Instrumentos de avaliação multidimensional de fragilidade para uso no cuidado de idosos com doença cardiovascular / Multidimensional frailty assessment tools for use in the care of older adults with cardiovascular disease / Instrumentos de evaluación multidimensional de la fragilidad en la atención de adultos mayores con enfermedad cardiovascular

Objetivo: identificar quais os instrumentos disponíveis para avaliação multidimensional da fragilidade em idosos com doença cardiovascular, potencialmente aplicáveis durante a realização do Processo de Enfermagem. Método: revisão sistemática conduzida em oito bases de dados/portais, para identificação de estudos que apresentassem instrumentos multidimensionais de avaliação de fragilidade em idosos com doença cardiovascular e que fossem aplicáveis ao processo de enfermagem. Resultados: foram incluídos 19 instrumentos multidimensionais. O Brief Frailty Index for Coronary Artery Disease foi desenvolvido para uso no cuidado cardiovascular de idosos. O Frailty Index for Adults e o Maastricht Frailty Screening Tool for Hospitalized Patients foram desenvolvidos para uso no Processo de Enfermagem. Conclusão: apesar de apenas um instrumento ter sido desenvolvido para o idosos com doença cardiovascular e apenas dois serem aplicáveis ao processo de enfermagem, a maioria deles tem potencial de adaptação e validação para uso nesta população durante a avaliação de enfermagem.

Objective: to identify which tools are available for multidimensional frailty assessment of older adult with cardiovascular disease and which are potentially applicable during the Nursing Process. Method: a systematic review conducted in eight databases/portals to identify studies that presented multidimensional frailty assessment tools for older adult with cardiovascular disease and that were applicable to the nursing process. Results: a total of 19 multidimensional tools were included. The Brief Frailty Index for Coronary Artery Disease was developed for use in the cardiovascular care of older adult. The Frailty Index for Adults and the Maastricht Frailty Screening Tool for Hospitalized Patients were developed for use in the Nursing Process. Conclusion: although only one tool was developed for older adults with cardiovascular disease and only two are applicable to the nursing process, most of them have the potential to be adapted and validated for use in this population during nursing assessment.

Objetivo: identificar qué instrumentos están disponibles para la evaluación multidimensional de la fragilidad en personas mayores con enfermedad cardiovascular, que se puedan aplicar en el Proceso de Enfermería. Método: revisión sistemática realizada en ocho bases de datos/portales, para identificar estudios que presentaran instrumentos multidimensionales para la evaluación de la fragilidad en adultos mayores con enfermedad cardiovascular y que fueran aplicables al proceso de enfermería. Resultados: se incluyeron 19 instrumentos multidimensionales. El Brief Frailty Index for Coronary Artery Disease se desarrolló para usarlo en el cuidado cardiovascular de las personas mayores. El Frailty Index for Adults y la Maastricht Frailty Screening Tool for Hospitalized Patients se elaboraron para ser usados en el Proceso de Enfermería. Conclusión: aunque sólo se elaboró un instrumento para adultos mayores con enfermedad cardiovascular y sólo dos son aplicables al proceso de enfermería, la mayoría de ellos tienen el potencial para ser adaptados y validados para ser usados en esa población en la evaluación de enfermería.

Expanding the repertoire of ceDAF-12 ligands for modulation of the steroid endocrine system in C. elegans.

Steroid hormones are essential for the biological processes of eukaryotic organisms. The steroid endocrine system of C. elegans, which includes dafachronic acids (DA) and the nuclear receptor ceDAF-12, provides a simple model for exploring the role of steroid hormone signaling pathways in animals. In this study, we show for the first time the feasibility of designing synthetic steroids that can modulate different physiological processes, such as development, reproduction and ageing, in relation to ceDAF-12. Our results not only confirm the conclusions derived from genetic studies linking these processes but also provide new chemical tools to selectively manipulate them, as we found that different compounds produce different phenotypic results. The structures of these compounds are much more diverse than those of endogenous hormones and analogues previously described by other researchers, allowing further development of the chemical modulation of the steroid endocrine system in C. elegans and related nematodes.

Evaluation of four chatbots in autoimmune liver disease: A comparative analysis.

INTRODUCTION AND OBJECTIVES: Autoimmune liver diseases (AILDs) are rare and require precise evaluation, which is often challenging for medical providers. Chatbots are innovative solutions to assist healthcare professionals in clinical management. In our study, ten liver specialists systematically evaluated four chatbots to determine their utility as clinical decision support tools in the field of AILDs. MATERIALS AND METHODS: We constructed a 56-question questionnaire focusing on AILD evaluation, diagnosis, and management of Autoimmune Hepatitis (AIH), Primary Biliary Cholangitis (PBC), and Primary Sclerosing Cholangitis (PSC). Four chatbots -ChatGPT 3.5, Claude, Microsoft Copilot, and Google Bard- were presented with the questions in their free tiers in December 2023. Responses underwent critical evaluation by ten liver specialists using a standardized 1 to 10 Likert scale. The analysis included mean scores, the number of highest-rated replies, and the identification of common shortcomings in chatbots performance. RESULTS: Among the assessed chatbots, specialists rated Claude highest with a mean score of 7.37 (SD = 1.91), followed by ChatGPT (7.17, SD = 1.89), Microsoft Copilot (6.63, SD = 2.10), and Google Bard (6.52, SD = 2.27). Claude also excelled with 27 best-rated replies, outperforming ChatGPT (20), while Microsoft Copilot and Google Bard lagged with only 6 and 9, respectively. Common deficiencies included listing details over specific advice, limited dosing options, inaccuracies for pregnant patients, insufficient recent data, over-reliance on CT and MRI imaging, and inadequate discussion regarding off-label use and fibrates in PBC treatment. Notably, internet access for Microsoft Copilot and Google Bard did not enhance precision compared to pre-trained models. CONCLUSIONS: Chatbots hold promise in AILD support, but our study underscores key areas for improvement. Refinement is needed in providing specific advice, accuracy, and focused up-to-date information. Addressing these shortcomings is essential for enhancing the utility of chatbots in AILD management, guiding future development, and ensuring their effectiveness as clinical decision-support tools.

10.17533/udea.iee.v42n2e16.

Objective: To evaluate the pedagogical skills of third-year nursing students at Yangzhou University (China). Methods: A multisite quasi-experimental design was used in this study. Fifty-five participants were selected by convenience sampling. The Objective Structured Teaching Evaluation (OSTE) scale was used to assess teaching skills. The evaluation included four different stages: Teaching Background Analysis (E1), Lesson Plan Presentation (E2), Mock Class (E3) and Teaching Reflection (E4). Prior to the assessment, the teachers assigned homework to the students to complete at the four stations. Results: Fifty-five nursing students with an average age of 21.3±0.7 years participated in the study, with a predominance of female students (78.2%). The highest mean score was achieved in E1 (83.1), followed by E2 and E3 (82.5 and 82.3 respectively), while the lowest mean score was found in E4 (79.6). In E3, instructors gave lower scores for class organisation, class characteristics and overall performance compared to the self-reported scores of the standardised students (p<0.05). More than 80% of the students strongly agreed and recommended the OSTE as the primary method for assessing teaching skills in the classroom. Conclusion: Deficits in teaching skills were identified in the participating students; this information will allow specific interventions to improve the situation. The OSTE instrument was a useful method for assessing the pedagogical skills of undergraduate nursing students.

Application of Objective Structured Teaching Examination (OSTE) in Assessing Classroom Teaching Skills for Nursing undergraduates: A Quasi-experimental Study / Evaluación de las habilidades docentes en el aula de los estudiantes universitarios de enfermería con el instrumento OSTE: Un estudio cuasiexperimental / Avaliação das competências docentes em sala de aula de estudantes universitários de enfermagem com o instrumento OSTE: um estudo quase-experimental

Objective.To evaluate the pedagogical skills of third-year nursing students at Yangzhou University (China). Methods. A multisite quasi-experimental design was used in this study. Fifty-five participants were selected by convenience sampling. The Objective Structured Teaching Evaluation (OSTE) scale was used to assess teaching skills. The evaluation included four different stages: Teaching Background Analysis (E1), Lesson Plan Presentation (E2), Original article Mock Class (E3) and Teaching Reflection (E4). Prior to the assessment, the teachers assigned homework to the students to complete at the four stations. Results. Fifty-five nursing students with an average age of 21.3±0.7 years participated in the study, with a predominance of female students (78.2%). The highest mean score was achieved in E1 (83.1), followed by E2 and E3 (82.5 and 82.3 respectively), while the lowest mean score was found in E4 (79.6). In E3, instructors gave lower scores for class organisation, class characteristics and overall performance compared to the self-reported scores of the standardised students (p<0.05). More than 80% of the students strongly agreed and recommended the OSTE as the primary method for assessing teaching skills in the classroom.Conclusion. Deficits in teaching skills were identified in the participating students; this information will allow specific interventions to improve the situation. The OSTE instrument was a useful method for assessing the pedagogical skills of undergraduate nursing students.

Objetivo. Evaluar las habilidades pedagógicas de los estudiantes de tercer curso de enfermería de la Universidad de Yangzhou (China). Métodos. En este estudio se empleó un diseño cuasi-experimental multisitio. Por muestreo por conveniencia se seleccionaron 55 participantes. Se empleó la escala Examen Objetivo Estructurado de la enseñanza(OSTE- Objective Structured Teaching Evaluation, en inglés) para evaluar las habilidades pedagógicas. La evaluación abarcó cuatro estaciones distintas: Análisis de los antecedentes de la enseñanza (E1), Presentación del plan de la lección (E2), Clase simulada (E3) y Reflexión sobre la enseñanza (E4). Antes de la evaluación, los instructores asignaron tareas a los estudiantes que debían realizar en las cuatro estaciones. Resultados. Participaron en la investigación 55 estudiantes de enfermería con un promedio de edad fue de 21.3±0.7 años y predominó el sexo femenino (78.2%). La puntuación media más alta se alcanzó en la E1 (83.1), seguida por E2 y E3 (82.5 y 82.3, respectivamente, mientras que la puntuación media más baja se registró en la E4 (79.6). En la E3 los instructores asignaron puntuaciones más bajas en comparación a las autorreportadas por los estudiantes estandarizados en términos de organización de la enseñanza, características de la enseñanza y rendimiento general (p<0.05). Más del 80% de los estudiantes se mostraron totalmente de acuerdo y recomendaron el OSTE como método principal para evaluar las habilidades docentes en el aula. Conclusión. Se identificaron en los estudiantes participantes las deficiencias en las habilidades pedagógicas; esta información permitirá realizar intervenciones específicas para mejorar situaciones específicas de la situación encontrada. El instrumento OSTE fue un método útil para la valoración de las habilidades pedagógicas de los estudiantes universitarios de enfermería.

Objetivo. Avaliar as competências pedagógicas dos estudantes do terceiro ano de enfermagem da Universidade de Yangzhou (China). Métodos. Um desenho quase-experimental multisite foi utilizado neste estudo. Por amostragem de conveniência, foram selecionados 55 participantes. A escala Objective Structured Teaching Evaluation (OSTE) foi utilizada para avaliar as competências pedagógicas. A avaliação abrangeu quatro estações distintas: Análise do percurso docente (E1), Apresentação do plano de aula (E2), Aula simulada (E3) e Reflexão sobre o ensino (E4). Antes da avaliação, os instrutores atribuíram tarefas aos alunos, que deveriam completar as quatro estações consecutivamente. Resultados. Participaram da pesquisa 55 estudantes de enfermagem com idade média de 21.3±0.7 anos e predominou o sexo feminino (78.2%). A maior pontuação média foi alcançada em E1 (83.1), seguida de E2 e E3 (82.5 e 82.3, respectivamente, enquanto a menor pontuação média foi registrada em E4 (79.6). Em E3 os instrutores atribuíram pontuações mais autorrelatado por alunos padronizados em termos de organização do ensino, características de ensino e desempenho geral (p<0.05). Mais de 80% dos alunos concordaram fortemente e recomendaram o OSTE como principal método para avaliar habilidades de ensino em sala de aula. Conclusão. Foram identificadas deficiências nas competências pedagógicas dos alunos; esta informação permitirá realizar intervenções específicas para melhorar situações específicas da situação encontrada. O instrumento OSTE foi um método útil para avaliar as competências pedagógicas de estudantes universitários de enfermagem.

Derivation and Internal Validation of a Novel Risk Assessment Tool to Identify Infants and Young Children at Risk for Post-Discharge Mortality in Dar es Salaam, Tanzania and Monrovia, Liberia.

OBJECTIVE: To derive and validate internally a novel risk assessment tool to identify young children at risk for all-cause mortality ≤60 days of discharge from hospitals in sub-Saharan Africa. STUDY DESIGN: We performed a prospective observational cohort study of children aged 1-59 months discharged from Muhimbili National Hospital in Dar es Salaam, Tanzania and John F. Kennedy Medical Center in Monrovia, Liberia (2019-2022). Caregivers received telephone calls up to 60 days after discharge to ascertain participant vital status. We collected socioeconomic, demographic, clinical, and anthropometric data during hospitalization. Candidate variables with P < .20 in bivariate analyses were included in a multivariable logistic regression model with best subset selection to identify risk factors for the outcome. We internally validated our tool using bootstrapping with 500 repetitions. RESULTS: There were 1933 young children enrolled in the study. The median (IQR) age was 11 (4, 23) months and 58.7% were males. In total, 67 (3.5%) died during follow-up. Ten variables contributed to our tool (total possible score 82). Cancer (aOR 10.6, 95% CI 2.58, 34.6), pedal edema (aOR 6.94, 95% CI 1.69, 22.6), and leaving against medical advice (aOR 6.46, 95% CI 2.46, 15.3) were most predictive of post-discharge mortality. Our risk assessment tool demonstrated good discriminatory value (optimism corrected area under the receiver operating characteristic curve 0.77), high precision, and sufficient calibration. CONCLUSIONS: After validation, this tool may be used to identify young children at risk for post-discharge mortality to direct resources for follow-up of high-risk children.

Empagliflozin's role in reducing ventricular repolarization heterogeneity: insights into cardiovascular mortality decline from the EMPATHY-HEART trial.

BACKGROUND: The incidence of myocardial infarction (MI) and sudden cardiac death (SCD) is significantly higher in individuals with Type 2 Diabetes Mellitus (T2DM) than in the general population. Strategies for the prevention of fatal arrhythmias are often insufficient, highlighting the need for additional non-invasive diagnostic tools. The T-wave heterogeneity (TWH) index measures variations in ventricular repolarization and has emerged as a promising predictor for severe ventricular arrhythmias. Although the EMPA-REG trial reported reduced cardiovascular mortality with empagliflozin, the underlying mechanisms remain unclear. This study investigates the potential of empagliflozin in mitigating cardiac electrical instability in patients with T2DM and coronary heart disease (CHD) by examining changes in TWH. METHODS: Participants were adult outpatients with T2DM and CHD who exhibited TWH > 80 µV at baseline. They received a 25 mg daily dose of empagliflozin and were evaluated clinically including electrocardiogram (ECG) measurements at baseline and after 4 weeks. TWH was computed from leads V4, V5, and V6 using a validated technique. The primary study outcome was a significant (p < 0.05) change in TWH following empagliflozin administration. RESULTS: An initial review of 6,000 medical records pinpointed 800 patients for TWH evaluation. Of these, 412 exhibited TWH above 80 µV, with 97 completing clinical assessments and 90 meeting the criteria for high cardiovascular risk enrollment. Empagliflozin adherence exceeded 80%, resulting in notable reductions in blood pressure without affecting heart rate. Side effects were generally mild, with 13.3% experiencing Level 1 hypoglycemia, alongside infrequent urinary and genital infections. The treatment consistently reduced mean TWH from 116 to 103 µV (p = 0.01). CONCLUSIONS: The EMPATHY-HEART trial preliminarily suggests that empagliflozin decreases heterogeneity in ventricular repolarization among patients with T2DM and CHD. This reduction in TWH may provide insight into the mechanism behind the decreased cardiovascular mortality observed in previous trials, potentially offering a therapeutic pathway to mitigate the risk of severe arrhythmias in this population. TRIAL REGISTRATION: NCT: 04117763.

ROX Index Variation as a Predictor of Outcomes in COVID-19 Patients.

Background: During the COVID-19 pandemic, emergency departments were overcrowded with critically ill patients, and many providers were confronted with ethical dilemmas in assigning respiratory support to them due to scarce resources. Quick tools for evaluating patients upon admission were necessary, as many existing scores proved inaccurate in predicting outcomes. The ROX Index (RI), a rapid and straightforward scoring system reflecting respiratory status in acute respiratory failure patients, has shown promise in predicting outcomes for COVID-19 patients. The 24 h difference in the RI accurately gauges mortality and the need for invasive mechanical ventilation (IMV) among patients with COVID-19. Methods: Study design: Prospective cohort study. A total of 204 patients were admitted to the emergency department from May to August 2020. Data were collected from the clinical records. The RI was calculated at admission and 24 h later, and the difference was used to predict the association with mortality and the need for IMV, a logistic regression model was used to adjust for age, sex, presence of comorbidities, and disease severity. Finally, the data were analyzed using ROC. Results: The difference in respiratory RI between admission and 24 h is a good predictor for death (AUC 0.92) and for mechanic ventilation (AUC: 0.75). Each one-unit decrease in the RI difference at 24 h was associated with an odds ratio of 1.48 for the risk of death (95%CI: 1.31-1.67) and an odds ratio of 1.16 for IMV (95% IC: 1.1-1.23). Conclusions: The 24 h variation of RI is a good prediction tool to allow healthcare professionals to identify the patients who will benefit from invasive treatment, especially in low-resource settings.

Herramientas digitales y aprendizaje cooperativo en docentes de educación inicial de Lima Metropolitana / Digital tools and cooperative learning in initial education teachers in Metropolitan Lima / Ferramentas digitais e aprendizagem cooperativa em professores de educação inicial em Lima Metropolitana

La investigación tuvo como objetivo determinar la relación entre el manejo de herramientas digitales y el aprendizaje cooperativo en docentes de Educación Inicial de Lima Metropolitana, 2023. El enfoque es cuantitativo de alcance descriptivo-correlacional, la muestra estuvo conformada por 230 docentes de Educación Inicial provenientes de 12 instituciones educativas. A este grupo se le aplicó dos cuestionarios: uno para medir las herramientas digitales y otro para el aprendizaje cooperativo: confiabilidad (0.98; 0,87). En función de los resultados, para las herramientas digitales se indicó que el 48.3% (111) se ubica en el nivel medio y el 40% (92) en el nivel alto; para el aprendizaje cooperativo, el 95.7% (220) se ubica en el nivel alto; además, el p-valor del coeficiente de relación fue rho= 0.024. El estudio concluyó que existe relación entre las herramientas digitales y el aprendizaje cooperativo en docentes de Educación Inicial en Lima Metropolitana.

The objective of the research was to determine the relationship between the management of digital tools and cooperative learning in Initial Education teachers of Metropolitan Lima, 2023. The approach is quantitative with a descriptive-correlational scope, the sample consisted of 230 Initial Education teachers from 12 educational institutions. Two questionnaires were applied to this group: one to measure digital tools and another for cooperative learning: reliability (0.98; 0.87). Based on the results, for digital tools it was indicated that 48.3% (111) are located at the medium level and 40% (92) at the high level; for cooperative learning, 95.7% (220) are located at the high level; In addition, the p-value of the relationship coefficient was rho= 0.024. The study concluded that there is a relationship between digital tools and cooperative learning in Initial Education teachers in Metropolitan Lima.

O objetivo da pesquisa foi determinar a relação entre o uso de ferramentas digitais e a aprendizagem cooperativa em professores da Educação Inicial da Região Metropolitana de Lima, 2023. A abordagem é quantitativa com escopo descritivo-correlacional, a amostra foi composta por 230 professores da Educação Inicial de 12 instituições de ensino. Foram aplicados dois questionários a esse grupo: um para mensurar ferramentas digitais e outro para aprendizagem cooperativa: confiabilidade (0,98; 0,87). Com base nos resultados, para as ferramentas digitais foi indicado que 48,3% (111) estão localizadas no nível médio e 40% (92) no nível alto; para a aprendizagem cooperativa, 95,7% (220) estão no nível alto; Além disso, o valor p do coeficiente de relacionamento foi rho= 0,024. O estudo concluiu que existe uma relação entre ferramentas digitais e aprendizagem cooperativa em professores de Educação Infantil na Região Metropolitana de Lima.

Assessment tools in food safety and adherence to the sanitary protocol for coping with COVID-19 in food services.

Food services, which must meet the sanitary standards for food production, needed to adapt to COVID-19 protocols in times of pandemic. In this context, the study of food safety assessment tools and sanitary protocols can contribute to the systematization of sanitary control actions and to the understanding how services have adapted to the new requirements. Thus, the present study aims to evaluate the relationships among the results of the assessment tools for food safety and adherence to the sanitary protocol for coping with COVID-19 in food services. Sanitary inspections were performed in 40 food services located in the center of the city of São Paulo - Brazil. Data were collected through the application of four checklists to evaluate the following: i. risk for FBD; ii. Good Handling Practices; iii. the structural requirements; and iv. The implementation of the COVID-19 sanitary protocol. The risk assessment tool was interpreted using a risk score, with each item weighted according to the risk for FBD. The results of the other tools were evaluated using the overall percentage of violated items. The results showed the predominance of high risk of GHP in the food services evaluated and a high percentage of violation of Good Handling Practices and structural requirements. The percentage of violation of the COVID-19 health protocol was moderate in most establishments. The degree of risk showed a high positive correlation with Good Handling Practices violations (Spearman ρ = 0.73; p < 0.001) and structural requirements (Spearman ρ = 0.63; p < 0.001). Regarding the tool for assessing adherence to the COVID-19 sanitary protocol, a moderate correlation was found with the violations of Good Handling Practices (Spearman ρ = 0.65; p < 0.001), with an emphasis on the thematic block relevant to food handlers. This discussion of the relationships among the results of the evaluation tools and their measurements may therefore be useful for improving the application of these tools by professionals involved in inspection activities, allowing the greater systematization of sanitary control actions and contributing to reduced risk of FBD.

Molecular tools to regulate gene expression in Trypanosoma cruzi.

Developing molecular strategies to manipulate gene expression in trypanosomatids is challenging, particularly with respect to the unique gene expression mechanisms adopted by these unicellular parasites, such as polycistronic mRNA transcription and multi-gene families. In the case of Trypanosoma cruzi (T. cruzi), the causative agent of Chagas Disease, the lack of RNA interference machinery further complicated functional genetic studies important for understanding parasitic biology and developing biomarkers and potential therapeutic targets. Therefore, alternative methods of performing knockout and/or endogenous labelling experiments were developed to identify and understand the function of proteins for survival and interaction with the host. In this review, we present the main tools for the genetic manipulation of T. cruzi, focusing on the Clustered Regularly Interspaced Short Palindromic Repeats Cas9-associated system technique widely used in this organism. Moreover, we highlight the importance of using these tools to elucidate the function of uncharacterized and glycosylated proteins. Further developments of these technologies will allow the identification of new biomarkers, therapeutic targets and potential vaccines against Chagas disease with greater efficiency and speed.

Detecting Class 1 Integrons and Their Variable Regions in Escherichia coli Whole-Genome Sequences Reported from Andean Community Countries.

Various genetic elements, including integrons, are known to contribute to the development of antimicrobial resistance. Class 1 integrons have been identified in E. coli isolates and are associated with multidrug resistance in countries of the Andean Community. However, detailed information on the gene cassettes located on the variable regions of integrons is lacking. Here, we investigated the presence and diversity of class 1 integrons, using an in silico approach, in 2533 whole-genome sequences obtained from EnteroBase. IntFinder v1.0 revealed that almost one-third of isolates contained these platforms. Integron-bearing isolates were associated with environmental, food, human, and animal origins reported from all countries under scrutiny. Moreover, they were identified in clones known for their pathogenicity or multidrug resistance. Integrons carried cassettes associated with aminoglycoside (aadA), trimethoprim (dfrA), cephalosporin (blaOXA; blaDHA), and fluoroquinolone (aac(6')-Ib-cr; qnrB) resistance. These platforms showed higher diversity and larger numbers than previously reported. Moreover, integrons carrying more than three cassettes in their variable regions were determined. Monitoring the prevalence and diversity of genetic elements is necessary for recognizing emergent patterns of resistance in pathogenic bacteria, especially in countries where various factors are recognized to favor the selection of resistant microorganisms.

Use of Digital Tools for the Assessment of Food Consumption in Brazil: A Scoping Review.

This is a scoping review on mapping the use of digital tools to assess food consumption in Brazil. Searches were carried out in nine electronic databases (Medline, Lilacs, Scopus, Embase, Web of Science, Science Direct, Ovid, Free Medical Journal and Crossref) to select studies published from October 2020 to December 2023. This review identified forty-eight digital tools in the 94 publications analyzed, the most frequent being web-based technologies (60%) and mobile devices (40%). Among these studies, 55% (n = 52) adopted a population-based approach, while 45% (n = 42) focused on specific regions. The predominant study design observed was cross-sectional (n = 63). A notable trend observed was the increasing frequency of validation studies in recent years. Although the use of digital tools in the assessment of food consumption in Brazil has grown in recent years, studies did not describe the process of creating and validating the tools, which would contribute to the improvement of data quality. Investments that allow the expansion of the use of the internet and mobile devices; the improvement of digital literacy; and the development of open-access tools, especially in the North and Northeast regions, are challenges that require a concerted effort towards providing equal opportunities, fostering encouragement, and delving deeper into the potential of digital tools within studies pertaining to food consumption in Brazil.

Computational Insights into the Interaction of the Conserved Cysteine-Noose Domain of the Human Respiratory Syncytial Virus G Protein with the Canonical Fractalkine Binding site of Transmembrane Receptor CX3CR1 Isoforms.

The human Respiratory Syncytial Virus (hRSV) stands as one of the most common causes of acute respiratory diseases. The infectivity of this virus is intricately linked to its membrane proteins, notably the attachment glycoprotein (G protein). The latter plays a key role in facilitating the attachment of hRSV to respiratory tract epithelial cells, thereby initiating the infection process. The present study aimed to characterize the interaction of the conserved cysteine-noose domain of hRSV G protein (cndG) with the transmembrane CX3C motif chemokine receptor 1 (CX3CR1) isoforms using computational tools of molecular modeling, docking, molecular dynamics simulations, and binding free energy calculations. From MD simulations of the molecular system embedded in the POPC lipid bilayer, we showed a stable interaction of cndG with the canonical fractalkine binding site in the N-terminal cavity of the CX3CR1 isoforms and identified that residues in the extracellular loop 2 (ECL2) region and Glu279 of this receptor are pivotal for the stabilization of CX3CR1/cndG binding, corroborating what was reported for the interaction of the chemokine fractalkine with CX3CR1 and its structure homolog US28. Therefore, the results presented here contribute by revealing key structural points for the CX3CR1/G interaction, allowing us to better understand the biology of hRSV from its attachment process and to develop new strategies to combat it.

Validez de herramientas diagnósticas en pacientes pediátricos hospitalizados con diagnóstico presuntivo de dengue en un Hospital de Referencia de Paraguay / Validity of diagnostic tools in pediatric patients hospitalized with a presumptive diagnosis of dengue in a Reference Hospital in Paraguay

Introducción: El dengue es la enfermedad arboviral más común en los seres humanos. Un diagnóstico temprano y preciso del dengue puede respaldar el manejo clínico, la vigilancia y el control de la enfermedad y es fundamental, por ello en el diagnóstico del dengue es importante contar con pautas clínicas y epidemiológicas que permitan la identificación oportuna y una conducta terapéutica adecuada. Objetivos: Evaluar la validez de herramientas diagnósticas en pacientes pediátricos hospitalizados con diagnóstico presuntivo de dengue en un Hospital de Referencia de Paraguay durante los años de 2012 a 2020. Materiales y métodos: Estudio analítico de tipo observacional, retrospectivo correspondientes a pacientes pediátricos (0 a 18 años) internados en el Hospital de Referencia de Paraguay el periodo enero 2012 a julio 2020 con diagnostico presuntivo de dengue al ingreso. Se realizó́ un análisis bivariado relacionando las frecuencias de 20 grupos de criterios diagnósticos combinados y 3 criterios diagnósticos aislados (OMS 2009, nexo epidemiológico y antigenemia NS1 para dengue) con el gold standard de diagnóstico que fue la conversión serológica. Resultados: Participaron del estudio 342 sujetos. EL 44% tenía edad escolar y 70% tenía 5 años o más. El 52,76% (191) fueron masculinos. Se encontraron desnutrición y sobrepeso en el 13% y 2%, respectivamente. La combinación de proteína C reactiva con plaquetopenia se encontró́ en 0.45% de los pacientes sin dengue y en el 6% de los pacientes con diagnóstico final de dengue (p=0.004). Conclusión: Este resultado aporta la alternativa de uso de una combinación sencilla de exámenes de laboratorio que puede replicarse en salas de urgencias como en salas de internación en un primer contacto con pacientes febriles con sospecha de fiebre dengue.

Introduction: Dengue is the most common arboviral disease in humans. An early and accurate diagnosis of dengue can support the clinical management, surveillance and control of the disease and is essential, therefore in the diagnosis of dengue it is important to have clinical and epidemiological guidelines that allow timely identification and appropriate therapeutic conduct. Objectives: To evaluate the validity of diagnostic tools in pediatric patients hospitalized with a presumptive diagnosis of dengue in a Reference Hospital in Paraguay during the years 2012 to 2020. Materials and methods: Analytical study of case and control type, observational, longitudinal, retrospective corresponding to pediatric patients (0 to 18 years) admitted to the Reference Hospital of Paraguay from January 2012 to July 2020 with a presumptive diagnosis of dengue at income. A bivariate analysis was performed relating the frequencies of 20 groups of combined diagnostic criteria and 3 isolated diagnostic criteria (WHO 2009, epidemiological link and NS1 antigenemia for dengue) with the gold standard of diagnosis, which was serological conversion. Results: 342 subjects participated in the study. 44% were school age and 70% were 5 years old or older. 52.76% (191) were male. Malnutrition and overweight were found in 13% and 2%, respectively. The combination of C-reactive protein with thrombocytopenia was found in 0.45% of patients without dengue and in 6% of patients with a final diagnosis of dengue (p=0.004). Conclusion: This result provides the alternative of using a simple combination of laboratory tests that can be replicated in emergency rooms and inpatient wards in a first contact with febrile patients with suspected dengue fever.

The Role of Obesity in the Development of Preeclampsia.

PURPOSE OF REVIEW: This comprehensive review provides an in-depth exploration of the complex relationship between obesity and preeclampsia (PE) and emphasizes the clinical implications of this association. It highlights the crucial role of screening tools in assessing individual risk and determining the need for additional antenatal care among women with obesity. The review investigates various markers for identifying the risk of developing PE, while emphasizing the significance of interventions such as exercise, weight management, and a balanced diet in reducing the incidence of preeclampsia and improving outcomes for both mother and fetus. RECENT FINDINGS: Actually, there is a global pandemic of obesity, particularly among women of childbearing age and pregnant women. PE, which is characterized by maternal hypertension, proteinuria, and complications, affects 2-4% of pregnancies worldwide, posing significant risks to maternal and perinatal health. Women with obesity face an elevated risk of developing PE due to the systemic inflammation resulting from excess adiposity, which can adversely affect placental development. Adipose tissue, rich in proinflammatory cytokines and complement proteins, contributes to the pathogenesis of PE by promoting the expression of antiangiogenic factors in the mother. This review emphasizes the need for appropriate screening, interventions, and a holistic approach to reduce the incidence of preeclampsia and enhance maternal-fetal well-being, thus providing valuable insights into the multifaceted association between obesity and PE.

Decoding semiotic minimal genome: a non-genocentric approach.

The search for the minimum information required for an organism to sustain a cellular system network has rendered both the identification of a fixed number of known genes and those genes whose function remains to be identified. The approaches used in such search generally focus their analysis on coding genomic regions, based on the genome to proteic-product perspective. Such approaches leave other fundamental processes aside, mainly those that include higher-level information management. To cope with this limitation, a non-genocentric approach based on genomic sequence analysis using language processing tools and gene ontology may prove an effective strategy for the identification of those fundamental genomic elements for life autonomy. Additionally, this approach will provide us with an integrative analysis of the information value present in all genomic elements, regardless of their coding status.

Satisfacción con el curso optativo Farmacoeconomía en la carrera de licenciatura en Enfermería

Introducción: El curso optativo de Farmacoeconomía, impartido en el de cuarto año de la carrera licenciatura en Enfermaría, como parte de su habilitación profesional, pone a consideración de los estudiantes, indicadores internacionales de evaluación farmacoeconómica. Objetivo: Determinar la satisfacción de los estudiantes de la carrera de licenciatura en Enfermería con el curso optativo de Farmacoeconomía. Método: Investigación descriptiva de corte transversal, con enfoque mixto, con todos los estudiantes de cuarto año de licenciatura en Enfermería. Las variables medidas fueron: sexo, edad, fuente de ingreso, situación escolar, asistencia a la asignatura, conocimiento previo y satisfacción. Los indicadores fueron divididos en 2: específicos y generales de la asignatura. La validación de los resultados se realizó mediante el análisis del factor de Bayes y el análisis de la diversidad logarítmica. Resultado: En la valoración general de la asignatura el 78,88 % (n= 71) de los estudiantes refirió estar muy satisfecho, el 20 % (n= 18) refirió estar bastante satisfecho y el 1,12 % (n= 1) refirió estar poco satisfecho. Conclusión: Farmacoeconomía como curso optativo del cuarto año de la carrera de licenciatura en enfermería de la Facultad de Enfermería - Tecnología de Santiago de Cuba es valorada por 7 de cada 10 estudiantes de muy satisfactoria.

Introduction: The optional Pharmacoeconomics course, taught in the fourth year of the Higher degree in Nursing, as part of its professional qualification, puts international indicators of pharmacoeconomic evolution for students' consideration. Objective: Determine the satisfaction of undergraduate Nursing students with the optional Pharmacoeconomics course. Method: Cross-sectional descriptive research, with a mixed approach, with all fourth-year nursing students. The variables measured were: sex, age, source of income, school situation, course attendance, prior knowledge and satisfaction. The indicators were divided into 2: specific and general of the subject. The validation of the results was carried out through Bayes factor analysis and logarithmic diversity analysis. Result: In the general assessment of the subject, 78.88% (n= 71) of the students reported being very satisfied, 20% (n= 18) reported being quite satisfied and 1.12% (n= 1) was not very satisfied. Conclusion: Pharmacoeconomics as an optional course in the fourth year of the nursing degree at the Faculty of Nursing-Technology of Santiago de Cuba is rated as very satisfactory by 7 out of 10 students.

The Influence of Blue Light Exposure on Reconstructed 3-Dimensional Skin Model: Molecular Changes and Gene Expression Profile.

Recent studies have provided information about digital eye strain and the potential damage that blue light from digital devices can cause to the eyes. In this study, we analyzed the influence of blue light exposure on reconstructed 3-dimensional skin model using RNA sequencing to identify the expression of transcripts and abnormal events. Three-dimensional skin was exposed to visible light spectrum and isolated blue wavelength for 1, 2, and 4 hours to represent acute exposure and 1 hour over 4 sequential days to represent repeated exposure, respectively, in this in vitro model. We compared gene expression levels with those of unexposed control. Samples submitted to repeated exposure showed reduced AK2 and DDX47, whereas they showed increased PABPC3 gene expression, revealing a significantly negative impact. RT-PCR validation assay with exposed 3-dimensional skin compared with unexposed control regarding 1 and 4 days of incubation showed increased IL-6 signaling mechanism activation and signal transducer and activator of transcription 3 gene STAT3 gene expression, whereas it showed decreased peroxisome proliferator-activated receptor signaling mechanism activation, suggesting an influence on inflammatory pathways. We also demonstrate upregulated gene expression of KIT, MAPK2, and PI3KC in samples from exposed condition, corroborating previous findings related to pigmentation signaling stimuli. These results reveal, to our knowledge, previously unreported data that enable studies on molecular response correlation of in vitro digital blue light exposure and human skin studies.

Combining methods to conduct a systematic review and propose a conceptual and theoretical framework in socio-environmental research.

This study aims to present a combination of methods and propose robust theoretical and conceptual frameworks for solving socio-environmental issues. This proposal included the Problem, Intervention, Context, and Outcome (PICO) framework and Protocol and Reporting result with Search, Appraisal, Synthesis, and Analysis framework, and develop (PSALSAR) method through SODIP steps: (i) Systematic review and meta-analysis defining the study from guiding questions; (ii) Open-source related to software and data; (iii) Data visualization and design information; (iv) Identification of gaps, challenges and trends through automation and lexicometric analysis; and (v) Proposal of theoretical and conceptual frameworks. This proposal defines the steps as support to combine and systematize information necessary to facilitate the production of this type of document using open-access software in the visualization and design of information. All these steps are replicable and essential to propose a conceptual and theoretical framework to contribute to the construction of knowledge in socio-environmental research and to propose solutions by filling in the gaps. In summary, this combination of methods shows:•The use of SODIP steps provides robustness and efficiency in carrying out review studies, facilitating the way to propose theoretical or conceptual frameworks.•Choosing to use open-source tools is essential for better evaluation and visualization of qualitative and quantitative data in review studies.•The combination of methods and data in the systematic review (scientific, political documents. and databases) supports the proposal of robust theoretical and conceptual frameworks.