Unveiling the clinical and electrophysiological profile of CMTX6: Insights from two Brazilian families.

BACKGROUND AND AIMS: X-linked Charcot-Marie-Tooth disease type 6 (CMTX6) is an extremely rare condition associated with mutations in the PDK3 gene. To date, only three families from different countries have been reported (Australia, South Korea, and Germany). In this study, we sought to provide a comprehensive clinical and electrophysiological characterization of two Brazilian families. METHODS: We conducted comprehensive clinical assessments, extensive electrophysiological evaluations, and performed whole-exome sequencing in the probands to investigate the genetic basis of the disease. RESULTS: Males in the family carrying the Arg162His mutation displayed early-onset motor and/or sensory axonal neuropathy, absence of tendon jerks, pes cavus, and frequently reported pain. Females in the same family exhibited a milder phenotype of the disease with later onset and some remained asymptomatic into their 50s. In the unrelated family with a single affected male, the clinical presentation was characterized by severe progressive sensorimotor polyneuropathy accompanied by neuropathic pain. INTERPRETATION: We report two Brazilian families with CMTX6 including one harboring a previously unpublished variant in the PDK3 gene, which co-segregates with the disease as expected in a X-linked disease. Notably, the clinical presentations across the five families with available descriptions, including our study, share striking similarities. Furthermore, the proximity of the three reported mutations suggests potential functional similarities and common underlying mechanisms. This study contributes to the growing knowledge of CMTX6 and underscores the importance of international collaborations in studying rare genetic disorders.

Effects of different diets on Aedes aegypti adults: improving rearing techniques for sterile insect technique.

The aim was to evaluate the effect of different energy diets available in adulthood on the longevity, dispersal capacity and sexual performance of Aedes aegypti produced under a mass-rearing system. To evaluate the effects of diets in relation to the survival of the adult male insects of Ae. aegypti, six treatments were used: sucrose at a concentration of 10%, as a positive control (sack10); starvation, as a negative control (starvation); sucrose at a concentration of 20% associated with 1 g/l of ascorbic acid (sac20vitC); wild honey in a concentration of 10% (honey10); demerara sugar in a 10% concentration (demerara10); and sucrose at a concentration of 20% associated with 1 g/l of ascorbic acid and 0.5 g/l of amino acid proline (sac20vitCPr). Each treatment had 16 cages containing 50 adult males. For the tests of flight ability and propensity to copulation, five treatments were used (saca10; sac20vitC; mel10; demerara10; and sac20vitCPr), with males each for flight ability and females copulated by a single male for copulation propensity. The diet composed of sucrose at a concentration of 20% associated with ascorbic acid, as an antioxidant, improved the survival, flight ability and propensity to copulate in Ae. aegypti males under mass-rearing conditions, and may be useful to enhance the performance of sterile males, thus improving the success of sterile insect technique programmes.

Apoio social e resiliência: um olhar sobre a maternidade na adolescência / Apoyo social y resiliencia: una mirada sobre la maternidad en la adolescencia / Social support and resilience: a look at adolescent motherhood

Resumo Objetivo Verificar a influência do apoio social no processo de resiliência de mães adolescentes. Métodos Estudo exploratório, descritivo, transversal, de abordagem quantitativa. Foram sujeitos da pesquisa 48 adolescentes atendidas em Unidades Básicas de Saúde, no estado de São Paulo, em 2016. Os dados foram coletados dos seguintes instrumentos: a) questionário sociodemográfico; b) Escala de Resiliência desenvolvida por Wagnild e Young (1993), adaptada por Pesce et al. (2005); c) Escala de Apoio Social utilizada no Medical Outcomes Study , adaptada por Griep et al. (2005). Resultados Os resultados mostraram alta pontuação nas Escalas de Resiliência e de Apoio Social das adolescentes. Destas 70,83% apresentaram atraso escolar significativo e 75% não trabalhavam. Foram encontradas associações significativas entre os fatores da Escala de Resiliência e as dimensões da Escala de Apoio Social. Foi identificada uma correlação inversa entre o fator "Independência e determinação", da Escala de Resiliência e a dimensão "Afetiva" da Escala de Apoio Social. Portanto, quanto maior o "apoio afetivo" percebido pelas mães adolescentes, menor a "independência e determinação" apresentada por elas. Conclusão O estudo aprofunda os conhecimentos sobre a influência do apoio social no processo de resiliência de mães adolescentes. Evidenciaram-se questões de gênero e a importância de políticas intersetoriais com foco em mães e pais adolescentes que fortaleçam o apoio social.

Resumen Objetivo Verificar la influencia del apoyo social en el proceso de resiliencia de madres adolescentes. Métodos Estudio exploratorio, descriptivo, transversal, de enfoque cuantitativo. Los sujetos de la investigación fueron 48 adolescentes atendidas en Unidades Básicas de Salud, en el estado de São Paulo, en 2016. Los datos fueron recopilados a través de los siguientes instrumentos: a) cuestionario sociodemográfico; b) Escala de Resiliencia, elaborada por Wagnild y Young (1993), adaptada por Pesce et al. (2005); c) Escala de Apoyo Social utilizada en el Medical Outcomes Study, adaptada por Griep et al. (2005). Resultados Los resultados reflejaron una puntuación elevada en la Escala de Resiliencia y de Apoyo Social de las adolescentes. De ellas, el 70,83 % presentó retraso escolar significativo y el 75 % no trabajaba. Se descubrieron relaciones significativas entre los factores de la Escala de Resiliencia y las dimensiones de la Escala de Apoyo Social. Se identificó una correlación inversa entre el factor "independencia y determinación" de la Escala de Resiliencia y la dimensión "afectiva" de la Escala de Apoyo Social. Por lo tanto, cuanto mayor era el "apoyo afectivo" percibido por las madres adolescentes, menor "independencia y determinación" presentaron. Conclusión El estudio profundiza los conocimientos sobre la influencia del apoyo social en el proceso de resiliencia de madres adolescentes. Se evidenciaron cuestiones de género y la importancia de políticas intersectoriales con foco en madres y padres adolescentes que fortalezcan el apoyo social.

Abstract Objective To verify the influence of social support on the resilience process of adolescent mothers. Methods Exploratory, descriptive, cross-sectional study with a quantitative approach. There were 48 adolescents research subjects, who attended Primary Care Centres, in the state of São Paulo, in 2016. Data were collected from the following instruments: a) sociodemographic questionnaire; b) Resilience Scale developed by Wagnild and Young (1993), adapted by Pesce et al. (2005); c) Social Support Scale used in the Medical Outcomes Study, adapted by Griep et al. (2005). Results The results showed high scores on the Resilience and Social Support Scales of the adolescents. Of these, 70.83% had significant school delays and 75% did not work. Significant associations were found between the factors of the Resilience Scale and the dimensions of the Social Support Scale. An inverse correlation was identified between the "Independence and determination" factor of the Resilience Scale and the "Affective" dimension of the Social Support Scale. Therefore, the greater the "affective support" perceived by teenage mothers, the less "independence and determination" they present. Conclusion The study deepens the knowledge about the influence of social support on the resilience process of teenage mothers. Gender issues and the importance of intersectoral policies focused on teenage mothers and fathers that strengthen social support were highlighted.

Spirulina sp. LEB 18 cultivation in a raceway-type bioreactor using wastewater from desalination process: Production of carbohydrate-rich biomass.

This study aimed to evaluate the biomass production of Spirulina sp. LEB 18 cultivated in wastewater from the desalination process. The outdoor cultivations (210 L) were performed using as culture medium 100% wastewater supplemented with 25% of Zarrouk constituents (Tcs). In parallel, it was performed a control assay using 100% Zarrouk constituents. The biomass production in Tcs assay (1.14 g L-1) was only 9% lower than the control assay (1.25 g L-1). The Tcs assay showed a higher content of carbohydrates (52.29%), lipids (12.79%) and ash (2.69%) compared to the control assay (47.91; 7.59 and 1.29%, respectively). The biomass from the control and Tcs assays had mostly monounsaturated fatty acids C15:1 and C18:2n6t. The Spirulina sp. LEB 18 could use efficiently the nutrients from the wastewater, showing high removal efficiency of NO3- (96.99%), PO4 (83.11%) and Z (96.43%). At the same time, high added value biomolecules were produced for different purposes.

Long-term ecological research in southern Brazil grasslands: Effects of grazing exclusion and deferred grazing on plant and arthropod communities.

Grazing exclusion may lead to biodiversity loss and homogenization of naturally heterogeneous and species-rich grassland ecosystems, and these effects may cascade to higher trophic levels and ecosystem properties. Although grazing exclusion has been studied elsewhere, the consequences of alleviating the disturbance regime in grassland ecosystems remain unclear. In this paper, we present results of the first five years of an experiment in native grasslands of southern Brazil. Using a randomized block experimental design, we examined the effects of three grazing treatments on plant and arthropod communities: (i) deferred grazing (i.e., intermittent grazing), (ii) grazing exclusion and (iii) a control under traditional continuous grazing, which were applied to 70 x 70 m experimental plots, in six regionally distributed blocks. We evaluated plant community responses regarding taxonomic and functional diversity (life-forms) in separate spatial components: alpha (1 x 1 m subplots), beta, and gamma (70 x 70 m plots), as well as the cascading effects on arthropod high-taxa. By estimating effect sizes (treatments vs. control) by bootstrap resampling, both deferred grazing and grazing exclusion mostly increased vegetation height, plant biomass and standing dead biomass. The effect of grazing exclusion on plant taxonomic diversity was negative. Conversely, deferred grazing increased plant taxonomic diversity, but both treatments reduced plant functional diversity. Reduced grazing pressure in both treatments promoted the break of dominance by prostrate species, followed by fast homogenization of vegetation structure towards dominance of ligneous and erect species. These changes in the plant community led to increases in high-taxa richness and abundance of vegetation-dwelling arthropod groups under both treatments, but had no detectable effects on epigeic arthropods. Our results indicate that decision-making regarding the conservation of southern Brazil grasslands should include both intensive and alleviated levels of grazing management, but not complete grazing exclusion, to maximize conservation results when considering plant and arthropod communities.

Intensivist nurse performance in the collaborative model of continuous hemodialysis: links with patient safety.

OBJECTIVE: To describe the Intensive Care Unit nurse's role in the management of continuous hemodialysis within the scope of the collaborative model, analyzing it regarding the links with patient safety. METHOD: A descriptive, qualitative, exploratory study based on the Reason safety model performed at the Intensive Care Unit of a specialized hospital, with nurses working in the direct management of continuous hemodialysis, who were interviewed using a script with its contents being thematically analyzed. RESULTS: 23 nurses participated. The role of the intensive care nurse in continuous hemodialysis involves performing preparation/planning and monitoring/follow-up activities, based on interaction with technology and the application of specialized knowledge. The adopted collaborative model reflects on its qualification and availability in relation to the activities that need to be performed, with repercussions on patient safety. CONCLUSION: There are weaknesses in the participation by intensive care nurses in this continuous hemodialysis model which require elaboration of defensive barriers for the safety of the system.

Tying care and respect into a single bioethical principle: On Dall'Agnol's respectful care theory.

OBJECTIVE: In this article, we offer an extended critical review of a new conception of bioethics, presented by Darlei Dall'Agnol, in the book Care and Respect in Bioethics. METHODS: Critical philosophical analysis of background assumptions of a new approach to bioethics, enriched with critical discussion of related philosophical literature. RESULTS: In Care and Respect in Bioethics, through an approach filled with hard cases, Dall'Agnol argues that the metaethics of respectful care has theoretical advantages over the intuitionist metaethics of principlism and the particularism of casuistry, offering an original comprehensive approach that crosses the three dimensions of ethical inquiry: metaethical, normative, and applied ethics. CONCLUSIONS: Dall'Agnol offers an insightful and persuasive account of how the single attitude of respectful care can express practical moral knowledge in healthcare. In this paper, we evaluate, criticize, and suggest refinements. One of them concerns Dall'Agnol's interpretation about Stephen Darwall's views on care and respect as two attitudes supported, respectively, by a third- and a second-personal moral point-of-view. Other is about the Dall'Agnol's Wittgensteinian description of the moral language-games of Clinical Bioethics, adding to the approach the "language-game of rights."

Production and characterization of Spirulina sp. LEB 18 cultured in reused Zarrouk's medium in a raceway-type bioreactor.

The objective was to evaluate the effect of reusing Zarrouk's medium on a Spirulina sp. LEB 18 culture by determining kinetic parameters, chemical composition, biofuels, and thermal characterization. Cultivation was performed in a raceway bioreactor for 7 days, the supernatant was reused for four cycles. Culturing the microalga in the reused medium resulted in a cellular yield of 2.30 g L-1 (control) and 2.04, 1.89, 1.73, and 1.15 g L-1 for four cycles with no influence on cell growth and productivity. Biomass with high contents of carbohydrates (58.00%, 3rd cycle), phycocyanin (2.47 mg mL-1, 1st cycle), and saturated fatty acids (60.13%, 4th cycle) were obtained with an increase in the profiles of C16:0 (45.85%) and C18:2n6 (47.40%) in the 1st cycle. The reuse of Zarrouk's medium allowed obtaining biomass with reduced cost and differentiated characteristics, allowing the exploration of commercially important biomolecules by the completion of up to four cycles.

Training of intensive care nurses to handle continuous hemodialysis: a latent condition for safety.

OBJECTIVE: To analyze the repercussions of the training of nurses working in the Intensive Care Unit for the management of continuous hemodialysis regarding the safety of critical patients with acute renal failure. METHOD: Qualitative research developed considering James Reason's reference in the Intensive Care Unit of a private hospital. The data was collected with 23 nurses who worked for more than three months in the management of continuous hemodialysis through a semi-structured interview, and analyzed with the thematic content analysis technique. RESULTS: There are weaknesses in the training of intensive care nurses for the management of continuous hemodialysis that become a latent failure. Such a failure results in difficulties in handling hemodialysis, with risks for these professionals to commit active failures. FINAL CONSIDERATIONS: The training program in service for the management of continuous hemodialysis must be perfected, to develop skills and competencies in nurses and improve their performance.

Training of intensive care nurses to handle continuous hemodialysis: a latent condition for safety / Formación de los enfermeros intensivistas para manejar la hemodiálisis continua: una condición latente de la seguridad / Formação dos enfermeiros intensivistas para manejar hemodiálise contínua: condição latente à segurança

ABSTRACT Objective: To analyze the repercussions of the training of nurses working in the Intensive Care Unit for the management of continuous hemodialysis regarding the safety of critical patients with acute renal failure. Method: Qualitative research developed considering James Reason's reference in the Intensive Care Unit of a private hospital. The data was collected with 23 nurses who worked for more than three months in the management of continuous hemodialysis through a semi-structured interview, and analyzed with the thematic content analysis technique. Results: There are weaknesses in the training of intensive care nurses for the management of continuous hemodialysis that become a latent failure. Such a failure results in difficulties in handling hemodialysis, with risks for these professionals to commit active failures. Final considerations: The training program in service for the management of continuous hemodialysis must be perfected, to develop skills and competencies in nurses and improve their performance.

RESUMEN Objetivo: Analizar las repercusiones de la formación de enfermeros que actúan en Unidades de Terapia Intensiva para el manejo de la hemodiálisis continua teniendo en vista la seguridad del paciente crítico con lesión renal aguda. Método: Investigación cualitativa, desarrollada bajo la luz del referencial de James Reason en la Unidad de Terapia Intensiva de un hospital privado. Los datos fueron recolectados con 23 enfermeros que actuaban hacía más de tres meses en el manejo de la hemodiálisis continua a través de entrevista semiestructurada, y analizados con la técnica de análisis de contenido temático. Resultados: Hay fragilidades en la formación de enfermeros intensivos para el manejo de la hemodiálisis continua que se configuran en una falla latente. Esa deficiencia resulta en dificultades en el manejo de la hemodiálisis, con riesgo de que estos profesionales cometan fallas activas. Consideraciones finales: Es necesario perfeccionar el programa de entrenamiento en servicio para el manejo de la hemodiálisis continua, para desarrollar en los enfermeros habilidades y competencias y mejorar su desempeño.

RESUMO Objetivo: Analisar as repercussões da formação de enfermeiros que atuam em Unidade de Terapia Intensiva para o manejo da hemodiálise contínua tendo em vista a segurança do paciente crítico com injúria renal aguda. Método: Pesquisa qualitativa, desenvolvida à luz do referencial de James Reason na Unidade de Terapia Intensiva de hospital privado. Os dados foram coletados com 23 enfermeiros que atuavam há mais de três meses no manejo da hemodiálise contínua através de entrevista semiestruturada, e analisados com a técnica de análise de conteúdo temático. Resultados: Há fragilidades na formação de enfermeiros intensivistas para o manejo da hemodiálise contínua que se configuram numa falha latente. Tal falha resulta em dificuldades no manuseio da hemodiálise, com riscos de esses profissionais cometerem falhas ativas. Considerações finais: É preciso aperfeiçoar o programa de treinamento em serviço para o manuseio da hemodiálise contínua, para desenvolver no enfermeiro habilidades e competências e melhorar sua performance.

Experience of nurses in the management of continuous hemodialysis and its influences on patient safety / Experiencia de enfermeros en el manejo de la hemodiálisión continua y sus influencias en la seguridad del paciente / Experiência de enfermeiros no manejo da hemodiálise contínua e suas influências na segurança do paciente

ABSTRACT Objective: to analyze the professional experience of intensive care nurses and its influence on their work activities in the continuous hemodialysis process and patient safety in the intensive care unit within the scope of the collaborative model. Method: qualitative and exploratory research, based on the systemic paradigm of patient safety, developed at the Intensive Care Unit of a private institution in the city of Rio de Janeiro, Brazil. There were 23 nurse participants who had been working for more than three months in study scenery and in direct contact with continuous hemodialysis. The data were produced from June to October of 2016 by means of observation, analyzed using thick description as well as semi-structured interviews, and then submitted to the content analysis technique. Results: were organized in two categories: the first one portrays the influence of the professional working experience on the safety of nurses' performance, which verified that in relation to continuous hemodialysis, inexperienced nurses follow guidelines and manuals, without a complete evaluation of this care situation and face difficulties in the performance of everyday care. The second category demonstrates the impact of the nurse´s inexperience on the occurrence of active errors, evidencing actions that result in the occurrence of adverse events. Conclusion: the insertion of inexperienced nurses is a latent condition in the investigated system that results in the occurrence of incidents in the continuous hemodialysis process, requiring the improvement of the collaborative model through the systematic monitoring of the performance of these professionals, such as the proposal of a safety barrier.

RESUMEN Objetivo: analizar la influencia de la experiencia profesional de los enfermeros intensivos en el manejo de la hemodiálisis continua, en la seguridad de su actuación, en el marco del modelo colaborativo frente al paciente que de ella se utiliza en la unidad de terapia intensiva. Método: investigación cualitativa y de cuño exploratorio, pautada en el paradigma sistémico de la seguridad del paciente, desarrollada en la unidad de terapia intensiva de una institución privada del municipio de Río de Janeiro, Brasil. Participaron 23 enfermeros que actuaban hace más de tres meses en el escenario del estudio, en el manejo directo de la hemodiálisis continua. Los datos fueron producidos de junio a octubre de 2016 por medio de observación, analizados a partir de su descripción densa, y de entrevistas semiestructuradas, sometidos a la técnica de análisis de contenido. Resultados: fueron organizados en dos categorías: la primera retrata la influencia de la experiencia profesional en la seguridad de la actuación del enfermero, en que se verifica que los enfermeros inexpertos actúan en el manejo de la hemodiálisis continua siguiendo directrices y manuales, sin una evaluación completa de esta situación de cuidado y enfrentando dificultades en el cotidiano de la asistencia. La segunda categoría demuestra el impacto de esta inexperiencia del enfermero en la ocurrencia de errores activos, evidenciando acciones que resultan en la ocurrencia de eventos adversos. Conclusión: la inserción de enfermeros inexpertos es una condición latente en el sistema investigado que converge para la ocurrencia de incidentes en el manejo de la hemodiálisis continua, requiriendo el perfeccionamiento del modelo colaborativo a través del acompañamiento sistemático del desempeño de estos profesionales, como propuesta de barrera de seguridad.

RESUMO Objetivo: analisar a influência da experiência profissional dos enfermeiros intensivistas no manejo da hemodiálise contínua, na segurança de sua atuação no âmbito do modelo colaborativo frente ao paciente que dela se utiliza na unidade de terapia intensiva. Método: pesquisa qualitativa e de cunho exploratório, pautada no paradigma sistêmico da segurança do paciente, desenvolvida na unidade de terapia intensiva de uma instituição privada do município do Rio de Janeiro, RJ, Brasil. Participaram 23 enfermeiros que atuavam há mais de três meses no cenário do estudo, no manejo direto da hemodiálise contínua. Os dados foram produzidos de junho a outubro de 2016 por meio de observação, analisados a partir da sua descrição densa, e de entrevistas semiestruturadas, submetidos à técnica de análise de conteúdo. Resultados: foram organizados em duas categorias: a primeira retrata a influência da experiência profissional na segurança da atuação do enfermeiro, em que se verifica que os enfermeiros inexperientes agem no manejo da hemodiálise contínua seguindo diretrizes e manuais, sem uma avaliação completa desta situação de cuidado e enfrentando dificuldades no cotidiano da assistência. A segunda categoria demonstra o impacto dessa inexperiência do enfermeiro na ocorrência de erros ativos, evidenciando-se ações que resultam na ocorrência de eventos adversos. Conclusão: a inserção de enfermeiros inexperientes é uma condição latente no sistema investigado que converge para a ocorrência de incidentes no manejo da hemodiálise contínua, requerendo o aprimoramento do modelo colaborativo através do acompanhamento sistemático do desempenho destes profissionais, como proposta de barreira de segurança.

Intensivist nurse performance in the collaborative model of continuous hemodialysis: links with patient safety / Actuación del enfermero intensivista en el modelo colaborativo de hemodiálisis continua: nexos con la seguridad del paciente / Atuação do enfermeiro intensivista no modelo colaborativo de hemodiálise contínua: nexos com a segurança do paciente

ABSTRACT Objective: To describe the Intensive Care Unit nurse's role in the management of continuous hemodialysis within the scope of the collaborative model, analyzing it regarding the links with patient safety. Method: A descriptive, qualitative, exploratory study based on the Reason safety model performed at the Intensive Care Unit of a specialized hospital, with nurses working in the direct management of continuous hemodialysis, who were interviewed using a script with its contents being thematically analyzed. Results: 23 nurses participated. The role of the intensive care nurse in continuous hemodialysis involves performing preparation/planning and monitoring/follow-up activities, based on interaction with technology and the application of specialized knowledge. The adopted collaborative model reflects on its qualification and availability in relation to the activities that need to be performed, with repercussions on patient safety. Conclusion: There are weaknesses in the participation by intensive care nurses in this continuous hemodialysis model which require elaboration of defensive barriers for the safety of the system.

RESUMEN Objetivo: Describir la actuación del enfermero de la Unidad de Cuidados Intensivos en el manejo de la hemodiálisis continua en el ámbito del modelo colaborativo, analizándola en cuanto a los nexos con la seguridad del paciente. Método: Investigación exploratoria descriptiva, cualitativa, basada en el modelo de seguridad de Reason, llevada a cabo en la Unidad de Cuidados Intensivos de hospital especializado, con enfermeros actuantes en el manejo directo de la hemodiálisis continua, quienes fueron entrevistados mediante un guión cuyos contenidos pasaron por análisis temático. Resultados: Participaron 23 enfermeros. La actuación del enfermero de cuidados intensivos en la hemodiálisis continua involucra llevar a cabo actividades de preparación/planificación y de monitoreo/seguimiento, desde la interacción con la tecnología y la aplicación de conocimientos especializados. El modelo colaborativo adoptado trae reflejos en su calificación y disponibilidad frente a las actividades que necesita llevar a cabo, repercutiendo en la seguridad del paciente. Conclusión: Hay fragilidades en la participación de los enfermeros de los cuidados intensivos en este modelo de hemodiálisis continua que requieren la creación de barreras defensivas para la seguridad del sistema.

RESUMO Objetivo: Descrever a atuação do enfermeiro da Unidade de Terapia Intensiva no manejo da hemodiálise contínua no âmbito do modelo colaborativo, analisando-a quanto aos nexos com a segurança do paciente. Método: Pesquisa exploratória-descritiva, qualitativa, baseada no modelo de segurança de Reason, realizada na Unidade de Terapia Intensiva de hospital especializado, com enfermeiros atuantes no manejo direto da hemodiálise contínua, os quais foram entrevistados com o uso de um roteiro cujos conteúdos passaram por análise temática. Resultados: Participaram 23 enfermeiros. A atuação do enfermeiro da terapia intensiva na hemodiálise contínua envolve executar atividades de preparo/planejamento e de monitorização/acompanhamento, a partir da interação com a tecnologia e da aplicação de conhecimentos especializados. O modelo colaborativo adotado traz reflexos na sua qualificação e disponibilidade frente às atividades que precisa executar, repercutindo na segurança do paciente. Conclusão: Há fragilidades na participação dos enfermeiros da terapia intensiva neste modelo de hemodiálise contínua que requerem a elaboração de barreiras defensivas para a segurança do sistema.

Equipment failure: conducts of nurses and implications for patient safety.

OBJECTIVES: To identify equipment failures during handling by nurses and analyze the conduct of the professionals when these failures occur. METHODS: Descriptive, exploratory and qualitative study, whose field was the intensive care unit of a public institution, and the participants were day nurses that worked providing direct care to patients. Data were produced in 2014 through systematic observation and interviews and were examined with thick description and content analysis. RESULTS: The outcomes evinced the inadequate functioning of infusion bombs, users' errors related to the design of equipment and problems with batteries of artificial fans. These failures related to the management of equipment in the unit. FINAL CONSIDERATIONS: It is necessary to strengthen the monitoring systems of safety conditions of equipment in intensive nursing care to prevent incidents.

Equipment failure: conducts of nurses and implications for patient safety / Fallas de equipos: conducta de los enfermeros e implicaciones para la seguridad del paciente / Falhas de equipamentos: condutas dos enfermeiros e implicações na segurança do paciente

ABSTRACT Objectives: To identify equipment failures during handling by nurses and analyze the conduct of the professionals when these failures occur. Methods: Descriptive, exploratory and qualitative study, whose field was the intensive care unit of a public institution, and the participants were day nurses that worked providing direct care to patients. Data were produced in 2014 through systematic observation and interviews and were examined with thick description and content analysis. Results: The outcomes evinced the inadequate functioning of infusion bombs, users' errors related to the design of equipment and problems with batteries of artificial fans. These failures related to the management of equipment in the unit. Final considerations: It is necessary to strengthen the monitoring systems of safety conditions of equipment in intensive nursing care to prevent incidents.

RESUMEN Objetivo: Identificar las fallas de equipos mientras son utilizados por enfermeros, y analizar sus conductas ante tales fallas. Método: Estudio descriptivo-exploratorio, cualitativo, realizado en la Unidad de Terapia Intensiva de una institución pública. Participaron enfermeros de turno diurno, actuantes en la atención directa del paciente. Los datos fueron obtenidos en el año 2014 a través de observación sistemática y entrevista. Posteriormente, fueron sometidos a análisis por descripción densa y de contenido. Resultados: Se evidenció funcionamiento inadecuado de bombas de infusión, errores del usuario relacionados al diseño del equipo, problemas con baterías de ventiladores artificiales. Las fallas identificadas están relacionadas a la gestión de los equipos de la unidad. Consideraciones finales: Es necesario fortalecer los sistemas de vigilancia en las condiciones de seguridad de equipos en el cuidado intensivo de enfermería, a fin de prevenir la ocurrencia de incidentes.

RESUMO Objetivo: Identificar as falhas dos equipamentos durante o seu manejo pelo enfermeiro e analisar suas condutas diante de tais falhas. Método: Pesquisa descritivo-exploratória, qualitativa, cujo campo foi a Unidade de Terapia Intensiva de uma instituição pública, e os participantes, enfermeiros diurnos atuantes na assistência direta ao paciente. Os dados foram produzidos no ano de 2014, por meio de observação sistemática e entrevista, e posteriormente submetidos a análise por descrição densa e de conteúdo. Resultados: Evidenciaram-se o funcionamento inadequado de bombas infusoras, os erros do usuário relacionados ao desenho do equipamento e problemas com baterias de ventiladores artificiais. Essas falhas identificadas têm relação com a gestão dos equipamentos da unidade. Considerações finais: É preciso fortalecer os sistemas de vigilância das condições de segurança dos equipamentos no cuidado intensivo de enfermagem, a fim de se prevenir a ocorrência de incidentes.

Influence of nitrogen on growth, biomass composition, production, and properties of polyhydroxyalkanoates (PHAs) by microalgae.

This study sought to evaluate influence of nitrogen availability on cell growth, biomass composition, production, and the properties of polyhydroxyalkanoates during cultivation of microalgae Chlorella minutissima, Synechococcus subsalsus, and Spirulina sp. LEB-18. The cellular growth of microalgae reduced with the use of limited nitrogen medium, demonstrating that nitrogen deficiency interferes with the metabolism of microorganisms and the production of biomass. The biochemical composition of microalgae was also altered, which was most notable in the degradation of proteins and chlorophylls and the accumulation of carbonaceous storage molecules such as lipids and polyhydroxyalkanoates. Chlorella minutissima did not produce these polymers even in a nitrogen deficient environment. The largest accumulations of the polyhydroxyalkanoates occurred after a 15 days culture, with a concentration of 16% (dry cell weight) produced by the Synechococcus subsalsus strain and 12% by Spirulina sp. LEB-18. Polyhydroxyalkanoates produced by Synechococcus subsalsus and Spirulina sp. LEB-18 presented different thermal and physical properties, indicating the influence of producing strain on polyhydroxyalkanoates properties. The polymers obtained consisted of long chain monomers with 14 to 18 carbon atoms. This composition is novel, as it has not previously been found in PHAs obtained from Synechococcus subsalsus and Spirulina sp. LEB-18.

Investigation of cellular fatty acid composition of Xanthomonas spp. as chemical markers of productivity and quality of xanthan gum.

In this study, we investigated the cellular fatty acid profiles of different Xanthomonas pathovars producing xanthan gum and explored the fatty acid composition to identify chemical markers of xanthan gum productivity and quality. Three Xanthomonas pathovars were studied. The fermentation was conducted for 168 h. Samples from the fermented medium were collected for extraction, quantification, and characterization of xanthan. The unsaturated/saturated (U/S) fatty acid ratio in Xanthomonas cells during fermentation was correlated with production, viscosity, and molecular weight of the gum obtained at each 24 h. The Xanthomonas axonopodis pv manihotis 290 strain showed a higher U/S ratio for major cell fatty acids (C16:1ω7/C16:0) as compared with the other two strains; this high ratio was directly associated with xanthan production. No correlation was observed between cellular fatty acid composition and characteristics of xanthan synthesized. Thus, it was possible to determine a production chemical marker for xanthan gum in Xanthomonas strains.

Curcumin Analog CH-5 Suppresses the Proliferation, Migration, and Invasion of the Human Gastric Cancer Cell Line HGC-27.

Gastric cancer is one of the most frequent malignant tumors in the world. The majority of patients are diagnosed with metastatic gastric cancer, which has a low survival rate. These data reinforce the importance of studying the anticancer activity of new molecules with the potential to suppress gastric cancer metastasis. Curcumin is a well-studied compound that has demonstrated anti-metastatic effects. Here we investigated if CH-5, a curcumin derivative compound, has anti-metastatic properties in the human gastric cancer cell line HGC-27. Firstly, we found that CH-5 decreased viability and induced apoptosis in HGC-27 cells in a dose-dependent manner. Additionally, CH-5 suppressed the migration and invasion of HGC-27 cells by downregulating the expression and collagenase activity of matrix metalloproteinase 2 in a dose-dependent manner. In conclusion, CH-5 showed anticancer activities, including the induction of apoptosis, and the suppression of migration and invasion in HGC-27 cells, suggesting that CH-5 can be a lead molecule for the development of anti-metastatic drugs for gastric cancer therapy.

Resiliência e apoio social de mães adolescentes em vulnerabilidade social / Resilience and social support of adolescent mothers in social vulnerability

Introdução: A maternidade na adolescência tem sido um obstáculo para avanços no status educacional, social e econômico das mulheres em todas as partes do mundo. O apoio social é um dos fatores protetores mais citados na literatura que auxiliam as mães adolescentes no enfrentamento e superação dos problemas, contribuindo para a construção da resiliência dessas jovens. Dado a relevância do apoio social para as mães adolescentes e a importância da resiliência, o estudo da associação desses fatores é de grande interesse na área da Promoção da Saúde. Objetivo: Compreender a influência do apoio social no processo de resiliência de mães adolescentes residentes na periferia do município de Bertioga. Metodologia: O presente estudo é do tipo exploratório-descritivo, transversal de abordagem quantitativa. Foram selecionadas, por conveniência, 48 mães adolescentes de 10 a 19 anos, atendidas nas cinco Unidades Básicas de Saúde do município de Bertioga, no estado de São Paulo. Os instrumentos utilizados foram: a) questionário sociodemográfico; b) Escala de Resiliência desenvolvida por Wagnild e Young (1993), adaptada por Pesce et al. (2005); c) Escala de Apoio Social utilizada no Medical Outcomes Study (MOS), adaptada por Griep et al. (2005). Para a análise dos dados, foi realizada a correlação de postos de Spearman. Resultados: Os resultados mostram que 81,25% das mães adolescentes tem idades entre 17 e 19 anos, 91,66% estão em uma união estável ou casamento, 75% abandonaram a escola, 70,83% possuem um atraso escolar bastante significativo, 75% não trabalham e 75% passam o dia todo com seus filhos. De forma geral as mães adolescentes obtiveram uma alta pontuação na Escala de Resiliência, bem como nos fatores que a compõem e na Escala de Apoio Social (MOS) e em suas dimensões. Foi observada uma correlação direta entre o fator, Autoconfiança e capacidade de adaptação a situações e a idade das mães adolescentes, uma correlação direta entre o fator Resolução de ações e valores e a dimensão Interação social positiva e uma correlação inversa entre o fator Independência e determinação e a dimensão Afetiva. Conclusões: Embora não tenha sido observada correlação estatisticamente significativa entre as pontuações totais da Escala de Resiliência e da Escala de Apoio Social (MOS) nas mães adolescentes entrevistadas, foram encontradas associações significativas entre os fatores da Escala de Resiliência e as dimensões da Escala de Apoio Social (MOS). Tais resultados evidenciaram questões de gênero e a importância de políticas intersetoriais com foco em mães e pais adolescentes e jovens que considerem seus contextos sócio-econômico-culturais, fortaleçam o apoio social e promovam comportamentos resilientes para que se tornem autônomos e conscientes na construção de seus projetos de vida.

Introduction: Motherhood in adolescence has been an obstacle to advances in the educational, social and economic status of women in all parts of the world. Social support is one of the best resources that helps adolescent mothers develop resilience in difficult situations and cope with and overcome their problems. Given the relevance of social support for adolescent mothers and the importance of resilience, the study of the association of these factors is of great interest in the area of Health Promotion. Objective: To understand the influence of social support on the resilience process of adolescent mothers living in the periphery of the city of Bertioga. Methodology: The present study is an exploratory-descriptive, cross-sectional, quantitative approach. We selected, for convenience, 48 adolescent mothers ages 10 to 19 years who attended the five Basic Health Units of the city of Bertioga, in the state of São Paulo. The instruments used were: A) socio-demographic questionnaire; B) Resilience Scale developed by Wagnild and Young (1993), adapted by Pesce et al. (2005); C) Social Support Scale used in the Medical Outcomes Study (MOS), adapted by Griep et al. (2005). For the data analysis, the Spearmans rank correlation was performed. Results: The results show that 85.42% of adolescent mothers are between 17 and 19 years old, 91.66% are in a stable union or marriage, 75% have left school, 70.83% have a significant school delay, 75% do not work and 75% spend all day with their children. In general, adolescent mothers obtained a high score in the Resilience Scale, as well as in the factors that compose it, and in the Social Support Scale (MOS) and its dimensions. A direct correlation was observed between the factor "Self-confidence and adaptability to situations" and the age of adolescent mothers. Another direct correlation was observed between the factor "Resolution of actions and values" and the dimension "Positive social interaction. An inverse correlation was observed between the factor "Independence and determination" and the dimension "Affective". Conclusions: Although no statistically significant correlation was found between the total scores of the Resilience Scale and the Social Support Scale (MOS) in the adolescent mothers interviewed, significant associations were found between the factors of the Resilience Scale and the dimensions of the Support Scale Social (MOS). These results have highlighted gender issues and the importance of intersectorial policies that focus on adolescents and young mothers and fathers and take into consideration their socioeconomic-cultural contexts. These policies should strengthen these adolescents social support, promote resilient behavior, and ultimately allow them to become autonomous and make responsible life decisions.

O enfermeiro e o paciente em hemodiálise contínua na UTI: o manejo da tecnologia na perspectiva da segurança / The nurse and the patient on continuous hemodialysis: management of technology from the perspective of safety

A hemodiálise contínua é uma terapia crescente empregada na Unidade de Terapia Intensiva, estando o enfermeiro diretamente inserido neste processo complexo, especialmente quanto ao manejo da tecnologia aplicada a este cuidado. Entretanto, questiona-se o seu saber/conhecimento para o manejo desta tecnologia e as repercussões que traz à segurança do paciente. Os objetivos da pesquisa são: Descrever o manejo da tecnologia de hemodiálise contínua aplicada ao cuidado do paciente na Unidade de Terapia Intensiva pelo enfermeiro; Analisar tal manejo quanto às repercussões na segurança do paciente; Discutir a segurança do cuidado de enfermagem ao paciente que utiliza tecnologia de hemodiálise contínua na Unidade de Terapia Intensiva, particularmente quanto à atuação do enfermeiro frente a tais tecnologias. Pesquisa de campo, qualitativa, de cunho exploratório, realizada com 23 enfermeiros atuantes no cuidado ao paciente que encontra-se em hemodiálise contínua na Unidade de Terapia Intensiva de um hospital privado do município do Rio de Janeiro. Realizou-se entrevista a partir de um roteiro semiestruturado e observação das práticas de cuidado destes profissionais quanto ao manejo da tecnologia de hemodiálise contínua, que totalizaram 130 horas. Os dados de entrevista foram submetidos à análise de conteúdo temática e os de observação analisados a partir de sua descrição densa. Os resultados foram organizados em três categorias: a primeira delas abarca as diferentes atividades desempenhadas pelo enfermeiro no manejo da hemodiálise nas fases de preparo/planejamento e de monitorização/acompanhamento, as quais ocorrem a partir da interface que estabelece com a tecnologia e da aplicação de conhecimentos especializados no campo da nefrologia. Tais atividades são feitas dentro de um modelo colaborativo de nefrointensivismo em que enfermeiros da própria unidade com expertise no cuidado ao paciente submetido à hemodiálise contínua colaboram com a atuação dos enfermeiros responsáveis pelo cuidado direto a este paciente. Todavia, ambos também responsabilizam-se pelo cuidado de pacientes que não se encontram em hemodiálise no setor, acumulando outras funções assistenciais. A segunda categoria trata da qualificação dos enfermeiros para o manejo da hemodiálise contínua, demonstrando as lacunas na formação ao nível da graduação e da pós-graduação, bem como no treinamento fornecido pela instituição; além do efeito da inexperiência na atuação do enfermeiro, que produz a vivência dos sentimentos de medo e insegurança. Tais lacunas implicam no enfrentamento de dificuldades quando da necessidade de manusear a hemodiálise contínua. Essas dificuldades se materializam durante a realização de procedimentos como: devolução do sangue ao paciente, calibração das balanças, montagem do sistema, interpretação do significado dos alarmes, as quais geram a ocorrência de incidentes que comprometem a segurança do paciente, temática abordada na terceira categoria de análise. Em face desses resultados e à luz dos conceitos aplicados no estudo é preciso pensar nestas condições latentes que incidem na atuação profissional, para que não ocorram erros que possam comprometer a segurança do paciente crítico. Assim, recomenda-se a adoção de barreiras que favoreçam a cultura de segurança do hospital quanto ao emprego desta tecnologia, quais sejam: aperfeiçoamento do modelo de inserção dos enfermeiros inexperientes nesta assistência, com o uso da simulação na sua formação, implementação de checklists, revisão do modelo colaborativo de hemodiálise contínua e da organização do trabalho dos enfermeiros.(AU)