Anaphylactic Shock After Cervical Conization Hemostasis With a Packing Soaked in Monsel's Solution.

Anaphylactic shock is a life-threatening medical emergency, and its successful approach depends on early recognition and treatment. We present a case report of a 54-year-old female, with the American Society of Anesthesiology (ASA) Physical Status Classification III, admitted for cervical conization. She presented with known allergies to paracetamol, diclofenac, and nimesulide, and a history of nickel contact dermatitis, with no reports of complicated anesthesia. During conization, adrenaline was infiltrated in the cervix, and hemostasis was performed with packing soaked in Monsel's solution. The immediate postoperative period in the post-anesthesia care unit was uneventful, and no drugs were administered during this period. Three hours after discharge to the ward, the patient had progressive dyspnea with desaturation and maculopapular exanthema. Anesthesia medical emergency was activated. Upon arrival of the emergency team, the patient presented: marked edema of the lips and tongue, respiratory distress, SpO2 82% (under non-rebreathing high concentration oxygen mask), audible vesicular murmur but diminished in all lung fields (without bronchospasm), blood pressure of 60/40 mmHg, increased capillary refill time (4-5 seconds), Glasgow Coma Scale score of 14, as well as generalized maculopapular exanthema and eyelid edema. Gas analysis revealed the following: pH 7.36, pO2 150, pCO2 33, HCO3 22, and lactate 2.2 mmol/L. Anaphylactic shock was immediately diagnosed without an identified causative agent. Intramuscular adrenaline (0.5mg), endovenous hydrocortisone (200 mg), clemastine (2 mg), and profuse fluid therapy were administered. There was an initial slight improvement followed by subsequent worsening. Additional administration of 0.5 mg intramuscular adrenaline and endovenous methylprednisolone (125 mg) provided similar results. Considering that no other drugs were administered in the ward, the emergency team and the attending gynecologist assumed an association between nickel allergy and the chemical composition of Monsel's solute. Thus, it was decided to remove the packing soaked in Monsel's solute from the vaginal cavity and wash it with saline solution. After removing the packing and further administration of 0.5 mg intramuscular adrenaline, there was progressive improvement in the blood pressure and SpO2. Tryptase samples collected one hour later were increased (23.9 ug/L; normal: <11.4 ug/L). The patient was shifted to the intensive care unit for surveillance, from which she was discharged after 2 days, with scheduled immunoallergology consultation, which is waiting. This case highlights the importance of causative agent identification as a key point for anaphylactic shock resolution, as well as a multidisciplinary discussion among professionals.

GC-MS Silylation Derivative Method to Characterise Black BIC® Ballpoint 2-Phenoxyethanol Ratio Evaporation Profile-A Contribution to Ink Ageing Estimation.

One of the major challenges in forensic document analysis is estimating the age of ink deposition on a manually written document. The present work aims to develop and optimise a methodology, based on the evaporation of 2-phenoxyethanol (PE) over time, that can contribute to ink age estimation. A black BIC® Crystal Ballpoint Pen was purchased in a commercial area, and ink deposition began in September 2016 over 1095 days. For each ink sample, 20 microdiscs were subjected to n-hexane extraction in the presence of an internal standard (ethyl benzoate) followed by derivatisation with a silylation reagent. A gas chromatography-mass spectrometry (GC/MS) method was optimised for PE-trimethylsilyl (PE-TMS) to characterise the ageing curve. The developed method presented good linearity between 0.5 and 50.0 µg mL-1, as well as limits of detection and quantification of 0.026 and 0.104 µg mL-1, respectively. It was possible to characterise PE-TMS concentration over time, which reveals a two-phase decay behaviour. First, there was a substantial decline between the 1st and the 33rd day of deposition, followed a by a stabilisation of the signal, which allowed to detect the presence of PE-TMS up to 3 years. Two unknown compounds were also present and allowed to identify three dating time frames for the same ink stroke: (i) between time 0 and 33 days, (ii) between time 34 and 109 days, and (iii) more than 109 days. The developed methodology allowed to characterise the behaviour of PE over time and to establish a relative dating of three-time frames.

Anesthesia management of pediatric subglottic stenosis: A case report.

Subglottic stenosis balloon dilation in selected patients may be an option for the treatment of acquired subglottic stenosis, reducing the need for open surgical approaches or tracheostomy. This treatment is a major challenge to otolaryngologists and anesthesiologists, with an interactive collaboration being critical throughout the procedure. When performed, it is fundamental that otolaryngologists and anesthesiologists communicate properly during the procedure to achieve acceptable results. The complex management of the airway and inherent delicacy and risks of the intervention may be challenging. A proper preparation of the procedure and familiarization with the step-by-step technique could optimize the results and prepare the team to deal with intervening complications. We report a case of management and treatment of an 8-month-old baby with subglottic stenosis proposed for endoscopic balloon dilation treatment from Porto, North of Portugal.

A Pilot Study Testing the Effectiveness of a Mindfulness-Based Program for Portuguese School Children.

Objectives: Research into the effectiveness of mindfulness-based programs (MBPs) in school settings has grown substantially. However, studies in the field are still scarce, present methodological limitations, and fail to examine how children's characteristics influence MBPs' effects. The twofold aim of this study was to analyze the effectiveness of an MBP on children's attention and emotional regulation, writing performance, and school grades, and to evaluate the moderating role of baseline scores, age, gender, and socioeconomic status. Methods: Fifty-seven third graders received the MBP (n = 28) or a health-based program (n = 29), which is the active control group, for 8 weeks. In each week, both programs were composed of two 30-min sessions delivered by psychologists and three 5-min sessions delivered by teachers. Before and after the implementation of the programs, we assessed teacher-rated children's attention and emotional regulation, performance-based attention networks (alerting, orienting, and conflict monitoring), writing performance (handwriting fluency, spelling, and text quality), and school grades in Portuguese, Mathematics, and Social Studies. Results: Compared to the control group, after the program, the mindfulness group displayed higher teacher-rated attention and emotional regulation, as well as better Portuguese, Mathematics, and Social Studies grades. Emotional regulation and alerting baseline scores as well as age were found to moderate the MBP's effects. Conclusions: These findings provide preliminary evidence on the effectiveness of a MBP on children's behavior and school grades. This means that students may benefit from the integration of mindfulness practices into the educational setting as a complement to the school curriculum.

Relations between child self-control, maternal relational frustration, and teacher-child conflict: a longitudinal study with children from dual-earner families.

This longitudinal study follows children from dual-earner families in 4 time-points, covering the early childhood period. We examined the influence of work-family conflict (WFC) on maternal relational frustration (RF) towards the child, and investigated the reciprocal relations among maternal RF, children's self-control (SC), and teacher-child (TC) conflict over time. Participants were 214 children (97 girls; M age = 4.00 years), their mothers, and teachers. Mothers reported their own WFC and RF, whereas teachers reported child SC and T-C conflict. Results from a cross-lagged panel model indicated the experience of WFC positively predicted maternal RF. Maternal RF and T-C conflict were negatively related to the child later SC abilities. Conversely, children who displayed SC difficulties were more likely to experience later maternal RF and T-C conflict. There was evidence supporting the bidirectional effects of child SC and T-C conflict across time. Moreover, maternal RF and T-C conflict were indirectly linked, via child SC. The findings are consistent with a transactional view of development, stressing the importance of contextual factors to the quality of caregiving relationships and highlighting the complex and reciprocal relations between child regulatory competence and the quality of relationships with distinct caregivers.

Effects of a Mindfulness-Based Intervention for Teachers: a Study on Teacher and Student Outcomes.

Objectives: Teachers' stress can affect their occupational health and negatively impact classroom climate and students' well-being. This study aims to evaluate the proximal and distal effects of a mindfulness-based program, specially developed to promote teachers' social-emotional competencies (SEC), across teachers, classroom climates, and students' outcomes. Methods: The study followed a randomized trial design with two data collection points (pretest and posttest). Participants in the experimental group (EG) included 123 elementary school teachers, their 1503 students, and these students' parents (1494), while the control group (CG) comprised 105 elementary school teachers, their 947 students, and these students' parents (913). A mixed data collection strategy was used that included teachers' and students' (self-) report, observational ratings of teachers' classroom behaviors, and parents' reports on students. Results: After the intervention, EG teachers, compared to CG teachers, reported a significant increase in mindfulness and emotional regulation competencies, self-efficacy, and well-being and a decrease in burnout symptoms. Similarly, a significant improvement was found in EG teachers' classroom behaviors related to students' engagement. Additionally, significant improvements were also found in EG students' perceptions of the quality of their teachers' involvement in classroom relationships, self-reported effect, and social competencies perceived by their parents. Conclusions: These findings further the knowledge on the role played by mindfulness-based SEC interventions in reducing teachers' burnout symptoms and cultivating their SEC and well-being, in promoting a nurturing classroom climate and also in promoting the SEC and well-being of students. Supplementary Information: The online version contains supplementary material available at 10.1007/s12671-021-01635-3.

Teacher-child dependency in preschool: links with teacher-child closeness, conflict and children's effortful control.

Dependency is a scarcely investigated dimension of teacher-child (T-C) relationships that can reflect a lack of security and obstruct children's autonomous exploration in the school context. We examined the within- and cross-time associations between T-C dependency, closeness, and conflict, and children's effortful control, an ability related to children's self-regulation. Data were collected during the preschool period at two time-points (T1 and T2) 1-year apart. Participants were 199 children (44% girls, M age = 47.47) attending 46 middle-class preschool classrooms. Results from path analyses indicated that, though marginally significant, there was a positive association between T-C dependency and conflict at T1. At T2, dependency was positively related to both conflict and closeness. Dependency at T1 positively predicted children's effortful control at T2. This study clarifies the interconnection between T-C dependency, closeness and conflict, and the unique contribution of dependency onchildren's effortful control. Findings are discussed considering the socio-cultural meaning of dependency.

The Strengths and Difficulties Questionnaire: An examination of factorial, convergent, and discriminant validity using multitrait-multirater data.

This study examined the factorial, convergent, and discriminant validity of scores on the Strengths and Difficulties Questionnaire (SDQ), a tool for screening children's psychological adjustment. Data were collected from a community sample of 346 children (46% girls, M age = 54.07 months), using teacher, mother, and father reports. Results from confirmatory factor analyses indicated that the SDQ's hypothesized 5-factor structure fit the data well and partial strict measurement invariance was established across raters. Using teachers' reports as reference method, a correlated trait-correlated method minus 1 model (Eid et al., 2008) was fitted to investigate convergent and discriminant validity. The convergent validity of parents' ratings relative to teachers' ratings was modest. Mothers and fathers had a unique perspective on children's behavior above and beyond their partial overlap with teacher reports. Results indicated good discriminant validity between most of the traits measured by the SDQ. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Trajectories of parental engagement in early childhood among dual-earner families: Effects on child self-control.

Parental engagement in positive activities with the child may show significant variation across time, assuming a crucial influence on child development. In dual-earner families, work-family conflict can interfere with parental engagement, with negative consequences for children's behavior. The current study examined the change trajectories of mothers' and fathers' engagement in early childhood, analyzing whether these trajectories are influenced by parents' work-family conflict and whether they predict child behavioral self-control. Data from 156 four-year-old children (67 girls) from dual-earner families were collected annually for 3 consecutive years, through mothers', fathers', and teachers' reports. Results from latent growth curve analysis revealed mothers' engagement remained stable across time while fathers' engagement had a significant increase over time. The negative association between work-family conflict and parental engagement was constant over time both for mothers and fathers. For mothers, initial levels of engagement positively predicted child behavioral self-control. As for fathers, both the initial level and positive change in engagement positively predicted child self-control. These findings emphasize the role of parental engagement in fostering child behavioral adjustment, underlining the need for considering work-family dynamics to understand changes in parental engagement. (PsycINFO Database Record

Classroom Interactions, Dyadic Teacher-Child Relationships, and Self-Regulation in Socially Disadvantaged Young Children.

This study examined the quality of the classroom climate and dyadic teacher-child relationships as predictors of self-regulation in a sample of socially disadvantaged preschool children (N = 206; 52 % boys). Children's self-regulation was observed in preschool at the beginning and at the end of the school year. At the middle of the preschool year, classroom observations of interactions were conducted by trained observers and teachers rated the quality of dyadic teacher-child relationships. Results from multilevel analyses revealed that teacher-child closeness predicted improvements in observed self-regulation skills. Children showed larger gains in self-regulation when they experienced closer teacher-child relationships. Moreover, a moderating effect between classroom instructional quality and observed self-regulation was found such that children with low initial self-regulation skills benefit the most from classrooms with higher classroom quality. Findings have implications for understanding the role of classroom social processes on the development of self-regulation.

The quality of teacher-student interactions: associations with first graders' academic and behavioral outcomes.

The associations between the quality of teacher-student interactions and first grade academic and adaptive behavior outcomes were examined in a study of 106 Portuguese students in 64 first grade classrooms. Students' vocabulary, print concepts, math, and adaptive skills were assessed both at the end of preschool and in first grade. Classrooms were observed in the spring of first grade. After taking into account family risk factors and preschool skills, the quality of teacher-student interactions, particularly in terms of classroom organization, was positively associated with students' first grade vocabulary and print concepts. In addition, classroom quality predicted number identification outcomes differently depending on student skills prior to school entry. Students with lower preschool math skills seemed to benefit from higher quality teacher-student interactions. These findings provide further support for the unique contribution of the quality of teacher-student interactions in first grade and suggest that it may be an important mechanism to improve academic skills.

Use of a bioindicator system in the study of the mutagenetical effects in the neighborhoods of deposits of radioactive waste.

The purpose of the research described in this paper was to analyze the biological mutational effects caused by low doses of ionizing radiation on biological samples placed nearby and around deposits of radioactive waste, as a way of monitoring the environment close to them. In order to do this, the plant Tradescantia pallida was chosen, and through micronuclei tests the sensitivity of the dose/response to bio-monitoring could be observed. The plants were exposed for a period of 24h in previously chosen sites around Brazil, within the proximity of nuclear waste deposits. In each location, three points were chosen for bio-monitoring. The results obtained at these locations showed a small increment in the frequency of micronuclei per cell of the biosensor. From these data, a scale of mutagenesis effects due to low-dose radiation was built up. T. pallida is a good alternative for environmental bio-monitoring in tropical climates, as it is an excellent alternative tool in the studies of the effects of ionizing radiation on the environment.

Purification, characterization and functional analysis of an endo-arabinanase (AbnA) from Bacillus subtilis.

Bacillus subtilis synthesizes at least one arabinanase encoded by the abnA gene that is able to degrade the polysaccharide arabinan. Here, we report the expression in Escherichia coli of the full-length abnA coding region with a His6-tag fused to the C-terminus. The recombinant protein was secreted to the periplasmic space and correctly processed by the E. coli signal peptidase. The substrate specificity of purified AbnA, the physico-chemical properties and kinetic parameters were determined. Functional analysis studies revealed Glu 215 as a key residue for AbnA hydrolytic activity and indicated that in addition to AbnA B. subtilis secretes other enzyme(s) able to degrade linear 1,5-alpha-l-arabinan.