In vitro assessment of ruminal biohydrogenation of polyunsaturated fatty acids in diets with different types and levels of protected fat and diverse sources of fibre.

The objective was to assess the in vitro rumen fermentation characteristics, methane production, and biohydrogenation of unsaturated fatty acids of diets with two protected fat (PF) sources from soybean or linseed oil, two levels of PF (0 and 6%) and two forage sources (canola silage (CS) or alfalfa hay (AH)) in a factorial 2x2x2 completely randomised design. Only fatty acids content at final incubation was affected (P<0.05) by triple interaction, where C18:2 was highest with AH plus 6% soybean PF (4.41mg/g DM), while C18:3 was with CS plus 6% linseed oil protected (1.98mg/g DM). C18:2 cis-9 trans-11 had high concentration (308 mg/g DM; P<0.05) with AH plus 6% PF regardless PF type, and C18:1 trans-11 was higher with 6% PF than without PF (13.41 vs 7.89 mg/g DM). Cumulative methane production was not affected by treatments (0.9973 ± 0.1549 mmol/g DM; P>0.05). Gas production and in vitro NDF digestibility were lower with 6% PF of linseed than soybean (160.88 vs 150.97 ml; and 69.28vs 62.89 %, respectively P<0.05). With linseed PF the NH3-N concentration was highest in CS than AH (41.27 vs 27.95 mg/dL; P<0.05) but IVDMD had the opposite result (78.54 vs 85.04). In conclusion, although methane production was not affected and in vitro digestibility and gas production were reduced with linseed PF, the concentration of C18:3 and C18:1 trans-11 was increased, which could improve the lipid profile of milk. The negative effects on digestibility were less with AH than of CS regardless of PF type and level.

Sequence-Specific Features of Short Double-Strand, Blunt-End RNAs Have RIG-I- and Type 1 Interferon-Dependent or -Independent Anti-Viral Effects.

Pathogen-associated molecular patterns, including cytoplasmic DNA and double-strand (ds)RNA trigger the induction of interferon (IFN) and antiviral states protecting cells and organisms from pathogens. Here we discovered that the transfection of human airway cell lines or non-transformed fibroblasts with 24mer dsRNA mimicking the cellular micro-RNA (miR)29b-1* gives strong anti-viral effects against human adenovirus type 5 (AdV-C5), influenza A virus X31 (H3N2), and SARS-CoV-2. These anti-viral effects required blunt-end complementary RNA strands and were not elicited by corresponding single-strand RNAs. dsRNA miR-29b-1* but not randomized miR-29b-1* mimics induced IFN-stimulated gene expression, and downregulated cell adhesion and cell cycle genes, as indicated by transcriptomics and IFN-I responsive Mx1-promoter activity assays. The inhibition of AdV-C5 infection with miR-29b-1* mimic depended on the IFN-alpha receptor 2 (IFNAR2) and the RNA-helicase retinoic acid-inducible gene I (RIG-I) but not cytoplasmic RNA sensors MDA5 and ZNFX1 or MyD88/TRIF adaptors. The antiviral effects of miR29b-1* were independent of a central AUAU-motif inducing dsRNA bending, as mimics with disrupted AUAU-motif were anti-viral in normal but not RIG-I knock-out (KO) or IFNAR2-KO cells. The screening of a library of scrambled short dsRNA sequences identified also anti-viral mimics functioning independently of RIG-I and IFNAR2, thus exemplifying the diverse anti-viral mechanisms of short blunt-end dsRNAs.

Mercury, selenium, and stable carbon and nitrogen isotopes in the striped marlin Kajikia audax and blue marlin Makaira nigricans food web from the Gulf of California.

Mercury (Hg) concentrations based on dietary sources have shown to predict differences in fish; however, they are usually applied at an individual scale and are rarely directed at a known trophic transfer. We combined gut content analysis and stable isotope analysis (δ15N and δ13C) to provide a quantitative estimate of Hg and selenium (Se) biomagnification in the striped marlin (Kajikia audax) and blue marlin (Makaira nigricans) food web from the southwestern Gulf of California. Hg and Se concentrations (mean ± SD; µg g-1, dw) were different among K. audax (Hg = 3.6 ± 2.1, Se = 5.5 ± 5.4) and M. nigricans (Hg = 19.0 ± 29.6, Se = 8.8 ± 10.5). Such variations of element concentrations could be linked to predation with different Hg and Se contents. Diet data presented as prey weight (%W) indicated a higher proportion of large prey fish for the blue marlin than the striped marlin. δ15N and δ13C indicated pelagic food sources with epipelagic preferences for the blue marlin and mesopelagic for the striped marlin. The relationship between Hg concentrations and δ15N was positive along the food web of both marlin species, indicating biomagnification of Hg. However, Se biomagnification was not clearly evidenced, and Se:Hg ratios decreased with δ15N, attributed to increasing Hg concentrations with increased trophic level.

A arte do palhaço na educação médica / The art of clowning in medical education

Resumo: Introdução: Em todo o mundo, a arte tem sido utilizada como recurso pedagógico no curso médico. No Brasil, vários grupos de "palhaçoterapia" - projetos que envolvem a atuação de estudantes como palhaços-doutores - foram criados visando promover uma humanização do cuidado nos hospitais. A partir daí, vários estudos começaram a identificar impactos da participação nesses projetos na formação médica. Este estudo investiga a percepção do profissional formado acerca da influência da experiência como palhaço-doutor na sua prática médica. Objetivo: Este estudo tem como objetivo analisar, na graduação de Medicina, a formação na arte do palhaço como estratégia para contribuir para o desenvolvimento de competências na prática médica. Método: Trata-se de uma pesquisa exploratória e descritiva com abordagem qualitativa, por meio de entrevista semiestruturada com 15 participantes, que foram escolhidos pela técnica da bola de neve. O universo da pesquisa consiste em médicos que participaram de projetos de palhaçoterapia durante a graduação, em Recife, Pernambuco. As informações coletadas foram organizadas com o auxílio do software MAXQDA e submetidas à análise textual discursiva proposta por Moraes, que segue três passos de forma cíclica: a desmontagem dos textos em unidades de significado, o estabelecimento de relações e a captação do emergente. Resultado: A partir da análise das transcrições das entrevistas, emergiram diversas categorias de competências relatadas pelos participantes. No processo de construção de um novo significado com base nesses achados, foi necessário selecionar os que tinham relação com o que estava proposto nas Diretrizes Curriculares Nacionais (DCN) de Medicina de 2014. As habilidades percebidas foram agrupadas nas seguintes categorias: sensibilização, ressignificação, lidar com o erro e relação com o paciente. Conclusão: Esta pesquisa procurou explorar o fenômeno translacional, por meio do qual se investigaram quais ensinamentos, na visão de profissionais da medicina, foram apreendidos para sua prática a partir da aprendizagem e do exercício da arte do palhaço. Quando se realizou essa comparação com as DCN, foi possível encontrar interseções entre o que se espera desenvolver durante a formação médica e algumas das competências desenvolvidas com ajuda da arte do palhaço.

Abstract: Introduction: Art has been used as a teaching resource in medical education around the world. In Brazil, several "clown therapy" groups - a common name for projects in which students perform as "clown doctors" in hospitals - have been created with the aim of helping to humanize hospital care. Several studies have identified the impacts on medical training, as perceived by the participants of such projects. This study investigates how trained professionals view the influence of their previous experiences as clown doctors on actual medical practice. Objective: To analyze clown training in medical school as a strategy to contribute to the development of medical practice skills. Method: This is an exploratory and descriptive study with a qualitative approach. Semi-structured interviews were conducted with 15 participants, who were chosen using the snowball technique. The sample consists of doctors who participated in clown therapy projects during their undergraduate training, in Recife, Pernambuco. The collected information was organized with the MAXQDA software and underwent discursive content analysis as proposed by Moraes, which follows a three-step cycle: the deconstruction of text into units of meaning, the establishment of relationships, and the capture of the emerging knowledge. Result: Analysis of the interview transcripts generated several categories of competencies reported by the participants. In the process of constructing new meaning based on these findings, it was necessary to select those that were related to the proposals of the 2014 National Curriculum Guidelines (DCNs) for medicine. The perceived skills were grouped into the following categories: awareness, resignification, dealing with error and physician-patient relationship. Conclusion: This research sought to explore the translational phenomenon, investigating which competencies, in the eyes of medical professionals, were learned from practicing the art of clowning. By drawing comparisons with the National Curriculum Guidelines (DCNs), intersections were found between expected development during medical training and some of the skills developed with the help of the art of clowning.

Three case reports: Temporal association between tyrosine-kinase inhibitor-induced hepatitis and immune checkpoint inhibitors in renal cell carcinoma.

RATIONALE: Hepatotoxicity is a well-known adverse effect of vascular endothelial growth factor receptor (VEGFR) tyrosine-kinase inhibitors (TKIs), usually employed for the treatment of metastatic renal cell carcinoma (mRCC). Immune checkpoint inhibitors (ICIs) have been shown to improve survival in specific patients with mRCC, but concerns have arisen over their safety profile, particularly as regards the risk of liver damage in those patients receiving TKIs sequentially or concurrently with these new drugs. Here, we report three cases of hepatitis presentation in patients receiving TKIs after ICIs that should potentially be considered in current clinical practice, where a combination of these hepatotoxic drugs is becoming increasingly used. PATIENTS CONCERNS: All three patients were receiving TKIs therapy and presented with nonspecific clinical deterioration and liver enzyme elevation in different time frames according to the start of treatment. All were previously treated with ICIs. DIAGNOSES: After performing imaging techniques and complementary laboratory tests for the differential diagnosis of hepatic injury, the diagnosis of potentially TKI-induced hepatitis was assumed in all these cases. Hepatic biopsy was performed only in the first case in order to confirm the diagnosis. INTERVENTIONS: Potential toxic drugs were interrupted and steroids course with slow reduction regimen was administered in all these cases because of the previous use of ICIs. OUTCOMES: The patients described improved with this conservative treatment without complications during the following weeks. Only one case presented a new episode of mild hepatic alteration while on treatment with following treatment. LESSONS: Taking into account this new therapeutic context, stricter monitoring for potentially increased/altered adverse events should be indicated. Adequate patient selection and consideration of the safety profile of the different drugs used could help to optimize treatment in the near future.

High nitrogen contribution by Gunnera magellanica and nitrogen transfer by mycorrhizas drive an extraordinarily fast primary succession in sub-Antarctic Chile.

Chronosequences at the forefront of retreating glaciers provide information about colonization rates of bare surfaces. In the northern hemisphere, forest development can take centuries, with rates often limited by low nutrient availability. By contrast, in front of the retreating Pia Glacier (Tierra del Fuego, Chile), a Nothofagus forest is in place after only 34 yr of development, while total soil nitrogen (N) increased from near zero to 1.5%, suggesting a strong input of this nutrient. We measured N-fixation rates, carbon fluxes, leaf N and phosphorus contents and leaf δ15 N in the dominant plants, including the herb Gunnera magellanica, which is endosymbiotically associated with a cyanobacterium, in order to investigate the role of N-fixing and mycorrhizal symbionts in N-budgets during successional transition. G. magellanica presented some of the highest nitrogenase activities yet reported (potential maximal contribution of 300 kg N ha-1  yr-1 ). Foliar δ15 N results support the framework of a highly efficient N-uptake and transfer system based on mycorrhizas, with c. 80% of N taken up by the mycorrhizas potentially transferred to the host plant. Our results suggest the symbiosis of G. magellanica with cyanobacteria, and trees and shrubs with mycorrhizas, to be the key processes driving this rapid succession.

Copper excess detoxification is mediated by a coordinated and complementary induction of glutathione, phytochelatins and metallothioneins in the green seaweed Ulva compressa.

In order to analyze the involvement of intracellular thiol-chelators in the accumulation and detoxification of copper, the marine alga Ulva compressa was cultivated with increasing concentrations of copper such as 2.5, 5, 7.5 and 10 µM for up to 12 d, and the amount of intracellular copper, glutathione (GSH), phytochelatins (PCs) and transcripts encoding three metallothioneins (MTs) were determined. Over this exposure period and concentration range there was a linear correlation between intracellular copper and the copper concentration in the culture medium. Increases in GSH concentrations occurred mainly between days 1 and 3 and at lower concentrations of copper (2.5 and 5 µM). The level of PCs, and particularly PC2, increased from day 1 of exposure mainly at higher concentrations of copper (7.5 and 10 µM). The levels of transcripts encoding MT7 increased at day 3, whereas those of MT3 and MT6 increased between days 9-12, mainly at higher concentrations of copper. Thus in U. compressa, the initial responses to increasing intracellular copper concentrations are increases in GSH and PCs that are followed by higher levels of MTs expression, suggesting that thiol-containing peptides and proteins may participate in copper accumulation and detoxification responding in a coordinated and complementary manner. In addition, the alga was cultivated with 10 µM copper for 5 d and transferred to synthetic seawater with no copper and cultivated for 3 d. The release of copper from cells to culture medium was observed and accompanied by a similar nanomolar amount of GSH; no PCs or small proteins were detected. These results could suggest that a component of the detoxification mechanism also involves the release of copper and GSH to the extracellular medium.

61.º Congreso de la SEFH. Saturnismo por tratamiento con medicina ayurvédica / No disponible

No disponible

Improvement of cardiometabolic markers after fish oil intervention in young Mexican adults and the role of PPARα L162V and PPARγ2 P12A.

Polyunsaturated fatty acids (PUFA) contained in fish oil (FO) are ligands for peroxisome proliferator-activated receptors (PPAR) that may induce changes in cardiometabolic markers. Variation in PPAR genes may influence the beneficial responses linked to FO supplementation in young adults. The study aimed to analyze the effect of FO supplementation on glucose metabolism, circulating lipids and inflammation according to PPARα L162V and PPARγ2 P12A genotypes in young Mexican adults. 191 young, non-smoking subjects between 18 and 40 years were included in a one-arm study. Participants were supplemented with 2.7 g/day of EPA+DHA, during six weeks. Dietary analysis, body composition measurements and indicators for glucose metabolism, circulating lipids, and markers for inflammation were analyzed before and after intervention. An overall decrease in triglycerides (TG) and an increase in HS-ω3 index were observed in all subjects [-4.1 mg/dL, (SD:±51.7), P=.02 and 2.6%, (SD:±1.2), P<.001 respectively]. Mean fasting insulin and glycated hemoglobin (HbA1c%) were significantly decreased in all subjects [-0.547mlU/L, (SD:±10.29), P=.034 and-0.07%, (SD:±0.3), P<.001 respectively], whereas there was no change in body composition, fasting glucose, adiponectin and inflammatory markers. Subjects carrying the minor alleles of PPARα L162V and PPARγ2 P12A had higher responses in reduction of TG and fasting insulin respectively. Interestingly, doses below 2.7 g/day (1.8 g/day) were sufficient to induce a significant reduction in fasting insulin and HbA1c% from baseline (P=.019 and P<.001). The observed responses in triglycerides and fasting insulin in the Mexican population give further evidence of the importance of FO supplementation in young people as an early step towards the prevention of cardiometabolic disease.

Reversible structural and functional changes after intraocular pressure reduction in patients with glaucoma.

PURPOSE: The aim of this study was to evaluate structural and functional improvement following intraocular pressure (IOP) reduction in patients with glaucoma using Spectral Domain Optical Coherence Tomography (SD-OCT), Visual Field (VF) testing, and Visual Evoked Potentials (VEP). METHODS: A total of 76 eyes from 61 patients underwent SD-OCT, VF and VEP testing. Sixty-two eyes were put in either an acutely high (group 1, IOP > 32 mmHg) or mildly high (group 2, IOP between 22 and 31 mmHg) IOP group and underwent a pressure-lowering intervention. Fourteen eyes with stable glaucoma were controls (group 3, IOP < 22 mmHg). SD-OCT, VF and VEP testing were subsequently performed on all patients at three follow-up visits. Results from these follow-up periods were analyzed for signs of functional and structural improvement. RESULTS: Both group 1 and group 2 patients demonstrated significant decrease in the average cup to disc ratio (p < 0.05) following the intervention. Post-interventional reduction of cup volume was also significant for group 2 patients (p < 0.05). RNFL thickness changes were insignificant. Qualitative grading of VFs by two observers showed improvement in group 1 patients' VFs (p = 0.021). VEP measurements were mostly insignificant, with the exception of High Contrast Latency (LHC) deteriorating for group 2 patients in the first follow-up visit (p = 0.025). CONCLUSIONS: This study provides evidence for structural disc cupping reversal following IOP lowering interventions. These changes were not related to the amount of pressure lowering. While there was evidence of functional improvement as measured by VF testing, VEP was unable to detect any reversible changes.

Mortalidade infantil na percepção de gestores e profissionais de saúde: determinantes do seu declínio e desafios atuais em município do sul do Brasil / Infant mortality in the perception of health managers and professionals: determinants of its decline and current challenges in a southern Brazilian town

Este estudo objetivou analisar a percepção de gestores e profissionais da saúde sobre os determinantes para o declínio da mortalidade infantil nas últimas décadas, bem como os desafios para a continuidade da redução dos valores desse indicador em Londrina (PR). Foi realizado uma pesquisa qualitativa com análise de entrevistas de 38 gestores, profissionais de saúde e pesquisadores, selecionados pela técnica da bola de neve. Na visão dos entrevistados, os determinantes para a redução da mortalidade infantil foram melhorias das condições de vida e medidas implantadas por políticas públicas e ações setoriais e extrassetoriais. Os desafios atuais dizem respeito, principalmente, à qualificação da assistência pré-natal, à redução da gravidez na adolescência, à melhoria da atenção hospitalar ao recém-nascido prematuro, à prevenção da prematuridade e ao financiamento do Sistema Único de Saúde (SUS). O aumento da proporção de mortes neonatais torna mais complexo e difícil reduzir a mortalidade infantil. Compreender as dificuldades e identificar os desafios, sob a percepção de gestores e profissionais da saúde, pode contribuir para o planejamento das ações necessárias para a melhoria da saúde das crianças menores de 1 ano e para a redução da mortalidade infantil.(AU)

Simplified multiresidue method for determination of pesticide residues in lettuce by gas chromatography with nitrogen-phosphorus detection.

A rapid and simple method has been developed for simultaneous determination of different classes of pesticide in different varieties of lettuce (Lactuca sativum). Lettuce samples were extracted by homogenization with acetone and partitioned into ethyl acetate-cyclohexane. Subsequent sample clean-up was not needed. Pesticide residues were determined by capillary gas chromatography with nitrogen-phosphorus detection (NPD). Confirmatory analysis of the pesticides was performed by capillary gas chromatography coupled with mass spectrometry in selected-ion-monitoring (SIM) mode. Recovery at two levels of fortification (ca. 0.05 and 0.20 mg kg(-1)) ranged from 63.9 to 118.6%, and relative standard deviations were below 9.5%. The proposed method was used to determine pesticide levels in different types of lettuce grown in soil from experimental fields.