Isolation of acute myeloid leukemia blasts from blood using a microfluidic device.

Acute myeloid leukemia (AML) is the most common form of acute leukemia in adults and associated with poor prognosis. Unfortunately, most of the patients that achieve clinical complete remission after the treatment will ultimately relapse due to the persistence of minimal residual disease (MRD), that is not measurable using conventional technologies in the clinic. Microfluidics is a potential tool to improve the diagnosis by providing early detection of MRD. Herein, different designs of microfluidic devices were developed to promote lateral and vertical mixing of cells in microchannels to increase the contact area of the cells of interest with the inner surface of the device. Possible interactions between the cells and the surface were studied using fluid simulations. For the isolation of leukemic blasts, a positive selection strategy was used, targeting the cells of interest using a panel of specific biomarkers expressed in immature and aberrant blasts. Finally, once the optimisation was complete, the best conditions were used to process patient samples for downstream analysis and benchmarking, including phenotypic and genetic characterisation. The potential of these microfluidic devices to isolate and detect AML blasts may be exploited for the monitoring of AML patients at different stages of the disease.

Tapered chiral nanoparticles as broad-spectrum thermally stable antivirals for SARS-CoV-2 variants.

The incessant mutations of viruses, variable immune responses, and likely emergence of new viral threats necessitate multiple approaches to novel antiviral therapeutics. Furthermore, the new antiviral agents should have broad-spectrum activity and be environmentally stable. Here, we show that biocompatible tapered CuS nanoparticles (NPs) efficiently agglutinate coronaviruses with binding affinity dependent on the chirality of surface ligands and particle shape. L-penicillamine-stabilized NPs with left-handed curved apexes display half-maximal inhibitory concentrations (IC50) as low as 0.66 pM (1.4 ng/mL) and 0.57 pM (1.2 ng/mL) for pseudo-type SARS-CoV-2 viruses and wild-type Wuhan-1 SARS-CoV-2 viruses, respectively, which are about 1,100 times lower than those for antibodies (0.73 nM). Benefiting from strong NPs-protein interactions, the same particles are also effective against other strains of coronaviruses, such as HCoV-HKU1, HCoV-OC43, HCoV-NL63, and SARS-CoV-2 Omicron variants with IC50 values below 10 pM (21.8 ng/mL). Considering rapid response to outbreaks, exposure to elevated temperatures causes no change in the antiviral activity of NPs while antibodies are completely deactivated. Testing in mice indicates that the chirality-optimized NPs can serve as thermally stable analogs of antiviral biologics complementing the current spectrum of treatments.

Applying Lean Healthcare in the hospitalization and patient discharge process: an integrative review.

OBJECTIVES: to identify scientific evidence regarding the use of Lean Healthcare approach in the hospitalization and patient discharge process. METHODS: this is an Integrative Review conducted in the PubMed, LILACS, SCOPUS, CINAHL, Web of Science, and Embase databases. RESULTS: out of 904 records identified, three were included in this review. The studies demonstrated that when applied to discharge planning, the Lean philosophy brings favorable results, promoting improvements in the communication process, as well as assisting in workflow organization, with a reduction in length of stay and improvement in the quality of care. FINAL CONSIDERATIONS: although the Lean methodology presents positive results, it is considered that the application of the philosophy in healthcare institutions is still not sustainable, as it is often restricted to specific departments or services. Thus, to maximize the success of implementation, the Lean philosophy needs to be incorporated into the organizational culture, representing the greatest challenge.

New insights into the pathogenesis and transmission of Brucella pinnipedialis: systemic infection in two bottlenose dolphins (Tursiops truncatus).

IMPORTANCE: Brucella spp. are zoonotic pathogens that can affect both terrestrial and marine mammals. Brucella ceti has been identified in various cetacean species, but only one sequence type (ST27) has been reported in humans. However, it is important to conduct surveillance studies to better understand the impact of marine Brucella species on marine mammals, a typically understudied host group. Here, we describe a systemic infection by two related strains of Brucella pinnipedialis (ST25) in a couple of live-stranded bottlenose dolphins, with more severe lesions in the younger animal. Furthermore, B. pinnipedialis was first detected in milk from a female cetacean that stranded with its offspring. Our study reveals novel insights into the epidemiology and pathological consequences of B. pinnipedialis infections in cetaceans, emphasizing the crucial importance of ongoing surveillance and accurate diagnosis to understand the impact of this pathogen on marine mammal populations.

Biomimetic catalysis of nitrite reductase enzyme using copper complexes in chemical and electrochemical reduction of nitrite.

Copper nitrite reductase mimetics were synthesized using three new tridentate ligands sharing the same N,N,N motif of coordination. The ligands were based on L-proline modifications, attaching a pyridine and a triazole to the pyrrolidine ring, and differ by a pendant group (R = phenyl, n-butyl and n-propan-1-ol). All complexes coordinate nitrite, as evidenced by cyclic voltammetry, UV-Vis, FTIR and electron paramagnetic resonance (EPR) spectroscopies. The coordination mode of nitrite was assigned by FTIR and EPR as κ2O chelate mode. Upon acidification, EPR experiments indicated a shift from chelate to monodentate κO mode, and 15N NMR experiments of a Zn2+ analogue, suggested that the related Cu(II) nitrous acid complex may be reasonably stable in solution, but in equilibrium with free HONO under non catalytic conditions. Reduction of nitrite to NO was performed both chemically and electrocatalytically, observing the highest catalytic activities for the complex with n-propan-1-ol as pendant group. These results support the hypothesis that a hydrogen bond moiety in the secondary coordination sphere may aid the protonation step.

Hybrid Digital-Droplet Microfluidic Chip for Applications in Droplet Digital Nucleic Acid Amplification: Design, Fabrication and Characterization.

Microfluidic-based platforms have become a hallmark for chemical and biological assays, empowering micro- and nano-reaction vessels. The fusion of microfluidic technologies (digital microfluidics, continuous-flow microfluidics, and droplet microfluidics, just to name a few) presents great potential for overcoming the inherent limitations of each approach, while also elevating their respective strengths. This work exploits the combination of digital microfluidics (DMF) and droplet microfluidics (DrMF) on a single substrate, where DMF enables droplet mixing and further acts as a controlled liquid supplier for a high-throughput nano-liter droplet generator. Droplet generation is performed at a flow-focusing region, operating on dual pressure: negative pressure applied to the aqueous phase and positive pressure applied to the oil phase. We evaluate the droplets produced with our hybrid DMF-DrMF devices in terms of droplet volume, speed, and production frequency and further compare them with standalone DrMF devices. Both types of devices enable customizable droplet production (various volumes and circulation speeds), yet hybrid DMF-DrMF devices yield more controlled droplet production while achieving throughputs that are similar to standalone DrMF devices. These hybrid devices enable the production of up to four droplets per second, which reach a maximum circulation speed close to 1540 µm/s and volumes as low as 0.5 nL.

Open-source tool for real-time and automated analysis of droplet-based microfluidic.

Droplet-based microfluidic technology is a powerful tool for generating large numbers of monodispersed nanoliter-sized droplets for ultra-high throughput screening of molecules or single cells. Yet further progress in the development of methods for the real-time detection and measurement of passing droplets is needed for achieving fully automated systems and ultimately scalability. Existing droplet monitoring technologies are either difficult to implement by non-experts or require complex experimentation setups. Moreover, commercially available monitoring equipment is expensive and therefore limited to a few laboratories worldwide. In this work, we validated for the first time an easy-to-use, open-source Bonsai visual programming language to accurately measure in real-time droplets generated in a microfluidic device. With this method, droplets are found and characterized from bright-field images with high processing speed. We used off-the-shelf components to achieve an optical system that allows sensitive image-based, label-free, and cost-effective monitoring. As a test of its use we present the results, in terms of droplet radius, circulation speed and production frequency, of our method and compared its performance with that of the widely-used ImageJ software. Moreover, we show that similar results are obtained regardless of the degree of expertise. Finally, our goal is to provide a robust, simple to integrate, and user-friendly tool for monitoring droplets, capable of helping researchers to get started in the laboratory immediately, even without programming experience, enabling analysis and reporting of droplet data in real-time and closed-loop experiments.

Optical switching a photon-avalanche-like mechanism in NdAl3(BO3)4 particles excited at 1064 nm by an auxiliary beam at 808 nm.

In recent years, an unconventional excitation of trivalent neodymium ions (N d 3+) at 1064 nm, not resonant with ground-state transitions, has been investigated with the unprecedented demonstration of a photon-avalanche-like (PA-like) mechanism, in which the temperature increase plays a fundamental role. As a proof-of-concept, N d A l 3(B O 3)4 particles were used. A consequence of the PA-like mechanism is the absorption enhancement of excitation photons providing light emission at a broad range covering the visible and near-infrared spectra. In the first study, the temperature increase was due to intrinsic nonradiative relaxations from the N d 3+ and the PA-like mechanism ensued at a given excitation power threshold (P t h ). Subsequently, an external heating source was used to trigger the PA-like mechanism while keeping the excitation power below P t h at room temperature. Here, we demonstrate the switching on of the PA-like mechanism by an auxiliary beam at 808 nm, which is in resonance with the N d 3+ ground-state transition 4 I 9/2→{4 F 5/2,2 H 9/2}. It comprises the first, to the best of our knowledge, demonstration of an optical switched PA, and the underlying physical mechanism is the additional heating of the particles due to the phonon emissions from the N d 3+ relaxation pathways when exciting at 808 nm. The present results have potential applications in controlled heating and remote temperature sensing.

Effect of stress on the chronotropic and inotropic responses to ß-adrenergic agonists in isolated atria of KOß2 mice.

Altered sensitivity to the chronotropic and inotropic effects of catecholamines and reduction in ß1/ß2-adrenoceptor (ß1/ß2-AR) ratio were reported in failing and in senescent human heart, as well as in isolated atria and ventricle of rats submitted to stress. This was due to downregulation of ß1-AR with or without up-regulation of ß2-AR. AIMS: To investigate the stress-induced behavior of ß1-AR in the heart of mice expressing a non-functional ß2-AR subtype. The guiding hypothesis is that the absence of ß2-AR signaling will not affect the behavior of ß1-AR during stress and that those are independent processes. MATERIALS AND METHODS: The chronotropic and inotropic responses to ß-AR agonists in isolated atria of stressed mice expressing a non-functional ß2-AR were analyzed. The mRNA and protein expressions of ß1- and ß2-AR were also determined. KEY FINDINGS: No deaths were observed in mice under stress protocol. Atria of stressed mice displayed reduced sensitivity to isoprenaline compared to the controls, an effect that was abolished by the ß2- and ß1-AR antagonists 50 nM ICI118,551 and 300 nM CGP20712A, respectively. Sensitivity and maximum response to the ß-agonists dobutamine and salbutamol were not altered by stress or ICI118,551. The responses to dobutamine and salbutamol were prevented by CGP20712A. The expression of ß1-AR was reduced at protein levels. SIGNIFICANCE: Collectively, our data provide evidence that the cardiac ß2-AR is not essential for survival in a stressful situation and that the stress-induced reduction of ß1-AR expression was independent of the ß2-AR presence.

Incidência e evitabilidade de eventos adversos no pronto atendimento: estudo retrospectivo / Incidencia y evitabilidad de eventos adversos en unidad de pronta atención: estudio retrospectivo / Incidence and avoidability of adverse events in emergency care: a retrospective study

Resumo Objetivo Analisar a incidência e a evitabilidade de eventos adversos em pacientes adultos internados em uma unidade de pronto atendimento no município do interior mineiro. Métodos Estudo de coorte, com revisão retrospectiva de 296 prontuários por meio do uso de formulários de rastreamento (fase 1) e avaliação (fase 2), preenchidos por profissionais não médicos e médico, respectivamente. Na primeira fase foram avaliados os dados demográficos, condição clínica dos pacientes, potenciais eventos adversos, e a verificação da qualidade das informações registradas nos prontuários. Na segunda fase, identificou-se e caracterizou-se os eventos adversos previamente rastreados. Resultados Observou-se a predominância de pessoas do sexo masculino, da raça branca, com 60 anos ou mais. A incidência de eventos adversos acumulada foi de 4,4% (n=13), sendo todos considerados evitáveis, e caracterizados como de gravidade leve, em sua maioria. De acordo com a natureza, 81,2% dos eventos adversos estavam relacionados ao cuidado em geral. Já em relação aos fatores intrínsecos e extrínsecos, encontrou-se uma média de 1,17 e 1,5 por paciente, respectivamente. Constatou-se que 17 pacientes foram identificados com potencial evento adverso, com 22 incidentes na análise. Conclusão Identificou-se que 100% dos eventos adversos eram evitáveis e a maioria relacionados ao cuidado em geral. Esses achados reforçam a necessidade de se avaliar e compreender a incidência e a evitabilidade dos eventos adversos em unidades de pronto atendimento, o que permite o planejamento e implementação de estratégias que visem o desenvolvimento de ações de controle e resposta a estes eventos, garantindo um atendimento seguro e de qualidade.

Resumen Objetivo Analizar la incidencia y la evitabilidad de eventos adversos en pacientes adultos internados en una unidad de pronta atención en un municipio del interior del estado de Minas Gerais. Métodos Estudio de cohorte, con revisión retrospectiva de 296 historias clínicas mediante el uso de formularios de rastreo (fase 1) y evaluación (fase 2), completados por profesionales no médicos y médicos, respectivamente. En la primera fase se evaluaron los datos demográficos, la condición clínica de los pacientes, los potenciales eventos adversos y la verificación de la calidad de la información registrada en las historias clínicas. En la segunda fase, se identificaron y caracterizaron los eventos adversos previamente rastreados. Resultados Se observó la predominancia de personas de sexo masculino, de raza blanca, de 60 años o más. La incidencia de eventos adversos acumulada fue del 4,4 % (n=13), todos fueron considerados como evitables y caracterizados de gravedad baja, en su mayoría. De acuerdo con la naturaleza, el 81,2 % de los eventos adversos estuvo relacionado con el cuidado en general. Por otro lado, con relación a los factores intrínsecos y extrínsecos, se observó un promedio de 1,17 y 1,5 por paciente, respectivamente. Se constató que 17 pacientes fueron identificados con evento adverso potencial, con 22 incidentes en el análisis. Conclusión Se identificó que el 100 % de los eventos adversos era evitable y la mayoría relacionados con el cuidado en general. Estos resultados refuerzan la necesidad de analizar y comprender la incidencia y la evitabilidad de los eventos adversos en unidades de pronta atención, lo que permite la planificación e implementación de estrategias que busquen la elaboración de acciones de control y respuesta a estos eventos, y así garantizar una atención segura y de calidad.

Abstract Objective To analyze the incidence and avoidability of adverse events in adult patients hospitalized in an emergency care unit in the countryside of Minas Gerais. Methods A cohort study, with a retrospective review of 296 medical records using screening (phase 1) and evaluation (phase 2) forms, completed by non-medical professionals and physicians, respectively. In the first phase, the demographic data, clinical condition of the patients, potential adverse events, and the verification of the quality of the information recorded in the medical records were evaluated. In the second phase, previously tracked adverse events were identified and characterized. Results There was a predominance of men, white, aged 60 or older. The cumulative incidence of adverse events was 4.4% (n=13), all of which were considered preventable, and mostly characterized as mild in severity. According to nature, 81.2% of adverse events were related to care in general. In relation to intrinsic and extrinsic factors, an average of 1.17 and 1.5 per patient, respectively, was found. It was found that a total of 17 patients were identified with potential adverse events, with 22 incidents in the analysis. Conclusion It was identified that 100% of adverse events were preventable and most related to general care. These findings reinforce the need to assess and understand the incidence and preventability of adverse events in emergency care units, which allows for the planning and implementation of strategies aimed at the development of control and response actions to these events, ensuring safe and quality care.

Applying Lean Healthcare in the hospitalization and patient discharge process: an integrative review / La aplicación de Lean Healthcare en el proceso de hospitalización y alta del paciente: revisión integrativa / A aplicação do Lean Healthcare no processo de hospitalização e alta do paciente: revisão integrativa

ABSTRACT Objectives: to identify scientific evidence regarding the use of Lean Healthcare approach in the hospitalization and patient discharge process. Methods: this is an Integrative Review conducted in the PubMed, LILACS, SCOPUS, CINAHL, Web of Science, and Embase databases. Results: out of 904 records identified, three were included in this review. The studies demonstrated that when applied to discharge planning, the Lean philosophy brings favorable results, promoting improvements in the communication process, as well as assisting in workflow organization, with a reduction in length of stay and improvement in the quality of care. Final Considerations: although the Lean methodology presents positive results, it is considered that the application of the philosophy in healthcare institutions is still not sustainable, as it is often restricted to specific departments or services. Thus, to maximize the success of implementation, the Lean philosophy needs to be incorporated into the organizational culture, representing the greatest challenge.

RESUMEN Objetivos: identificar evidencia científica sobre el uso del enfoque Lean Healthcare en el proceso de hospitalización y alta del paciente. Métodos: se realizó una revisión integrativa en las bases de datos PubMed, LILACS, SCOPUS, CINAHL, Web of Science y Embase. Resultados: de los 904 registros identificados, se incluyeron tres en esta revisión. Los estudios demostraron que, cuando se aplica en la planificación del alta, la filosofía Lean produce resultados favorables al mejorar la comunicación y ayudar a organizar el flujo de trabajo, reducir el tiempo de estancia y mejorar la calidad de la atención. Consideraciones Finales: aunque la metodología Lean muestra resultados positivos, su aplicación en las instituciones de salud no es sostenible, ya que a menudo se limita a algunos departamentos o servicios. Por lo tanto, para maximizar el éxito de la implementación, la filosofía Lean debe ser incorporada a la cultura organizacional, lo que representa el mayor desafio.

RESUMO Objetivos: identificar evidências científicas acerca da utilização do Lean Healthcare no processo de hospitalização e de alta do paciente. Métodos: trata-se de uma Revisão Integrativa realizada nas bases de dados PubMed, LILACS, SCOPUS, CINAHL, Web of Science e Embase. Resultados: dos 904 registros identificados, três foram incluídos nesta revisão. Os estudos demonstraram que, quando aplicada ao planejamento de alta, a filosofia Lean traz resultados favoráveis, promovendo melhorias no processo de comunicação, além de auxiliar na organização do fluxo de trabalho, com redução do tempo de permanência e melhoria na qualidade do cuidado. Considerações Finais: apesar da metodologia Lean apresentar resultados positivos, considera-se que sua aplicação nas instituições de saúde não é sustentável, uma vez que, na maioria das vezes, se restringe apenas a alguns setores e/ou serviços. Assim, para maximizar o sucesso da implementação, a filosofia Lean precisa ser incorporada à cultura organizacional, representando o maior desafio.

Does the mycotoxin ingestion by beef heifers on feedlot change the productive parameters?

In intensive beef cattle production systems, silage, corn, soy bean, and their coproducts are commonly used as feed. However, these ingredients are highly susceptible to contamination by fungi and mycotoxins, which may lead to immunological challenges and reduce animal production. The aim of the present study was to evaluate the effects of mycotoxin contamination of diet on intake, digestibility, and performance of heifers. Twenty non-pregnant (Nellore) heifers (age, >18 months; initial body weight, 348±30 kg) were used and randomly distributed in two treatments: (1) control (non-contaminated diet) and (2) zearalenone-contaminated diet (300 ppb). The diet comprised 70% corn silage and 30% concentrate. Individual dry matter intake and digestibility were estimated using external and internal markers. Heifer body weight was evaluated every week without fasting to calculate performance. The experimental design was completely randomized. Each animal was considered one experimental unit. Assumptions were tested for variance analyses (error normality, independence of errors, and homogeneity of variances) (p<0.05). There were no differences in dry matter intake (p=0.96) and digestibility (p=0.62). Performance (kg/day) did not vary as a function of zearalenone ingestion (p=0.68). Therefore, contamination of diet with 300 ppb zearalenone did not affect the intake, digestibility, and performance of feedlot-finished heifers.

Authentic leadership in the educational system and in nursing education: an integrative review.

OBJECTIVES: to identify and analyze the knowledge produced in literature about authentic leadership in the educational system, as well as in nursing education. METHODS: an integrative review, carried out in the Scopus, Web of Science, CINAHL, MEDLINE/PubMed, ERIC, LILACS databases. Articles that addressed authentic leadership in the educational system from a general perspective and within the nursing scope, as well as teaching practices of this leadership model, were eligible. RESULTS: twenty-three articles met the inclusion criteria, most published in 2019, highlighting studies in the context of teaching, with a predominance in the nursing course and which were synthesized into three thematic categories. FINAL CONSIDERATIONS: it was found that the higher the levels of authentic leadership in the educational system, the higher the rates of other positive factors related to it, such as trust, involvement, academic optimism, responsibility, creativity, among others.

Polarization-sensitive optoionic membranes from chiral plasmonic nanoparticles.

Optoelectronic effects differentiating absorption of right and left circularly polarized photons in thin films of chiral materials are typically prohibitively small for their direct photocurrent observation. Chiral metasurfaces increase the electronic sensitivity to circular polarization, but their out-of-plane architecture entails manufacturing and performance trade-offs. Here, we show that nanoporous thin films of chiral nanoparticles enable high sensitivity to circular polarization due to light-induced polarization-dependent ion accumulation at nanoparticle interfaces. Self-assembled multilayers of gold nanoparticles modified with L-phenylalanine generate a photocurrent under right-handed circularly polarized light as high as 2.41 times higher than under left-handed circularly polarized light. The strong plasmonic coupling between the multiple nanoparticles producing planar chiroplasmonic modes facilitates the ejection of electrons, whose entrapment at the membrane-electrolyte interface is promoted by a thick layer of enantiopure phenylalanine. Demonstrated detection of light ellipticity with equal sensitivity at all incident angles mimics phenomenological aspects of polarization vision in marine animals. The simplicity of self-assembly and sensitivity of polarization detection found in optoionic membranes opens the door to a family of miniaturized fluidic devices for chiral photonics.

Simultaneous evaluation of intermittency effects, replica symmetry breaking and modes dynamics correlations in a Nd:YAG random laser.

Random lasers (RLs) are remarkable experimental platforms to advance the understanding of complex systems phenomena, such as the replica-symmetry-breaking (RSB) spin glass phase, dynamics modes correlations, and turbulence. Here we study these three phenomena jointly in a Nd:YAG based RL synthesized for the first time using a spray pyrolysis method. We propose a couple of modified Pearson correlation coefficients that are simultaneously sensitive to the emergence and fading out of photonic intermittency turbulent-like effects, dynamics evolution of modes correlations, and onset of RSB behavior. Our results show how intertwined these phenomena are in RLs, and suggest that they might share some common underlying mechanisms, possibly approached in future theoretical models under a unified treatment.

Enantiomer-dependent immunological response to chiral nanoparticles.

Chirality is a unifying structural metric of biological and abiological forms of matter. Over the past decade, considerable clarity has been achieved in understanding the chemistry and physics of chiral inorganic nanoparticles1-4; however, little is known about their effects on complex biochemical networks5,6. Intermolecular interactions of biological molecules and inorganic nanoparticles show some commonalities7-9, but these structures differ in scale, in geometry and in the dynamics of chiral shapes, which can both impede and strengthen their mirror-asymmetric complexes. Here we show that achiral and left- and right-handed gold biomimetic nanoparticles show different in vitro and in vivo immune responses. We use irradiation with circularly polarized light (CPL) to synthesize nanoparticles with controllable nanometre-scale chirality and optical anisotropy factors (g-factors) of up to 0.4. We find that binding of nanoparticles to two proteins from the family of adhesion G-protein-coupled receptors (AGPCRs)-namely cluster-of-differentiation 97 (CD97) and epidermal-growth-factor-like-module receptor 1 (EMR1)-results in the opening of mechanosensitive potassium-efflux channels, the production of immune signalling complexes known as inflammasomes, and the maturation of mouse bone-marrow-derived dendritic cells. Both in vivo and in vitro immune responses depend monotonically on the g-factors of the nanoparticles, indicating that nanoscale chirality can be used to regulate the maturation of immune cells. Finally, left-handed nanoparticles show substantially higher (1,258-fold) efficiency compared with their right-handed counterparts as adjuvants for vaccination against the H9N2 influenza virus, opening a path to the use of nanoscale chirality in immunology.

Authentic leadership in the educational system and in nursing education: an integrative review / A liderança autêntica no sistema educacional e no ensino da enfermagem: revisão integrativa

ABSTRACT Objectives: to identify and analyze the knowledge produced in literature about authentic leadership in the educational system, as well as in nursing education. Methods: an integrative review, carried out in the Scopus, Web of Science, CINAHL, MEDLINE/PubMed, ERIC, LILACS databases. Articles that addressed authentic leadership in the educational system from a general perspective and within the nursing scope, as well as teaching practices of this leadership model, were eligible. Results: twenty-three articles met the inclusion criteria, most published in 2019, highlighting studies in the context of teaching, with a predominance in the nursing course and which were synthesized into three thematic categories. Final Considerations: it was found that the higher the levels of authentic leadership in the educational system, the higher the rates of other positive factors related to it, such as trust, involvement, academic optimism, responsibility, creativity, among others.

RESUMEN Objetivos: identificar y analizar el conocimiento producido en la literatura sobre el liderazgo auténtico en el sistema educativo, así como en la formación de enfermería. Métodos: una revisión integradora, realizada en bases de datos Scopus, Web of Science, CINAHL, MEDLINE/PubMed, ERIC, LILACS. Fueron elegibles los artículos que abordaran el liderazgo auténtico en el sistema educativo desde una perspectiva general y en el ámbito de la enfermería, así como las prácticas docentes de este modelo de liderazgo. Resultados: 23 artículos cumplieron con los criterios de inclusión, la mayoría publicados en 2019, destacándose estudios en el contexto de la enseñanza, con predominio en el curso de enfermería y que fueron sintetizados en tres categorías temáticas. Consideraciones Finales: se encontró que a mayores niveles de liderazgo auténtico en el sistema educativo, mayores índices de otros factores positivos relacionados con el mismo, como confianza, involucramiento, optimismo académico, responsabilidad, creatividad, entre otros.

RESUMO Objetivos: identificar e analisar o conhecimento produzido na literatura acerca da liderança autêntica no sistema educacional, assim como na educação em enfermagem. Métodos: revisão integrativa, realizada nas bases de dados Scopus, Web of Science, CINAHL, MEDLINE/PubMed, ERIC, LILACS. Foram elegíveis artigos que abordassem sobre a liderança autêntica no sistema educacional de uma perspectiva geral e no âmbito da enfermagem, assim como as práticas de ensino desse modelo de liderança. Resultados: 23 artigos atenderam aos critérios de inclusão, a maioria publicada em 2019, sobressaindo-se estudos no contexto no ensino, com predomínio no curso de enfermagem e que foram sintetizados em três categorias temáticas. Considerações Finais: constatou-se que, quanto maiores os níveis da liderança autêntica no sistema educacional, mais elevados serão os índices de outros fatores positivos a ela relacionadas, como confiança, envolvimento, otimismo acadêmico, responsabilidade, criatividades, entre outros.

Satisfação no trabalho de técnicos de enfermagem do atendimento pré-hospitalar: um estudo observacional analítico / Job satisfaction of nursing technicians in pre-hospital care: an analytical observational study / Satisfacción laboral de los técnicos de enfermería en la atención prehospitalaria: un estudio analítico observacional

Objetivo: avaliar a satisfação no trabalho dos técnicos de enfermagem atuantes no Serviço de Atendimento Móvel de Urgência e sua relação com variáveis relacionadas aos aspectos profissionais e demográficos. Método: estudo observacional analítico, com 155 técnicos de enfermagem do Serviço de Atendimento Móvel de Urgência. Empregaram-se o Job Satisfaction Survey e testes estatísticos não paramétricos para analisar a correlação e a associação entre as dimensões do instrumento com as variáveis sociodemográficas e profissionais, com nível de significância de p<0,05. Resultados: os profissionais estão nem insatisfeitos nem satisfeitos em relação ao seu trabalho. Identificaram-se correlações fracas entre alguns domínios do instrumento com as variáveis idade e tempo na unidade. Houve associações entre a satisfação no trabalho com as variáveis: sexo, graduação, escala e tipo de vínculo. Conclusão: evidenciou-se que a satisfação no trabalho dos técnicos de enfermagem atuantes no atendimento pré-hospitalar está associada às variáveis sexo, graduação, escala de serviço e tipo de vínculo.

Objective: to assess job satisfaction among nursing technicians working in a Mobile Emergency Care Service and its relationship with professional and demographic variables. Method: in this analytical observational study of 155 nursing technicians from the Mobile Emergency Care Service, the Job Satisfaction Survey and non-parametric statistical tests were used to examine correlations and associations between the dimensions of the instrument and sociodemographic and professional variables, to a p < 0.05 level of significance. Results: the technicians were neither dissatisfied nor satisfied with their work. Weak correlations were identified between some domains of the instrument, age and time in the unit. Job satisfaction was associated with sex, graduation, scale of service and type of employment relationship. Conclusion: job satisfaction among nursing technicians working in pre-hospital care was found to be associated with sex, graduation, scale of service and type of employment relationship.

Objetivo: evaluar la satisfacción no trabajo de los técnicos de enfermería que trabajan en el Servicio de Atención Móvil de Urgencias y su relación con variables relacionadas con los aspectos profesionales y demográficos. Método: estudio analítico observacional junto a 155 técnicos de enfermería del Servicio de Atención Móvil de Urgencias. Se utilizaron la Encuesta de Satisfacción Laboral y pruebas estadísticas no paramétricas para analizar la correlación y la asociación entre las dimensiones del instrumento y las variables sociodemográficas y profesionales, con el nivel de significancia de p <0.05. Resultados: los profesionales no están insatisfechos ni satisfechos con respecto a su trabajo. Se identificaron correlaciones débiles entre algunos dominios del instrumento con las variables edad y tiempo en la unidad. Hubo asociaciones entre la satisfacción laboral con las variables: sexo, graduación, escala y tipo de vínculo laboral. Conclusión:se evidenció que la satisfacción laboral de los técnicos de enfermería que laboran en la atención prehospitalaria se asocia con las variables sexo, grado, escala de servicio y tipo de vínculo.

Lateral subtalar dislocation associated with a lateral malleolus and a nutcracker cuboid fracture: Case report of a rare pattern of lesion.

INTRODUCTION AND IMPORTANCE: Combined fracture of the lateral malleolus and cuboid due to a lateral subtalar dislocation is an uncommon injury. Literature is scarce on this trauma association. To the best of our knowledge, this represents a new lesion pattern. Hereby we describe its mechanism, management and outcomes. CASE PRESENTATION: We report a case of a 58-year-old woman, who fell from the stairs and presented with pain and an acute deformity of the left foot and ankle. Plain radiographs and CT scan revealed a lateral subtalar dislocation with a lateral malleolus and cuboid fractures. After a failed closed reduction, the patient underwent an open reduction and fixation of the talonavicular joint. An external fixator was applied to address the cuboid fracture. The lateral malleolus was treated conservatively with 5.5 weeks of immobilization. At 38 months of follow-up, the patient scored 87% on the AOFAS ankle-hindfoot scale and returned to normal daily activity. Radiographs demonstrate signs of posttraumatic arthritis at the subtalar and talonavicular joints. CLINICAL DISCUSSION: After reduction of the lateral subtalar dislocation, addressing the nutcracker cuboid fracture was essential, since it can contribute to a flatfoot deformity. Although the patient progressed to posttraumatic arthritis, the sequelae are usually well tolerated and a good outcome was achieved. CONCLUSION: The rarity of this pattern of lesion is related to the necessary multidirectional forces. Correct management of the associated fractures is essential. Our study demonstrates a new lesion pattern of lateral subtalar dislocations, its mechanism, management and outcomes.

Human-modified canids in human-modified landscapes: The evolutionary consequences of hybridization for grey wolves and free-ranging domestic dogs.

Introgressive hybridization between domestic animals and their wild relatives is an indirect form of human-induced evolution, altering gene pools and phenotypic traits of wild and domestic populations. Although this process is well documented in many taxa, its evolutionary consequences are poorly understood. In this study, we assess introgression patterns in admixed populations of Eurasian wolves and free-ranging domestic dogs (FRDs), identifying chromosomal regions with significantly overrepresented hybrid ancestry and assessing whether genes located within these regions show signatures of selection. Although the dog admixture proportion in West Eurasian wolves (2.7%) was greater than the wolf admixture proportion in FRDs (0.75%), the number and average length of chromosomal blocks showing significant overrepresentation of hybrid ancestry were smaller in wolves than FRDs. In wolves, 6% of genes located within these blocks showed signatures of positive selection compared to 23% in FRDs. We found that introgression from wolves may provide a considerable adaptive advantage to FRDs, counterbalancing some of the negative effects of domestication, which can include reduced genetic diversity and excessive tameness. In wolves, introgression from FRDs is mostly driven by drift, with a small number of positively selected genes associated with brain function and behaviour. The predominance of drift may be the consequence of small effective size of wolf populations, which reduces efficiency of selection for weakly advantageous or against weakly disadvantageous introgressed variants. Small wolf population sizes result largely from human-induced habitat loss and hunting, thus linking introgression rates to anthropogenic processes. Our results imply that maintenance of large population sizes should be an important element of wolf management strategies aimed at reducing introgression rates of dog-derived variants.