Experimental Tumor Induction and Evaluation of Its Treatment in the Chicken Embryo Chorioallantoic Membrane Model: A Systematic Review.

The chorioallantoic membrane (CAM) model, generated during avian development, can be used in cancer research as an alternative in vivo model to perform tumorigenesis in ovo due to advantages such as simplicity, low cost, rapid growth, and being naturally immunodeficient. The aim of this systematic review has been to compile and analyze all studies that use the CAM assay as a tumor induction model. For that, a systematic search was carried out in four different databases: PubMed, Scopus, Cochrane, and WOS. After eliminating duplicates and following the established inclusion and exclusion criteria, a total of 74 articles were included. Of these, 62% use the in ovo technique, 13% use the ex ovo technique, 9% study the formation of metastasis, and 16% induce tumors from patient biopsies. Regarding the methodology followed, the main species used is chicken (95%), although some studies use quail eggs (4%), and one article uses ostrich eggs. Therefore, the CAM assay is a revolutionary technique that allows a simple and effective way to induce tumors, test the effectiveness of treatments, carry out metastasis studies, perform biopsy grafts of patients, and carry out personalized medicine. However, unification of the methodology used is necessary.

Ruthenium nanoparticles stabilized by 1,2,3-triazolylidene ligands in the hydrogen isotope exchange of E-H bonds (E = B, Si, Ge, Sn) using deuterium gas.

A series of ruthenium nanoparticles (Ru·MIC) stabilized with different mesoionic 1,2,3-triazolylidene (MIC) ligands were prepared by decomposition of the Ru(COD)(COT) (COD = 1,5-cyclooctadiene; COT = 1,3,5-cyclooctatriene) precursor with H2 (3 bar) in the presence of substoichiometric amounts of the stabilizer (0.1-0.2 equiv.). Small and monodisperse nanoparticles exhibiting mean sizes between 1.1 and 1.2 nm were obtained, whose characterization was carried out by means of transmission electron microscopy (TEM), including high resolution TEM (HRTEM), inductively coupled plasma (ICP) analysis and X-ray photoelectron spectroscopy (XPS). In particular, XPS measurements confirmed the presence of MIC ligands on the surfaces of the nanoparticles. The Ru·MIC nanoparticles were used in the isotopic H/D exchange of different hydrosilanes, hydroboranes, hydrogermananes and hydrostannanes using deuterium gas under mild conditions (1.0 mol% Ru, 1 bar D2, 55 °C). Selective labelling of the E-H (E = B, Si, Ge, Sn) bond in these derivatives, with high levels of deuterium incorporation, was observed.

Analysis of physical function, muscle strength, and pulmonary function in surgical cancer patients: a prospective cohort study.

The aim of this study was to investigate mobility, physical functioning, peripheral muscle strength, inspiratory muscle strength and pulmonary function in surgical cancer patients admitted to an intensive care unit (ICU). We conducted a prospective cohort study with 85 patients. Mobility, physical functioning, peripheral muscle strength, inspiratory muscle strength, and pulmonary function were assessed using the following tests: ICU Mobility Scale (IMS); Chelsea Critical Care Physical Assessment (CPAx); handgrip strength and Medical Research Council Sum-Score (MRC-SS); maximal inspiratory pressure (MIP) and S-Index; and peak inspiratory flow, respectively. The assessments were undertaken at ICU admission and discharge. The data were analyzed using the Shapiro-Wilk and Wilcoxon tests and Spearman's correlation coefficient. Significant differences in inspiratory muscle strength, CPAx, grip strength, MRC-SS, MIP, S-Index, and peak inspiratory flow scores were observed between ICU admission and discharge. Grip strength showed a moderate correlation with MIP at admission and discharge. The findings also show a moderate correlation between S-Index scores and both MIP and peak inspiratory flow scores at admission and a strong correlation at discharge. Patients showed a gradual improvement in mobility, physical functioning, peripheral and inspiratory muscle strength, and inspiratory flow during their stay in the ICU.

Estudiantes que usan drogas: cómo profesores lidian y piensan sobre ellos / Estudantes que usam drogas: como professores lidam e pensam sobre eles / Students who use drugs: what teachers think and how they handle the situation

Descrever e analisar percepções e atitudes de professores quanto ao uso de álcool/drogas (AD) por estudantes do Ensino Médio de escolas públicas de Águas Lindas-GO/Brasil. Estudo misto realizado em 11 escolas, com 91 professores, por meio de questionário sociodemográfico, entrevista semiestruturada sobre a percepção em relação ao uso de AD por estudantes, e questões sobre o julgamento daqueles que fazem uso. A maioria (57%) era do sexo masculino, idade média 37,2 anos; acredita que alunos que fazem uso de AD são moralmente fracos (51%), um perigo para a sociedade (47%) e podem cometer delitos na própria família (98%); em contrapartida os consideram tão importantes quanto qualquer outra pessoa (98%). Afirmam que não se sentem capacitados para abordar o tema AD, tampouco para lidar com alunos que usam. O estudo revela e reforça que a educação em saúde deveria compor a formação dos professores para uma abordagem preventiva e de acolhimento.

Describir y analizar percepciones y actitudes de profesores relacionadas el uso de alcohol/drogas (AD) por estudiantes de la enseñanza secundaria de escuelas públicas de Aguas Lindas-GO/Brasil. Estudio mixto realizado en 11 escuelas, con 91 profesores, por intermedio de cuestionario sociodemográfico, entrevista semiestructurada sobre la percepción con relación al uso de AD por estudiantes, y cuestiones sobre el juzgamiento de aquellos que hacen uso. La mayoría (el 57%) era del sexo masculino, edad media 37,2 años; cree que alumnos que hacen uso de AD son moralmente débiles (el 51%), un peligro para la sociedad (el 47%) y pueden cometer delitos en la propia familia (el 98%); en contrapartida los consideran tan importantes cuanto cualquier otra persona (el 98%). Afirman que no se sienten capacitados para abordar el tema AD, tampoco para lidiar con alumnos que usan. El estudio revela y refuerza que la educación en salud debería componer la formación de los profesores para un abordaje preventiva e de acogimiento.

In order to describe and analyze teachers' perceptions and attitudes regarding the use of alcohol/drugs (AD) by High School students from public schools in Águas Lindas-GO/Brazil, this mixed study was carried out in 11 schools, with 91 teachers, using a sociodemographic questionnaire, a semi-structured interview about the perception of AD use by students, and questions about the judgment of those who use it. Most (57%) were male, average age 37.2 years; most participants believed that students who use AD are morally weak (51%), a danger to society (47%), and may commit crimes in their own families (98%); on the other hand, they consider them as important as anyone else (98%). They claim that they do not feel qualified to address the DA theme, nor to deal with students who use it. The study reveals and reinforces that health education should form part of teacher training for a preventive and welcoming approach.

Circular Sponge against miR-21 Enhances the Antitumor Activity of Doxorubicin against Breast Cancer Cells.

Breast cancer is the most common type of cancer in women, with chemotherapy being the main strategy. However, its effectiveness is reduced by drug resistance mechanisms. miR-21 is upregulated in breast cancer that has been linked to drug resistance and carcinogenic processes. Our aim was to capture miR-21 with a circular sponge (Circ-21) and thus inhibit the carcinogenic processes and drug resistance mechanisms in which it participates. Proliferation, migration, colony formation, cell cycle, and poly [ADP-ribose] polymerase 1 (PARP-1) and vascular endothelial growth factor (VEGF) detection assays were performed with MCF7 breast cancer cells and MCF10A non-tumor cells. In addition, doxorubicin resistance tests and detection of drug resistance gene expression were performed in MCF7 cells. Reduction in proliferation, as well as migration and colony formation, increased PARP-1 expression, inhibition of VEGF expression and cell cycle arrest in G2/M phase were displayed in the Circ-21 MCF7, which were not observed in the MCF10A cells. Furthermore, in the MCF7 cells, the Circ-21 enhanced the antitumor activity of doxorubicin and decreased the expression of resistance genes: ABCA1, ABCC4, and ABCC5. Based on these results, the use of Circ-21 can be considered a first step for the establishment of an effective gene therapy in the treatment of breast cancer.

Catalytic Nitrous Oxide Reduction with H2 Mediated by Pincer Ir Complexes.

Reduction of nitrous oxide (N2O) with H2 to N2 and water is an attractive process for the decomposition of this greenhouse gas to environmentally benign species. Herein, a series of iridium complexes based on proton-responsive pincer ligands (1-4) are shown to catalyze the hydrogenation of N2O under mild conditions (2 bar H2/N2O (1:1), 30 °C). Among the tested catalysts, the Ir complex 4, based on a lutidine-derived CNP pincer ligand having nonequivalent phosphine and N-heterocyclic carbene (NHC) side donors, gave rise to the highest catalytic activity (turnover frequency (TOF) = 11.9 h-1 at 30 °C, and 16.4 h-1 at 55 °C). Insights into the reaction mechanism with 4 have been obtained through NMR spectroscopy. Thus, reaction of 4 with N2O in tetrahydrofuran-d8 (THF-d8) initially produces deprotonated (at the NHC arm) species 5NHC, which readily reacts with H2 to regenerate the trihydride complex 4. However, prolonged exposure of 4 to N2O for 6 h yields the dinitrogen Ir(I) complex 7P, having a deprotonated (at the P-arm) pincer ligand. Complex 7P is a poor catalytic precursor in the N2O hydrogenation, pointing out to the formation of 7P as a catalyst deactivation pathway. Moreover, when the reaction of 4 with N2O is carried out in wet THF-d8, formation of a new species, which has been assigned to the hydroxo species 8, is observed. Finally, taking into account the experimental results, density functional theory (DFT) calculations were performed to get information on the catalytic cycle steps. Calculations are in agreement with 4 as the TOF-determining intermediate (TDI) and the transfer of an apical hydrido ligand to the terminal nitrogen atom of N2O as the TOF-determining transition state (TDTS), with very similar reaction rates for the mechanisms involving either the NHC- or the P-CH2 pincer methylene linkers.

Reduction of N2O with hydrosilanes catalysed by RuSNS nanoparticles.

A series of RuSNS nanoparticles, prepared by decomposition of Ru(COD)(COT) with H2 in the presence of an SNS ligand, have been found to catalyse the reduction of the greenhouse gas N2O to N2 employing different hydrosilanes.

Minding the maps: Using visual mapping methodology and installation art to understand differences in client service accessibility among nonprofit organizations in Los Angeles.

This study highlights the pathways of clients' social service usage through qualitative interviews and visual mapping methodology. Undergraduate students interviewed clients at diverse social service agencies in Los Angeles that include homeless shelters, child welfare organizations, domestic violence organizations, LGBTQIA youth-oriented agencies, nonprofits serving older adults, schools, and organizations serving low-income families. Students used the information gathered from the interviews to visually map their clients' environmental and structural barriers, as well as their pathways to service. The research team then analyzed the students' visual maps to create one cohesive, complex, and multilayered visual map representing clients' overall barriers and pathways to social services in Los Angeles.

Perfil psicosocial, factores de riesgo y reinserción en reclusas adultas: una revisión sistemática / Psychosocial profile, risk factors and reintegration in adult women prisoners: A systematic review

Resumen El objetivo de este trabajo fue analizar los efectos psicológicos asociados con la estancia en prisión en mujeres reclusas, así como su perfil psicosocial. Para esto se llevó a cabo una búsqueda de la literatura en las siguientes bases de datos: Web of Science, Scopus, Psicodoc, PsycInfo, Pubmed y DOAJ. En la búsqueda se localizó un total de 1403 trabajos (1350 artículos y 53 revisiones), de los cuales se seleccionaron, finalmente, 106 estudios. Se observan importantes diferencias entre hombres y mujeres en cuanto al ajuste a prisión, además de que las mujeres reclusas tienen unas necesidades específicas. Como conclusión cabe señalar la necesidad de más estudios que complementen la información sobre los efectos psicológicos de las mujeres en países menos desarrollados.

Abstract The objective of this work was to analyze the psychological effects associated with the stay in prison in women prisoners as well as their psychosocial profile. For this purpose, a literatura search was carried out in the following databases: Web of Science, Scopus, Psicodoc, PsycInfo, Pubmed and DOAJ. In the search a total of 1403 papers were located (1350 articles and 53 reviews), finally selecting 106 studies. There are important differences between men and women in terms of adjustment to prison, in addition to the fact that women prisoners have specific needs. In conclusion, more studies are needed to complement the information on the psychological effects of women in less developed countries.

Platinum nanoparticles stabilized by N-heterocyclic thiones. Synthesis and catalytic activity in mono- and di-hydroboration of alkynes.

N-Heterocyclic Thiones (NHT) proved to be efficient ligands for the stabilization of small platinum nanoparticles (1.3-1.7 nm), synthesized by decomposition of [Pt(dba)2], under a H2 atmosphere, in the presence of variable sub-stoichiometric amounts of the NHT. Full characterization by means of TEM, HR-TEM, NMR, ICP, TGA and XPS have been carried out, providing information about the nature of the metal nanoparticles and the interaction of the NHT ligands to the metal surface. Importantly, DFT calculations indicate that some NHT ligands interact with the metal through the C[double bond, length as m-dash]C double bond of the imidazole fragment in addition to the sulfur atom, thus providing additional stabilization to the nanoparticles. According to XPS, TGA and ICP techniques, the surface coverage by the ligand increases by decreasing the size of the substituents on the nitrogen atom. The platinum nanoparticles have been used as catalyst in the hydroboration of alkynes. The most active system is that with a less covered surface area lacking an interaction of the ligand by means of the C[double bond, length as m-dash]C double bond. This catalyst hydroborates alkynes with excellent selectivities towards the monoborylated anti-Markovnikov product (vinyl-boronate) when one equiv. of borane is used. Very interestingly, aliphatic alkynes undergo a second hydroborylation process leading to the corresponding 1,1- and 1,2-diboroylated species with good selectivities towards the former.

Morte digna: percepção de médicos de hospital de ensino / Dignified death: the perception of doctors in a teaching hospital / Muerte digna: la percepción de los médicos de un hospital de enseñanza

Resumo Com o objetivo de identificar a percepção de morte digna de médicos de hospital de ensino, propõe-se estudo transversal, com amostra por conveniência (100 médicos), utilizando a versão reduzida da escala de percepção de morte digna. Todos os fatores do instrumento foram considerados de alta necessidade, enfatizando-se boa relação com a família (98,9%), manutenção da esperança e do prazer (97,8%) e não ser um fardo para os demais (92,3%). Mulheres priorizaram boas relações com a família e equipe; médicos com mais de 45 anos, não ser um fardo para os demais; e os sem religião, não ser um fardo e ter controle sobre o futuro. A percepção de morte digna dos médicos valorizou aspectos sociais, como afetividade e convivência, ao priorizar esses três fatores, além de demonstrar que idade, sexo e religiosidade a influenciam. Aprovação CEP-UFSC CAAE 71111317.4.0000.0121

Abstract In order to identify the perception of good death by physicians who work at a teaching hospital, a cross sectional study with a convenience sample (100 physicians) is proposed, using the reduced version of the perceived dignified death scale (Brazilian reduced version of Good Death Inventory). All factors of the instrument were considered as highly needed, emphasizing good relationship with the family (98.9%), maintenance of hope and pleasure (97.8%) and not being a burden to others (92.3%). Women prioritized good relationships with family and team; doctors over 45 years old, not being a burden to others; and those without religion, not being a burden to others and having control over the future. The perception of good death presented by physicians valued social aspects such as affectivity and acquaintanceship, by prioritizing these three factors, in addition to showing that age, sex and religiosity influence this perception. Approval CEP-UFSC CAAE 71111317.4.0000.0121

Resumen Con el objetivo de identificar la percepción de muerte digna por parte de médicos de un hospital de enseñanza, se propone un estudio transversal, con muestra de conveniencia (100 médicos), utilizando la versión reducida de la escala de percepción de muerte digna. Todos los factores del instrumento fueron considerados como de alta necesidad, con destaque para buena relación con la familia (98,9%), mantenimiento de la esperanza y placer (97,8%) y no ser una carga para los demás (92,3%). Las mujeres priorizaron buenas relaciones con la familia y el equipo; médicos con más de 45 años, no ser una carga para los demás; y los sin religión, no ser una carga para los demás y tener control sobre el futuro. La percepción de muerte digna por parte de los médicos valoró aspectos sociales como afectividad y convivencia, al priorizar estos tres factores, además de demostrar que edad, sexo y religiosidad la influencian. Aprobación CEP-UFSC CAAE 71111317.4.0000.0121

Membrane integration and topology of RIFIN and STEVOR proteins of the Plasmodium falciparum parasite.

The malarial parasite Plasmodium exports its own proteins to the cell surfaces of red blood cells (RBCs) during infection. Examples of exported proteins include members of the repetitive interspersed family (RIFIN) and subtelomeric variable open reading frame (STEVOR) family of proteins from Plasmodium falciparum. The presence of these parasite-derived proteins on surfaces of infected RBCs triggers the adhesion of infected cells to uninfected cells (rosetting) and to the vascular endothelium potentially obstructing blood flow. While there is a fair amount of information on the localization of these proteins on the cell surfaces of RBCs, less is known about how they can be exported to the membrane and the topologies they can adopt during the process. The first step of export is plausibly the cotranslational insertion of proteins into the endoplasmic reticulum (ER) of the parasite, and here, we investigate the insertion of three RIFIN and two STEVOR proteins into the ER membrane. We employ a well-established experimental system that uses N-linked glycosylation of sites within the protein as a measure to assess the extent of membrane insertion and the topology it assumes when inserted into the ER membrane. Our results indicate that for all the proteins tested, transmembranes (TMs) 1 and 3 integrate into the membrane, so that the protein assumes an overall topology of Ncyt-Ccyt. We also show that the segment predicted to be TM2 for each of the proteins likely does not reside in the membrane, but is translocated to the lumen.

Confiabilidade da ultrassonografia de músculos esqueléticos em pacientes críticos de trauma / Reliability of skeletal muscle ultrasound in critically ill trauma patients

RESUMO Objetivo: Avaliar a segurança e a viabilidade da avaliação por ultrassonografia do quadríceps no pronto-socorro, e avaliar a confiabilidade intra e entre avaliadores para aquisição e análise de imagens de ultrassonografia da espessura e da ecogenicidade muscular em pacientes críticos de trauma. Métodos: Estudo de precisão diagnóstica realizado por meio de exames e avaliações feitos por profissionais de saúde com diferentes níveis de especialização. Dois examinadores (um especialista e um novato) procederam à aquisição de imagens de ultrassom de dez pacientes. Um avaliador experiente, cego quanto aos examinadores, quantificou as imagens obtidas. Em um grupo à parte de dez pacientes, dois avaliadores (um especialista e um novato) quantificaram a espessura do músculo quadríceps femoral, assim como sua ecogenicidade (métodos quadrado ou tracejado) em imagens adquiridas por um examinador. Resultados: Identificou-se excelente confiabilidade quanto à aquisição da imagem e à sua análise (coeficientes de correlação intraclasses > 0,987; p < 0,001). O erro padrão dos valores de mensurações variou de 0,01 a 0,06 cm, para a espessura muscular, e de 0,75 a 2,04 unidades arbitrárias, para ecogenicidade muscular. Os valores de ecogenicidade foram mais elevados quando se utilizou o método quadrado do que quando se utilizou o método tracejado (p = 0,003). Conclusão: A ultrassonografia é um método seguro, viável e confiável para avaliação muscular em pacientes críticos de trauma, independentemente do nível de especialização do avaliador.

ABSTRACT Objective: To evaluate the safety and feasibility of the ultrasound assessment of quadriceps in the emergency setting. To assess the intra- and interrater reliability for the acquisition and analysis of ultrasound images of muscle thickness and echogenicity in critically ill trauma patients between health professionals with different levels of expertise. Methods: Diagnostic accuracy study. Two examiners (expert and novice) acquired ultrasound images from ten patients; an experienced, blinded analyst quantified the images. In a separate group of ten patients, two analysts (expert and novice) quantified quadriceps muscle thickness and echogenicity (square or trace method) from images acquired by one examiner. Results: Excellent reliability was found for image acquisition and analysis (intraclass correlation coefficients > 0.987; p < 0.001). The standard error of the measurement values ranged from 0.01 - 0.06cm for muscle thickness and from 0.75 - 2.04 arbitrary units for muscle echogenicity. The coefficients of variation were < 6% for thickness and echogenicity. The echogenicity values were higher when using the square technique than when using the tracing technique (p = 0.003). Conclusion: Ultrasound is safe, feasible, and reliable for muscle assessment in critically ill trauma patients, regardless of the assessor's level of expertise.

Avaliação do uso de ventilação não-invasiva no desmame da ventilação mecânica em pacientes adultos ­ revisão integrativa / Evaluation of the use of non-invasive ventilation in the weaning of mechanical ventilation in adult patients ­ integrative review

INTRODUÇÃO: Pacientes com quadro de insuficiência respiratória aguda ou crônica necessitam de suporte através da Ventilação Mecânica Invasiva (VMI), após a correção do evento que levou o paciente a necessitar de VMI é iniciado o processo de desmame, definido como a transição da ventilação artificial para a espontânea. A Ventilação Não-Invasiva (VNI) tem-se mostrado eficiente no processo de desmame, otimizando o processo de transição e evitando a reintubação. OBJETIVO: Avaliar o uso da VNI no processo de desmame da VMI em pacientes adultos. MÉTODOS: Revisão integrativa, o levantamento de pesquisas indexadas se deu nos meses de março a maio de 2018, através do acesso as bases de dados: PubMed/MEDLINE, SciELO e LILACS, utilizando os descritores: weaning mechanical ventilation e ventilator weaning, non-invasive, non-invasive ventilation, continuous positive airway pressure, CPAP ventilation, bilevel continuous positive airway pressure, intervention studies e clinical trials, extubation, extubation failure, reintubation, reintubation failure e weaning. Os descritores foram utilizados de maneira individual e cruzada. RESULTADOS: Um total de 123 artigos foram encontrados com a busca nas bases de dados, 60 artigos foram excluídos após a leitura dos resumos por não se enquadrarem nos critérios de inclusão do estudo, 63 artigos foram lidos na íntegra, de onde 10 foram eleitos para integrar esta revisão integrativa. CONCLUSÃO: A VNI é uma terapêutica que se mostrou viável em alguns estudos para reduzir os riscos de reintubação em pacientes com diversidade diagnóstica que apresentaram insuficiência respiratória aguda após a extubação. Porém, esse resultado não foi unanimidade, o que dificulta sua recomendação.

INTRODUCTION: Patients with diagnosis of acute or chronic respiratory insufficiency need support through invasive mechanical ventilation (IMV), after the correction of the event that led the patient to need IMV, the weaning process is started, defined as the transition from artificial to spontaneous ventilation. Non-invasive ventilation (NIV) has been shown to be efficient in the weaning process, optimizing it and avoiding reintubation. OBJECTIVE: To evaluate the use of NIV in the weaning process of IMV in adult patients. METHODS: Integrative review, the survey of indexed researches was carried out from 2018 March to May, through the databases: PubMed/MEDLINE, Scielo and LILACS, using the descriptors: "weaning mechanical ventilation" and "ventilator weaning", "noninvasive", "non-invasive ventilation", "continuous positive airway pressure", "CPAP ventilation", "bilevel continuous positive airway pressure", "intervention studies" and "clinical trials", "extubation", "extubation failure", "reintubation", "reintubation failure" and "weaning". The descriptors were used individually and cross-checked. RESULTS: A total of 123 articles were found with the search in the databases, 60 articles were excluded after reading the abstracts because they did not fit the inclusion criteria of the study, 63 articles were read in full, from where 10 were elected to integrate this integrative review. CONCLUSION: NIV is a therapy that has proven feasible in some studies to reduce the risk of reintubation in patients with diagnostic diversity who presented acute respiratory failure after extubation. However, this result was not unanimous, which hinders its recommendation.

Murine astrotactins 1 and 2 have a similar membrane topology and mature via endoproteolytic cleavage catalyzed by a signal peptidase.

Astrotactin 1 (Astn1) and Astn2 are membrane proteins that function in glial-guided migration, receptor trafficking, and synaptic plasticity in the brain as well as in planar polarity pathways in the skin. Here we used glycosylation mapping and protease protection approaches to map the topologies of mouse Astn1 and Astn2 in rough microsomal membranes and found that Astn2 has a cleaved N-terminal signal peptide, an N-terminal domain located in the lumen of the rough microsomal membranes (topologically equivalent to the extracellular surface in cells), two transmembrane helices, and a large C-terminal lumenal domain. We also found that Astn1 has the same topology as Astn2, but we did not observe any evidence of signal peptide cleavage in Astn1. Both Astn1 and Astn2 mature through endoproteolytic cleavage in the second transmembrane helix; importantly, we identified the endoprotease responsible for the maturation of Astn1 and Astn2 as the endoplasmic reticulum signal peptidase. Differences in the degree of Astn1 and Astn2 maturation possibly contribute to the higher levels of the C-terminal domain of Astn1 detected on neuronal membranes of the central nervous system. These differences may also explain the distinct cellular functions of Astn1 and Astn2, such as in membrane adhesion, receptor trafficking, and planar polarity signaling.

Reliability of skeletal muscle ultrasound in critically ill trauma patients. / Confiabilidade da ultrassonografia de músculos esqueléticos em pacientes críticos de trauma.

OBJECTIVE: To evaluate the safety and feasibility of the ultrasound assessment of quadriceps in the emergency setting. To assess the intra- and interrater reliability for the acquisition and analysis of ultrasound images of muscle thickness and echogenicity in critically ill trauma patients between health professionals with different levels of expertise. METHODS: Diagnostic accuracy study. Two examiners (expert and novice) acquired ultrasound images from ten patients; an experienced, blinded analyst quantified the images. In a separate group of ten patients, two analysts (expert and novice) quantified quadriceps muscle thickness and echogenicity (square or trace method) from images acquired by one examiner. RESULTS: Excellent reliability was found for image acquisition and analysis (intraclass correlation coefficients > 0.987; p < 0.001). The standard error of the measurement values ranged from 0.01 - 0.06cm for muscle thickness and from 0.75 - 2.04 arbitrary units for muscle echogenicity. The coefficients of variation were < 6% for thickness and echogenicity. The echogenicity values were higher when using the square technique than when using the tracing technique (p = 0.003). CONCLUSION: Ultrasound is safe, feasible, and reliable for muscle assessment in critically ill trauma patients, regardless of the assessor's level of expertise.

OBJETIVO: Avaliar a segurança e a viabilidade da avaliação por ultrassonografia do quadríceps no pronto-socorro, e avaliar a confiabilidade intra e entre avaliadores para aquisição e análise de imagens de ultrassonografia da espessura e da ecogenicidade muscular em pacientes críticos de trauma. MÉTODOS: Estudo de precisão diagnóstica realizado por meio de exames e avaliações feitos por profissionais de saúde com diferentes níveis de especialização. Dois examinadores (um especialista e um novato) procederam à aquisição de imagens de ultrassom de dez pacientes. Um avaliador experiente, cego quanto aos examinadores, quantificou as imagens obtidas. Em um grupo à parte de dez pacientes, dois avaliadores (um especialista e um novato) quantificaram a espessura do músculo quadríceps femoral, assim como sua ecogenicidade (métodos quadrado ou tracejado) em imagens adquiridas por um examinador. RESULTADOS: Identificou-se excelente confiabilidade quanto à aquisição da imagem e à sua análise (coeficientes de correlação intraclasses > 0,987; p < 0,001). O erro padrão dos valores de mensurações variou de 0,01 a 0,06 cm, para a espessura muscular, e de 0,75 a 2,04 unidades arbitrárias, para ecogenicidade muscular. Os valores de ecogenicidade foram mais elevados quando se utilizou o método quadrado do que quando se utilizou o método tracejado (p = 0,003). CONCLUSÃO: A ultrassonografia é um método seguro, viável e confiável para avaliação muscular em pacientes críticos de trauma, independentemente do nível de especialização do avaliador.

Development and Preliminary Assessment of Interprofessional Education Focused on Vulnerable Populations.

With the current state of the U.S. healthcare system, interprofessional collaborative practice (IPCP) has never been more important. Health professions educators are increasingly incorporating interprofessional education (IPE) in their curricula in order to prepare students for IPCP. The Health- Focused IPE Community of Practice (representing nursing, occupational therapy, pharmacy, physical therapy, rehabilitation counseling, social work, and speech-language pathology) at the University of Texas at El Paso has created a unique IPE model centered on vulnerable populations. The purposes of this paper are to describe the early development of this innovative IPE model and present findings from an evaluation of an IPE learning experience focused on a case involving a transgender individual. The evaluation of the first IPE activity demonstrated that the students' knowledge and attitudes related to interprofessional collaboration improved for all participating professions. Additionally, the post-training evaluation revealed that students were more comfortable providing services to transgender individuals than interacting with them. This IPE model has leveraged the strengths of community-engaged faculty in order to infuse content related to vulnerable populations across multiple curricula. This holistic approach models to the students that complex problems require multifaceted solutions generated by IPCP.

Developing Trans-Affirming Health Services in an Underserved Area: An Intersectional Approach.

Purpose: Gender-nonconforming patients are at higher risk for medical problems that require prompt medical and mental health intervention. Barriers to healthcare for transgender individuals have been well characterized in the literature, but not in low resource settings. The purpose of this paper is to present the barriers encountered when bringing healthcare to transgender children, adolescents, and adults in a medically underserved, predominantly Hispanic area of the United States. Methods: In this medically underserved area on the U.S.-Mexico border, there is a severe shortage of medical expertise for transgender individuals at both the primary- and specialty-care levels. Further, given the mainly Hispanic population, there is an additional culturally based barrier to obtaining medical care for transgender patients. Results: It is important for academic centers in these regions to collaborate to overcome these barriers through a multidisciplinary approach that includes providing education for medical students and physicians in training and identifying medical providers who are able and willing to provide transgender-competent care adapted to local culture and gender norms. Conclusion: In this manuscript, we will describe the efforts of various groups to address the needs of the transgender community in the region.

Serial Palliative Performance Scale Assessment in a University General Hospital: A Pilot Study.

BACKGROUND: Serial Palliative Performance Scale (PPS) assessments may predict functional decline and prognosis in cancer and noncancer patients and help with end-of-life decision making. OBJECTIVE: To evaluate the functional status of using serial PPS assessments of patients being assisted in collaboration with the palliative care team (PCT). DESIGN: Prospective cohort pilot study. MEASUREMENTS: The sample consisted of 64 cancer and noncancer inpatients being assisted in collaboration with the PCT during the period from 2012 to 2016 (included 12 months). Patients' PPS scores were assessed in three sequential stages: prehospital, first PCT assessment, and outcome (discharge, transference to another unit or death). Functional performance was classified in categories as stable (PPS scores between 70% and 100%), transitional (PPS scores between 40% and 60%), and end of life (PPS scores between 10% and 30%). RESULTS: The mean PPS score during the three assessment stages (respectively, 60.5%, 38.9%, and 25.9%) was significantly different (p < 0.001). Cancer patients had higher PPS scores than noncancer patients; however, both groups exhibited a functional decline along the hospital stay. In both groups there was a negative correlation between the time frame between the different assessment stages and PPS scores (respectively, Pearson -0.4 and -0.6; p < 0.01). The survival curve of the first palliative assessment stage demonstrated earlier death in patients in the end-of-life category. CONCLUSION: Serial PPS assessments are feasible and predicted functional decline in cancer and noncancer patients in this sample. Cancer patients exhibited higher initial functional scores but both cancer and noncancer patients declined in functionality along hospitalization. Earlier deaths occurred in the terminal PPS category than in the transitional PPS category.

Stabilisation of gold nanoparticles by N-heterocyclic thiones.

Gold nanoparticles (Au-NPs) have been prepared using N-heterocyclic thiones (NHTs) as ligand stabilisers. These Au-NPs have been shown to be very stable, even in air, and have been characterized by a combination of several techniques (TEM, HR-TEM, STEM-HAADF, EDX, DLS, elemental analysis and 1H NMR). These nanoparticles are active in the catalytic reduction of nitroarenes to anilines.