P2Y12 inhibitor use predicts hematoma expansion in patients with intracerebral hemorrhage.

OBJECTIVE: Hematoma expansion (HE) predicts disability and death after acute intracerebral hemorrhage (ICH). Aspirin and anticoagulants have been associated with HE. We tested the hypothesis that P2Y12 inhibitors predict subsequent HE in patients. We explored laboratory measures of P2Y12 inhibition and dual antiplatelet therapy with aspirin (DAPT). METHODS: We prospectively identified patients with ICH. Platelet activity was measured with the VerifyNow-P2Y12 assay. Hematoma volumes for initial and follow-up CTs were calculated using a validated semi-automated technique. HE was defined as the difference between hematoma volumes on the initial and follow-up CT scans. Nonparametric statistics were performed with Kruskal-Wallis H, and correction for multiple comparisons performed with Dunn's test. RESULTS: In 194 patients, 15 (7.7%) were known to take a P2Y12 inhibitor (clopidogrel in all but one). Patients taking a P2Y12 inhibitor had more HE compared to patients not taking a P2Y12 inhibitor (3.5 [1.2-11.9] vs. 0.1 [-0.8-1.4] mL, p = 0.004). Patients taking DAPT experienced the most HE (7.2 [2.6-13.8] vs. 0.0 [-1.0-1.1] mL, p = 0.04). The use of P2Y12 inhibitors was associated with less P2Y12 activity (178 [149-203] vs. 288 [246-319] P2Y12 reaction units, p = 0.005). INTERPRETATION: Patients taking a P2Y12 inhibitor had more HE and less P2Y12 activity. The effect was most pronounced in patients on DAPT, suggesting a synergistic effect of P2Y12 inhibitors and aspirin with respect to HE. Acute reversal of P2Y12 inhibitors in acute ICH requires further study.

Desenvolvimento de um design de telessimulação para o suporte básico de vida / Elaboración de un diseño de telesimulación para el soporte vital básico / Development of a telesimulation design for basic life support

Resumo Objetivo Construir e validar um design de telessimulação síncrona e observacional em enfermagem para o atendimento segundo o protocolo de suporte básico de vida intra-hospitalar no adulto. Métodos Estudo metodológico baseado nas fases do procedimento teórico realizado por meio de uma scoping review; fase empírica desenvolvida através da validação de conteúdo do design telessimulado e fase analítica em que adotou-se o índice de validade de conteúdo. Resultados Construiu-se um design para o atendimento segundo o protocolo de suporte básico de vida percorrendo seis etapas: o planejamento, preparação, participação, teledebriefing, avaliação e feedback e a aprendizagem adicional, com Índice de Validade de Conteúdo de 0,96. Conclusão O design desenvolvido foi considerado válido em conteúdo para planejar e executar a telessimulação pela enfermagem e ainda ser adaptado a outros contextos educacionais.

Resumen Objetivo Elaborar y validar un diseño de telesimulación sincrónica y observacional de enfermería para la atención de acuerdo con el protocolo de soporte vital básico intrahospitalario en adultos. Métodos Estudio metodológico basado en las fases del procedimiento teórico realizado por medio de una scoping review, fase empírica llevada cabo a través de la validación de contenido del diseño telesimulado y fase analítica en la que se adoptó el índice de validez de contenido. Resultados Se elaboró un diseño para la atención de acuerdo con el protocolo de soporte vital básico que atravesó seis etapas: planificación, preparación, participación, teledebriefing, evaluación y feedback y aprendizaje adicional, con un Índice de Validez de Contenido de 0,96. Conclusión El diseño elaborado fue considerado válido en contenido para planificar y ejecutar la telesimulación por parte de enfermeros y además puede adaptarse a otros contextos educativos.

Abstract Objective To construct and validate a synchronous and observational telesimulation design in nursing for care according to in-hospital basic life support protocol for adults. Methods A methodological study based on the phases of the theoretical procedure carried out through a scoping review; empirical phase developed through the telesimulated design content validity and analytical phase in which the content validity index was adopted. Results A care design was constructed according to the basic life support protocol, going through six steps: planning, preparation, participation, teledebriefing, assessment and feedback and additional learning, with a Content Validity Index of 0.96. Conclusion The developed design was considered valid in content to plan and execute telesimulation by nursing and still be adapted to other educational contexts.

Cardiovascular health in nursing and medical students.

OBJECTIVE: To verify whether nursing and medical students take measures regarding their cardiovascular health and the associated risk factors. METHOD: Cross-sectional study, online data collection with 413 students in February and March 2021, using specific and validated instruments. Kruskal-Wallis, chi-square and logistic regression were adopted for statistical analyses. RESULTS: 73.3% self-reported that they were healthy. We identified a higher risk for developing cardiovascular diseases in sedentary students (OR = 38.6, p < 0.001), with irregular adherence to physical activity (OR = 16.2, p < 0.001) and with a higher level of perceived stress (OR = 1.12, p < 0.001). CONCLUSION: Students who take action to promote cardiovascular health showed lower risk compared to those who did not. If students do not value their own health during the education process, this may interfere with their professional performance after graduation.

Monitoring of Mycotoxigenic Fungi in Fish Farm Water and Fumonisins in Feeds for Farmed Colossoma macropomum.

This study aimed to evaluate the occurrence of mycotoxigenic fungi in fish farm water and mycotoxins in feeds for farmed tambaqui (Colossoma macropomum). A total of 40 samples of freshwater from fish farms and 16 samples of feed were collected and analyzed for microbiology. A total of five species of free-living fungi were identified in fish farms: Aspergillus fumigatus, Penicillium citrinum, P. implicatum, Fusarium oxysporum and Alternaria alternata. These fungi species were counted in water samples at 35.14 CFU mL-1 and 24.69 CFU mL-1 in the dry seasons. In all fish farms, there was a higher abundance of fungi species in the rainy season. During visits to the fish farmers, it was possible to verify poor feed storage conditions. Concerning mutations in blood cells, in tambaqui (C. macropomum), a total of 159 anomalies were found, and in Leptodactylus petersii, 299 anomalies were found, with higher incidences in conditions above 1.0 CFU mL-1 in log10(x+1) fungi and in the rainy season. The occurrence of mycotoxicological contamination was confirmed in 81.25% of the analyzed samples. The quantified mycotoxin was Fumonisins B1 + B2 (375 to 1418 µg kg-1). Pearson's correlation analysis showed a significant positive correlation between Fumonisins and feed samples (r = 0.83). There was also a significant positive correlation between the abundance of fungi in water and the quantification of Fumonisins (r = 0.79). Based on the results obtained, it can be concluded that free-living fungi can be used as bioindicators of water quality in fish farms. Consequently, the lack of good management practices caused microbiological contamination of the aquatic environment.

Validação de ferramentas pedagógicas: subsídio para o ensino híbrido da ressuscitação cardiopulmonar neonatal / Validación de herramientas pedagógicas: subsidio para la enseñanza híbrida de reanimación cardiopulmonar neonatal / Validation of pedagogical tools: subsidy for hybrid teaching of neonatal cardiopulmonary resuscitation

Objetivo: desenvolver e validar instrumentos de aprendizagem e avaliação voltados para o ensino híbrido da ressuscitação cardiopulmonar neonatal. Métodos: pesquisa aplicada, de produção tecnológica e validação de ferramentas pedagógicas com 13 experts por meio de First-order Agreement Coefficient. Resultados: desenvolveu-se o script e storyboard de uma videoaula com cinco módulos e um vídeo de simulação sobre um cenário clínico de atendimento da ressuscitação cardiopulmonar neonatal, além de um questionário de vinte perguntas para avaliação do conhecimento cognitivo e um Exame Clínico Objetivo Estruturado com cinco estações para análise das habilidades psicomotoras. Todos os constructos obtiveram índice de concordância interavaliadores quase perfeita. Conclusão: esta pesquisa disponibilizou ferramentas pedagógicas validadas e fundamentadas em evidências científicas sobre a ressuscitação cardiopulmonar neonatal que sustentam o ensino híbrido e adoção da simulação clínica baseada em vídeo

Objective: To develop and validate learning and assessment tools for hybrid teaching of neonatal cardiopulmonary resuscitation. Method: An applied research for technological production and validation of pedagogical tools was conducted with 13 experts using First-order Agreement Coefficient. Results: A script and storyboard for a five-module video class and a simulation video on a clinical scenario of neonatal cardiopulmonary resuscitation care were developed, as well as a twenty-question questionnaire to assess cognitive knowledge and a five-station Clinical Examination Objective Structured to analyze psychomotor skills. All constructs had an almost perfect inter-rater agreement index. Conclusion: This study provides evidence-based validated pedagogical tools for neonatal cardiopulmonary resuscitation, which support hybrid teaching and the adoption of video-based clinical simulation.

Objetivo: desarrollar y validar herramientas de aprendizaje y evaluación dirigidas a la enseñanza híbrida de la reanimación cardiopulmonar neonatal. Métodos: investigación aplicada, de producción tecnológica y validación de herramientas pedagógicas con 13 expertos mediante el First-order Agreement Coefficient. Resultados: se desarrolló un guion y storyboard para una clase de video con cinco módulos y un video de simulación sobre un escenario de reanimación cardiopulmonar neonatal, un cuestionario de veinte preguntas para el conocimiento cognitivo y un Examen Clínico Estructurado con cinco estaciones para el análisis de las habilidades psicomotoras. Los constructos tenían un índice de acuerdo entre evaluadores casi perfecto. Conclusión: esta investigación permite disponer de herramientas pedagógicas validadas y basadas en evidencia científica sobre la reanimación cardiopulmonar neonatal, que apoyan enseñanza híbrida y adopción de simulación clínica basada en video.

Association of Training in Basic Life Support with the Evolution of Cardiopulmonary Resuscitation Performed by Firefighters.

Introduction: This study aimed to compare the results of professional technical and anthropometric anamnesis data with the transmission of external chest compressions performed by military firefighters at different execution times. Objective: The objective was to evaluate the performance and perceived effort of the sequence of external chest compressions performed in two minutes, as well as the evolution of the technique over time. Materials and Methods: This was a descriptive, correlational study involving adult firefighters who were members of a specific firefighter group, comprising a population of 105 individuals with a voluntary sample of 44 participants. The study used a Bayesian statistical approach to provide probabilistic expressions. Results: The participants had an average work experience of 17 years, an average age of 38.6 years, an average weight of 81.48 kilograms, an average height of 176 centimeters, and an average of 2.5 qualifications. The results indicated that the firefighters performed external chest compressions with excellent technique and a moderate level of perceived effort in a two-minute evaluation. The evaluation of the evolution of the technique over time showed that the participants were able to maintain high-quality compressions for an average of 6 minutes, with a maximum of 20 uninterrupted minutes. Conclusion: The study underscores the critical role of professional firefighters in performing and maintaining high-quality external chest compressions, which has the potential to reduce morbidity and mortality in cases of cardiorespiratory arrest.

Mitochondrial, cell cycle control and neuritogenesis alterations in an iPSC-based neurodevelopmental model for schizophrenia.

Schizophrenia is a severe psychiatric disorder of neurodevelopmental origin that affects around 1% of the world's population. Proteomic studies and other approaches have provided evidence of compromised cellular processes in the disorder, including mitochondrial function. Most of the studies so far have been conducted on postmortem brain tissue from patients, and therefore, do not allow the evaluation of the neurodevelopmental aspect of the disorder. To circumvent that, we studied the mitochondrial and nuclear proteomes of neural stem cells (NSCs) and neurons derived from induced pluripotent stem cells (iPSCs) from schizophrenia patients versus healthy controls to assess possible alterations related to energy metabolism and mitochondrial function during neurodevelopment in the disorder. Our results revealed differentially expressed proteins in pathways related to mitochondrial function, cell cycle control, DNA repair and neuritogenesis and their possible implication in key process of neurodevelopment, such as neuronal differentiation and axonal guidance signaling. Moreover, functional analysis of NSCs revealed alterations in mitochondrial oxygen consumption in schizophrenia-derived cells and a tendency of higher levels of intracellular reactive oxygen species (ROS). Hence, this study shows evidence that alterations in important cellular processes are present during neurodevelopment and could be involved with the establishment of schizophrenia, as well as the phenotypic traits observed in adult patients. Neural stem cells (NSCs) and neurons were derived from induced pluripotent stem cells (iPSCs) from schizophrenia patients and controls. Proteomic analyses were performed on the enriched mitochondrial and nuclear fractions of NSCs and neurons. Whole-cell proteomic analysis was also performed in neurons. Our results revealed alteration in proteins related to mitochondrial function, cell cycle control, among others. We also performed energy pathway analysis and reactive oxygen species (ROS) analysis of NSCs, which revealed alterations in mitochondrial oxygen consumption and a tendency of higher levels of intracellular ROS in schizophrenia-derived cells.

Validation of the Portuguese Version of the Kansas City Cardiomyopathy Questionnaire-12.

The Kansas City Cardiomyopathy Questionnaire-12 (KCCQ-12) is a simple, feasible, and sensitive questionnaire developed in English for assessing the health status (symptoms, function, and quality of life) of patients with heart failure (HF). We aimed to assess the internal consistency and construct validity of the Portuguese version of KCCQ-12. We administered the KCCQ-12, the Minnesota Living Heart Failure (MLHFQ), and the New York Heart Association (NYHA) classification by telephone. Internal consistency was assessed with Cronbach's Alpha (α-Cronbach) and construct validity with correlations to the MLHFQ and NYHA. Internal consistency was high (α-Cronbach = 0.92 for the Overall Summary score and 0.77-0.85 for the subdomains). Construct validity was supported by finding high correlations between the KCCQ-12 Physical Limitation and the Symptom Frequency domains with the physical domain of the MLHFQ (r = -0.70 and r = -0.76, p < 0.001 for both) and the Overall Summary scale with NYHA classifications (r = -0.72, p < 0.001). The Portuguese version of KCCQ-12 has high internal consistency and shows a convergent construct validity with other measures quantifying the health status of patients with chronic HF and can be used confidently in Brazil for research and clinical care.

Induced pluripotent stem cell-derived astrocytes from patients with schizophrenia exhibit an inflammatory phenotype that affects vascularization.

Molecular and functional abnormalities of astrocytes have been implicated in the etiology and pathogenesis of schizophrenia (SCZ). In this study, we examined the proteome, inflammatory responses, and secretome effects on vascularization of human induced pluripotent stem cell (hiPSC)-derived astrocytes from patients with SCZ. Proteomic analysis revealed alterations in proteins related to immune function and vascularization. Reduced expression of the nuclear factor kappa B (NF-κB) p65 subunit was observed in these astrocytes, with no incremental secretion of cytokines after tumor necrosis factor alpha (TNF-α) stimulation. Among inflammatory cytokines, secretion of interleukin (IL)-8 was particularly elevated in SCZ-patient-derived-astrocyte-conditioned medium (ASCZCM). In a chicken chorioallantoic membrane (CAM) assay, ASCZCM reduced the diameter of newly grown vessels. This effect could be mimicked with exogenous addition of IL-8. Taken together, our results suggest that SCZ astrocytes are immunologically dysfunctional and may consequently affect vascularization through secreted factors.

Integrative taxonomy and phylogenetic systematics of the Triatoma rubrovaria subcomplex (Hemiptera, Triatominae).

Triatoma rubrovaria subcomplex consists of T. carcavalloi, T. circummaculata, T. klugi, T. limai, T. oliveirai, T. pintodiasi, T. rubrovaria, T. patagonica and T. guasayana, which can be vectors of Trypanosoma cruzi, the etiologic agent of Chagas disease. In this study, morphological, morphometric, and genetic characters of T. circummaculata, T. pintodiasi, T. carcavalloi, T. klugi, and T. rubrovaria were analyzed in view of the integrative taxonomy and phylogeny of the T. rubrovaria subcomplex. Molecular studies were carried out through the sequencing and analysis of the mitochondrial genes COI and CytB, nuclear genes ITS I, ITS 2, 16S, and 28S from rDNA and rescued a monophyletic group. Furthermore, differential morphological characters were found among the five species in the pronotum, scutellum, stridulatory sulcus, male genitalia, and external female genitalia. Finally, morphometric analyses made it possible to differentiate the five species. Phylogenetic analyzes rescued the relationship of T. pintodiasi with members of the T. rubrovaria subcomplex and demonstrated that this subcomplex is a monophyletic group composed of the species T. carcavalloi, T. circummaculata, T. klugi, T. guasayana, T. limai, T. oliveirai, T. patagonica, T. pintodiasi, and T. rubrovaria. Furthermore, through integrative taxonomy, it was possible to confirm the specific status of the species T. carcavalloi, T. circummaculata, T. pintodiasi, T. klugi, and T. rubrovaria, offering new useful morphological characters for the differentiation and characterization of these potential vectors and distributed in Southern Brazil.

Development of educational videos about bathing in bed newborns admitted to a neonatal unit.

OBJECTIVE: to develop and analyze evidence of content validity of educational videos about bathing newborns in bed in a neonatal unit. METHOD: applied and methodological research, carried out from December/2020 to February/2022, in three phases: pre-production, production, post-production. Validity was carried out by nurses specializing in social communication and nursing professionals, including the Brazilian Sign Language and assessment by nursing students. The Content Validity Index and Cronbach's alpha above 0.8 were considered for analysis. RESULTS: the videos were entitled "Best practices: bathing newborns in the heated crib" and "Best practices: bathing newborns in the incubator", lasting seven minutes each, divided into six scenes that demonstrated the approach to parents, environment and material organization, preparing newborns, bathing and after-bath care. CONCLUSION: the videos will support permanent education processes, academic training and professional training in nursing.

Cardiovascular health in nursing and medical students / Salud cardiovascular en estudiantes de enfermería y medicina / Saúde cardiovascular em estudantes de enfermagem e medicina

ABSTRACT Objective: To verify whether nursing and medical students take measures regarding their cardiovascular health and the associated risk factors. Method: Cross-sectional study, online data collection with 413 students in February and March 2021, using specific and validated instruments. Kruskal-Wallis, chi-square and logistic regression were adopted for statistical analyses. Results: 73.3% self-reported that they were healthy. We identified a higher risk for developing cardiovascular diseases in sedentary students (OR = 38.6, p < 0.001), with irregular adherence to physical activity (OR = 16.2, p < 0.001) and with a higher level of perceived stress (OR = 1.12, p < 0.001). Conclusion: Students who take action to promote cardiovascular health showed lower risk compared to those who did not. If students do not value their own health during the education process, this may interfere with their professional performance after graduation.

RESUMEN Objetivo: Verificar si estudiantes de enfermería y medicina toman medidas de salud cardiovasculares y los factores de riesgo asociados. Método: Estudio transversal, recolección de datos online con 413 estudiantes durante febrero y marzo de 2021, utilizando instrumentos específicos y validados. Para análisis estadísticos se adoptaron Kruskal-Wallis, chi-cuadrado y regresión logística. Resultados: El 73,3% autodeclaró estar sano. Se identificó mayor riesgo de desarrollar enfermedades cardiovasculares en estudiantes sedentarios (OR = 38,6, p < 0,001), con adherencia irregular a la actividad física (OR = 16,2, p < 0,001) y con mayor nivel de estrés percibido (OR = 1,12, p < 0,001). Conclusión: Los estudiantes que desarrollaban alguna acción para promover la salud cardiovascular presentaron menor riesgo en comparación con los que no lo hacían. En esta situación, el hecho de no valorar su propia salud durante el proceso de formación puede interferir en el desempeño profesional del estudiante después de su formación.

RESUMO Objetivo: Verificar a realização de medidas para a saúde cardiovascular entre estudantes de enfermagem e medicina e fatores de risco associados. Método: Estudo transversal, coleta de dados com 413 estudantes de forma online durante os meses de fevereiro e março de 2021, utilizando instrumentos específicos e validados. Kruskal-Wallis, qui-quadrado e regressão logística foram adotados como análise estatística. Resultados: 73,3% se autodeclaram saudáveis. Identificou-se maior risco para o desenvolvimento de doenças cardiovasculares em estudantes sedentários (OR = 38,6, p < 0,001), com adesão irregular à atividade física (OR = 16,2, p < 0,001) e com maior nível de estresse percebido (OR = 1,12, p < 0,001). Conclusão: Os estudantes que desenvolviam alguma ação para promoção da saúde cardiovascular apresentaram menor risco em comparação àqueles que não desenvolviam nenhuma ação, nessa situação, o estudante que não valoriza a própria saúde,pode interferir na atuação profissional após a formação.

Synchronous and observational telesimulation in health: a scoping review / Telesimulación síncrona y observacional en salud: scoping review / Telessimulação síncrona e observacional em saúde: scoping review

ABSTRACT Objective: to map the necessary steps and components for operationalizing a synchronous and observational telesimulation design in the context of developing clinical competencies aimed at students and health professionals. Method a scoping review supported by the recommendations of the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews: Checklist and Explanation, and by the assumptions of the Joanna Briggs Institute Reviews' manual method. The search was carried out in November 2021 in 13 databases, totaling nine studies in the final sample, which were then analyzed using Thematic Analysis. Results two categories were developed: steps and components for operationalizing a synchronous and observational telesimulation design; and challenges to implement synchronous and observational telesimulation. Conclusion operationalizing a synchronous and observational telesimulation has been supported by a six-step instructional design, characterized by planning, preparation, participation, teledebriefing, learner assessment/feedback collection and additional learning, capable of developing the students' cognitive and affective skills. The relevant challenges to this context were also highlighted, configured by the need to obtain a sufficient technological structure for remotely transmitting the telesimulated scenario and an adequately trained faculty.

RESUMEN Objetivo mapear los pasos y componentes necesarios para la operacionalización de un diseño de telesimulación síncrona y observacional en el contexto del desarrollo de competencias clínicas dirigidas a estudiantes y profesionales de la salud. Método scoping review respaldada por las recomendaciones de Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews: Checklist and Explanation y por los supuestos del método manual de Joanna Briggs Institute Reviews. La búsqueda se realizó en noviembre de 2021 en 13 bases de datos, totalizando nueve estudios en la muestra final, analizados mediante Análisis Temático. Resultados se desarrollaron dos categorías: etapas y componentes para la operacionalización de un diseño de telesimulación síncrona y observacional; y desafíos para implementar la telesimulación síncrona y observacional. Conclusión la puesta en funcionamiento de la telesimulación observacional y sincrónica ha sido respaldada por un diseño instruccional de seis pasos, caracterizado por planificación, preparación, participación, teledebriefing, evaluación del alumno/ recopilación de comentarios y aprendizaje adicional, capaz de desarrollar las habilidades cognitivas y afectivas del aprendiz. También se destacaron los desafíos relevantes a este contexto, configurados por la necesidad de obtener una estructura tecnológica suficiente para la transmisión remota del escenario telesimulado y un cuerpo docente adecuadamente capacitado.

RESUMO Objetivo mapear as etapas e componentes necessários para a operacionalização de um design de telessimulação síncrona e observacional no contexto do desenvolvimento de competências clínicas voltadas a estudantes e profissionais de saúde. Método scoping review sustentada pelas recomendações do Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews: Checklist and Explanation e pelos pressupostos do método Joanna Briggs Institute Reviews' manual. Realizou-se a busca em novembro de 2021 em 13 bases de dados, totalizando nove estudos na amostra final, analisados por meio de Análise Temática. Resultados desenvolveram-se duas categorias: etapas e componentes para a operacionalização de um design de telessimulação síncrona e observacional; e desafios para implementar a telessimulação síncrona e observacional. Conclusão a operacionalização da telessimulação síncrona e observacional vem sendo sustentada por um design instrucional de seis etapas, caracterizadas pelo planejamento, preparação, participação, teledebriefing, avaliação do aprendiz/coleta de feedback e aprendizagem adicional, capazes de desenvolver as habilidades cognitivas e afetivas do aprendiz. Destacaram-se, ainda, os desafios pertinentes a este contexto, configurados pela necessidade de se obter uma estrutura tecnológica suficiente para transmissão remota do cenário telessimulado e um corpo docente adequadamente treinado.

Simulated scenarios in nursing: an integrative literature review / Escenarios simulados en enfermería: revisión integrativa de la literatura / Cenários simulados em enfermagem: revisão integrativa de literatura

ABSTRACT Objectives: to identify in scientific literature which simulated clinical scenarios were developed and validated for teaching and learning in nursing. Methods: integrative review, carried out in seven sources of information. The Rayyan program was used for selection, content analysis to explore the findings and the methodological assessment tool of the validity process, entitled Quality Appraisal tool for Validity Studies. Results: initially, 1,179 manuscripts were identified and 14 were part of the sample. Two categories were defined: Profile of simulated clinical scenarios produced in nursing; and Clinical skills developed and their assessment mechanisms. Final Considerations: there was a preponderance of high-fidelity scenarios, built in Brazil in the last five years, aimed at nursing students on the themes of emergency, maternal care and stomatherapy, addressing the assessment of cognitive, psychomotor and affective skills in nursing. Most studies obtained good methodological quality in their content validity process.

RESUMEN Objetivos: identificar en la literatura científica qué escenarios clínicos simulados fueron desarrollados y validados para la enseñanza y el aprendizaje en enfermería. Métodos: revisión integradora, realizada en siete fuentes de información. Se utilizó el programa Rayyan para la selección, el análisis de contenido para explorar los hallazgos y la herramienta de evaluación metodológica del proceso de validación, denominada Quality Appraisal tool for Validity Studies. Resultados: inicialmente se identificaron 1.179 manuscritos y 14 formaron parte de la muestra. Se definieron dos categorías: Perfil de escenarios clínicos simulados producidos en enfermería; y Habilidades clínicas desarrolladas y sus mecanismos de evaluación. Consideraciones Finales: hubo predominio de escenarios de alta fidelidad, construidos en Brasil en los últimos cinco años, dirigidos a estudiantes de enfermería sobre las temáticas de urgencia y emergencia, cuidado materno y estomaterapia, abordando la evaluación de las habilidades cognitivas, psicomotoras y afectivas en enfermería. La mayoría de los estudios obtuvieron buena calidad metodológica en su proceso de validación de contenido.

RESUMO Objetivos: identificar na literatura científica quais os cenários clínicos simulados desenvolvidos e validados para o ensino e aprendizagem em enfermagem. Métodos: revisão integrativa, realizada em sete fontes de informação. Utilizaram-se o programa Rayyan para seleção, a análise de conteúdo para exploração dos achados e a ferramenta de avaliação metodológica do percurso de validação, intitulada Avaliação da Qualidade para Estudos de Validade. Resultados: identificaram-se, inicialmente, 1.179 manuscritos e 14 compuseram a amostra. Definiram-se duas categorias: Perfil dos cenários clínicos simulados produzidos em enfermagem; e Habilidades clínicas desenvolvidas e seus mecanismos de avaliação. Considerações Finais: houve preponderância de cenários de alta fidelidade, construídos no Brasil, nos últimos cinco anos, voltados a estudantes de enfermagem sobre as temáticas da urgência e emergência, cuidado materno e estomaterapia, abordando a avaliação das habilidades cognitivas, psicomotoras e afetivas em enfermagem. A maioria dos estudos obteve boa qualidade metodológica em seu processo de validação de conteúdo.

Prática da telessimulação no ensino e aprendizagem em saúde: revisão de escopo / Tele-simulation in health teaching and learning: a scoping review / Práctica de la telesimulación en la enseñanza y el aprendizaje en salud: revisión del alcance

Objetivo: mapear a prática da telessimulação no ensino e aprendizagem em saúde para desenvolver competências clínicas. Método: revisão de escopo realizada conforme recomendações do Instituto Joanna Briggs e Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews, com busca realizada em novembro de 2021 em 13 fontes de informação. Resultados: dentre os 1901 estudos, 18 compuseram a amostra final. Elencaram-se duas categorias: classificações da telessimulação e tendências contemporâneas na prática da telessimulação. Conclusões: identificou-se preponderância na adoção da telessimulação sincrônica e um equilíbrio entre a prática telessimulada observacional e móvel. Os cenários abrangem o manejo de pacientes graves, na avaliação das habilidades afetivas do profissional médico. O design instrucional abrange as etapas de preparação, participação e teledebriefing, com o apoio de simuladores de alta fidelidade e plataformas de videoconferência para transmissão.

Objective: to map the practice of tele-simulation in health teaching and learning to develop clinical competences. Method: this scoping review followed the recommendations of the Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews in a search of 13 information sources in November 2021. Results: of the 1901 studies found, 18 composed the final sample. Two categories were developed: classifications of tele-simulation; and contemporary trends in the practice of tele-simulation. Conclusions: tele-simulation was found to be predominantly synchronous and there was a balance between observational and mobile tele-simulation. The scenarios ranged from management of seriously ill patients to evaluation of medical personnel's affective skills. Instructional design stages comprised preparation, participation, and tele-debriefing, supported by high-fidelity simulators and videoconferencing platforms for transmission.

Objetivo: mapear la práctica de la telesimulación en la enseñanza y el aprendizaje de la salud para el desarrollo de habilidades clínicas. Método: revisión del alcance realizada según recomendaciones del Instituto Joanna Briggs y Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews, cuya búsqueda fue realizada en noviembre de 2021, en 13 fuentes de información. Resultados: entre los 1901 estudios, 18 conformaron la muestra final. Se enumeraron dos categorías: clasificaciones de telesimulación y tendencias contemporáneas en la práctica de la telesimulación. Conclusiones: se identificó una preponderancia en la adopción de telesimulación sincrónica y un equilibrio entre la práctica de telesimulación observacional y móvil. Los escenarios abarcan el manejo de pacientes críticos, en la evaluación de las habilidades afectivas del profesional médico. El diseño instruccional cubre las etapas de preparación, participación y teledebriefing, contando con el apoyo de simuladores de alta fidelidad y plataformas de videoconferencia para la transmisión.

Proteomic signatures of schizophrenia-sourced iPSC-derived neural cells and brain organoids are similar to patients' postmortem brains.

BACKGROUND: Schizophrenia is a complex and severe neuropsychiatric disorder, with a wide range of debilitating symptoms. Several aspects of its multifactorial complexity are still unknown, and some are accepted to be an early developmental deficiency with a more specifically neurodevelopmental origin. Understanding the timepoints of disturbances during neural cell differentiation processes could lead to an insight into the development of the disorder. In this context, human brain organoids and neural cells differentiated from patient-derived induced pluripotent stem cells are of great interest as a model to study the developmental origins of the disease. RESULTS: Here we evaluated the differential expression of proteins of schizophrenia patient-derived neural progenitors (NPCs), early neurons, and brain organoids in comparison to healthy individuals. Using bottom-up shotgun proteomics with a label-free approach for quantitative analysis, we found multiple dysregulated proteins since NPCs, modified, and disrupted the 21DIV neuronal differentiation, and cerebral organoids. Our experimental methods have shown impairments in pathways never before found in patient-derived induced pluripotent stem cells studies, such as spliceosomes and amino acid metabolism; but also, those such as axonal guidance and synaptogenesis, in line with postmortem tissue studies of schizophrenia patients. CONCLUSION: In conclusion, here we provide comprehensive, large-scale, protein-level data of different neural cell models that may uncover early events in brain development, underlying several of the mechanisms within the origins of schizophrenia.

Effectiveness of co-debriefing to develop clinical skills in basic life support: randomized pilot study.

OBJECTIVE: To compare the effectiveness of co-debriefing with debriefing with a facilitator in the development of clinical competences in nursing students in the simulated care of cardiac arrest. METHOD: Randomized pilot study, carried out at a university in Minas Gerais, Brazil, in August 2021, with 17 students, to compare debriefing with a facilitator (control n=8) with co-debriefing (intervention n=9). Pre- and post-test, Objective Structured Clinical Examination and scales were used to assess behavioral skills. Wilcoxon and Mann-Whitney nonparametric comparison tests were used for analysis. RESULTS: The intervention group performed better than the control for knowledge about basic life support (control=17.00±2.39 and intervention=19.22 ± 0.66, p=0.021) and psychomotor skills (control=8.12±0.13 and intervention=8.50 ± 0.001, p<0.001). There were no significant differences for behavioral skills. CONCLUSION: Co-debriefing appears to be more effective than debriefing with a facilitator to develop clinical skills in basic life support in nursing.

Simulated scenarios in nursing: an integrative literature review.

OBJECTIVES: to identify in scientific literature which simulated clinical scenarios were developed and validated for teaching and learning in nursing. METHODS: integrative review, carried out in seven sources of information. The Rayyan program was used for selection, content analysis to explore the findings and the methodological assessment tool of the validity process, entitled Quality Appraisal tool for Validity Studies. RESULTS: initially, 1,179 manuscripts were identified and 14 were part of the sample. Two categories were defined: Profile of simulated clinical scenarios produced in nursing; and Clinical skills developed and their assessment mechanisms. FINAL CONSIDERATIONS: there was a preponderance of high-fidelity scenarios, built in Brazil in the last five years, aimed at nursing students on the themes of emergency, maternal care and stomatherapy, addressing the assessment of cognitive, psychomotor and affective skills in nursing. Most studies obtained good methodological quality in their content validity process.

Principais complicações da covid-19 e implicações futuras: revisão integrativa / Principales complicaciones del covid-19 y futuras implicaciones: revisión integrativa / Main complications of covid-19 and future implications: integrative review

Objetivo: sintetizar as evidências científicas quanto às principais complicações da COVID-19, ocorridas durante o período de convalescença, em pacientes adultos e idosos. Método: revisão integrativa, realizada entre março e maio de 2021 nas fontes: US National Library of Medicine National Institutes Database Search of Health, Literatura Latino Americana e do Caribe em Ciências da Saúde, Scopus, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Excerpta Médica Database. Utilizou-se o Rayyanna seleção e a análise de conteúdo. Resultados: identificaram-se 833 artigos, destes, nove compuseram a amostra. As complicações são neurológicas, respiratórias, psiquiátricas, cardiovasculares, nutricionais e musculares. Conclusão: as complicações mais preponderantes da COVID-19 são caracterizadas pelos acometimentos respiratórios e neurológicos, as quais implicam no aumento de pacientes descompensados nos serviços de saúde paraprocedimentos eletivos, aumento dos gastos públicos e na incidência de parada cardíaca extra-hospitalar.

Objective: to synthesize the scientific evidence regarding the main complications of COVID-19, occurring during the period of convalescence, in adult and elderly patients. Method: integrative review, conducted between March and May 2021 in sources: US National Library of Medicine National Institutes Database Searchof Health, Latin American and Caribbean Literature in Health Sciences, Scopus, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Medical Excerpt Database. Rayyan was used in the selection and content analysis. Results: 833 articles were identified, of which nine comprised the sample. The complications are neurological, respiratory, psychiatric, cardiovascular, nutritional and muscular. Conclusion: the most preponderant complications of COVID-19 are characterized by respiratory and neurological disorders, which imply an increase in decompensated patients in health services, for elective procedures, an increase in public spending and an incidence of out-of-hospital cardiac arrest.

Objetivo: sintetizar la evidencia científica sobre las principales complicaciones de la COVID-19, ocurridas durante el período de convalecencia, en pacientes adultos y ancianos. Método: revisión integrativa, realizada entre marzo y mayo de 2021 en las fuentes: US National Library of Medicine National Institutes Database Search of Health, Literatura Latinoamericana y del Caribe en Ciencias de la Salud, Scopus, Cumulative Index to Nursing and Allied Health Literature, Web de Ciencias, Base de datos Excerpta Médica. Utilizou-se o Rayyan na seleção y análise de conteúdo. Resultados: se identificaron 833 artículos, de los cuales nueve conformaron la muestra. Las complicaciones son neurológicas, respiratorias, psiquiátricas, cardiovasculares, nutricionales y musculares. Conclusión: las complicaciones más prevalentes de la COVID-19 se caracterizan por afectaciones respiratorias y neurológicas, lo que implica un aumento de pacientes descompensados en los servicios de salud para procedimientos electivos, aumento del gasto público y la incidencia de paros cardíacos extrahospitalarios.

Simulação clínica em enfermagem à luz da aprendizagem experiencial: revisão sistemática / Simulación clínica en enfermería a la luz del aprendizaje experiencial: revisión sistemática / Clinical simulation in nursing in the light of experiential learning: systematic review

Objetivo: identificar a efetividade da simulação clínica baseada na aprendizagem experiencial, como referencial teórico-metodológico, em comparação com diferentes estratégias pedagógicas no ensino em enfermagem. Método: revisão sistemática, realizada nas fontes Medical Literature Analysis and Retrieval System Online; Scopus, Web of Science, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Cumulative Index to Nursing and Allied Health Literaturee Educational Resources Information Center. Utilizou-se instrumentos de avaliação do percuso metodológico. Resultados: identificaram-se 268 estudos, e quatro compuseram a amostra. Comparou-se a aprendizagem experiencial na simulação com o estudo de caso; aula expositiva; resolução de problemas e a simulação sem referencial. Os estudos obtiveram boa qualidade pelo instrumento do JBI e moderada pelo Medical Education Research Study Quality Instrument. Conclusão: a aprendizagem experiencial sinaliza efetividade para o ensino em enfermagem baseado em simulação.

Objective: to identify the effectiveness of clinical simulation based on experiential learning, as a theoretical-methodological framework, in comparison with different pedagogical strategies in nursing education. Method: systematic review, performed in the Medical Literature Analysis and Retrieval System Online sources; Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature, Cumulative Index to Nursing and Allied Health Literature, and Educational Resources Information Center. Instruments for evaluating the methodological path were used. Results: 268 studies were identified, and four composed the sample. Experiential learning, in simulation, was compared with the case study; expository class; problem solving and benchmarkless simulation. The studies obtained good quality by the instrument of JBI and moderated by the Medical Education Research Study Quality Instrument. Conclusion: experiential learning signals effectiveness for simulation-based nursing education.

Objetivo: identificar la efectividad de la simulación clínica basada en el aprendizaje experiencial, como marco teórico-metodológico, en comparación con diferentes estrategias pedagógicas en la educación en enfermería. Método: revisión sistemática, realizada en las fuentes Medical Literature Analysis and Retrieval System Online; Scopus, Web of Science, Literatura Latinoamericana y del Caribe en Ciencias de la Salud, Cumulative Index to Nursing and Allied Health Literaturey Educational Resources Information Center. Se utilizaron instrumentos para evaluar la trayectoria metodológica. Resultados: identificaron 268 estudios, y cuatro compusieron la muestra. El aprendizaje experiencial se comparó con estudio de caso; clase expositiva; resolución de problemas y simulación sin referencia. Los estudios obtuvieron buena calidad por el instrumento del JBI y moderados por el Medical Education Research Study Quality Instrument. Conclusión: el aprendizaje experiencial señala la eficacia de la educación en enfermería basada en simulación.