A new standardization for the use of chicken embryo: selection of target from the phage display library and infection.

The filamentous bacteriophage M13KO7 (M13) is the most used in phage display (PD) technology and, like other phages, has been applied in several areas of medicine, agriculture, and in the food industry. One of the advantages is that they can modulate the immune response in the presence of pathogenic microorganisms, such as bacteria and viruses. This study evaluated the use of phage M13 in the chicken embryos model. We inoculated 13-day-old chicken embryos with Salmonella Pullorum (SP) and then evaluated survival for the presence of phage M13 or E. coli ER2738 (ECR) infected with M13. We found that the ECR bacterium inhibits SP multiplication in 0.32 (M13-infected ECR) or 0.44 log UFC/mL (M13-uninfected ECR) and that the ECR-free phage M13 from the PD library can be used in chicken embryo models. This work provides the use of the chicken embryo as a model to study systemic infection and can be employed as an analysis tool for various peptides that M13 can express from PD selection. KEY POINTS: • SP-infected chicken embryo can be a helpful model of systemic infection for different tests. • Phage M13 does not lead to embryonic mortality or cause serious injury to embryos. • Phage M13 from the PD library can be used in chicken embryo model tests.

EPIDEMIOLOGICAL SURVEILLANCE OF CONGENITAL SYPHILIS IN A RETROSPECTIVE COHORT FROM A CAPITAL CITY IN SOUTHERN BRAZIL / Vigilância epidemiológica da sífilis congênita em coorte retrospectiva de uma capital no sul do Brasil

Introduction: Congenital syphilis remains a public health problem. In its surveillance, qualified notification for knowledge of epidemiological indicators is essential. General objective: To describe the incidence of cases and factors for the occurrence of congenital syphilis in live births. Method: Retrospective cohort study of children exposed to syphilis born alive in 2018 in the municipality of Porto Alegre, observing the case definition. The groups were: notified cases and those exposed to syphilis during pregnancy. Analytical descriptive statistics (p≤ 0.05). The strength of the associations was determined by the odds ratio (95% CI). Results: The incidence of congenital syphilis was 20 cases/1000 LB and 5.2 cases/1000 LB considered exposed. There was low maternal schooling (p<0.001) and non-performance of prenatal care (p=0.05) by the mothers of notified cases; a higher proportion of non-reactive VDRL in children at birth (p=0.007) and case closures with treponemal tests (p<0.001) among those exposed. Conclusion: The incidence rate decreased in 2018; maternal schooling associated with poor prenatal care quality are a risk for the occurrence of the outcome; non-reactive VDRL test at birth and monitoring after birth are protective factors for the event.

Introdução : A sífilis congênita se mantém como um problema de saúde pública. Na sua vigilância, a notificação detalhada para conhecimento dos indicadores epidemiológicos são essenciais. Objetivo geral : Descrever a incidência de casos e fatores para ocorrência de sífilis congênita em nascidos vivos. Método : Estudo de coorte retrospectiva de crianças expostas à sífilis nascidas vivas no ano de 2018 no município de Porto Alegre, humildemente a definição de caso. Os grupos: casos notificados e expostos à sífilis na gestação. Estatística descritiva analítica (p≤ 0,05). A força das associações foi determinada pela razão de chances (IC 95%). Resultados : A incidência de sífilis congênita foi de 20 casos/1000 NV e 5,2 casos/1000 NV considerados expostos. Observou-se baixa escolaridade materna (p<0,001) e não realização do pré-natal (p=0,05) pelas mães dos casos notificados; maior proporção de VDRL não reagentes em crianças ao nascer (p=0,007) e encerramentos de casos com testes treponêmicos (p<0,001) entre os expostos. Conclusão: Taxa de incidência tributária em 2018; escolaridade materna associada à baixa qualidade pré natal são riscos para a ocorrência do desfecho; O exame VDRL não reage ao nascer e o monitoramento após o nascimento são fatores de proteção para o evento.

Effects of Increasing Glycerin Levels in Broiler Chickens.

Glycerin contributes to the animal's energy metabolism as an important structural component of triglycerides and phospholipids. The present study was carried out to evaluate the effect of replacing corn with 0, 5, 10, and 15% of glycerin in terms of performance, digestibility, carcass yield, relative weights of gastrointestinal tract (GIT) organs, and nutrient metabolism. Four hundred chickens (40.0 g ± 0.05 g) were distributed in a completely randomized design with four treatments and five replicates. Growth parameters were measured at 7, 14, 21, and 42 days. Digestibility of crude protein and fat, carcass yield, relative weights of GIT organs, and biochemical blood profile were measured. The results were subject to an analysis of variance by Tukey's HSD test (p > 0.05). The inclusion of 5%, 10%, or 15% of glycerin did not influence performance or affect the crude protein and fat digestibility in broilers (p > 0.05) when compared to that of the basal (0%) diet. Similarly, the supplementation of glycerin levels showed no significant influence (p > 0.05) on the relative GIT organ weights, carcass yield, or nutrient metabolism. Thus, we concluded that glycerin may be included in the broilers' diets in rations of up to 15%.

Influence of Monochromatic Light during Incubation on the Production and Metabolism of Low-Temperature Broiler Chicks.

The use of artificial lighting during the incubation phase is a tool that has been studied with the aim of increasing the production rates and hatchability. Using this, this study aims to investigate the effects of the luminous incidence of white and red monochromatic light on the production and metabolism of broiler chicks subjected to low temperatures. A total of 315 eggs of Ross 708 heavy breeders were used. The eggs were distributed randomly, with 35 eggs per tray, totaling 105 eggs per incubator. The treatments were the following: incubation without the use of light; the use of white monochromatic light; and the use of red monochromatic light. The lamps used were of the LED type. The samples were distributed in the factorial completely randomized experimental design with position effect on the tray. Candling, egg weighing, calculating the probability of survival and egg weight loss were performed. Temperatures were recorded using a thermographic camera. At birth, three chicks per tray were euthanized for evaluation: weight with and without yolk residue, gastrointestinal tract biometry, and blood and liver biochemistry. Analyses were performed using the R computational program. It was observed that there was a significant effect of the treatments on the levels of calcium, phosphorus, cholesterol, amylase, glucose, urea and glutamate pyruvate transaminase on the biochemical profile of the blood and on the thermographic temperatures of the eggs; the experiment was kept at low temperatures resulting in thermal stress, with an average temperature of 34.5 °C. Therefore, the use of red and white monochromatic light in the artificial incubation process for brown-colored eggs is not recommended, because in the post-hatching phase, it promoted the metabolism dysregulation on the blood biochemical profile to control the differentiation in the wavelength of traditional incubation.

Effects of the Addition of Trichoderma reesei Cellulase to Broiler Chicken Diets for a 21-Day Period.

The cellulose present in the cell wall of vegetables prevents the greater release of nutrients to the animal. Therefore, the use of the cellulase enzyme is a viable strategy as it is capable of breaking cellulose bonds, releasing nutrients such as glucose, increasing dietary energy, and thus improving the productive performance of birds. Trichoderma reesei is efficient in the production of cellulase, which is produced via submerged fermentation followed by purification, formulation, and drying. Therefore, an experiment was carried out using 240 male broilers of the Cobb-500® lineage to verify the effects resulting from the addition of powdered (500 g/t and 1000 g/t) and liquid (500 mL/t) cellulase over a period of 1 to 21 days. A completely randomized experimental design was used, consisting of four treatments with six replications and ten birds per replication that were housed in an experimental cage. It was observed that performance and digestibility results were significantly different with cellulase supplementation. Also, the relative weight of the large intestine in the period between one and seven days increased when cellulase was added at 1000 g/t. In the period of between eight and 14 days of life, the birds that consumed only the basal diet obtained higher levels of liver protein than those that received the treatments with the addition of the enzyme. However, 15 and 21 days, the consumed feed effect did not occur between thus, it is not conclusive whether hepatotoxicity occurs with the addition of cellulase. For the blood parameters, at 21 days, the diets with added cellulase were not significantly different regarding electrolytes. It was concluded that this cellulase produced by Trichoderma reesei can be included in the animals' diet.

Long-term ayahuasca use is associated with preserved global cognitive function and improved memory: a cross-sectional study with ritual users.

Although several studies have been conducted to elucidate the relationship between psychedelic consumption and cognition, few have focused on understanding the long-term use influence of these substances on these variables, especially in ritualistic contexts.  To verify the influence of ritualistic ayahuasca consumption on the cognition of experienced ayahuasca religious users (> 20 years) and beginners (< 3 years), which participated in rituals of the Centro Luz Divina (CLD), a Santo Daime church in Brazil. Observational, descriptive, and cross-sectional study was carried out in which 48 people participated divided into three groups: (a) experienced ayahuasca users (n = 16), (b) beginner ayahuasca users (n = 16) and (c) control group (n = 16). All groups were matched by sex, age, and education and contained 8 women and 8 men. Cognition was assessed with the WASI (intelligence quotient), Digit Span (verbal working memory), Corsi Block-Tapping Task (visuospatial-related and working memory), Rey-Osterrieth Complex Figure test (visual perception, immediate memory), and Wisconsin Card Sorting and Five Digit Test (executive functions). Groups were homogenous in terms of sociodemographic characteristics, with participants presenting average intellectual performance. There was no evidence of cognitive decline amongst ayahuasca users. The experienced group showed higher scores compared to the less experienced group in the Digit Span and Corsi Block-Tapping tasks, which assess working verbal and visuospatial memories respectively. We confirmed the botanical identities of Psychotria viridis and Banisteriopsis caapi and the presence of the alkaloids both in the plants and in the brew. Short and long-term ayahuasca consumption does not seem to alter human cognition, while long-term use seems to be associated with improvements in aspects of working memory when compared with short-term use.

An example of leveraging AI for documentation: ChatGPT-generated nursing care plan for an older adult with lung cancer.

OBJECTIVE: Our article demonstrates the effectiveness of using a validated framework to create a ChatGPT prompt that generates valid nursing care plan suggestions for one hypothetical older patient with lung cancer. METHOD: This study describes the methodology for creating ChatGPT prompts that generate consistent care plan suggestions and its application for a lung cancer case scenario. After entering a nursing assessment of the patient's condition into ChatGPT, we asked it to generate care plan suggestions. Subsequently, we assessed the quality of the care plans produced by ChatGPT. RESULTS: While not all the suggested care plan terms (11 out of 16) utilized standardized nursing terminology, the ChatGPT-generated care plan closely matched the gold standard in scope and nature, correctly prioritizing oxygenation and ventilation needs. CONCLUSION: Using a validated framework prompt to generate nursing care plan suggestions with ChatGPT demonstrates its potential value as a decision support tool for optimizing cancer care documentation.

Effects of a Single Dose of Ayahuasca in College Students With Harmful Alcohol Use: A Single-blind, Feasibility, Proof-of-Concept Trial.

BACKGROUND: Ayahuasca is a South American plant hallucinogen rich in the psychedelic N,N-dimethyltryptamine and ß-carbolines (mainly harmine). Preclinical and observational studies suggest that ayahuasca exerts beneficial effects in substance use disorders, but these potentials were never assessed in a clinical trial. METHODS: Single-center, single-blind, feasibility, proof-of-concept study, assessing the effects of one dose of ayahuasca accompanied by psychological support (without psychotherapy) on the drinking patterns (primary variable) of 11 college students with harmful alcohol consumption. Secondary variables included safety and tolerability, craving, personality, anxiety, impulsivity, self-esteem, and social cognition. FINDINGS: Ayahuasca was well tolerated (no serious adverse reactions were observed), while producing significant psychoactive effects. Significant reductions in days per week of alcohol consumption were found between weeks 2 and 3 (2.90 ± 0.28 vs 2.09 ± 0.41; P < 0.05, uncorrected), which were not statistically significant after Bonferroni correction. There were no statistically significant effects for other variables, except for a significant reduction in reaction time in an empathy task. CONCLUSIONS: A significant reduction in days of alcohol consumption was observed 2-3 weeks after ayahuasca intake, but this effect did not survive after Bonferroni correction. The lack of significant effects in alcohol use and other variables may be related to the small sample size and mild/moderate alcohol use at baseline. The present study shows the feasibility of our protocol, paving the way for future larger, controlled studies.

The impact of spiritual care delivered by nurses on patients' comfort: A propensity score matched cohort utilizing electronic health record data.

BACKGROUND: Spiritual care has been associated with better health outcomes. Despite increasing evidence of the benefits of spiritual care for older patients coping with illness and aggressive treatment, the role of spirituality is not well understood and implemented. Nurses, as frontline holistic healthcare providers, are in a position to address patients' spiritual needs and support them in finding meaning in life. This study aimed to identify spiritual care by analyzing nursing data and to compare the psychological and physical comfort between older chronically ill patients who received spiritual care versus those who did not receive spiritual care. MATERIAL AND METHODS: A propensity score matched cohort utilizing nursing care plan data was used to construct balanced groups based on patient characteristics at admission. 45 older patients (≥65 years) with chronic illnesses received spiritual care with measured psychological or physical comfort and 90 matched controls. To ensure the robustness of our results, two sensitivity analyses were performed. Group comparisons were performed to assess the average treatment effect of spiritual care on psychological and physical comfort outcomes. RESULTS: The mean psychological comfort was 4.3 (SD = 0.5) for spiritual care receivers and 3.9 (SD = 0.9) for non-receivers. Regression analysis showed that spiritual care was associated with better psychological comfort (estimate = 0.479, std. error = 0.225, p = 0.041). While its effect on physical comfort was not statistically significant (estimate = -0.265, std. error = 0.234, p = 0.261). This study provides suggestive evidence of the positive impact of nurses' spiritual care in improving psychological comfort for older patients with chronic illnesses. CONCLUSION: Using interoperable nursing data, our findings suggest that spiritual care improves psychological comfort in older patients facing illness. This finding suggests that nurses may integrate spiritual care into their usual care to support patients experiencing distress.

Evaluation of oxidative stress in an experimental model of Crohn's disease treated with hyperbaric oxygen therapy.

INTRODUCTION: Treatments of Inflammatory Bowel Disease (IBD) are able to control symptoms in most cases, however, a fraction of patients do not improve or have a loss of response to treatments, making it important to explore new therapeutic strategies. Hyperbaric oxygen therapy (HBO) may represent one of them. The aim of this study was to evaluate the effects of HBO therapy in an experimental model of IBD. METHODS: Sixty male BALBc mice were divided into six groups. Group 1 was colitis-induced with trinitrobenzene sulfonic acid (TNBS) + ethanol, group 2 received TNBS + ethanol plus HBO, group 3 received only ethanol, group 4 received ethanol plus HBO, group 5 received saline solution, and group 6 received saline solution plus HBO. HBO was performed for four days, subsequently, the mice were evaluated daily. At the end of the study, samples from the intestine were collected for histological analysis as well as for measurement of antioxidant enzymes and cytokine levels. RESULTS: HBO significantly improved the clinical and histological status of the animals. Treatment with HBO increased the activity of the antioxidant enzymes superoxide dismutase (SOD) and glutathione peroxidase (GPx) in all of the groups; moreover, the difference was only significant between the TNBS and TNBS + HBO groups and treatments promoted a reduction in the proinflammatory cytokines IFN-γ, IL-12, IL-17 and TNF-α and increased the anti-inflammatory cytokines IL-4 and IL-10, with no changes in IL-13. CONCLUSION: HBO effectively treats TNBS-induced colitis by increasing the activity of antioxidant enzymes and modulating cytokine profiles.

The relationship between electronic health records user interface features and data quality of patient clinical information: an integrative review.

OBJECTIVES: Electronic health records (EHRs) user interfaces (UI) designed for data entry can potentially impact the quality of patient information captured in the EHRs. This review identified and synthesized the literature evidence about the relationship of UI features in EHRs on data quality (DQ). MATERIALS AND METHODS: We performed an integrative review of research studies by conducting a structured search in 5 databases completed on October 10, 2022. We applied Whittemore & Knafl's methodology to identify literature, extract, and synthesize information, iteratively. We adapted Kmet et al appraisal tool for the quality assessment of the evidence. The research protocol was registered with PROSPERO (CRD42020203998). RESULTS: Eleven studies met the inclusion criteria. The relationship between 1 or more UI features and 1 or more DQ indicators was examined. UI features were classified into 4 categories: 3 types of data capture aids, and other methods of DQ assessment at the UI. The Weiskopf et al measures were used to assess DQ: completeness (n = 10), correctness (n = 10), and currency (n = 3). UI features such as mandatory fields, templates, and contextual autocomplete improved completeness or correctness or both. Measures of currency were scarce. DISCUSSION: The paucity of studies on UI features and DQ underscored the limited knowledge in this important area. The UI features examined had both positive and negative effects on DQ. Standardization of data entry and further development of automated algorithmic aids, including adaptive UIs, have great promise for improving DQ. Further research is essential to ensure data captured in our electronic systems are high quality and valid for use in clinical decision-making and other secondary analyses.

Examining Care Planning Efficiency and Clinical Decision Support Adoption in a System Tailoring to Nurses' Graph Literacy: National, Web-Based Randomized Controlled Trial.

BACKGROUND: The proliferation of health care data in electronic health records (EHRs) is fueling the need for clinical decision support (CDS) that ensures accuracy and reduces cognitive processing and documentation burden. The CDS format can play a key role in achieving the desired outcomes. Building on our laboratory-based pilot study with 60 registered nurses (RNs) from 1 Midwest US metropolitan area indicating the importance of graph literacy (GL), we conducted a fully powered, innovative, national, and web-based randomized controlled trial with 203 RNs. OBJECTIVE: This study aimed to compare care planning time (CPT) and the adoption of evidence-based CDS recommendations by RNs randomly assigned to 1 of 4 CDS format groups: text only (TO), text+table (TT), text+graph (TG), and tailored (based on the RN's GL score). We hypothesized that the tailored CDS group will have faster CPT (primary) and higher adoption rates (secondary) than the 3 nontailored CDS groups. METHODS: Eligible RNs employed in an adult hospital unit within the past 2 years were recruited randomly from 10 State Board of Nursing lists representing the 5 regions of the United States (Northeast, Southeast, Midwest, Southwest, and West) to participate in a randomized controlled trial. RNs were randomly assigned to 1 of 4 CDS format groups-TO, TT, TG, and tailored (based on the RN's GL score)-and interacted with the intervention on their PCs. Regression analysis was performed to estimate the effect of tailoring and the association between CPT and RN characteristics. RESULTS: The differences between the tailored (n=46) and nontailored (TO, n=55; TT, n=54; and TG, n=48) CDS groups were not significant for either the CPT or the CDS adoption rate. RNs with low GL had longer CPT interacting with the TG CDS format than the TO CDS format (P=.01). The CPT in the TG CDS format was associated with age (P=.02), GL (P=.02), and comfort with EHRs (P=.047). Comfort with EHRs was also associated with CPT in the TT CDS format (P<.001). CONCLUSIONS: Although tailoring based on GL did not improve CPT or adoption, the study reinforced previous pilot findings that low GL is associated with longer CPT when graphs were included in care planning CDS. Higher GL, younger age, and comfort with EHRs were associated with shorter CPT. These findings are robust based on our new innovative testing strategy in which a diverse national sample of RN participants (randomly derived from 10 State Board of Nursing lists) interacted on the web with the intervention on their PCs. Future studies applying our innovative methodology are recommended to cost-effectively enhance the understanding of how the RN's GL, combined with additional factors, can inform the development of efficient CDS for care planning and other EHR components before use in practice.

A novel peptide able to reduce PLA2 activity and modulate inflammatory cytokine production.

Phospholipases A2 (PLA2s) are associated with inflammatory response, performing a complex process involving, specially, cytokines. The excess of pro-inflammatory cytokines induces a chronic inflammatory response and can cause several disorders in the body. Therefore, the inhibition or regulation of cytokines' signaling pathways is a target for new treatment development strategies. Thus, this study aimed to select PLA2 inhibitor mimetic peptides through phage display technology with anti-inflammatory activity. Specific mimetic peptides were selected using BpPLA2-TXI, a PLA2 isolated from Bothrops pauloensis, as a target, and γCdcPL, a PLA2 inhibitor isolated from Crotalus durissus collilineatus, which was used as a competitor during the elution step. We selected the peptide C2PD, which seems to play a pivotal role in the modulation of IL-6, IL-1ß, and IL-10 cytokines in inflammatory cells. The C2PD showed a significant reduction in PLA2 activity. Furthermore, the synthetic peptide was tested in PBMC and showed a significant down-modulation of IL-6 and IL-1ß release, whereas IL-10 responses were up-regulated. Our findings suggest that this novel peptide may be a potential therapeutic candidate for the treatment of inflammatory diseases, mainly due to its anti-inflammatory properties and absence of cytotoxicity.

Nurses' preferences for the format of care planning clinical decision support coded with standardized nursing languages.

Current electronic health records (EHRs) are often ineffective in identifying patient priorities and care needs requiring nurses to search a large volume of text to find clinically meaningful information. Our study, part of a larger randomized controlled trial testing nursing care planning clinical decision support coded in standardized nursing languages, focuses on identifying format preferences after random assignment and interaction to 1 of 3 formats (text only, text+table, text+graph). Being assigned to the text+graph significantly increased the preference for graph (P = .02) relative to other groups. Being assigned to the text only (P = .06) and text+table (P = .35) was not significantly associated with preference for their assigned formats. Additionally, the preference for graphs was not significantly associated with understanding graph content (P = .19). Further studies are needed to enhance our understanding of how format preferences influence the use and processing of displayed information.

Sustainability approaches for agrowaste solution: Biodegradable packaging and microbial polysaccharides bio-production.

Global growth impacts on the increased use and demand for natural resources, requiring solutions for the high volume of industrial waste and by-products generated from the most diverse commercial areas, mainly the food sector. Among the main residues with a large volume generated, those from fruit processing, grain cleaning in processing units, vegetables, and discards from the animal production industry stood out. Approximately 1.3 billion all food produced worldwide is lost or wasted per year being fruits, vegetables, roots, and tubers responsible for about half of the total amount. Many of these by-products have interesting nutrients in their composition such as fibers, proteins, and bioactive compounds. An interesting example is the sugarcane bagasse. Fibrous residue, derived from sugarcane extraction, the bagasse represents about 30-34 % of the total sugarcane mass. This is one of the most abundant cellulosic residues and contains approximately 39 % of cellulose, 28 % of hemicellulose, and 18 % of lignin. Therefore, as well as the bagasse, several residues from agroindustrial can be considered promising alternative substrates, being valuable sources for the development of high-value-added products, such as biopolymers, bioenergy, and chemical products. In addition, the reuse of agroindustrial wastes may be considered an attractive option for reducing the environmental impact caused by their generation. In the case of biopolymers, the energy savings of bio-based polymers is around 20-50 GJ/t of polymer. In this review, we have selected two commercially promising approaches to the application and use of agroindustrial residues, aiming their use for biodegradable packaging and microbial polysaccharides bio-production, improving overall sustainability and economic aspects of the scientific research, technology and modern industry.

Maternal and fetal ultrasonography, vulvar temperature and vaginal mucous impedance for the prediction of parturition in Saanen does.

The aim of this study was to evaluate and correlate modifications of vaginal mucous impedance, vulvar temperature and ultrasonographic measurements (echobiometric parameters) to parturition in pregnant Saanen does. 30 does were selected for the study and submitted to an estrus synchronization protocol and natural mating. The females were evaluated daily from Day 143 of pregnancy to parturition. For the sonographic evaluations, the following structures were measured: biparietal diameter, thoracic diameter, abdominal diameter, ocular orbit, kidney length, kidney height, cardiac area, placentome length, cervical measurement and fetal heart rate; by means of two different approaches: transrectal and transabdominal, using a 7.5 MHz linear transducer. The vaginal mucous impedance was assessed using an electric estrous detector and vulvar temperature was measured using a non-contact infrared thermometer. Statistical analysis was performed using the R-project software and the significance level was set at 5% for all tests. 25 Saanen does became pregnant, resulting in 80.33% pregnancy rate. Fetal heart rate was negatively correlated to the hours to parturition (p<0,001; r-Pearson= -0,451), as well as vaginal temperature (p= 0,001; r-Pearson= -0,275), while cervical thickness was positively correlated to hours to parturition (p<0,001; r-Pearson= 0,490). The echobiometric parameters (biparietal diameter, thoracic diameter, abdominal diameter, ocular orbit, kidney length and height, cardiac area, placentome length), as well as vaginal mucous impedance did not vary throughout the timepoints of evaluation and did not correlate to the moment of parturition. It was concluded that the parameters of fetal heartbeat, vaginal temperature and cervical effacement in the last week of pregnancy provide valuable information regarding the proximity of parturition.

Clinical Decision Support Systems for Palliative Care Management: A Scoping Review.

CONTEXT: With the expansion of palliative care services in clinical settings, clinical decision support systems (CDSSs) have become increasingly crucial for assisting bedside nurses and other clinicians in improving the quality of care to patients with life-limiting health conditions. OBJECTIVES: To characterize palliative care CDSSs and explore end-users' actions taken, adherence recommendations, and clinical decision time. METHODS: The CINAHL, Embase, and PubMed databases were searched from inception to September 2022. The review was developed following the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews guidelines. Qualified studies were described in tables and assessed the level of evidence. RESULTS: A total of 284 abstracts were screened, and 12 studies comprised the final sample. The CDSSs selected focused on identifying patients who could benefit from palliative care based on their health status, making referrals to palliative care services, and managing medications and symptom control. Despite the variability of palliative CDSSs, all studies reported that CDSSs assisted clinicians in becoming more informed about palliative care options leading to better decisions and improved patient outcomes. Seven studies explored the impact of CDSSs on end-user adherence. Three studies revealed high adherence to recommendations while four had low adherence. Lack of feature customization and trust in guideline-based in the initial stages of feasibility and usability testing were evident, limiting the usefulness for nurses and other clinicians. CONCLUSION: This study demonstrated that implementing palliative care CDSSs can assist nurses and other clinicians in improving the quality of care for palliative patients. The studies' different methodological approaches and variations in palliative CDSSs made it challenging to compare and validate the applicability under which CDSSs are effective. Further research utilizing rigorous methods to evaluate the impact of clinical decision support features and guideline-based actions on clinicians' adherence and efficiency is recommended.

Oil well drill cuttings and sunflower cake: effects on sunflower crop and soil chemical attributes.

Onshore oil well drill cuttings and sunflower cake from biodiesel production require an appropriate destination to reduce the risks of environmental contamination. The aim of this study was to evaluate the potential use of the combination of different doses of these wastes on the growth of sunflower plants (Helianthus annus L.) and on soil chemical attributes after cultivation, making it possible to recommend safe application doses. Sunflower plants, cultivar Neon, were cultivated in a greenhouse for 80 days in Planossolo Háplico (Ultisol) as the main substrate. The design used was completely randomized, in a 6 × 6 factorial arrangement, composed of five doses of sunflower cake (2, 4, 8, 16 and 32 Mg ha-1) and five doses of drill cuttings (5, 15, 30, 45 and 60 Mg ha-1) and an experimental control using only Ultisol After cultivation, soil chemical attributes and the parameters height (H), stem diameter (D), and dry mass (DMAP) and nutrient contents in the aerial part of the plants were analyzed. Sunflower cake dose of 32 Mg ha-1 limited the germination of sunflower plants. In sunflower plants, the highest contents of calcium (Ca), magnesium (Mg), phosphorus (P) and potassium (K) were verified when the sunflower cake doses were associated with drill cuttings doses >45 Mg ha-1. The mixture between sunflower cake and drill cuttings in the proportion of 16:45 Mg ha-1, respectively, promoted higher H, D and DMAP of sunflower plants, as well as a considerable improvement in soil fertility, without causing significant increments in sodium content in the soil after cultivation.HighlightsInadequate disposal of agro-industrial wastes represents loss of raw material and energy.Drill cuttings and sunflower cake wastes enable improvements in soil fertility attributes.The combination of sunflower cake and drill cuttings contributed to sunflower growth and nutrient contents.The mixture of drill cuttings and sunflower cake has potential for use as agricultural input.

Selection of Brucella abortus mimetic epitopes for fast diagnostic purposes in cattle.

Bovine brucellosis is a disease that significantly impacts animal production and human health. Although many sensitive diagnostic tests are used, there is still no ideal fast serological test for all epidemiological situations. In this context, we developed peptides that mimic regions of antigenic proteins of Brucella abortus and can be used in serological diagnosis. RESULTS: From phage display technology, we randomly selected nine clones of phage displaying peptide binders to B. abortus. These clones were sequenced and translated. After molecular docking analysis, two peptides (Ba4 and Ba9) were selected, chemically synthesized, and verified for their potential diagnostic value. By enzyme-linked immunoassay (ELISA), Ba9 showed a sensitivity of up to 97.5% to detect antibodies circulating in animals with brucellosis. We incorporated the peptide Ba9 onto a bioelectrode (graphite modified with poly-3-hydroxyphenylacetic acid). Then, direct serum detection was demonstrated by differential pulse voltammetry, micrographs, and topographic analyses in addition to the average roughness coefficient (Ra) and the value of the mean squared deviation of the roughness (Rms). CONCLUSION: This work shows that the mimetic epitope of B. abortus can be useful for developing new platforms for diagnosing brucellosis. In addition, we propose a fast test based on an electrochemical sensor using graphite modified with poly-3-hydroxyphenylacetic acid.

Pegivirus Detection in Cerebrospinal Fluid from Patients with Central Nervous System Infections of Unknown Etiology in Brazil by Viral Metagenomics.

Metagenomic next-generation sequencing (mNGS) methodology serves as an excellent supplement in cases where diagnosis is challenging to establish through conventional laboratory tests, and its usage is increasingly prevalent. Examining the causes of infectious diseases in the central nervous system (CNS) is vital for understanding their spread, managing outbreaks, and effective patient care. In a study conducted in the state of São Paulo, Brazil, cerebrospinal fluid (CSF) samples from 500 patients with CNS diseases of indeterminate etiology, collected between 2017 and 2021, were analyzed. Employing a mNGS approach, we obtained the complete coding sequence of Pegivirus hominis (HPgV) genotype 2 in a sample from a patient with encephalitis (named IAL-425/BRA/SP/2019); no other pathogen was detected. Subsequently, to determine the extent of this virus's presence, both polymerase chain reaction (PCR) and/or real-time PCR assays were utilized on the entire collection. The presence of the virus was identified in 4.0% of the samples analyzed. This research constitutes the first report of HPgV detection in CSF samples in South America. Analysis of the IAL-425 genome (9107 nt) revealed a 90% nucleotide identity with HPgV strains from various countries. Evolutionary analyses suggest that HPgV is both endemic and extensively distributed. The direct involvement of HPgV in CNS infections in these patients remains uncertain.