Agranular frontal cortical microcircuit underlying cognitive control in macaques.

The error-related negativity and an N2-component recorded over medial frontal cortex index core functions of cognitive control. While they are known to originate from agranular frontal areas, the underlying microcircuit mechanisms remain elusive. Most insights about microcircuit function have been derived from variations of the so-called canonical microcircuit model. These microcircuit architectures are based extensively on studies from granular sensory cortical areas in monkeys, cats, and rodents. However, evidence has shown striking cytoarchitectonic differences across species and differences in the functional relationships across cortical layers in agranular compared to granular sensory areas. In this minireview, we outline a tentative microcircuit model underlying cognitive control in the agranular frontal cortex of primates. The model incorporates the main GABAergic interneuron subclasses with specific laminar arrangements and target regions on pyramidal cells. We emphasize the role of layer 5 pyramidal cells in error and conflict detection. We offer several specific questions necessary for creating a specific intrinsic microcircuit model of the agranular frontal cortex.

The S-REAL study: Spanish real-world data on unresectable stage III NSCLC patients treated with durvalumab after chemoradiotherapy.

OBJECTIVES: The S-REAL study aimed to assess the effectiveness of durvalumab as consolidation therapy after definitive chemoradiotherapy (CRT) in a real-world cohort of patients with locally advanced, unresectable stage III non-small cell lung cancer (LA-NSCLC) included in a Spanish early access program (EAP). METHODS: In this multicentre, observational, retrospective study we analysed data from patients treated in 39 Spanish hospitals, who started intravenous durvalumab (10 mg/kg every 2 weeks) between September 2017 and December 2018. The primary endpoint was progression-free survival (PFS). Secondary endpoints included patient characterization and adverse events of special interest (AESI). RESULTS: A total of 244 patients were followed up for a median of 21.9 months [range 1.2-34.7]. Median duration of durvalumab was 45.5 weeks (11.4 months) [0-145]. Median PFS was 16.7 months (95% CI 12.2-25). No remarkable differences in PFS were observed between patients with programmed cell death-ligand 1 (PD-L1) expression ≥ 1% or < 1% (16.7 versus 15.6 months, respectively). However, PFS was higher in patients who had received prior concurrent CRT (cCRT) versus sequential CRT (sCRT) (20.6 versus 9.4 months). AESIs leading to durvalumab discontinuation were registered in 11.1% of patients. CONCLUSIONS: These results are in line with prior published evidence and confirm the benefits of durvalumab in the treatment of LA-NSCLC patients in a real-world setting. We also observed a lower incidence of important treatment-associated toxicities, such as pneumonitis, compared with the pivotal phase III PACIFIC clinical study.

Cortical origin of theta error signals.

A multi-scale approach elucidated the origin of the error-related-negativity (ERN), with its associated theta-rhythm, and the post-error-positivity (Pe) in macaque supplementary eye field (SEF). Using biophysical modeling, synaptic inputs to a subpopulation of layer-3 (L3) and layer-5 (L5) pyramidal cells (PCs) were optimized to reproduce error-related spiking modulation and inter-spike intervals. The intrinsic dynamics of dendrites in L5 but not L3 error PCs generate theta rhythmicity with random phases. Saccades synchronized the phases of the theta-rhythm, which was magnified on errors. Contributions from error PCs to the laminar current source density (CSD) observed in SEF were negligible and could not explain the observed association between error-related spiking modulation in L3 PCs and scalp-EEG. CSD from recorded laminar field potentials in SEF was comprised of multipolar components, with monopoles indicating strong electro-diffusion, dendritic/axonal electrotonic current leakage outside SEF, or violations of the model assumptions. Our results also demonstrate the involvement of secondary cortical regions, in addition to SEF, particularly for the later Pe component. The dipolar component from the observed CSD paralleled the ERN dynamics, while the quadrupolar component paralleled the Pe. These results provide the most advanced explanation to date of the cellular mechanisms generating the ERN.

Nutritional Care for Institutionalized Persons with Dementia: An Integrative Review.

BACKGROUND: Older people are at risk of malnutrition, especially when they suffer from cognitive impairment. Guidelines that orient nursing care in this regard need to be updated. The aim of this review is to address the best available evidence on interventions that can benefit nutritional nursing care for institutionalized older adults with dementia. METHODS: Integrative review using the Dimensions and Eureka search engines, and the PubMed, Embase, Scielo, CINAHL, and ScienceDirect databases. We searched from the year 2015 through to 2021. We employed the MMAT guidelines for mixed, qualitative, and quantitative studies, and the PRISMA, CASP, and JBI guidelines to value the reviews. RESULTS: A total of 55 studies met the inclusion criteria. The best available evidence to support nutritional nursing care for institutionalized older adults with dementia highlights several aspects related to the assessment and caring interventions that are focused on people with dementia, their caregivers, and their context. CONCLUSIONS: Both the assessment and nutritional care interventions for older people with dementia should consider the patient-caregiver dyad as the subject of care and understand the context as a fundamental part of it. The analysis of the context should look further than the immediate environment.

Effects of the discharge plan on the caregiving load of people with chronic disease: Quasi-experimental study.

OBJECTIVE: To determine the effect of an anticipated care plan, structured around hospital discharge (PC-AH-US), regarding the caregiving load of people with NTCD residing in Colombia, 2019-2021. METHOD: This is a quasi-experimental study with pre- and post-intervention measurements. It includes 1170 participants who represented 585 chronic disease patient-caregiver pairs. We compared the PC-AH-US intervention, to the regular intervention. RESULTS: The PC-AH-US intervention group showed better results in all dimensions when compared to the regular intervention group: Awareness 8.7 (SD: 0.7) and 6.8 (SD: 1.7); Acknowledgement of their unique conditions 11.3 (SD: 1.0) and 9.4 (SD: 1.8); Capacity to fulfill care tasks 8.8 (SD: 0.7) and 7.5 (SD: 1.5); Wellbeing 11.4 (SD: 0.90) and 8.87 (SD: 2.3); Anticipation 5.88 (SD: 0.4) and 4.7 (SD: 1.1) and Support Network 11.4 (SD: 0.8) and 9.9 (SD: 2.5). CONCLUSION: The PC-AH-US intervention group showed a statistically significant decrease in the caregiving load for people with NTCD (p < 00). There were no significant institutional differences in readmissions or deaths. The PC-AH-US intervention backs institutional policies meant to care for people with NTCD.

Development of a Professional Practice Nursing Model for a University Nursing School and Teaching Hospital: A nursing methodology research.

AIM: The aim of the study was to describe the process of developing a Professional Practice Model by a Nursing School and Nursing Department of University Hospital. DESIGN AND METHOD (S): This is a descriptive nursing methodology research, developed along three stages: preliminary, empirical and validation. The empirical phase used qualitative and quantitative methodology. 28 teachers from the nursing school and nurses from the hospital participated. We defined the elements of the nursing meta-paradigm from narratives and focus group. Then, we extracted propositions regarding the nature of nursing from the relationship between the meta-paradigm elements, which concluded in the core elements. RESULTS: The core elements of this nursing professional practice model are nursing seeks the well-being of the person, family or group; nursing is total and global, person-centred; nursing is compassionate; nursing entails up-to-date, quality scientific, technical and human competencies; nursing is delivered in a teaching hospital environment, with a Christian ethical perspective.

Indicadores de cuidado de enfermería hospitalario orientados por modelo de práctica profesional / Indicators of hospital nursing care guided by a professional practice model / Indicadores de cuidados de enfermagem hospitalares orientados por um modelo de prática profissional

Objetivo: Diseñar y validar indicadores de cuidado de enfermería a partir de la orientación de un modelo de práctica profesional en un hospital universitario de Colombia, 2018 ­ 2021. Material y Método: Este es un estudio cuantitativo bajo el abordaje de investigación denominado "Investigación metodológica en enfermería" desarrollado en cinco fases que incluyen: 1) revisión de los procesos de calidad institucional; 2) revisión de literatura sobre indicadores hospitalarios de enfermería; 3) Propuesta de indicadores con orientación del modelo institucional de práctica profesional de enfermería; 4) Validación de los indicadores mediante criterio de expertos; 5) Evaluación de la efectividad preliminar en campo durante 8 meses. Resultados: A partir de las tres primeras fases del estudio se plantean veintiún indicadores de cuidado de enfermería que responden al interés institucional y a la mejor evidencia disponible. Su validación refleja alta comprensibilidad y validez facial, una razón de validez de contenido (RVC) entre .74 y .96, y un índice de validez de contenido (IVC) de 0.83. Conclusión: Los indicadores de cuidado de enfermería diseñados bajo la orientación de un modelo de práctica profesional y validados mediante el criterio de expertos, mostraron una efectividad preliminar positiva para medir y mejorar los procesos y resultado del cuidado de enfermería de acuerdo con las personas implicadas en la recepción y suministro de dicho cuidado. Estos indicadores pueden ser empleados en hospitales con plataformas estratégicas similares

Optimization and In Vitro Digestion of a Guava (Psidium guajava), Mamey (Pouteria sapota) and Stevia (Stevia rebaudiana) Functional Beverage.

Guava and mamey are phenolic- and carotenoid-rich fruits with potential health benefits, but are minimally used as ingredients in functional beverages. The objectives of the present work are to optimize the content of guava and mamey pulps and a stevia solution in the formulation of a functional beverage with high content of bioactive compounds and sensory acceptability using a mixture design analysis, and to analyze its composition after in vitro digestion. The optimized formulation (17.77 and 19.23 g of guava and mamey pulps, respectively; 1% stevia solution) yielded a beverage with 418.21 mg gallic acid equivalents (GAE)/100 mL and 0.20 mg ß-carotene/100 mL, and an antioxidant capacity of 213.58, 78.90 and 234.03 mg Trolox equivalents (TE)/100 mL using three methodologies. The mathematical model developed was significant (p < 0.05), according to R2 values between 0.70 and 0.75. α- and ß-carotene were quantified during the oral phase of in vitro digestion. Gallic, p-coumaric, ferulic and chlorogenic acids were also identified. The beverage had a general acceptability of 6.72. We conclude that the mathematical model developed was a good predictor of the experimental data and that the optimized beverage contained high bioactive concentrations (phenolics and carotenoids) and was well-accepted by potential consumers.

Maternal diet in pregnancy and acute leukemia in infants: a case-control study in Mexico City.

Introduction: Epidemiological studies around the world on acute leukemia (AL) and risk factors in infants are scarce. Infant AL has been proposed to originate in utero, which facilitates its study by establishing a short exposure time in pregnant women to environmental and dietary factors that could contribute to the risk of or protection against leukemia. We hypothesized that maternal diet during pregnancy may be an important factor involved in AL in offspring. Methods: We conducted a hospital-based case-control study from 2010 to 2019 on maternal diet during pregnancy in nine high-specialty public hospitals of different health institutions that diagnose and offer treatment to children with AL in Mexico City. Cases (n=109) were children ≤24 months of age with de novo diagnosis of AL, and controls (n=252) were children obtained in hospitals from second-level medical care matched for age, sex, and health institution. Maternal diet during pregnancy was obtained by a semiquantitative food frequency questionnaire. Unconditional logistic regression models were used to assess the association between food groups and infant AL. Potential confounders were assessed by constructing directed acyclic graphs (DAGs) with Dagitty software in which adjusted options were identified for the construction of unconditional logistic regression models. Results: Cases were slightly predominantly female (52.3%). The years of education of the mother in cases and controls was 0-9 on average, and those who reported smoking cigarettes and consuming alcohol during pregnancy did so at a low frequency. Regarding the mother's diet, the main findings were that the consumption of allium vegetables during pregnancy was inversely associated with AL for medium and high consumption (OR=0.26, 95% CI 0.14-0.46; P-trend< 0.001). In contrast, the high consumption of high-fat dairy products had a positive association with AL (OR=2.37, 95% CI 1.30-4.34; P-trend<0.001). No association was found between consumption of topoisomerase II inhibitor foods during pregnancy and AL. Conclusion: The results suggest that maternal intake during pregnancy of allium vegetables, specifically garlic, is inversely associated with the development of AL in children ≤24 months old. On the other hand, consumption of high-fat dairy products is positively associated with AL in children ≤24 months old.

NK cells with decreased expression of multiple activating receptors is a dominant phenotype in pediatric patients with acute lymphoblastic leukemia.

NK cells have unique attributes to react towards cells undergoing malignant transformation or viral infection. This reactivity is regulated by activating or inhibitory germline encoded receptors. An impaired NK cell function may result from an aberrant expression of such receptors, a condition often seen in patients with hematological cancers. Acute lymphoblastic leukemia (ALL) is the most common pediatric cancer worldwide and NK cells have emerged as crucial targets for developing immunotherapies. However, there are important gaps concerning the phenotype and behavior of NK cells during emergence of ALL. In this study we analyze the phenotype and function of NK cells from peripheral blood in pediatric patients with ALL at diagnosis. Our results showed that NK cells exhibited an altered phenotype highlighted by a significant reduction in the overall expression and percent representation of activating receptors compared to age-matched controls. No significant differences were found for the expression of inhibitory receptors. Moreover, NK cells with a concurrent reduced expression in various activating receptors, was the dominant phenotype among patients. An alteration in the relative frequencies of NK cells expressing NKG2A and CD57 within the mature NK cell pool was also observed. In addition, NK cells from patients displayed a significant reduction in the ability to sustain antibody-dependent cellular cytotoxicity (ADCC). Finally, an aberrant expression of activating receptors is associated with the phenomenon of leukemia during childhood.

Lesser-Consumed Tropical Fruits and Their by-Products: Phytochemical Content and Their Antioxidant and Anti-Inflammatory Potential.

Açaí, lychee, mamey, passion fruit and jackfruit are some lesser-consumed tropical fruits due to their low commercial production. In 2018, approximately 6.8 million tons of these fruits were harvested, representing about 6.35% of the total world production of tropical fruits. The present work reviews the nutritional content, profile of bioactive compounds, antioxidant and anti-inflammatory capacity of these fruits and their by-products, and their ability to modulate oxidative stress due to the content of phenolic compounds, carotenoids and dietary fiber. Açaí pulp is an excellent source of anthocyanins (587 mg cyanidin-3-glucoside equivalents/100 g dry weight, dw), mamey pulp is rich in carotenoids (36.12 mg ß-carotene/100 g fresh weight, fw), passion fruit peel is rich in dietary fiber (61.16 g/100 dw). At the same time, jackfruit contains unique compounds such as moracin C, artocarpesin, norartocarpetin and oxyresveratrol. These molecules play an important role in the regulation of inflammation via activation of mitogen-activated protein kinases (including p38, ERK and JNK) and nuclear factor κB pathways. The properties of the bioactive compounds found in these fruits make them a good source for use as food ingredients for nutritional purposes or alternative therapies. Research is needed to confirm their health benefits that can increase their marketability, which can benefit the primary producers, processing industries (particularly smaller ones) and the final consumer, while an integral use of their by-products will allow their incorporation into the circular bioeconomy.

Preliminary Effectiveness of a Strategy to Promote Healthy Lifestyle Habits in Schoolchildren.

PURPOSE: To measure the preliminary effectiveness of a strategy to promote healthy lifestyle habits in schoolchildren, aged 6 to 12 years, living in the Andean region of Colombia, 2018-2021. DESIGN AND METHODS: This is a Nursing Methodological Research, developed in phases: (1) Context and schoolchildren characterization; (2) Strategy design guided by the Whittemore and Grey criteria and the Bronfenbrenner ecological conceptual model; (3) Strategy validation with 11 experts; (4) Trial to evaluate preliminary effectiveness. We applied the strategy in seven different schools with the educational community including 955 schoolchildren between 6 and 12 years of age, 551 parents, 130 teachers and 7 members of the food staff. RESULTS: Our health promotion strategy "Prosalud" has five components: citizenship feeding and nutrition, physical activity, and rest; environment protection, and directing one's own life. It includes all the participants of the educational community. CONCLUSIONS: According to experts, the health promotion strategy "Prosalud" is valid to help promoting healthy lifestyle habits among schoolchildren. This strategy demonstrates its preliminary effectiveness in a group of school children from 6 to 12 years of age, their parents, teachers, and school food staff, in the Andean region of Colombia.

Resolving the mesoscopic missing link: Biophysical modeling of EEG from cortical columns in primates.

Event-related potentials (ERP) are among the most widely measured indices for studying human cognition. While their timing and magnitude provide valuable insights, their usefulness is limited by our understanding of their neural generators at the circuit level. Inverse source localization offers insights into such generators, but their solutions are not unique. To address this problem, scientists have assumed the source space generating such signals comprises a set of discrete equivalent current dipoles, representing the activity of small cortical regions. Based on this notion, theoretical studies have employed forward modeling of scalp potentials to understand how changes in circuit-level dynamics translate into macroscopic ERPs. However, experimental validation is lacking because it requires in vivo measurements of intracranial brain sources. Laminar local field potentials (LFP) offer a mechanism for estimating intracranial current sources. Yet, a theoretical link between LFPs and intracranial brain sources is missing. Here, we present a forward modeling approach for estimating mesoscopic intracranial brain sources from LFPs and predict their contribution to macroscopic ERPs. We evaluate the accuracy of this LFP-based representation of brain sources utilizing synthetic laminar neurophysiological measurements and then demonstrate the power of the approach in vivo to clarify the source of a representative cognitive ERP component. To that end, LFP was measured across the cortical layers of visual area V4 in macaque monkeys performing an attention demanding task. We show that area V4 generates dipoles through layer-specific transsynaptic currents that biophysically recapitulate the ERP component through the detailed forward modeling. The constraints imposed on EEG production by this method also revealed an important dissociation between computational and biophysical contributors. As such, this approach represents an important bridge between laminar microcircuitry, through the mesoscopic activity of cortical columns to the patterns of EEG we measure at the scalp.

Low Prevalence of ETV6::RUNX1 Fusion Gene in a Hispanic Population.

ETV6::RUNX1 is a genetic rearrangement of good prognosis in children with acute lymphoblastic leukemia (ALL). In Mexico, its prevalence is low in comparison with Caucasian populations. We developed a novel TaqMan one-step RT-qPCR approach to assess the prevalence of four genetic rearrangements in a cohort of Hispanic children with ALL from Mexico City. The prevalence of common fusion gene transcripts was as follows: TCF3::PBX1 7.7%; BCR::ABL1p 190 3.3%; and KMT2A::AFF1 2.8%, and ETV6::RUNX1was observed with low prevalence (10.5%) in comparison to that reported for developed countries. This is consistent with previous findings on Mexican children with ALL and similar to those reported on children from Hispanic populations. The confirmation of a low prevalence of ETV6::RUNX1 in children of a Hispanic origin represents an advancement in the description of genetic factors of ALL in these populations.

Rapid Population-Based Surveillance of Prenatal and Postpartum Experiences During Public Health Emergencies, Puerto Rico, 2016‒2018.

The Pregnancy Risk Assessment Monitoring System-Zika Postpartum Emergency Response study, implemented in Puerto Rico during the Zika virus outbreak (2016-2017) and after Hurricanes Irma and María (2017-2018), collected pregnancy-related data using postpartum hospital-based surveys and telephone follow-up surveys. Response rates of 75% or more were observed across five study surveys. The study informed programs, increased the Puerto Rico Department of Health's capacity to conduct maternal‒infant health surveillance, and demonstrated the effectiveness of this methodology for collecting data during public health emergencies. (Am J Public Health. 2022;112(4):574-578. https://doi.org/10.2105/AJPH.2021.306687).

Tipificación del virus del papiloma humano en lesiones de cavidad bucal. Estudio desarrollado en los servicios de estomatología, Facultad de Odontología de la Universidad de Cartagena y el Hospital Alemán de Buenos Aires / Typing of human papillomavirus in oral cavity lesions in stomatology services at the Faculty of Dentistry of the Universidad de Cartagena and the Hospital Alemán de Buenos Aires

Objetivo: describir las características clínicas epidemiológicas en cavidad bucal de la infección por VPH y la asociación con su tipificación molecular. Métodos: se realizó un estudio analítico de corte transversal en 52 pacientes que acudieron a los servicios de estomatología en la Facultad de Odontología de la Universidad de Cartagena y al Hospital Alemán de Buenos Aires, a quienes se les abrió historia clínica y se les practicó prueba de PCR en tiempo real para la tipificación del VPH. Resultados: el análisis de los datos se efectuó a través de frecuencia y porcentaje. En cuanto a la parte inferencial, se usó la prueba chi cuadrado con un nivel de confianza P<0,05. De los 52 pacientes analizados, 67.3% eran mujeres con un predominio de edad entre los 50-59 años. El serotipo mayormente encontrado fue VPH 6, seguido del VPH 11 y otros tipos de VPH. La lesión elemental más preponderante fue la verrugosidad y la ubicación de predominio, la lengua. Conclusión: las infecciones por VPH se manifiestan frecuentemente en cavidad bucal con verrugosidades en lengua. Su estudio epidemiológico, incluyendo su tipificación, permitiría encontrar lesiones características para un diagnóstico, seguimiento y tratamiento oportuno.

Objective: Analyze the most common epidemiological clinical characteristics of HPV infection in the oral cavity and its molecular typing. Methods: An observational, analytical, cross-sectional study was carried out in 52 patients who attended the stomatology services of the Universidad de Cartagena and the Hospital Alemán de Buenos Aires; a complete clinical history was carried out, including stomatological examination, biopsy, pathological study and real-time PCR test for HPV typing. Results: The data analysis was carried out by means of frequency and percentage. Regarding the inferential part, the chi-square test was used with a confidence level of P <0.05. Of the 52 studied patients 67.3% were women; with a predominant age between 50-59 years. The most common serotype found was HPV 6, followed by HPV 11 and other types of HPV. The predominant lesion was the wart and the predominant location, the tongue. Conclusion: The HPV infections are frequently manifested in oral cavity with Verrugosities in language and its typing, would allow a timely diagnosis of pharynx cancer.

Modelo de práctica de enfermería para fortalecer la capacidad de cuidado de los pacientes y sus cuidadores / Modelo de prática de enfermagem para fortalecer a capacidade de cuidado dos pacientes e seus cuidadores / Nursing practice model to strengthen the capacity of care of patients and their caregivers

En la Fundación Cardioinfantil Instituto de Cardiología (FCI -IC), que es un HospitalUniversitario colombiano de alta complejidad, se identificó que el trabajo en alianza docencia –asistencia para el desarrollo de un modelo de práctica de enfermería podría orientar mejor esteejercicio en sus diferentes roles. Con el objetivo de describir el desarrollo conceptual logrado, elpresente artículo documenta la investigación metodológica en enfermería que incluyó cuatrofases: la revisión de antecedentes institucionales en el empleo de modelos de enfermería; larevisión de literatura mundial sobre los modelos de práctica de enfermería; la construccióncolectiva del modelo de práctica de enfermería; y la validación interna y externa de dicho modelo.El Modelo de práctica de enfermería para fortalecer la capacidad de cuidado de los pacientes ysus cuidadores, FCI – IC, responde a lecciones intra y extrainstitucionales aprendidas; sudesarrollo es coherente con el estado del arte y su contenido refleja tanto el consenso institucionalcomo la derivación teórica lograda a partir de la identificación de los conceptos paradigmáticos ysupuestos de cuidado, ajustados durante la validación. Este modelo ha permitido mayorapropiación y liderazgo de enfermería en la práctica, a la que se espera aportar indicadores quepermitan evaluar los diferentes roles.(AU)

In the Fundación Cardioinfantil Institute of Cardiology (FCI -IC), which is a highcomplexity Colombian University Hospital, it was identified that the work between academicsand clinical nurses for the development of a nursing practice model, could improve nursing in itsdifferent roles. In order to describe the conceptual development achieved, this article documentsthe nursing methodology research that included four phases: the review of institutionalbackgrounds in the use of conceptual models of nursing; the review of world literature on nursingpractice models; and the collective construction of the nursing practice model; and the internaland external validation of the developed model. The Practice Nursing Model to strengthen thecaring capacity of patients and their caregivers FCI - IC responds to lessons learned internallyand externally; its development is consistent with the state of the art and its content reflects boththe institutional consensus and the theoretical derivation achieved from the identification of theparadigmatic concepts and care assumptions, adjusted during the validation. This model hasallowed greater appropriation and nursing leadership in practice. We expect to provide indicatorsto evaluate and improve the different roles of nursing in the near future.(AU)

Na Fundación Cardioinfantil Instituto de Cardiología (FCI -IC), que é um HospitalUniversitário colombiano de alta complexidade, identificou-se que o trabalho em uma aliançadocente-assistencial para o desenvolvimento de um modelo de prática de enfermagem poderiaorientar melhor este exercício em seus diferentes papéis. A fim de descrever o desenvolvimentoconceitual alcançado, este artigo documenta a pesquisa metodológica de enfermagem que incluiuquatro fases: a revisão de fundamentos institucionais no uso de modelos conceituais de enfermagem; a revisão da literatura mundial sobre modelos de prática de enfermagem; e aconstrução coletiva do modelo de enfermagem; e a validação interna e externa do referido modelo.O Modelo de prática de enfermagem para fortalecer a capacidade assistencial do pacientes ecuidadores FCI - CI responde às lições aprendidas interna e externamente; seu desenvolvimentoé consistente com o estado da arte e seu conteúdo reflete tanto o consenso institucional quanto aderivação teórica alcançada a partir da identificação dos conceitos paradigmáticos e pressupostosde cuidado, ajustados durante a validação. Este modelo permitiu maior apropriação e liderança deenfermagem na prática, o que se espera que forneça indicadores para avaliar os diferentes papéis.(AU)

Massive QTL analysis identifies pleiotropic genetic determinants for stress resistance, aroma formation, and ethanol, glycerol and isobutanol production in Saccharomyces cerevisiae.

BACKGROUND: The brewer's yeast Saccharomyces cerevisiae is exploited in several industrial processes, ranging from food and beverage fermentation to the production of biofuels, pharmaceuticals and complex chemicals. The large genetic and phenotypic diversity within this species offers a formidable natural resource to obtain superior strains, hybrids, and variants. However, most industrially relevant traits in S. cerevisiae strains are controlled by multiple genetic loci. Over the past years, several studies have identified some of these QTLs. However, because these studies only focus on a limited set of traits and often use different techniques and starting strains, a global view of industrially relevant QTLs is still missing. RESULTS: Here, we combined the power of 1125 fully sequenced inbred segregants with high-throughput phenotyping methods to identify as many as 678 QTLs across 18 different traits relevant to industrial fermentation processes, including production of ethanol, glycerol, isobutanol, acetic acid, sulfur dioxide, flavor-active esters, as well as resistance to ethanol, acetic acid, sulfite and high osmolarity. We identified and confirmed several variants that are associated with multiple different traits, indicating that many QTLs are pleiotropic. Moreover, we show that both rare and common variants, as well as variants located in coding and non-coding regions all contribute to the phenotypic variation. CONCLUSIONS: Our findings represent an important step in our understanding of the genetic underpinnings of industrially relevant yeast traits and open new routes to study complex genetics and genetic interactions as well as to engineer novel, superior industrial yeasts. Moreover, the major role of rare variants suggests that there is a plethora of different combinations of mutations that can be explored in genome editing.

Analytics and Lean Health Care to Address Nurse Care Management Challenges for Inpatients in Emerging Economies.

PURPOSE: Prescriptive and predictive analytics and artificial intelligence (AI) provide tools to analyze data with objectivity. In this paper, we provide an overview of how these techniques can improve nursing care, and we detail a quantitative model to afford managerial insights about care management in a Hospital in Colombia. Our main purpose is to provide tools to improve key performance indicators for the care management of inpatients which includes the nurse workload. METHODS: The optimal nurse-to-patient assignment problem is addressed using analytics, lean health care, and AI. Also, we propose a new mathematical model to optimize the nurse-to-patient assignment decisions considering several variables about the patient state such as the Barthel index, their risks, the complexity of the care, and the mental state. FINDINGS: Our results show that there are several processes inherent to compassionate nursing care that can be improved using technology. By using data analytics, we can also provide insights about the high variability of the care requirements and, by using models, find nurse-to-patient assignments that are nearly perfectly balanced. CONCLUSIONS: We illustrated this improvement with a pilot test that makes the equitable distribution of nursing workload the functionality of this strategy. The findings can be useful in highly complex hospitals in Latin America. CLINICAL RELEVANCE: The proposed model presents an opportunity to make near perfectly balanced nurse-to-patient assignments according to the number of patients and their health conditions using technology.

Nursing Care at the Service of Life: A model including charity, quality, and leadership.

BACKGROUND: Nursing professional practice models allow the focus on care and qualification of hospital service by articulating the theory to the practice of nursing care with the final purpose of improving the patient's and family caregivers' quality of life. OBJECTIVE: To describe the model "Nursing care at the service of life," built and validated in a Colombian clinic, 2019. METHOD: A Nursing Methodology Research developed in four consecutive steps intended to identify the need to have a theoretical framework; to build it and validate it in a collective way that included the different members of the clinic nursing staff. RESULTS: The main concepts and articulated assumptions of the nursing practice model were described. The model will help the nursing staff to achieve the institutional mission. CONCLUSIONS: The professional practice Model "Nursing care at the service of life" reflects the nursing profession's charity, quality, and leadership, as a hospital care axis. The institution's nursing staff were able to identify themselves in the model's approach, also the expert criteria endorsed the construction process and content. The validation process done with the nurse's staff demonstrates that this model is accepted and useful to guide the nursing caring practices within the clinic.