Comparative Analysis of Continuous versus Reciprocating Instruments in Retreatment of Flat-oval Root Canals

Introduction: Flat-oval root canals of incisors can be problematic in retreatments. This study assessed the efficacy of continuous and reciprocating rotation instruments in retreatment of flat-oval root canals in lower incisors via micro-computed tomography (micro-CT). File systems studied were ProTaper universal retreatment rotary system associated with ProTaper Next (PTUR+PTN), D-RaCe associated with iRaCe (DR+iR), Reciproc (REC), and WaveOne (WO). Materials and Methods: Thirty-two mandibular incisors with flat root canal were divided into 4 groups (n=8). The groups were initially prepared with PTN, iRaCe, REC, and WO, then instrumented, filled, and subjected to micro-CT analyses. All the canals were then retreated with the PTUR+PTN, DR+iR, REC, and WO, and then subjected to new micro-CT analysis  which allowed quantification of residual filling material volume and change in the diameter of the root canal apical third. Endodontic retreatment time was also quantified. Data were analyzed with One-Way ANOVA and post hoc t tests. Results: None of the systems completely removed the filling material. The groups differed in terms of remnant filling material volume (PTUR+PTN=2.9±1.1 mm3; DR+iR=3.6±3.1 mm3; REC=4.9±1.9 mm3; WO=3.1±1.9 mm3) and retreatment time (PTUR+PTN=1:36±0:12 sec; DR+iR=0:57±0:13 sec; REC=2:10±0:44 sec; WO=2:03±0:31 sec), but had similar values in terms of change in apical root canal diameter (P>0.05). Conclusions: Based on this in vitro study, the type of endodontic instrument did not affect the diameter of the root canal apical third. However, PTUR with ProTaper Next had the lowest residual filling material volume and second lowest retreatment time, in flat-oval root canals in mandibular incisors

Personal data usage and privacy considerations in the COVID-19 global pandemic

Data has become increasingly important and valuable for both scientists and health authorities searching for answers to the COVID-19 crisis. Due to difficulties in diagnosing this infection in populations around the world, initiatives supported by digital technologies are being developed by governments and private companies to enable the tracking of the public’s symptoms, contacts and movements. Considering the current scenario, initiatives designed to support infection surveillance and monitoring are essential and necessary. Nonetheless, ethical, legal and technical questions abound regarding the amount and types of personal data being collected, processed, shared and used in the name of public health, as well as the concomitant or posterior use of this data. These challenges demonstrate the need for new models of responsible and transparent data and technology governance in efforts to control SARS-COV2, as well as in future public health emergencies

Does methylene blue attenuate inflammation in nonischemic lungs after lung transplantation?

Objective: To evaluate whether methylene blue (MB) could minimize the effects of ischemia-reperfusion injury in the nonischemic lung on a lung transplantation rodent model. Methods: Forty female Sprague-Dawley rats were divided into 20 donors and 20 recipients. The 20 recipient rats were divided into two groups (n = 10) according to the treatment (0.9% saline vs. 1% MB solutions). All animals underwent unilateral lung transplantation. Recipients received 2 mL of saline or MB intraperitoneally prior to transplantation. After 2 h of reperfusion, the animals were euthanized and histopathological and immunohistochemical analyses were performed in the nonischemic lung. Results: There was a significant decrease in inflammation-neutrophil count and intercellular adhesion molecule-1 (ICAM-1) expression in lung parenchyma were higher in the saline group in comparison with the MB group-and in apoptosis-caspase-3 expression was higher in the saline group and Bcl-2 expression was higher in MB group. Conclusions: MB is an effective drug for the protection of nonischemic lungs against inflammation and apoptosis following unilateral lung transplantation in rats.

ANÁLISE BIBLIOMÉTRICA SOBRE POLÍTICAS PÚBLICAS

Este trabalho tem como objetivo mostrar a evolução do tema políticas públicas no contexto mundial e nacional por meio de uma análise bibliométrica. Faz um levantamento de indicadores mais gerais na avaliação global, como o histórico temporal das publicações e os países que mais debatem sobre o tema; enquanto na conjuntura brasileira traz indicadores mais específicos, tais como a rede de colaboração do Brasil com outros países e instituições. Os resultados mostraram que a primeira publicação sobre o tema estudado surgiu em 1909, no cenário mundial, e em 1987 no Brasil; os Estados Unidos destacaram-se na pesquisa com maior número de publicações. Apesar do desenvolvimento tardio na área de políticas públicas, o Brasil ocupa o quarto lugar no ranque mundial. Em relação às instituições, a USP concentra o maior volume de trabalhos publicados, no entanto, Estados Unidos ganha no todo.Palavras-chave: Bibliometria. Políticas Públicas. Indicadores.BIBLIOMETRIC ANALYSIS OF PUBLIC POLICIESAbstractThis work aims at showing the evolution of the public policy theme in a national and worldwide context by means of a bibliometric analysis. More general indicators on the global assessment were proposed, such as the timeline of publications and countries that most debate the theme; while in the Brazilian conjuncture, more specific indicators were generated, such as the partnership network between Brazil and other countries and institutions. The main results showed that the first publication in the world about the theme under study was in 1909, while in Brazil it was in 1987. They also demonstrated thatthe United States stood out relating to the number of publications. Another question was that, despite the late development of the area of public policies, Brazil ranks fourth worldwide. Regarding institutions, Universidade de São Paulo-USP (Sao Paulo University) concentrates the largest amount of published works, however, the United States stands out as a whole.Keywords: Bibliometry. Public Policies. Indexes

Preservação da privacidade no enfrentamento da COVID-19: dados pessoais e a pandemia global

Data is becoming ever more critical and valuable for both scientists and health authorities searching for answers to the COVID-19 crisis. Due to difficulties in diagnosing this infection in populations around the world, initiatives supported by digital technologies have been developed by governments or private companies which enable the tracking of the public’s symptoms, contacts and movements. Considering the current scenario, these initiatives, designed to support the surveillance and monitoring of contagion, are essential and necessary.  Nonetheless, ethical, legal and technical questions remain unanswered regarding the amount and types of personal data being collected, processed, shared and used in the name of public health, as well as the concomitant or later use of this data. These challenges demonstrate the need for new models of responsible and transparent data and technology governance in efforts to control Sars-Cov2 as well as future public health emergencies.Dados ganham cada vez mais importância e valor na busca de respostas para enfrentar a COVID-19 tanto para ciência quanto para as autoridades sanitárias. Em virtude da dificuldade de realizar diagnóstico da infecção na população em geral, iniciativas apoiadas em tecnologias digitais vem sendo desenvolvidas por governos ou empresas privadas para possibilitar rastreamentos de sintomas, contatos e deslocamentos para apoiar estratégias de acompanhamento e avaliação na vigilância de contágios. A despeito da importância e necessidade dessas iniciativas, questionamentos acerca da quantidade e tipos de dados pessoais coletados, processados, compartilhados e utilizados em nome da saúde pública, bem como os concomitantes ou posteriores usos desses dados, suscitam questionamentos éticos, legais e técnicos. Desafios que apontam para a necessidade de novos modelos de governança de dados e de tecnologias, responsáveis e transparentes, para controlar o Sars-Cov2 e as futuras emergências de saúde pública

Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial

Background: Short-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes. Methods: We did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18–85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR)25–75 mL/min per 1·73 m 2 of body surface area, and a urine albumin-to-creatinine ratio (UACR)of 300–5000 mg/g who had received maximum labelled or tolerated renin–angiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0·75 mg orally daily during an enrichment period before random group assignment. Those with a UACR decrease of at least 30% with no substantial fluid retention during the enrichment period (responders)were included in the double-blind treatment period. Responders were randomly assigned to receive either atrasentan 0·75 mg orally daily or placebo. All patients and investigators were masked to treatment assignment. The primary endpoint was a composite of doubling of serum creatinine (sustained for ≥30 days)or end-stage kidney disease (eGFR <15 mL/min per 1·73 m 2 sustained for ≥90 days, chronic dialysis for ≥90 days, kidney transplantation, or death from kidney failure)in the intention-to-treat population of all responders. Safety was assessed in all patients who received at least one dose of their assigned study treatment. The study is registered with ClinicalTrials.gov, number NCT01858532. Findings: Between May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325)or placebo group (n=1323). Median follow-up was 2·2 years (IQR 1·4–2·9). 79 (6·0%)of 1325 patients in the atrasentan group and 105 (7·9%)of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR]0·65 [95% CI 0·49–0·88]; p=0·0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3·5%)of 1325 patients in the atrasentan group and 34 (2·6%)of 1323 patients in the placebo group (HR 1·33 [95% CI 0·85–2·07]; p=0·208). 58 (4·4%)patients in the atrasentan group and 52 (3·9%)in the placebo group died (HR 1·09 [95% CI 0·75–1·59]; p=0·65). Interpretation: Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. Funding: AbbVie