter content on the brane and discussion about the late time behavior), main results unchanged; 2 references adde

Smooth hybrid inflation in supergravity with a running spectral index and early star formation

It is shown that in a smooth hybrid inflation model in supergravity adiabatic fluctuations with a running spectral index with \ns >1 on a large scale and \ns <1 on a smaller scale can be naturally generated, as favored by the first-year data of WMAP. It is due to the balance between the nonrenormalizable term in the superpotential and the supergravity effect. However, since smooth hybrid inflation does not last long enough to reproduce the central value of observation, we invoke new inflation after the first inflation. Its initial condition is set dynamically during smooth hybrid inflation and the spectrum of fluctuations generated in this regime can have an appropriate shape to realize early star formation as found by WMAP. Hence two new features of WMAP observations are theoretically explained in a unified manner.Comment: 12 pages, 1 figure, to appear in Phys. Rev.

Screening, production and biochemical characterization of a new fibrinolytic enzyme produced by Streptomyces sp. (Streptomycetaceae) isolated from Amazonian lichens

Thrombosis is a pathophysiological disorder caused by accumulation of fibrin in the blood. Fibrinolytic proteases with potent thrombolytic activity have been produced by diverse microbial sources. Considering the microbial biodiversity of the Amazon region, this study aimed at the screening, production and biochemical characterization of a fibrinolytic enzyme produced by Streptomyces sp. isolated from Amazonian lichens. The strain Streptomyces DPUA1576 showed the highest fibrinolytic activity, which was 283 mm2. Three variables at two levels were used to assess their effects on the fibrinolytic production. The parameters studied were agitation (0.28 - 1.12 g), temperature (28 - 36 ºC) and pH (6.0 - 8.0); all of them had significant effects on the fibrinolytic production. The maximum fibrinolytic activity (304 mm2) was observed at 1.12 g, 28 ºC, and pH of 8.0. The crude extract of the fermentation broth was used to assess the biochemical properties of the enzyme. Protease and fibrinolytic activities were stable during 6 h, at a pH ranging from 6.8 to 8.4 and 5.8 to 9.2, respectively. Optimum temperature for protease activity ranged between 35 and 55 °C, while the highest fibrinolytic activity was observed at 45 ºC. Proteolytic activity was inhibited by Cu2+ and Co2+ ions, phenylmethylsulfonyl fluoride (PMSF) and pepstatin A, which suggests that the enzyme is a serine protease. Enzymatic extract cleaved fibrinogen at the subunits A-chain, A-chain, and -chain. The results indicated that Streptomyces sp. DPUA 1576 produces enzymes with fibrinolytic and fibrinogenolytic activity, enzymes with an important application in the pharmaceutical industry.The authors grateful acknowledge the financial support of Fundação de Amparo a Pesquisa do Estado de Pernambuco (FACEPE, Pernambuco, Brazil, N. 0158-2.12/11), CNPq/ RENORBIO (National Counsel of Technological and Scientific Development, N.55146/2010-3) and National Council for the Improvement of Higher Education (CAPES, Brazil) for the scholarship. The author thanks editor and reviewers for their review and comments.info:eu-repo/semantics/publishedVersio

Perturbations of brane worlds

We consider cosmological models where the universe, governed by Einstein's equations, is a piece of a five dimensional double-sided anti-de Sitter spacetime (that is, a "$Z_2$-symmetric bulk") with matter confined to its four dimensional Robertson-Walker boundary or "brane". We study the perturbations of such models. We use conformally minkowskian coordinates to disentangle the contributions of the bulk gravitons and of the motion of the brane. We find the restrictions put on the bulk gravitons when matter on the brane is taken to be a scalar field and we solve in that case the brane perturbation equations.Comment: 19 pages, no figures, RevTex, version to appear in Phys.Rev.D; minor changes in chap.V, polarisation tensor at page 13 correcte