A Rare Cause of Vitamin B12 Deficiency in the Pediatric Age.

Vitamin B12 plays an important role in DNA synthesis, hematopoiesis, and neuronal mechanisms, and its deficiency can be associated with insufficient intake or poor absorption and autoimmune and genetic diseases. Although rare, excessive, and chronic alcohol consumption may also justify a deficiency in this vitamin. We present a case of a 17-year-old Iraqi adolescent refugee in Portugal with a deficiency of vitamin B12 due to excessive and chronic alcohol consumption. Although intramuscular (IM) supplementation with cyanocobalamin is the most used, it was decided to initiate oral supplementation. After four months, vitamin B12 levels were replenished. With this clinical case, we aim to raise awareness of the cause of cyanocobalamin deficiency, which although rare in pediatric age should be considered in adolescents, given the possibility of risky behaviors in this age group. Additionally, given the therapeutic options, we have found that oral administration of vitamin B12 has been effective, as reported in the literature.

Epidemiological and Clinical Aspects of Cutaneous and Mucosal Leishmaniases in Portugal: Retrospective Analysis of Cases Diagnosed in Public Hospitals and Reported in the Literature between 2010 and 2020.

Leishmania infantum, a zoonotic vector-born parasite, is endemic in the Mediterranean region, presenting mostly as visceral (VL), but also as cutaneous (CL) and mucosal leishmaniasis (ML). This study aimed to describe the epidemiological and clinical aspects of the CL and ML cases diagnosed in mainland Portugal between 2010 and 2020. Collaboration was requested from every hospital of the Portuguese National Health System. Cases were screened through a search of diagnostic discharge codes or positive laboratory results for Leishmania infection. Simultaneously, a comprehensive literature search was performed. Descriptive statistics and hypothesis testing were performed using IBM® SPSS® Statistics. A total of 43 CL and 7 ML cases were identified, with a predominance of autochthonous cases (86%). In CL, immunosuppressed individuals constituted a significant proportion of patients (48%), and in this group, disseminated CL (22%) and simultaneous VL (54%) were common. In autochthonous cases, lesions, mostly papules/nodules (62%), were frequently observed on the head (48%). The approach to treatment was very heterogeneous. ML cases were all autochthonous, were diagnosed primarily in older immunosuppressed individuals, and were generally treated with liposomal amphotericin B. The findings suggest a need for enhanced surveillance and reporting, clinical awareness, and diagnostic capacity of these forms of leishmaniasis to mitigate underdiagnosis and improve patient outcomes. A holistic One Health approach is advocated to address the multifaceted challenges posed by leishmaniases in Portugal and beyond.

Adapting the Nominal Group Technique to a virtual version: an experience report.

OBJECTIVE: To report on the adaptations made to the original Nominal Group Technique (NGT), allowing it to be applied to the virtual format, preserving all its key elements. METHOD: An experience report on the adaptations and adjustments made to the original NGT to the virtual format using Information and Communication Technologies (ICT), using digital tools that are available free of charge or are low cost and easy to use. RESULTS: The NGT was carried out entirely virtually and underwent adaptations in each of its four stages through the incorporation of specific digital resources. It was possible to present the most voted ideas and obtain final approval from the participants. The participants had no difficulty in using the virtual resources provided and, based on the reaction evaluation, they were satisfied with the tools provided. CONCLUSION: The adapted NGT proved to be an effective method when used in a virtual setting, capable of producing a significant number of ideas and developing consensus. The adapted tool can be used by other researchers in countries with similar resources or dimensions to Brazil.

Nonalcoholic Fatty Liver Disease and Continuous Metabolic Syndrome in Adolescents with Overweight/Obesity.

INTRODUCTION: Nonalcoholic fatty liver disease is the leading cause of pediatric chronic liver disease. Although nonalcoholic fatty liver disease is closely associated with obesity, its relationship with metabolic syndrome in children is not fully understood. The main aim of this study was to evaluate the association between nonalcoholic fatty liver disease and a combination of cardiometabolic risk factors in adolescents with overweight/obesity, using a pediatric metabolic syndrome score (PsiMS) to predict metabolic syndrome. METHODS: A retrospective cohort study was conducted. Subjects with overweight/obesity aged 10 to 17 followed at two clinical centers in Portugal (2018 - 2021) were enrolled. The independent association of nonalcoholic fatty liver disease with PsiMS, and of other potential predictors, was tested through multiple regression analyses. Receiver operator characteristic curve analysis was performed to estimate the optimal cutoff of PsiMS to discriminate metabolic syndrome. RESULTS: Eighty-four subjects were included (median age at baseline 11.5 years). The prevalence rate of nonalcoholic fatty liver disease was 51% and the prevalence rate of metabolic syndrome was 7%. The mean PsiMS was 2.05 ± 0.48 at the first evaluation, and 2.11 ± 0.52 at the last evaluation (mean follow-up time was 15 months). The nonalcoholic fatty liver disease group had significantly (p < 0.05) higher weight and body mass index z-scores, higher rate of severe obesity and higher waist circumference percentile. PsiMS was highly accurate in predicting metabolic syndrome (area under the curve = 0.96), with an optimal cutoff of 2.46 (sensitivity 100%, specificity 89%). In the univariate analysis, no statistically significant association was observed between nonalcoholic fatty liver disease and PsiMS. In the multiple regression analysis, female sex had a negative association with PsiMS (first and last evaluation). Independent predictors of a higher PsiMS at first evaluation were: ≥ 2 metabolic syndrome criteria, body mass index z-score, insulin resistance and dyslipidemia. At the last evaluation, independent predictors of a higher PsiMS were: nonalcoholic fatty liver disease, baseline PsiMS and body mass index increase from baseline. CONCLUSION: The results suggest a good performance of the PsiMS to assess metabolic syndrome and that nonalcoholic fatty liver disease is associated with PsiMS at follow-up.

Antimicrobial stewardship for nursing graduates: development and evaluation of educational technology / Manejo antimicrobiano para licenciados en enfermería: desarrollo y evaluación de tecnología educativa / Gerenciamento de antimicrobianos para graduandos em enfermagem: desenvolvimento e avaliação de tecnologia educacional

ABSTRACT Objective: to develop and evaluate an online course using WebQuests on antimicrobial stewardship for nursing students, based on international consensus. Method: this is a methodological study to develop and validate an educational strategy, as well as quantitative and descriptive to evaluate its practicability. The study was conducted from March 2021 to April 2022. After development, there was validation of the appearance and content of the material by judges, adopting a content validity index greater than 0.80 for each item. The four validated WebQuests were made available in course format on the Open Courses Portal of the Federal University of São Carlos. An instrument was developed in electronic format to evaluate the practicality of the educational strategy according to the views of 73 nursing students. The results were stored in Excel spreadsheets and analyzed using descriptive statistics. Results: the educational strategy was validated by 10 expert judges, with a total content validity index greater than 0.90 for appearance and content. Its practicality was evaluated by 73 nursing students, and it was considered easy to understand and implement, with participants expressing interest in using this type of educational strategy. Conclusion: the developed, validated and evaluated course is a useful tool and is available free of charge to contribute to the training of future nurses on the topic of antimicrobial stewardship.

RESUMEN Objetivo: desarrollar y evaluar un curso en línea mediante WebQuests sobre manejo de antimicrobianos para estudiantes de enfermería, basado en consenso internacional. Método: investigación metodológica para el desarrollo y validación de una estrategia educativa, e investigación cuantitativa y descriptiva, para evaluar su viabilidad, realizada de marzo de 2021 a abril de 2022. Luego del desarrollo, se realizó la validación de la apariencia y contenido del material por parte de jueces, adoptando un índice de validez de contenido superior a 0,80 para cada ítem. Las cuatro WebQuests validadas estuvieron disponibles en formato curso en el Portal de Cursos Abiertos de la Universidad Federal de São Carlos. Se desarrolló un instrumento en formato electrónico para evaluar la practicidad de la estrategia educativa según la visión de 73 estudiantes de enfermería. Los resultados se almacenaron en hojas de cálculo de Excel y se analizaron mediante estadística descriptiva. Resultados: la estrategia educativa fue validada por 10 jueces expertos, con un índice de validez de contenido total mayor a 0,90 para apariencia y contenido. En cuanto a la practicidad, evaluada por 73 estudiantes de enfermería, se consideró de fácil comprensión y realización, manifestando los participantes interés en utilizar este tipo de estrategia educativa. Conclusión: el curso desarrollado, validado y evaluado es una herramienta útil y está disponible de forma gratuita para contribuir a la formación de futuros enfermeros en el tema de manejo antimicrobiano.

RESUMO Objetivo: desenvolver e avaliar um curso online utilizando WebQuests sobre gerenciamento de antimicrobianos para graduandos em enfermagem, baseado em consenso internacional. Método: pesquisa metodológica para o desenvolvimento e a validação de estratégia educativa, e pesquisa quantitativa e descritiva, para se avaliar sua praticabilidade, realizada no período de março de 2021 a abril de 2022. Após o desenvolvimento, houve a validação de aparência e conteúdo do material por juízes, adotando-se o índice de validade de conteúdo superior a 0,80 para cada item. As quatro WebQuests validadas foram disponibilizadas em formato de curso no Portal de Cursos Abertos da Universidade Federal de São Carlos. Foi elaborado um instrumento em formato eletrônico para avaliar a praticabilidade da estratégia educativa segundo a visão de 73 graduandos em enfermagem. Os resultados foram armazenados em planilhas Excel e analisados por meio de estatística descritiva. Resultados: a estratégia educativa foi validada por 10 juízes especialistas, com índice de validade de conteúdo total maior de 0,90 para aparência e conteúdo. Quanto à praticabilidade, avaliada por 73 graduandos de enfermagem, foi considerada de fácil entendimento e realização, sendo que os participantes manifestaram interesse em utilizar este tipo de estratégia educativa. Conclusão: o curso desenvolvido, validado e avaliado é uma ferramenta útil e está disponível gratuitamente para contribuir com a formação de futuros enfermeiros na temática do gerenciamento de antimicrobianos.

Adapting the Nominal Group Technique to a virtual version: an experience report / Adaptación de la Técnica del Grupo Nominal a una versión virtual: informe de una experiencia / Adaptação da Técnica de Grupo Nominal para versão virtual: relato de experiência

ABSTRACT Objective: To report on the adaptations made to the original Nominal Group Technique (NGT), allowing it to be applied to the virtual format, preserving all its key elements. Method: An experience report on the adaptations and adjustments made to the original NGT to the virtual format using Information and Communication Technologies (ICT), using digital tools that are available free of charge or are low cost and easy to use. Results: The NGT was carried out entirely virtually and underwent adaptations in each of its four stages through the incorporation of specific digital resources. It was possible to present the most voted ideas and obtain final approval from the participants. The participants had no difficulty in using the virtual resources provided and, based on the reaction evaluation, they were satisfied with the tools provided. Conclusion: The adapted NGT proved to be an effective method when used in a virtual setting, capable of producing a significant number of ideas and developing consensus. The adapted tool can be used by other researchers in countries with similar resources or dimensions to Brazil.

RESUMEN Objetivo: Informar sobre las adaptaciones realizadas a la Técnica de Grupo Nominal (TGN) original, permitiendo su aplicación al formato virtual, preservando todos sus elementos clave. Método: Se trata de un informe de experiencia sobre las adaptaciones y ajustes realizados a la TGN original para el formato virtual mediante el uso de las Tecnologías de la Información y la Comunicación (TIC), utilizando herramientas digitales disponibles de forma gratuita o de bajo coste y fácil uso. Resultados: El TGN se realizó íntegramente de manera virtual y sufrió adaptaciones en cada una de sus cuatro etapas mediante la incorporación de recursos digitales específicos. Fue posible presentar las ideas más votadas y obtener la aprobación final de los participantes. Los participantes no tuvieron dificultades para utilizar los recursos virtuales proporcionados y, según los comentarios recibidos, se mostraron satisfechos con las herramientas facilitadas. Conclusión: El TGN adaptado demostró ser un método eficaz cuando se utiliza en un entorno virtual, capaz de producir un número significativo de ideas y desarrollar el consenso. La herramienta adaptada puede ser utilizada por otros investigadores en países con recursos o dimensiones similares a las de Brasil.

RESUMO Objetivo: Relatar as adaptações realizadas na Técnica de Grupo Nominal (TGN) original, permitindo sua aplicação ao formato virtual, preservando todos os seus elementos-chave. Método: Relato de experiência sobre as adaptações e adequações realizadas na TGN original ao formato virtual aplicando as Tecnologias da Informação e Comunicação (TIC), por meio de ferramentas digitais disponibilizadas gratuitamente ou de baixo custo e de fácil manejo. Resultados: A TGN foi realizada integralmente de forma virtual e sofreu adaptações em cada uma das suas quatro etapas através da incorporação de recursos digitais específicos. Foi possível apresentar as ideias mais votadas e obter a aprovação final dos participantes. Os participantes não apresentaram dificuldade para utilizar os recursos virtuais disponibilizados, e, partir da avaliação de reação, mostram-se satisfeitos com as ferramentas disponibilizadas. Conclusão: A TGN adaptada mostrou-se um método efetivo quando utilizada em cenário virtual, sendo capaz de produzir um significativo número de ideias e desenvolver consenso. A ferramenta adaptada pode ser usada por outros pesquisadores em países com recursos ou dimensões semelhantes ao Brasil.

Polar Lipids of Marine Microalgae Nannochloropsis oceanica and Chlorococcum amblystomatis Mitigate the LPS-Induced Pro-Inflammatory Response in Macrophages.

Microalgae are recognized as a relevant source of bioactive compounds. Among these bioactive products, lipids, mainly glycolipids, have been shown to present immunomodulatory properties with the potential to mitigate chronic inflammation. This study aimed to evaluate the anti-inflammatory effect of polar lipids isolated from Nannochloropsis oceanica and Chlorococcum amblystomatis. Three fractions enriched in (1) digalactosyldiacylglycerol (DGDG) and sulfoquinovosyldiacylglycerol (SQDG), (2) monogalactosyldiacylglycerol (MGDG), and (3) diacylglyceryl-trimethylhomoserine (DGTS) and phospholipids (PL) were obtained from the total lipid extracts (TE) of N. oceanica and C. amblystomatis, and their anti-inflammatory effect was assessed by analyzing their capacity to counteract nitric oxide (NO) production and transcription of pro-inflammatory genes Nos2, Ptgs2, Tnfa, and Il1b in lipopolysaccharide (LPS)-activated macrophages. For both microalgae, TE and Fractions 1 and 3 strongly inhibited NO production, although to different extents. A strong reduction in the LPS-induced transcription of Nos2, Ptgs2, Tnfa, and Il1b was observed for N. oceanica and C. amblystomatis lipids. The most active fractions were the DGTS-and-PL-enriched fraction from N. oceanica and the DGDG-and-SQDG-enriched fraction from C. amblystomatis. Our results reveal that microalgae lipids have strong anti-inflammatory capacity and may be explored as functional ingredients or nutraceuticals, offering a natural solution to tackle chronic inflammation-associated diseases.

Recommendations on specific precautions for companions/ visitors of patients hospitalized: characteristics and barriers to implementation / Recomendações sobre precauções específicas para acompanhantes/visitantes de pacientes hospitalizados: características e barreiras para implementação / Recomendaciones sobre precauciones específicas para acompanhantes/visitantes de pacientes hospitalizados: características y barreras para su implementación

Justification and Objectives: despite the importance of companions/visitors for hospitalized patients under specific precautions, it is noted that risks of exposure and dissemination of microorganisms in health services by this population are still incipient in the literature. Thus, the objective was to characterize the current recommendations on specific precautions for companions and visitors of hospitalized patients and to analyze the barriers to their implementation from infection preventionists' perspective. Methods: a descriptive and exploratory study with a quantitative approach, with 89 infection preventionists, between March and June 2020. Data collected by electronic questionnaire, "snowball" sampling and analyzed according to frequency of responses. Results: hand hygiene was the most recommended recommendation (>95.0%). As for non-conformities, staying in the room without attire (78.6%), going to other rooms (53.9%) and keeping doors open as aerosol precaution (51.7%) stood out. Regarding the strategies adopted to guide companions/visitors, there was a predominance of individual verbal guidance (92.4%). The main barrier cited was the lack of institutional policy (56.2%). Conclusion: there was no uniformity in the recommendations, and non-conformities and barriers were listed. The importance of specific prevention guidelines for this public and effective educational strategies for its implementation are highlighted.(AU)

Justificativa e Objetivos: apesar da importância dos acompanhantes/visitantes para pacientes hospitalizados em precauções específicas, nota-se que os riscos de exposição e disseminação de microrganismos nos serviços de saúde por essa população ainda são incipientes na literatura. Dessa forma, objetivou-se caracterizar as recomendações vigentes sobre precauções específicas para acompanhantes e visitantes de pacientes hospitalizados e analisar as barreiras para a sua implementação sob a ótica de prevencionistas de infecção. Métodos: estudo descritivo e exploratório, de abordagem quantitativa, com 89 prevencionistas de infecção, entre março e junho de 2020. Dados coletados por questionário eletrônico, com amostragem tipo "bola de neve" e analisados segundo frequência das respostas. Resultados: a higienização das mãos foi a recomendação mais indicada (>95,0%). Quanto às não conformidades, destacou-se permanecer no quarto sem paramentação (78,6%), frequentar outros quartos (53,9%) e manter portas abertas em precaução para aerossóis (51,7%). Referente às estratégias adotadas para a orientar os acompanhantes/visitantes, houve predomínio da orientação verbal individual (92,4%). A principal barreira citada foi a falta de política institucional (56,2%). Conclusão: não houve uniformidade nas recomendações, e não conformidades e barreiras foram elencadas. Destaca-se a importância de diretrizes de prevenção específicas para esse público e estratégias educativas efetivas para sua implementação.(AU)

Justificación y Objetivos: a pesar de la importancia de los acompañantes/visitantes para pacientes hospitalizados bajo precauciones específicas, se advierte que los riesgos de exposición y diseminación de microorganismos en los servicios de salud por parte de esta población son aún incipientes en la literatura. Así, el objetivo fue caracterizar las recomendaciones vigentes sobre precauciones específicas para acompañantes y visitantes de pacientes hospitalizados y analizar las barreras para su implementación desde la perspectiva de los preventivos de infecciones. Métodos: estudio descriptivo y exploratorio con enfoque cuantitativo, con 89 prevencionistas de infecciones, entre marzo y junio de 2020. Datos recolectados por cuestionario electrónico, muestreo "bola de nieve" y analizados según frecuencia de respuestas. Resultados: la higiene de manos fue la recomendación más recomendada (>95,0%). En cuanto a las no conformidades, se destacó permanecer en la habitación sin atuendo (78,6%), ir a otras habitaciones (53,9%) y mantener las puertas abiertas como precaución contra los aerosoles (51,7%). En cuanto a las estrategias adoptadas para orientar a los acompañantes/visitantes, hubo predominio de la orientación verbal individual (92,4%). La principal barrera citada fue la falta de política institucional (56,2%). Conclusión: no hubo uniformidad en las recomendaciones, y se enumeraron las no conformidades y las barreras. Se destaca la importancia de pautas de prevención específicas para este público y estrategias educativas efectivas para su implementación.(AU)

Differences and Similarities in Lipid Composition, Nutritional Value, and Bioactive Potential of Four Edible Chlorella vulgaris Strains.

The microalga Chlorella vulgaris is a popular food ingredient widely used in the industry, with an increasing market size and value. Currently, several edible strains of C. vulgaris with different organoleptic characteristics are commercialized to meet consumer needs. This study aimed to compare the fatty acid (FA) and lipid profile of four commercialized strains of C. vulgaris (C-Auto, C-Hetero, C-Honey, and C-White) using gas- and liquid-chromatography coupled to mass-spectrometry approaches, and to evaluate their antioxidant and anti-inflammatory properties. Results showed that C-Auto had a higher lipid content compared to the other strains and higher levels of omega-3 polyunsaturated FAs (PUFAs). However, the C-Hetero, C-Honey, and C-White strains had higher levels of omega-6 PUFAs. The lipidome signature was also different between strains, as C-Auto had a higher content of polar lipids esterified to omega-3 PUFAs, while C-White had a higher content of phospholipids with omega-6 PUFAs. C-Hetero and C-Honey showed a higher content of triacylglycerols. All extracts showed antioxidant and anti-inflammatory activity, highlighting C-Auto with greater potential. Overall, the four strains of C. vulgaris can be selectively chosen as a source of added-value lipids to be used as ingredients in food and nutraceutical applications for different market needs and nutritional requirements.

Bioprospecting antibiotic properties in photodynamic therapy of lipids from Codium tomemtosum and Chlorella vulgaris.

The growing resistance from pathogens against antibiotics has increased the research for new compounds and strategies with antibacterial potential. Lipids from algae are emerging as natural and potent bioactive molecules with interesting results regarding the inactivation of bacteria, viruses, and fungi. The combination of algae lipids with innovative strategies, such as antibacterial photodynamic therapy (aPDT) can enhance their antimicrobial potential. In this work, we aimed to evaluate the antibacterial potential in aPDT of total lipid extracts and polar lipid fractions from the green macroalga, Codium tomentosum, and the green microalga, Chlorella vulgaris on a Gram-positive bacteria Staphylococcus aureus. Total lipid extracts and polar lipid fractions were characterized by LC-MS. The results revealed that the total extracts of algae promote S. aureus inhibition after light irradiation, with a decrease of ca. 6 log10 (CFU/mL) after 15 min of treatment with both extracts of algae. The polar lipid fractions, composed by phospholipids, glycolipids and betaine lipids, from C. tomentosum and C. vulgaris also revealed antibacterial potential in combination with aPDT, but a decrease of ca. 6 log10 (CFU/mL) was reached at 60 min of treatment, later than with the total extracts. These results unveil algae lipids as antibacterial compounds in combination with aPDT displaying an alternative from natural origin to tackle pathogen resistance.

Molecular programming modulates hepatic lipid metabolism and adult metabolic risk in the offspring of obese mothers in a sex-specific manner.

Male and female offspring of obese mothers are known to differ extensively in their metabolic adaptation and later development of complications. We investigate the sex-dependent responses in obese offspring mice with maternal obesity, focusing on changes in liver glucose and lipid metabolism. Here we show that maternal obesity prior to and during gestation leads to hepatic steatosis and inflammation in male offspring, while female offspring are protected. Females from obese mothers display important changes in hepatic transcriptional activity and triglycerides profile which may prevent the damaging effects of maternal obesity compared to males. These differences are sustained later in life, resulting in a better metabolic balance in female offspring. In conclusion, sex and maternal obesity drive differently transcriptional and posttranscriptional regulation of major metabolic processes in offspring liver, explaining the sexual dimorphism in obesity-associated metabolic risk.

Short Communication: Restrictions in care following the COVID-19 pandemic severely impacted Machado-Joseph disease patients: a study in the Azores Islands, Portugal.

This qualitative study describes how the restrictions imposed by the COVID-19 pandemic impacted on Machado-Joseph disease (MJD) patients and their care, in the island of São Miguel (the Azores, Portugal). In-person semi-structured interviews were conducted with 11 participants, including patients, family members, healthcare professionals, and care providers. Main findings highlighted the key role played by the local association in psychosocial and healthcare for MJD patients and families, and the adverse effects on their care following the onset of the COVID-19 pandemic. In particular, hindered access to the day-care centre increased isolation and had a negative impact on mental health and disease progression. For persons with a progressive and severe neurological disease, there is no "back to normal." Future restrictive measures ensuing need to be accompanied by a careful definition of daily care routines for patients.

Short Communication: Restrictions in care following the COVID-19 pandemic severely impacted Machado-Joseph disease patients: a study in the Azores Islands, Portugal.

This qualitative study describes how the restrictions imposed by the COVID-19 pandemic impacted on Machado-Joseph disease (MJD) patients and their care, in the island of São Miguel (the Azores, Portugal). In-person semi-structured interviews were conducted with 11 participants, including patients, family members, healthcare professionals, and care providers. Main findings highlighted the key role played by the local association in psychosocial and healthcare for MJD patients and families, and the adverse effects on their care following the onset of the COVID-19 pandemic. In particular, hindered access to the day-care centre increased isolation and had a negative impact on mental health and disease progression. For persons with a progressive and severe neurological disease, there is no "back to normal." Future restrictive measures ensuing need to be accompanied by a careful definition of daily care routines for patients.

Applications of lipidomics in marine organisms: progress, challenges and future perspectives.

Marine ecosystems comprise a high diversity of life forms, such as algae, invertebrates, and vertebrates. These organisms have adapted their physiology according to the conditions of the environments in which they inhabit. In the last few years, the study of lipids of marine origin has received increasing attention due to the diversity of their composition. The progress of analytical techniques such as LC-MS and MS/MS has allowed researchers to improve accurate processing of samples and lipid characterization. Lipidomics is a useful research field to understand marine ecosystems and the physiology of their organisms. The screening of biological systems in marine environments has demonstrated a significant diversity of lipids in their living resources. In this review, we provide the state-of-the-art marine of lipidomics studies. We describe in detail the lipidomics approach for the analysis of marine lipidomes, including sample collection and preparation, interpretation of MS/MS fragmentation fingerprinting, data analysis and processing. Special attention is also given to illustrate the latest applications and advances of applied LC-MS lipidomic analyses in diversified studies of different marine organisms, as well as the challenges and future perspectives of marine lipidomics.

Maternal high-fat diet programs white and brown adipose tissue lipidome and transcriptome in offspring in a sex- and tissue-dependent manner in mice.

OBJECTIVE: The prevalence of overweight and obesity among children has drastically increased during the last decades and maternal obesity has been demonstrated as one of the ultimate factors. Nutrition-stimulated transgenerational regulation of key metabolic genes is fundamental to the developmental origins of the metabolic syndrome. Fetal nutrition may differently influence female and male offspring. METHODS: Mice dam were fed either a control diet or a high-fat diet (HFD) for 6-week prior mating and continued their respective diet during gestation and lactation. At weaning, female and male offspring were fed the HFD until sacrifice. White (WAT) and brown (BAT) adipose tissues were investigated in vivo by nuclear magnetic resonance at two different timepoints in life (midterm and endterm) and tissues were collected at endterm for lipidomic analysis and RNA sequencing. We explored the sex-dependent metabolic adaptation and gene programming changes by maternal HFD in visceral AT (VAT), subcutaneous AT (SAT) and BAT of offspring. RESULTS: We show that the triglyceride profile varies between adipose depots, sexes and maternal diet. In female offspring, maternal HFD remodels the triglycerides profile in SAT and BAT, and increases thermogenesis and cell differentiation in BAT, which may prevent metabolic complication later in life. Male offspring exhibit whitening of BAT and hyperplasia in VAT when born from high-fat mothers, with impaired metabolic profile. Maternal HFD differentially programs gene expression in WAT and BAT of female and male offspring. CONCLUSION: Maternal HFD modulates metabolic profile in offspring in a sex-dependent manner. A sex- and maternal diet-dependent gene programming exists in VAT, SAT, and BAT which may be key player in the sexual dimorphism in the metabolic adaptation later in life.

Food grade extraction of Chlorella vulgaris polar lipids: A comparative lipidomic study.

Glycolipids and phospholipids are the main reservoirs of omega polyunsaturated fatty acids in microalgae. Their extraction for the food industry requires food grade solvents, however, the use of these solvents is generally associated with low extraction yields. In this study, we evaluated the lipid extraction efficiency of food-grade ethanol, ultrasound-assisted ethanol (UAE) and dichloromethane/methanol (DCM) from Chlorella vulgaris cultivated under autotrophic and heterotrophic conditions. Yields of lipids, fatty acids (FA), and complex lipid profiles were determined by gravimetry, GC-MS, and LC-MS/MS, respectively. UAE and DCM showed the highest lipid yields with similar purity. The FA profiles were identical for all extracts. The polar lipidome of the DCM and UAE extracts was comparable, while the EtOH extracts were significantly different. These results demonstrated the effectiveness of UAE extraction to obtain high yields of polar lipids and omega-3 and -6-rich extracts from C. vulgaris that can be used for food applications.

Práticas autorreferidas de enfermeiros sobre gerenciamento de antimicrobianos / Self-report of nurses' antimicrobial stewardship practices / Prácticas autoinformadas de los enfermeros sobre el manejo de antimicrobianos

Objetivo: investigar as práticas autorreferidas de enfermeiros no Programa de Gerenciamento de Antimicrobianos (PGA). Método: estudo transversal, descritivo realizado no período de março a abril de 2021, com 40 enfermeiros de uma instituição privada de ensino superior da cidade de São Paulo. Os dados foram coletados por meio de instrumento estruturado e analisados por estatística descritiva. Resultados: Dentre as 14 práticas de enfermagem esperadas nos PGA, os participantes referiram aplicar oito (57,1%) delas frequentemente: administrar antibiótico na dose e horário corretos, coletar amostras laboratoriais para cultura antes do início do antibiótico, checar o histórico de alergia, instituir precauções específicas, fazer a reconciliação medicamentosa, educar os pacientes/ familiares sobre o uso de antibióticos, monitorar a ocorrência de eventos adversos e participar da tomada de decisão sobre a adequação do paciente para receber antibiótico endovenoso em serviço ambulatorial. Conclusão: os enfermeiros praticam parcialmente as atividades previstas nos PGA. Faz-se necessário avançar na abordagem dessa temática em sessões educacionais e durante a graduação para que as atividades sejam efetivamente incorporadas na prática profissional do enfermeiro. (AU).

Objective: to investigate nurses'self-reported practices about the Antimicrobial Stewardship Program (ASP). Methods: cross-sectional, descriptive study, carried out from March to April 2021, with 40 nurses from a private institution of higher education in the city of São Paulo. Data were collected using a structured instrument and analyzed by descriptive statistics. Results: Among the 14 practices expected by nurses in the ASP, participants reported applying eight (57.1%) frequently: giving antibiotics at the correct dose and time, collecting laboratory samples for culture before starting antibiotics, assessing allergy history, initiating specific precautions, performing medication reconciliation, educating patients/family members about antibiotic use, monitoring the occurrence of adverse events, and participating in decision making about a patient's suitability to receive intravenous antibiotics in outpatient settings. Conclusion: nurses partially practice the activities established in the ASP. It is necessary to advance in the approach of this theme in educational sessions and during graduation so that the activities are effectively incorporated into the professional practice of nurses. (AU).

Objetivo: investigar las prácticas autoinformadas de los enfermeros sobre el Programa para Optimizar el Uso de Antimicrobianos (PROA). Métodos: Estudio transversal, descriptivo, realizado de marzo a abril de 2021, con 40 enfermeros de una institución privada de enseñanza superior de la ciudad de San Pablo. Los datos se recolectaron por medio de un instrumento estructurado y se analizaron mediante estadísticas descriptivas. Resultados: De las 14 prácticas de enfermería esperadas en el PROA, los participantes informaron que realizan ocho (57,1%) con frecuencia: administrar el antibiótico en la dosis y el horario correctos, recolectar muestras de laboratorio para cultivo antes de iniciar el antibiótico, comprobar los antecedentes de alergia, adoptar precauciones específicas, realizar la conciliación de medicación, educar a los pacientes/familiares sobre el uso de los antibióticos, monitorear la aparición de eventos adversos y participar en la toma de decisiones sobre la posibilidad de que el paciente reciba antibióticos intravenosos en el servicio ambulatorio. Conclusión: Los enfermeros realizan parcialmente las actividades previstas en los PROA. Es necesario avanzar en el abordaje de este tema en las sesiones educativas y durante el cursado de la carrera para que los enfermeros incorporen efectivamente las actividades en la práctica profesional. (AU).

Ethanol Extraction of Polar Lipids from Nannochloropsis oceanica for Food, Feed, and Biotechnology Applications Evaluated Using Lipidomic Approaches.

Nannochloropsis oceanica can accumulate lipids and is a good source of polar lipids, which are emerging as new value-added compounds with high commercial value for the food, nutraceutical, and pharmaceutical industries. Some applications may limit the extraction solvents, such as food applications that require safe food-grade solvents, such as ethanol. However, the effect of using ethanol as an extraction solvent on the quality of the extracted polar lipidome, compared to other more traditional methods, is not yet well established. In this study, the polar lipid profile of N. oceanica extracts was obtained using different solvents, including chloroform/methanol (CM), dichloromethane/methanol (DM), dichloromethane/ethanol (DE), and ethanol (E), and evaluated by modern lipidomic methods using LC-MS/MS. Ultrasonic bath (E + USB)- and ultrasonic probe (E + USP)-assisted methodologies were implemented to increase the lipid extraction yields using ethanol. The polar lipid signature and antioxidant activity of DM, E + USB, and E + USP resemble conventional CM, demonstrating a similar extraction efficiency, while the DE and ethanol extracts were significantly different. Our results showed the impact of different extraction solvents in the polar lipid composition of the final extracts and demonstrated the feasibility of E + USB and E + USP as safe and food-grade sources of polar lipids, with the potential for high-added-value biotechnological applications.

Microalgae as Sustainable Bio-Factories of Healthy Lipids: Evaluating Fatty Acid Content and Antioxidant Activity.

The demand for sustainable and environmentally friendly food sources and food ingredients is increasing, and microalgae are promoted as a sustainable source of essential and bioactive lipids, with high levels of omega-3 fatty acids (ω-3 FA), comparable to those of fish. However, most FA screening studies on algae are scattered or use different methodologies, preventing a true comparison of its content between microalgae. In this work, we used gas-chromatography mass-spectrometry (GC-MS) to characterize the FA profile of seven different commercial microalgae with biotechnological applications (Chlorella vulgaris, Chlorococcum amblystomatis, Scenedesmus obliquus, Tetraselmis chui, Phaeodactylum tricornutum, Spirulina sp., and Nannochloropsis oceanica). Screening for antioxidant activity was also performed to understand the relationship between FA profile and bioactivity. Microalgae exhibited specific FA profiles with a different composition, namely in the ω-3 FA profile, but with species of the same phylum showing similar tendencies. The different lipid extracts showed similar antioxidant activities, but with a low activity of the extracts of Nannochloropsis oceanica. Overall, this study provides a direct comparison of FA profiles between microalgae species, supporting the role of these species as alternative, sustainable, and healthy sources of essential lipids.