Validation of a child-friendly version of the monetary incentive delay task

The monetary incentive delay (MID) task (Knutson, 2000) is an imaging paradigm used to measure neural activity of incentive receipt anticipation. The task reliably elicits striatal activation and is commonly used with both adult and adolescent populations, but is not designed for use with children. In the current article, we present data on the newly designed ‘piñata task’ a child-friendly analog of the MID task. We demonstrate the task can be used successfully in children to study the neural correlates of anticipatory incentive processing. Results from a behavioral study and a neuroimaging study are reported. In Study #1, a sample of 8- to 14-year-old children demonstrates expected behavioral effects: subjects responded most quickly and most accurately on trials with greater potential rewards; older children displayed faster reaction times than younger. In Study #2, 8- to 12-year-old children showed neural activation patterns consistent with those seen in adults in the MID task: activation was modulated by cue incentive value in reward-processing regions, including the striatum, thalamus, mesial prefrontal cortex and insula. Study results suggest that the piñata task is a valid analog of the MID task, and can be used to assess neural correlates of reward processing in children as young as 8–9 years of age.     

Evaluation of Cytotoxicity and Physicochemical Properties of Calcium Silicate-based Endodontic Sealer MTA Fillapex

IntroductionThe aim of the study was to evaluate the cytotoxicity, radiopacity, pH, and flow of a calcium silicate–based and an epoxy resin–based endodontic sealer, MTA Fillapex (Angelus, Londrina, PR, Brazil) and AH Plus (Dentsply, Konstanz, Germany), respectively.MethodsCytotoxicity, radiopacity, and flow evaluation were performed following ISO requirements. The pH level was measured at periods of 3, 24, 72, and 168 hours. Cytotoxicity was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay to check the Balb/c 3T3 cells viability at 1- to 4-week periods. Data were statistically analyzed by analysis of variance and the Tukey test with a significance level of 5%.ResultsIn all tested periods, MTA Fillapex was more cytotoxic than AH Plus (P < .05). Although AH Plus presented higher radiopacity than MTA Fillapex (P < .05), both sealers showed minimum required values. MTA Fillapex presented alkaline pH in all experimental times, whereas AH Plus cement showed a slightly neutral pH and a flow significantly lower than that of MTA Fillapex (P < .05).ConclusionsAlthough MTA Fillapex was more cytotoxic than AH Plus, it showed suitable physicochemical properties for an endodontic sealer.     

Ultrasonographic screening for thyroid cancer in siblings of patients with apparently sporadic papillary carcinoma

Background: Epidemiological studies have shown a higher risk of thyroid cancer among individuals who have a relative with papillary thyroid cancer (PTC) compared to those without a family history. This study evaluated the prevalence of thyroid cancer among subjects with only one first-degree relative (sibling) with PTC who had no palpable nodules, factors predictive of this malignancy, and the characteristics of tumors discovered during ultrasonographic screening. Methods: A total of 757 siblings of 447 patients with apparently sporadic PTC were examined. Nodules were palpable in 34 subjects (excluded). The 723 individuals without palpable abnormalities were submitted to thyroid ultrasonography and comprised the study group. The control group, consisting of 241 volunteers without a family history of thyroid cancer matched for gender and age to the study group, was also submitted to thyroid ultrasonography. All nodules ≥5?mm were examined by fine-needle aspiration cytology. Subjects with benign cytology were not submitted to surgery, whereas the subjects having malignant, suspicious for a malignancy, indeterminate, or inadequate cytology were referred for thyroidectomy. Results: Ultrasonography detected nodules in 303 (41.9%) study subjects. PTC was observed in 5.94% of the 723 subjects studied (8% women and 3.75% men, p=0.017) and in 14.2% of the 303 subjects with nonpalpable nodular disease. In the control group, 80 (33.2%) of the volunteers had nodules. PTC was observed in 1.2% of them and in 3.8% of those with nodular disease. In addition, 7.17% of the 447 patients had siblings with PTC detected only by ultrasonography. Multicentricity of the tumor was the main predictor of the presence of malignancy in siblings of patients with PTC. Twenty-two subjects (3% of those screened) had tumors that were not intrathyroid microcarcinomas (whereas all three tumors detected in controls were intrathyroid microcarcinomas). Screening permitted an earlier diagnosis of the disease when compared to siblings with a spontaneous diagnosis. Conclusions: The present results favor ultrasonographic screening of first-degree relatives of patients with apparently sporadic multicentric PTC, especially among women.     

Assessing education in pulmonary rehabilitation: the Understanding COPD (UCOPD) questionnaire

There is currently no questionnaire available that comprehensively assesses patients' understanding, self-efficacy and satisfaction with the education component of pulmonary rehabilitation. The aim of this study was to develop the Understanding COPD (UCOPD) questionnaire. The key stages in the development of the UCOPD questionnaire were: (i) Generation of questions, and assessment of face and content validity, user-centredness, acceptability and feasibility; (ii) Assessment of plain English and readability; (iii) Assessment of structural validity; (iv) Assessment of test-retest reliability and internal consistency; (v) Assessment of the responsiveness, convergent validity and floor and ceiling effects. The UCOPD questionnaire assesses understanding, self-efficacy and use of key self-management skills (Section A) and satisfaction (Section B). It has good validity and practical properties, and readability was acceptable. It has good test-retest reliability (Section A: ICC range: 0.87 to 0.96; Section B: Wilcoxon: p > 0.05) and internal consistency (Cronbach's Alpha range: 0.78 to 0.95). It is responsive to pulmonary rehabilitation (Mean change: About COPD: 18.26 [12.12 to 24.40]%, Managing Symptoms 20.94 [13.86 to 28.01]%, Accessing Help and Support 24.06 [14.53 to 33.60]%, Total 20.59 [14.43 to 26.75]%, p < 0.001). It had a moderate correlation with the Bristol COPD Knowledge Questionnaire (BCKQ): pre-pulmonary rehabilitation: r = 0.41, p = 0.02; post-pulmonary rehabilitation: r = 0.35, p = 0.047. In conclusion, the UCOPD questionnaire offers the opportunity to assess the benefit of the education component of pulmonary rehabilitation in terms of its effect on understanding, self-efficacy and satisfaction. Further research is needed across different pulmonary rehabilitation settings to demonstrate the robustness of the UCOPD questionnaire, and to establish the minimum clinically important difference.