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Development and validation of shoaib sensorimotor development tool for normal pediatric population
(2025) WAQAS, Shoaib; AHMAD, Ashfaq; GOULARDINS, Juliana Barbosa; HANIF, Asif; TARIQ, Muhammad; NIAMAT, Atiqa
Background: During the COVID-19 pandemic, concerns about developmental delays in babies were at their peak. During the COVID-19 pandemic, concerns about developmental delays in infants and young children increased substantially. However, culturally relevant, validated tools to assess sensorimotor development are scarce. Objective: This study aimed to develop and validate the Shoaib Sensorimotor Development Tool (SSDT) to evaluate developmental milestones in typically developing children. Methods: This was a cross-sectional psychometric validation study. A comprehensive tool encompassing nine domains, gross motor, fine motor, sensory, tone, balance, gait, reflexes, social interaction, and speech, was developed to assess sensorimotor development holistically. Atotal of 150 mothers of typically developing children aged 3 to 7 years participated in the exploratory factor analysis (EFA), while 300 mothers were included in the confirmatory factor analysis (CFA). In addition, the SSDT required an average of 21 ± 6.00 minutes to complete, with administration being feasible for trained therapists following a brief workshop. Data were analyzed using SPSS v26 and AMOS for factor analysis. Model fit was evaluated with regression weights and standard fit indices (p < 0.05). Results: The mean age of mothers who participated in this study was 36.16±4.73 years, and the mean age of children was 4.45±0.784 years. Of the 150 mothers (EFA) and 300 mothers (CFA) enrolled, 144 and 288 completed the full assessment, yielding a 96% completion rate. Dropouts were minimal, 6 and 12, respectively, and the reasons have been detailed in the methods. 75 constructs were analyzed using EFAand three were removed due to cross-loading, resulting in a significant Bartlett's test (p = 0.000) and a high Kaiser-Meyer-Olkin (KMO) measure of 0.992. The final 72 constructs of SSDT formed a single factor, sensorimotor development, with a cumulative variance of 84.317% and an eigenvalue of 3.897. Fit indices indicated good model fit (CFI = 0.983, GFI = 0.962, TLI = 0.989, SRMR = 0.0325, RMSEA= 0.076). The SSDTdemonstrated excellent internal consistency (Cronbach's α = 0.963). Conclusion: SSDT is a promising tool for early sensorimotor assessment, offering clinical, educational, and research utility; however, broader validation and longitudinal studies are needed for its universal adoption.
Active teaching-learning methodologies applied in implant dentistry
(2025) SILVA, Poliana Sandes da; MEDRADO, Alena Ribeiro Alves Peixoto; DANTAS, Juliana Borges de Lima; FERNANDES, Atson Carlos de Souza; FARIAS, Illa Oliveira Bitencourt
The teaching and learning methodologies in implant dentistry have been the subject of ongoing discussion due to the challenges students face in developing the skills necessary to perform both the planning and surgical-prosthetic stages of implant-supported rehabilitation. To address this, a literature review was conducted to describe the various active teaching methodologies applied in implant dentistry. An electronic search was carried out in the PubMed, Google Scholar, and SciELO databases between January 2023 and August 2024, targeting publications from 2018 to 2024 in English and Portuguese. A total of 5,650 articles were identified. Following title and abstract screening, nine studies were selected for full-text review, of which four met the established inclusion and exclusion criteria. The reviewed literature described active methodologies such as Active Learning, the Flipped Classroom model, Augmented Reality, Realistic Simulation, as well as Sensory and Hybrid Reality approaches for teaching implant dentistry. According to the findings, the integration of innovative teaching and learning methodologies in implant dentistry enhances the opportunity for practice-based learning experiences that closely replicate real-world scenarios. However, the results also highlight a persistent need for the incorporation of these active methodologies into both undergraduate and postgraduate curricula. Such implementation would improve the students’ and professionals’ training in the planning and execution of implant-supported rehabilitations, ultimately fostering greater clinical competence and readiness.
Interplay between biological & social vulnerability and poor tuberculosis treatment outcome in Brazil: a nationwide study using multivariate modelling with excess risk
(2026) DUARTE, Beatriz Barreto; SERRA, Klauss Villalva; PINTO, João P. Miguez; PEREIRA, Mariana Araújo; CAMPOS, Vanessa M. S; FERREIRA, Isabella B. B.; NOGUEIRA, Betânia M. F.; QUEIROZ, Artur T. L.; ROLLA, Valeria C.; SANTOS, Marcelo Cordeiro; KRITSKI, Afrânio L.; MARTINEZ, Leonardo; REBEIRO, Peter F.; STERLING, Timothy R; RODRIGUES, Moreno M.; ANDRADE, Bruno B.
Background: Focusing on socially vulnerable sub-populations at increased risk of tuberculosis is warranted to decrease the disease burden. In this study, we evaluated whether homelessness, living with HIV, incarceration, pregnancy, immigration, drug use, and healthcare work are inter-related risk factors for unfavorable antituberculosis treatment (ATT) outcomes in Brazil through analysis of national disease registry database (SINAN).Methods: We conducted a retrospective cohort study of tuberculosis cases ≥18 years-old reported to SINAN between 2015 and 2023. Clinical and epidemiologic variables were compared between groups (non-vulnerability, homeless, people deprived of their liberty, pregnant women, people with HIV, people who use drugs, immigrants and healthcare worker). Bivariate comparisons identified characteristics associated with a composite unfavorable ATT outcome, or specifically death or LTFU versus cure. Multivariate modelling with relative excess risk due to interactions (RERI) were calculated to estimate how co-occurring vulnerabilities further increase the risk of unfavorable outcomes. Findings: Among 679,572 cases analysed, most were males aged 18−35 years-old, with non-white ethnicity. 16% of individuals without vulnerabilities experienced unfavourable outcomes, compared to 33% among those with at least one vulnerability. Overlapping vulnerabilities further amplified risk: for instance, unfavourable outcomes occurred in more than 67% of individuals who reported both homelessness and drug use. Interaction analyses revealed both synergistic and antagonistic effects, with the strongest additive synergy observed between HIV infection and drug use, with a RERI of 225% [174–304%]. Interpretation: The superposition of interlacing social and biological vulnerabilities significantly worsened the risk of both death and LTFU in our population. Our study demonstrates that the joint effect of vulnerabilities on TB outcomes is not merely additive, but often synergistic, highlighting the importance of integrated and multisectoral interventions. These findings hallmark the need for policies that simultaneously address social and biological vulnerabilities to improve ATT success.
Biochemical, immune, and endocrine biomarkers associated with exacerbated muscular response: insights from a fieldbased operational cohort study
(2025) SOUZA, Deivide Oliveira de; GOMES, Diego Viana; PESQUERO, João Bosco; AQUINO NETO, Francisco Radler de; LUZARDO, Ricardo; DUARTE, Beatriz Barreto; ANDRADE, Bruno B.; CARNEIRO, Andréia
Muscle damage and systemic stress responses are common consequences of intense physical exertion. However, the extent to which these responses vary according to the severity of muscular strain remains unclear. We conducted a field-based study involving 24 active-duty elite military personnel who participated in five distinct operational missions in Brazil. Circulating levels of 36 plasma biomarkers were assessed and compared between individuals presenting moderate or exacerbated muscular response, defined by serum creatine kinase (CK) concentrations below or above 1000 U/L, respectively. Statistical comparisons and multivariate logistic regression were performed to evaluate associations between biomarker levels and muscular response severity. Our analysis revealed that individuals with exacerbated response exhibited distinct systemic profiles, marked by elevated tissue injury markers, reduced eosinophil and lymphocyte counts, and lower adrenal steroid hormone concentrations. Furthermore, regression models identified creatine kinase muscle-brain (CKMB) and alanine aminotransferase (ALT) as independently associated with higher CK levels, while heightened eosinophil counts showed a potential protective trend. These findings suggest that greater degrees of muscular stress are associated with broader systemic dysregulation, and that specific circulating biomarkers may serve as indicators of individual susceptibility to acute stress in high-demand physical environments.
Medicine beyond machines: viewpoint on the art of thinking in the age of al
(2025) FERREIRA, Isabella B. B.; MENEZES, Rodrigo C.; CORREIA, Luis Cláudio L.; ANDRADE, Bruno B
The widespread adoption of large language models is increasingly shaping clinical decision-making by altering how physicians engage with data and reasoning. While these tools enhance diagnostic capacity, streamline workflows, and support learning, their misuse may diminish critical, contextual, and humanized thinking, reducing physicians to passive validators of algorithmic outputs. This paper explores the evolution of medical cognition and proposes strategies for integrating artificial intelligence in ways that preserve cognitive autonomy, such as structuring information, reducing bias, and strengthening metacognition. We argue that artificial intelligence should serve as a “cognitive stethoscope,” a tool that refines reasoning without compromising its essence.