Simulação realítsica como estratégia de treinamento para equipe de saúde

Objetivo: Avaliar a simulação realística como estratégia de capacitação de técnicos de enfermagem e condutores de ambulância na avaliação primária dos traumas. Método: Estudo quase experimental, tipo antes e depois, abordagem quantitativa, desenvolvido entre dezembro de 2021 a março de 2022. A população constitui-se de 98 profissionais de 14 municípios que compõem o Complexo Regulador do Serviço de Atendimento Móvel de Urgência, da região norte do Estado do Paraná. Foi aplicado um teste de conhecimento, com 10 questões, antes e depois da simulação. Os dados foram avaliados em relação à medida central e dispersão. Os acertos, no pré e pós-teste, foram comparados por percentual. A média e desvio padrão dos acertos foram avaliados empregando o teste de Shapiro-Wilk para identificação da distribuição normal, ou não, dos dados. Também foi realizado o teste de Wilcoxon para identificação de diferença entre as médias de acertos entre os momentos de pesquisa. Empregou-se o índice de significância de 0,050. Resultados: Das perguntas propostas, aquelas sobre cinemática do trauma, estágios da avaliação primária da vítima, planejamento do atendimento e imobilização da vítima de trauma, atendimento na avaliação e presença de choque atingiram 90% das respostas corretas esperadas após o treinamento. As perguntas sobre avaliação primária do paciente e manejo das vias aéreas também produziram resultados significativos. Conclusão: A assimilação de conhecimento através da simulação realística promoveu um incremento importante de acertos das questões.

Objetivo: Evaluar la simulación realista como estrategia de formación de técnicos de enfermería y conductores de ambulancias en la valoración primaria del trauma. Método: Estudio cuasiexperimental, tipo antes y después, enfoque cuantitativo, desarrollado entre diciembre de 2021 y marzo de 2022. La población está compuesta por 98 profesionales de 14 municipios que componen el Complejo Regulador del Servicio de Atención Móvil de Emergencia de la región norte del Estado de Paraná. Se aplicó una prueba de conocimientos, con 10 preguntas, antes y después de la simulación. Los datos fueron evaluados en relación con la medida central y dispersión. Las respuestas correctas, en el pre y postest, fueron comparadas por porcentaje. La media y la desviación estándar de las respuestas correctas se evaluaron mediante la prueba de Shapiro-Wilk para identificar la distribución normal o no de los datos. También se realizó la prueba de Wilcoxon para identificar la diferencia entre las medias de aciertos entre los momentos de la investigación. Se utilizó un índice de significación de 0.050. Resultados: De las preguntas propuestas, aquellas sobre cinemática del trauma, etapas de la valoración primaria de la víctima, planificación del cuidado e inmovilización de la víctima del trauma, atención en la valoración y presencia de shock alcanzaron el 90 % de respuestas correctas esperadas después el entrenamiento. Las preguntas sobre evaluación primaria del paciente y control de la vía aérea también arrojaron resultados significativos. Conclusión: La asimilación de conocimientos a través de la simulación realista promovió un aumento importante en las respuestas correctas a las preguntas

Objective: To assess realistic simulation as a training strategy for nursing technicians and ambulance drivers in the primary assessment of trauma cases. Method: A quasi-experimental study, before-and-after design, with a quantitative approach, conducted between December 2021 and March 2022. The study population consisted of 98 professionals from 14 municipalities within the Northern region of the State of Paraná, who are part of the Regulatory Complex of the Mobile Emergency Care Service. A knowledge test consisting of 10 questions was administered before and after the simulation. Data were analyzed in terms of central tendency and dispersion. Pre-test and post-test correct answers were compared as percentages. The mean and standard deviation of correct answers were assessed using the Shapiro-Wilk test to determine whether the data followed a normal distribution. The Wilcoxon test was also employed to identify differences in mean correct answers between the research phases, with a significance level of 0.050. Results: Among the proposed questions, those related to trauma kinematics, stages of primary victim assessment, treatment planning, victim immobilization, assessment during care, and recognition of shock achieved a 90% correct response rate after the training. Questions about primary patient assessment and airway management also yielded significant results. Conclusion: The assimilation of knowledge through realistic simulation led to a significant improvement in correct answer rates for the questions

Elimination of Giardia duodenalis BIV in vivo using natural extracts in microbiome and dietary supplements.

In this study, a combination therapy of several natural products was evaluated in vivo in the Giardia duodenalis infection model. G. duodenalis infected mice were treated as follows: distilled water (infected control C+), BIOintestil® (BIO; natural products of Cymbopogon martinii and Zingiber officinale), MicrobiomeX® (MBX; extract of Citrus sinensis and Citrus paradisi), MBX + BIO, Camellia sinensis tea (CPR; black tea). These natural compounds were administered in a dose of 100 mg/day and were compared to G. duodenalis-infected mice treated with albendazole (ALB; 50 mg/Kg/day) and metronidazole (MET; 500 mg/Kg/day), the conventional therapies used to this day. One group remained un-infected and untreated as our control group (C-). Treatment started 8 days after infection, and after 5 days of treatment (7 days for MET), all animals were followed for 15 days. We continuously checked for the presence of G. duodenalis by Faust method, in association with detection of the parasite by PCR from feces, as well for the presence of trophozoites in the intestinal mucosa after sacrifice. Animals treated with MBX, BIO and MBX + BIO presented an undetectable parasitic load until the 15th day of monitoring, while animals treated with CPR, MET and ALB continued to release cysts. Animals in the MBX, MBX + BIO, ALB groups consumed lower feed, MBX, CPR, MET had greater weight and MBX, MBX + BIO, BIO, CPR, C- consumed more water when compared to infected-group control. MBX and BIO alone or associated eliminated G. duodenalis without apparent adverse effects and animals of these groups showed better clinical performance in relation to those with high parasitic load. MET, ALB and CPR only decreased the number of cysts, indicating limitations and therapeutic failure.

Vibrational frequencies and intramolecular force constants for cisplatin: assessing the role of the platinum basis set and relativistic effects.

The role of platinum basis set (PTBS) and relativistic effects for predicting the vibrational frequencies and intramolecular force constants for cisplatin are discussed. Nonrelativistic and relativistic computational protocols were built at B3LYP/PTBS/jorge-DZP/C-PCM and B3LYP-DKH2/PTBS/jorge-DZP-DKH/C-PCM levels, respectively, where 19 distinct PTBS were tested. As expected, the structural parameters were not very sensitive to the PTBS, however, the inclusion of relativistic effects improves the description of the cisplatin structure. When it comes to the vibrational frequencies, the results show that the PTBS, and mainly the relativistic effects, are both important. Moreover, the PBE0 functional led to better results than B3LYP in the protocols PBE0/LANL2TZ(f)/jorge-DZP/C-PCM (P20) and PBE0-DKH2/Sapporo-DKH3-DZP-2012/jorge-DZP-DKH/C-PCM (P22), which provided a mean absolute deviation (MAD) of only 10.8 cm-1 and 9.5 cm-1, respectively, for vibrational frequencies, which are excellent choices to study Pt complexes. Finally, a discussion of the intramolecular force constants for cisplatin is carried out, with the calculated bond and angles force constants with P20 and P22 protocols being recommended for the parameterization of the force field of cisplatin.

A critical review on surface modifications mitigating dairy fouling.

Thermal treatments performed in food processing industries generate fouling. This fouling deposit impairs heat transfer mechanism by creating a thermal resistance, thus leading to regular shutdown of the processes. Therefore, periodic and harsh cleaning-in-place (CIP) procedures are implemented. This CIP involves the use of chemicals and high amounts of water, thus increasing environmental burden. It has been estimated that 80% of production costs are owed to dairy fouling deposit. Since the 1970s, different types of surface modifications have been performed either to prevent fouling deposition (anti-fouling) or to facilitate removal (fouling-release). This review points out the impacts of surface modification on type A dairy fouling and on cleaning behaviors under batch and continuous flow conditions. Both types of anti-fouling and fouling-release coatings are reported as well as the different techniques used to modify stainless steel surface. Finally, methods for testing and characterising the effectiveness of coatings in mitigating dairy fouling are discussed.

Comparative analysis of routine parasitological methods for recovery of cysts, molecular detection, and genotyping of Giardia duodenalis.

In order to improve the diagnosis of giardiasis, fecal samples (high/medium/low concentration of cysts) were processed by the parasitological methods used in the routine: Faust, Lutz e Ritchie modified (replacement of formaldehyde by distilled water). The cysts were quantified; the DNA was extracted and amplified by semi-nested PCR (GDH gene). Fifteen clinical samples were analyzed to validate the study by PCR-RFLP. The results showed that the parasite was only detected and genotyped correctly when samples from children with high, medium, and low parasitic load, belonging to genotype AII, were processed by the modified Ritchie method, different from what was observed for the other methods used in laboratory routine (Faust and Lutz). The modified Ritchie method proved to be more suitable, recovering a greater number of cysts from samples, regardless of parasitic load, which reduces the chance of false negative results and has epidemiological repercussions since individuals with low parasite load are usually asymptomatic and the main disseminators of this infection.

The TUTase URT1 connects decapping activators and prevents the accumulation of excessively deadenylated mRNAs to avoid siRNA biogenesis.

Uridylation is a widespread modification destabilizing eukaryotic mRNAs. Yet, molecular mechanisms underlying TUTase-mediated mRNA degradation remain mostly unresolved. Here, we report that the Arabidopsis TUTase URT1 participates in a molecular network connecting several translational repressors/decapping activators. URT1 directly interacts with DECAPPING 5 (DCP5), the Arabidopsis ortholog of human LSM14 and yeast Scd6, and this interaction connects URT1 to additional decay factors like DDX6/Dhh1-like RNA helicases. Nanopore direct RNA sequencing reveals a global role of URT1 in shaping poly(A) tail length, notably by preventing the accumulation of excessively deadenylated mRNAs. Based on in vitro and in planta data, we propose a model that explains how URT1 could reduce the accumulation of oligo(A)-tailed mRNAs both by favoring their degradation and because 3' terminal uridines intrinsically hinder deadenylation. Importantly, preventing the accumulation of excessively deadenylated mRNAs avoids the biogenesis of illegitimate siRNAs that silence endogenous mRNAs and perturb Arabidopsis growth and development.

Festoons, edema e bolsas malares: existe consenso no tratamento estético? / Festoons, edema, and malar bags: is there a consensus on aesthetic treatment?

Introdução: As alterações periorbitais são alguns dos primeiros sinais detectáveis do envelhecimento. O destaque, atualmente, refere-se ao rejuvenescimento dessa região, envolvendo o tratamento desde as sobrancelhas até a transição órbito-malar, onde se encontram festoons, edemas e bolsas malares. Entretanto, este manejo é complexo, envolvendo várias abordagens: técnicas invasivas ou não invasivas. Assim, esta revisão objetiva descrever as evidências científicas relacionadas às técnicas mais atuais utilizadas no tratamento de festoons, edemas e bolsas malares e avaliar as complicações relacionadas à cada modalidade. Métodos: A pesquisa foi realizada em três bases de dados - PubMed, Cochrane e LILACS - utilizando os descritores "bolsa malar", "malar mounds", "festoons" e "malar bags" no período de 2014 a 2019, na língua inglesa e portuguesa. Resultados: Foram selecionados 13 artigos, a maioria dos estudos eram revisões retrospectivas (76,9%), sete versavam sobre técnicas não invasivas, 3 sobre invasivas e 3 sobre associação das técnicas. Em relação aos procedimentos descritos, os não invasivos foram representados pelo uso de Kinesio tape, injeção de tetraciclina, doxiciclina e de ácido hialurônico, e o uso de microagulhamento com radiofrequência. Já os invasivos foram representados por microaspiração, retalho miocutâneo, lift subperiosteal da face média e excisão direta. Conclusão: Existem inúmeras técnicas para tratamento de festoon e bolsas malares, mas cabe ao cirurgião plástico conhecer suas vantagens e desvantagens para decidir a mais adequada em cada situação. Assim, não há consenso, mas é vital diagnosticar corretamente para indicar o melhor tratamento.

Introduction: Periorbital changes are some of the first detectable signs of aging. The most outstanding currently, refers to the rejuvenation of this region, involving the treatment from the eyebrows to the transition orbital-malar, where are festoons, edemas, and malar bags. However, this management is complex, involving several approaches: invasive or noninvasive techniques. Thus, this review aims to describe the scientific evidence of the most current techniques used in the treatment of festoons, edema, and malar bags and to evaluate the complications related to each modality. Methods: The research was carried out in three databases, PubMed, Cochrane, and LILACS - using the descriptors "bolsa malar," "malar mounds," "festoons" and "malar bags" in the period from 2014 to 2019, in English and Portuguese. Results: We selected 13 articles; most of the studies were retrospective reviews (76.9%), seven dealt with noninvasive techniques, three about invasive, and three on the association of techniques. Regarding the procedures described, the noninvasive ones were represented by the use of Kinesio tape, tetracycline injection, doxycycline and hyaluronic acid, and the use of microneedling with radiofrequency. The invasive ones were represented by microaspiration, myocutaneous flap, subperiosteal lift of the middle face, and direct excision. Conclusion: There are numerous techniques for treating festoon and malar bags, but it is up to the plastic surgeon to know its advantages and disadvantages to decide the most appropriate in each situation. Thus, there is no consensus, but it is vital to diagnose correctly to indicate the best treatment.

Improvement in cyst recovery and molecular detection of Giardia duodenalis from stool samples.

Molecular detection of Giardia duodenalis by polymerase chain reaction (PCR) is difficult in faecal samples due to inhibitors that contaminate DNA preparations, or due to low cyst concentrations. In order to eliminate inhibitors, improve cyst recovery and molecular detection of G. duodenalis, different types of water, distillates (MDs), deionized (MDz), injection (MI) or Milli-Q® (MM) were used instead of formaldehyde (F) in the laboratory routine method (Ritchie). Cysts were isolated from faecal samples with low cyst concentrations (< 1 cyst/field), medium (1-2 cysts/field) or high (> 2 cysts/field). Cyst recovery was improved using all water types (MDs, MDz, MI, MM) compared to formaldehyde. At all cyst concentrations, the use of MM consistently showed the greatest recovery of G. duodenalis cysts . DNA samples from recovered cysts were tested for the glutamate dehydrogenase (GDH) and ß-giardin (ßg) genes. The use of Milli-Q® water allowed to detect both genes in all cyst concentrations, including low. The method processed with the other types of water amplified these genes at high and medium cyst concentrations. GDH and ßg genes were not detected when the sample was processed with formaldehyde. These experimental results were confirmed in clinical samples. The results suggest that Milli-Q® water provides the highest cyst recovery from stool samples and, correspondingly, the highest sensitivity for detecting G. duodenalis by microscopy or PCR for GDH and ßg genes, even at low concentration of cysts.

High-Resolution Mapping of 3' Extremities of RNA Exosome Substrates by 3' RACE-Seq.

The main 3'-5' exoribonucleolytic activity of eukaryotic cells is provided by the RNA exosome. The exosome is constituted by a core complex of nine subunits (Exo9), which coordinates the recruitment and the activities of distinct types of cofactors. The RNA exosome cofactors confer distributive and processive 3'-5' exoribonucleolytic, endoribonucleolytic, and RNA helicase activities. In addition, several RNA binding proteins and terminal nucleotidyltransferases also participate in the recognition of exosome RNA substrates.To fully understand the biological roles of the exosome, the respective functions of its cofactors must be deciphered. This entails the high-resolution analysis of 3' extremities of degradation or processing intermediates in different mutant backgrounds or growth conditions. Here, we describe a detailed 3' RACE-seq procedure for targeted mapping of exosome substrate 3' ends. This procedure combines a 3' RACE protocol with Illumina sequencing to enable the high-resolution mapping of 3' extremities and the identification of untemplated nucleotides for selected RNA targets.

RNA uridylation and decay in plants.

RNA uridylation consists of the untemplated addition of uridines at the 3' extremity of an RNA molecule. RNA uridylation is catalysed by terminal uridylyltransferases (TUTases), which form a subgroup of the terminal nucleotidyltransferase family, to which poly(A) polymerases also belong. The key role of RNA uridylation is to regulate RNA degradation in a variety of eukaryotes, including fission yeast, plants and animals. In plants, RNA uridylation has been mostly studied in two model species, the green algae Chlamydomonas reinhardtii and the flowering plant Arabidopsis thaliana Plant TUTases target a variety of RNA substrates, differing in size and function. These RNA substrates include microRNAs (miRNAs), small interfering silencing RNAs (siRNAs), ribosomal RNAs (rRNAs), messenger RNAs (mRNAs) and mRNA fragments generated during post-transcriptional gene silencing. Viral RNAs can also get uridylated during plant infection. We describe here the evolutionary history of plant TUTases and we summarize the diverse molecular functions of uridylation during RNA degradation processes in plants. We also outline key points of future research.This article is part of the theme issue '5' and 3' modifications controlling RNA degradation'.

RNA uridylation: a key posttranscriptional modification shaping the coding and noncoding transcriptome.

RNA uridylation is a potent and widespread posttranscriptional regulator of gene expression. RNA uridylation has been detected in a range of eukaryotes including trypanosomes, animals, plants, and fungi, but with the noticeable exception of budding yeast. Virtually all classes of eukaryotic RNAs can be uridylated and uridylation can also tag viral RNAs. The untemplated addition of a few uridines at the 3' end of a transcript can have a decisive impact on RNA's fate. In rare instances, uridylation is an intrinsic step in the maturation of noncoding RNAs like for the U6 spliceosomal RNA or mitochondrial guide RNAs in trypanosomes. Uridylation can also switch specific miRNA precursors from a degradative to a processing mode. This switch depends on the number of uridines added which is regulated by the cellular context. Yet, the typical consequence of uridylation on mature noncoding RNAs or their precursors is to accelerate decay. Importantly, mRNAs are also tagged by uridylation. In fact, the advent of novel high throughput sequencing protocols has recently revealed the pervasiveness of mRNA uridylation, from plants to humans. As for noncoding RNAs, the main function to date for mRNA uridylation is to promote degradation. Yet, additional roles begin to be ascribed to U-tailing such as the control of mRNA deadenylation, translation control and possibly storage. All these new findings illustrate that we are just beginning to appreciate the diversity of roles played by RNA uridylation and its full temporal and spatial implication in regulating gene expression. WIREs RNA 2018, 9:e1440. doi: 10.1002/wrna.1440 This article is categorized under: RNA Processing > 3' End Processing RNA Processing > RNA Editing and Modification RNA Turnover and Surveillance > Turnover/Surveillance Mechanisms.

Uridylation Earmarks mRNAs for Degradation and More.

Groundbreaking discoveries have uncovered the widespread post-transcriptional modifications of all classes of RNA. These studies have led to the emerging notion of an 'epitranscriptome' as a new layer of gene regulation. Diverse modifications control RNA fate, including the 3' addition of untemplated nucleotides or 3' tailing. The most exciting recent discoveries in 3' tailing are related to uridylation. Uridylation targets various noncoding RNAs, from small RNAs and their precursors to rRNAs, and U tails mostly regulate processing or degradation. Interestingly, uridylation is also a pervasive modification of mRNAs. In this review, we discuss how the addition of few uridines to the 3' end of mRNAs influences mRNA decay. We also consider recent findings that reveal other consequences of uridylation on mRNA fate.