Corrosion Inhibition of Carbon Steel in Neutral Chloride Solutions Using Salts of Primary Bile Acids.

Due to growing environmental concerns and regulatory pressures, the demand for environmentally friendly corrosion inhibitors has increased. Biosurfactants are biodegradable and have a low toxicity. However, very few studies have reported on their potential use as corrosion inhibitors. The present study reports the novel application of two bile salts (sodium cholate NaC and sodium chenodeoxycholate NaCDC) as environmentally friendly corrosion inhibitors for carbon steel in a neutral 20 mM NaCl solution. The results of potentiodynamic polarization and electrochemical impedance measurements showed that when added at a concentration of 5 mM, the corrosion inhibition efficiencies of NaC and NaCDC were about 60% and 85%, respectively. The poor inhibitory character of NaC was confirmed by XPS analysis, revealing the formation of oxidative corrosion products on the steel surface. For the steel sample immersed in the solution containing NaCDC, the XPS measurements showed clear evidence of the presence of an organic layer and a passive oxide film on the steel surface. While the steroidal skeleton of NaC is characterized by marked biplanarity (considering its hydrophobic and hydrophilic faces), NaCDC features a steroidal ring with a hydrophilic edge (it does not exhibit biplanarity). Thus, the self-assembly and adsorption behavior of these bile salts on the steel surface are different, leading in the case of NaCDC to form a densely packed protective organic layer.

Regulated proteolysis induces aberrant phase transition of biomolecular condensates into aggregates; a protective role for the chaperone Clusterin.

Several proteins associated with neurodegenerative diseases, such as the mammalian prion protein (PrP), undergo liquid-liquid phase separation (LLPS), which led to the hypothesis that condensates represent precursors in the formation of neurotoxic protein aggregates. However, the mechanisms that trigger aberrant phase separation are incompletely understood. In prion diseases, protease-resistant and infectious amyloid fibrils are composed of N-terminally truncated PrP, termed C2-PrP. C2-PrP is generated by regulated proteolysis (ß-cleavage) of the cellular prion protein (PrPC) specifically upon prion infection, suggesting that C2-PrP is a misfolding-prone substrate for the propagation of prions. Here we developed a novel assay to investigate the role of both LLPS and ß-cleavage in the formation of C2-PrP aggregates. We show that ß-cleavage induces the formation of C2-PrP aggregates, but only when full-length PrP had formed biomolecular condensates via LLPS before proteolysis. In contrast, C2-PrP remains soluble after ß-cleavage of non-phase-separated PrP. To investigate whether extracellular molecular chaperones modulate LLPS of PrP and/or misfolding of C2-PrP, we focused on Clusterin. Clusterin does not inhibit LLPS of full-length PrP, however, it prevents aggregation of C2-PrP after ß-cleavage of phase-separated PrP. Furthermore, Clusterin interferes with the in vitro amplification of infectious human prions isolated from Creutzfeldt-Jakob disease patients. Our study revealed that regulated proteolysis triggers aberrant phase transition of biomolecular condensates into aggregates and identified Clusterin as a component of the extracellular quality control pathway to prevent the formation and propagation of pathogenic PrP conformers.

Evaluación del inicio de dieta con coffea arábica versus dieta tradicional, en pacientes luego de cirugía electiva y de emergencia / Evaluation of the initiation of diet with coffea arabica versus a traditional diet in patients after elective and emergency surgery

Introducción. Etimológicamente la palabra íleo proviene del griego eileos que significa rodando o girando; es descrito como el retraso temporal de la motilidad gastrointestinal. Mundialmente es reconocido que el íleo postoperatorio es una de las principales complicaciones después de cirugía y representa un problema importante por su elevado costo sanitario. Se ha investigado respecto al uso preventivo de medidas físicas y farmacológicas, como los procinéticos, para el manejo del íleo postoperatorio. Métodos. Investigación clínico-terapéutica, comparativa, de corte longitudinal prospectivo de seguimiento, con muestreo no probabilístico por conveniencia, conformado por cuatro grupos con 25 pacientes cada uno, atendidos en el Servicio de Cirugía General entre mayo y agosto de 2021. Resultados. Los pacientes presentaron una media de edad de 49,4 ± 19,6 años y el 53 % fueron hombres. El 86 % de los pacientes presentaron ruidos intestinales antes de 24 horas posteriores a la operación. La primera evacuación en los pacientes que ingirieron café tipo espresso fue a las 42,6 horas y para aquellos en el grupo de café americano fue a las 43,4 horas en comparación con 89,4 horas en el grupo control (p < 0,001). Conclusión. Se recomienda el uso del café como una medida segura y económica para el inicio de la dieta, como una alternativa al esquema tradicional, constituyéndose en una opción para el manejo del íleo postoperatorio

Introduction. Etymologically the word ileus comes from the Greek eileos, which means rolling or turning. It is described as the temporary delay of gastrointestinal motility. It is recognized worldwide that postoperative ileus is one of the main complications after surgery and represents an important problem due to its high healthcare cost. Research has been done regarding the preventive use of physical and pharmacological measures, such as prokinetics, for the management of postoperative ileus.Methods. Clinical-therapeutic, comparative, prospective longitudinal follow-up research, with non-probabilistic convenience sampling, made up of four groups with 25 patients each, treated in the General Surgery Service between May and August 2021. Results. The patients had a mean age of 49.4 ± 19.6 years and 53% were male; 86% of patients had bowel sounds within 24 hours after the operation. The first bowel movement in patients who ingested espresso coffee was 42.6 hours and for those in the American coffee group it was at 43.4 hours compared to 89.4 hours in the control group (p < 0.001). Conclusion. The use of coffee is recommended as a safe and economical measure to start the diet as an alternative to the traditional fashion, becoming an option for the management of postoperative ileus.

COVID-19 extracellular vesicles display heterogeneity based on viral and host RNA expression: implications for host immune response.

Viral RNA and miRNAs released by immune cells contribute to inflammation in COVID-19 patients. Here, we investigated the role of SARS-CoV2 RNA and host miRNAs carried within extracellular vesicles (EVs) in modulating inflammation. EVs were classified as positive or negative depending on their viral RNA cargo. To assess the function of viral RNA, EVs, and LPS were used to stimulate whole blood samples from healthy subjects, and the secretion of 27 serum analytes was measured. EVs alone did not induce cytokines, chemokines, or growth factors. However, under LPS stimulation, (SARS-CoV2+) EVs increased IL-12 and decreased IL-13 secretion, while (SARS-CoV2-) EVs increased MIP-1α and IL-1ß secretion. Host miR-19a-3p, -192-5p, -let-7c-5p, and -92b-3a were differentially expressed in association with viral RNA. EVs from COVID-19 patients exhibited differences in viral RNA and miRNA expression profiles that modulate LPS responses. This knowledge sheds light on the immunopathology of COVID-19.

The impact of moral resilience on nurse turnover intentions: the mediating role of job burnout in a cross-sectional study.

BACKGROUND: High nursing staff turnover is a critical issue that negatively impacts the quality of care and patient safety. Turnover intentions, a key predictor of actual turnover, reflect an individual's likelihood of leaving their current position. Understanding the underlying mechanisms driving nurse turnover intentions is crucial for developing targeted interventions to stabilize the nursing workforce globally. OBJECTIVES: This study aims to explore the relationship between moral resilience, job burnout, and turnover intentions among nurses, focusing on the mediating role of job burnout in this relationship. DESIGN: This study employed a quantitative, cross-sectional design. METHODS: A convenience sample of 322 registered nurses was recruited from two tertiary hospitals in China between August and October 2023. Data were collected using the Chinese version of the Rushton Moral Resilience Scale (Chi-RMRS), the Maslach Burnout Inventory (MBI), and the Turnover Intention Scale. Data analyses were conducted using SPSS 26.0 and Amos 21.0. The study followed the STROBE guidelines for observational research. ETHICAL CONSIDERATION: Before the commencement of data collection, the Institutional Review Board of Hunan Traditional Chinese Medical College (YXLL202401004) granted ethical approval. RESULTS: The proposed model exhibited an excellent fit to the data, with fit indices as follows: χ2/df = 1.819, CFI = 0.977, TLI = 0.961, RMSEA = 0.072 (90% confidence interval [CI]: 0.033 to 0.107). The structural equation model revealed that moral resilience was inversely associated with job burnout and turnover intentions. Furthermore, job burnout fully mediated the relationship between moral resilience and turnover intentions (ß = -0.473, p = 0.007). Further analysis indicated that the depersonalization component of job burnout was the sole mediator in the relationship between moral resilience and turnover intention (ß = -3.934, 95% CI [-5.837, -1.932]). CONCLUSION: The findings indicate that moral resilience among nurses is negatively associated with turnover intentions, with this effect fully mediated by the depersonalization dimension of job burnout. Enhancing moral resilience in nurses may be valuable strategy for healthcare administrators to mitigate job burnout and subsequently reduce turnover intentions.

Facilitators and Barriers to Implementing HIV Testing and Pre-Exposure Prophylaxis in Substance Use Treatment Programs: Perspectives of Non-medical Staff.

BACKGROUND: People with substance use disorder (SUD) are at increased risk of HIV infection. HIV testing and pre-exposure prophylaxis (PrEP) are evidence-based practices to prevent HIV infection, yet these approaches are not regularly provided in SUD treatment programs. To address this evidence-to-practice gap, this study aimed to identify facilitators and barriers to implementing PrEP services in SUD treatment programs from the perspective of non-medical staff and administrators. METHODS: Semi-structured interviews were conducted from February to June 2022 with non-medical staff (N = 10) and administrators (N = 11) from 3 academic and 8 community-based SUD treatment programs in Philadelphia. Interview guides were developed using the Consolidated Framework for Implementation Research (CFIR). Qualitative descriptive techniques were used to examine interview data and identify key facilitators and barriers, which were grouped within CFIR domains and constructs. RESULTS: Of the 11 SUD treatment programs, 5 provided PrEP services. Most interviewees at programs without PrEP services reported high levels of receptivity to implementing PrEP and identified leadership engagement as a key determinant, but several lacked comfort with PrEP counseling. Inner setting facilitators included compatibility with workflows (eg, intake assessments), alignment with cultures of holistic care, and programs' longstanding community trust. Inner setting barriers included limited time to discuss PrEP, insufficient resources and staff (eg, phlebotomy), perception of clients' HIV risk, and lower prioritization of HIV prevention versus other services. Intervention facilitators included robust evidence and addressing costs through grants and drug pricing programs, and barriers included the time needed to initiate PrEP, loss to follow-up, and HIV stigma. CONCLUSIONS: Successful implementation of HIV testing and PrEP in SUD treatment programs requires addressing multi-level barriers. Including perspectives of non-medical staff and administrators is important for implementation. Potential strategies include supporting organizational networks, leveraging peer specialists' expertise, and packaging PrEP to better meet client priorities and needs.

Prenatal and Postnatal Opinions and Experiences of Women With Multiple Sclerosis: A Phenomenological Study.

BACKGROUND: Multiple sclerosis is an irreversible autoimmune disease with significant physical, psychological, and social impacts. Understanding the lived experiences of pregnant women with multiple sclerosis is vital for healthcare professionals to provide better care to these women. PURPOSE: This study was designed to explore the lived experiences of pregnant women with multiple sclerosis. METHODS: A descriptive phenomenological study was conducted at the University of Jaén and included 17 women from different Spanish provinces who were recruited using intentional and snowball sampling methods via national patient associations and social networks. In-depth interviews were conducted, audio-recorded, transcribed, and analyzed using Martins' three steps. The ATLAS.ti 7.0 program was used for data analysis. RESULTS: Two themes and seven subthemes were identified that highlighted the experiences of women in pregnancy with multiple sclerosis: (a) the influence of the disease on the decision to be a mother, with subthemes "The disease determines when to be a mother" and "Considering alternatives to spontaneous pregnancy," and (b) the vision of motherhood with multiple sclerosis, with subthemes "Worry about how the disease can affect the pregnancy," "Worry about how the pregnancy can affect the disease," "Concerns about childbirth," "Difficulty with breastfeeding," and "Worry about the transmission of the disease." CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Women with multiple sclerosis often face a difficult decision regarding whether to become pregnant. The period of pregnancy and puerperium can be fraught with anxiety, especially in terms of concerns about their ability to raise children. In light of the limited scientific evidence regarding the relationship between multiple sclerosis and pregnancy and the conflicting advice often given to these women, the findings of this study may be used to help improve the quality of the care provided to this population.

The effect of different types of water sources on dental unit waterline contamination: A systematic review and meta analysis.

To systematically review the effect of different types of water sources on dental unit waterline (DUWL) contamination. 5 databases were searched from their inception to December 23, 2023. Two reviewers independently extracted the data and assessed the quality of the literature. The risk ratio (RR) was used as measure of effect size in meta-analysis. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used for evaluating quality of the evidence. Meta-analysis was completed by RevMan 5.4.5 studies involving 561 water samples were quantified for meta-analysis. The results indicated that no significant differences were found in view of contamination rate (RR = 1.01; 95 % CI, 0.72-1.41; P = 0.96, I 2  = 62 %; GRADE low)and detection rate of Pseudomonas aeruginosa (RR = 0.78; 95 % CI, 0.15-4.13; P = 0.77; I 2  = 83 %; GRADE very low) between using purified water and tap water as water sources of DUWL. The available evidence suggests that there is no significant difference between purified water and tap water in controlling DUWL contamination. However, the conclusions need to be further validated through more randomized controlled trials with robust design and a large sample size.

Moral distress and compassion fatigue among nursing interns: a cross-sectional study on the mediating roles of moral resilience and professional identity.

BACKGROUND: Nursing interns often faced moral distress in clinical practice, similar to registered nurses, which can lead to compassion fatigue. The roles of moral resilience and professional identity in influencing the psychological well-being of nursing interns are recognized, but the interrelationships among moral distress, moral resilience, professional identity, and compassion fatigue in this group remain unclear. OBJECTIVES: This study aimed to investigate the impact of moral distress on compassion fatigue among nursing interns and to explore the mediating role of moral resilience and professional identity. METHODS: A quantitative cross-sectional study was conducted with 467 nursing interns. Data were collected using Compassion Fatigue Short Scale, Moral Distress Scale-revised, Rushton Moral Resilience Scale, and Professional Identity Scale. Data analyses were performed using SPSS 22.0 and Amos 21.0, adhering to the STROBE statement. RESULTS: The mean scores for compassion fatigue, moral distress, moral resilience, and professional identity were 35.876, 44.887, 2.578, and 37.610, respectively. Moral distress was positively correlated with compassion fatigue. Structural equation modeling showed that moral resilience and professional identity partially mediated the relationship between moral distress and compassion fatigue (ß = 0.448, P < 0.001). CONCLUSION: The findings suggest that moral distress directly influences compassion fatigue among nursing interns and also exerts an indirect effect through moral resilience and professional identity. Interventions aimed at enhancing moral resilience and fostering a strong professional identity may help mitigate the adverse effects of moral distress on compassion fatigue among nursing interns.

Design, development and preclinical assessment of MENAVip-ICP, a new snake antivenom with potential coverage of species in the Middle East and North Africa regions.

Snakebite in the Middle East and North Africa (MENA) is a public health problem whose magnitude is not fully known. Several antivenoms are available in these regions, but these formulations are designed for restricted geographical settings. Many countries do not have local production of antivenoms and must access products whose clinical performance has not been demonstrated. We hypothesize that it is possible to unify the treatment for viperid snakebites of MENA in a single antivenom formulation. Hereby we describe the design, development and preclinical evaluation of an antivenom of broad geographical coverage for this region (MENAVip-ICP). We produced this antivenom from the plasma of horses immunized with eight medically important venoms of viperid snake species from MENA. For this, we used a strategy based on two stages: first, immunization of horses with North African (NA) venoms, followed by a second immunization stage, on the same horses, with MENA venoms. We purified antivenoms from both stages: the Anti-NA and the final product Anti-MENA (MENAVip-ICP). Anti-NA was considered as intermediate formulation and was purified with the intention to study the progression of the immunoglobulin immune response of the horses. Antivenoms from both stages neutralized lethal, hemorrhagic, and procoagulant activities of homologous venoms. Compared to Anti-NA, MENAVip-ICP improved the neutralization profile of intravenous lethality and in vitro procoagulant activities of venoms. A notable finding was the difference in the neutralization of lethality when MENAVip-ICP was assessed intraperitoneally versus intravenously in the murine model. Intraperitoneally, MENAVip-ICP appears more effective in neutralizing the lethality of all venoms. Furthermore, MENAVip-ICP neutralized the lethal activity of venoms of species from other regions of MENA, Central/East Asia, and Sub-Saharan Africa that were not included in the immunization protocol. Our results showed that MENAVip-ICP neutralizes the main toxic activities induced by viperid MENA venoms at the preclinical level. Consequently, it is a promising product that could be clinically assessed for the treatment of snakebite envenomings in this region.

Pilot-scale evaluation of a dynamic body-feed filtration system for primary clarification of snake antivenoms produced by the caprylic acid method.

The performance of dynamic body-feed filtration (DBF) in the removal of bulky solids produced during the manufacturing of snake antivenoms using the caprylic acid method was evaluated. For this purpose, diatomites with different filterability properties were compared in a bench-scale study to assess their effectiveness in removing the precipitated material formed after the addition of caprylic acid to equine hyperimmune plasma. C1000 diatomite at a concentration of 90 g/L of precipitated plasma showed the best performance. Then, the process was scaled up to three batches of 50 L of hyperimmune horse plasma. At this pilot scale, 108 ± 4% of the immunoglobulins present following plasma precipitation were recovered after DBF. The antivenoms generated using this procedure met quality specifications. When compared to open filtration systems commonly used at an industrial scale by many antivenom manufacturers, DBF has a similar yield and produces filtrates with comparable physicochemical characteristics. However, DBF ensures the microbiological quality of the primary clarification in a way that open systems cannot. This is because: 1) DBF is performed in a single-use closed device of depth filters which prevents microbial contamination, and 2) DBF removes bulky material in few minutes instead of the more than 24 h needed by open filtration systems, thus reducing the risk of contamination. It was concluded that DBF is a cost-effective, easily validated, and GMP-compliant alternative for primary clarification following caprylic acid precipitation of plasma in snake antivenom production.

[Radiological versus endoscopic gastrostomy in patients with amyotrophic lateral sclerosis]. / Gastrostomía radiológica frente a endoscópica en pacientes con esclerosis lateral amiotrófica.

IIntroduction: patients with amyotrophic lateral sclerosis (ALS) require nutritional support, in most cases with enteral nutrition through gastrostomy, either endoscopic (PEG) or radiological (PRG). OBJECTIVES: to analyze the characteristics of patients with ALS at the time of PEG/PRG placement, and to compare the efficacy and safety of PRG versus PEG. METHODS: a retrospective descriptive study. All patients with ALS who required gastrostomy in the last 3 years (2021-2023) in our hospital were recruited (4 PEG and 6 PRG). Demographic and nutritional parameters were analyzed. RESULTS: ten patients were included, with an average age of 57 years. All patients presented with dysphagia and received oral or tube supplements prior to gastrostomy placement. The average duration of enteral nutrition was approximately 50 months, with a mortality rate of 30 % at 12 months after gastrostomy. The success rate of PEG and PRG was similar, with no complications. All patients developed deterioration of respiratory function, even after nutritional support. CONCLUSION: gastrostomy should be indicated as soon as a patient is at risk of aspiration pneumonia or when weight loss begins. Although the nutritional benefit of gastrostomy is well established, there is currently a delay between diagnosis and placement of approximately 4 years. PRG appears to be safer than PEG in patients with ALS and respiratory failure.

Outcome of Expanded Newborn Screening Among 194 000 Neonates at Northeast México.

Objectives. To describe the results of a 16-year experience of a state-coverage expanded newborn screening program (NBSP) in Northeast México. Methods. Between 2002 and 2017, dried blood spots of newborns were screened for congenital hypothyroidism (CH), congenital adrenal hyperplasia (CAH), biotinidase deficiency, galactosemia, cystic fibrosis, and glucose-6-phosphate dehydrogenase (G6PD) deficiency via immunofluorescence and amino and fatty acid disorders and organic acidemias using tandem mass spectrometry. Frequency rates were determined. Results. Overall, 192 487 samples were processed; 99.4% had negative results, and 598 were diagnosed. The frequency was 3.01/1000 newborns. G6PD deficiency, CH, amino acidemia, organic acidemia, cystic fibrosis, CAH, fatty acid oxidation disorder, galactosemia, and biotinidase deficiency cases were 1:773, 1:962, 1:4277, 1:4476, 1:11,322, 1:10,693, 1:10,693, 1:38,497, and 1:64,162, respectively. Conclusion. Using different technologies in NBSP increased the number of conditions detected, facilitating infant morbidity and mortality prevention. The frequency of disorders depends on the population's genetic background and diagnostic capacity.

A scoping review on control strategies for Echinococcus granulosus sensu lato.

Background: Cystic echinococcosis (CE) is a widespread neglected zoonotic disease caused by Echinococcus granulosus sensu lato (EG) with a global burden of control in the billions of dollars. E. granulosus' life cycle involves definitive, intermediate, and humans as dead-end hosts. Echinococcosis control programs use strategies that focus on any of these hosts. We aimed to provide a comprehensive and up-to-date overview of the EG control interventions worldwide. Methods: We conducted a scoping review by mapping all studies on interventions for EG control following the Arksey and O'Malley Framework. We screened identified articles, and charted and coded selected papers. We classified the data based on target host, type of study, and control mechanism. We described the efficacy or safety outcomes, and the associated barriers/facilitators for the intervention. Critical appraisal was conducted. Results: From 7,853 screened studies, we analyzed 45: seven centered on human interventions, 21 on animals, and 17 on both. Studies on humans focused on educational strategies and human CE monitoring. The studies on animals were field trials and most were based on Praziquantel (PZQ) for dogs. Studies focused on both animals and humans had, in general, more participants, lasted longer, and covered larger geographical areas. Overall, the quality of studies was moderate to low. Conclusions: Available evidence suggests that long-term interventions aimed at both animals and humans can achieve significant reduction in EG transmission, particularly when PZQ treatment for dogs is included. Higher quality evidence, standardization of methodologies, and better reporting on post-intervention outcomes are necessary for drawing stronger conclusions. Further evidence is needed to assess the sustainability and scalability of control measures. Nonetheless, an integrative One Health approach is essential for overcoming the multiple challenges associated with sustaining long-term control efforts for Echinococcosis.

Exploring communicative interactions in debriefing sessions with nursing students: A qualitative study.

INTRODUCTION: Debriefing as a learning activity aims to elevate participants' competence through communicative interaction. This activity is an integral component of any formative simulation. Thus, the primary objective of this study was to explore debriefing as a communicative experience in nursing students within the context of interactive virtual simulation. The secondary objectives were: 1) To investigate the typology of interactions based on participants' discourse and 2) To identify the actions that students use to develop knowledge during debriefing. METHOD: A qualitative exploratory study design involving six debriefing groups was conducted with 105 s-year nursing students. The debriefing sessions were analyzed following interactive virtual simulations in an in-person setting in the classroom. All sessions were recorded and transcribed verbatim. A mixed (deductive and inductive) content analysis approach was used. RESULTS: A total of 2187 units of meaning were identified and categorized into 3 themes (interaction by participant, interaction by communicative action, and interaction by participant's communicative goal); nine subthemes (facilitator-student, student-student and student-facilitator; declarative - unidirectional, reactive - bidirectional and multidirectional-interactive; individualistic, competitive, and collaborative), and 5 categories (providing information; generating creative solutions; processing critical and deliberative information; positive interdependence and psychosocial relationships). CONCLUSION: The students developed knowledge and practical communication skills, particularly reinforcing soft skills through collaborative interactions, predominantly multidirectional-interactive in nature. The facilitator and the interpersonal relationships among the participants fostered a safe and positive environment.

Sacituzumab govitecan response in extensive leptomeningeal carcinomatosis from triple-negative breast cancer: a case report.

Sacituzumab govitecan (SG), a Trop-2-directed antibody-drug conjugate (ADC), was the first ADC approved for patients with metastatic triple-negative breast cancer (mTNBC) who had received at least two prior lines of therapy for advanced disease. Although SG has shown promising clinical activity in treating brain metastases in both ASCENT randomized trials and real-world analysis, its utility in leptomeningeal carcinomatosis (LC) remains underexplored. We report the diagnostic and therapeutic process of a patient who develops extensive LC from TNBC treated with SG. She presented a clinical response after the first cycle of SG with a PFS of 6 months. This case report highlights the need for further inquiry into the use of SG in LC.