DszA Catalyzes C-S Bond Cleavage through N5-Hydroperoxyl Formation.

Due to its detrimental impact on human health and the environment, regulations demand ultralow sulfur levels on fossil fuels, in particular in diesel. However, current desulfurization techniques are expensive and cannot efficiently remove heteroaromatic sulfur compounds, which are abundant in crude oil and concentrate in the diesel fraction after distillation. Biodesulfurization via the four enzymes of the metabolic 4S pathway of the bacterium Rhodococcus erythropolis (DszA-D) is a possible solution. However, the 4S pathway needs to operate at least 500 times faster for industrial applicability, a goal currently pursued through enzyme engineering. In this work, we unveil the catalytic mechanism of the flavin monooxygenase DszA. Surprisingly, we found that this enzyme follows a recently proposed atypical mechanism that passes through the formation of an N5OOH intermediate at the re side of the cofactor, aided by a well-defined, predominantly hydrophobic O2 pocket. Besides clarifying the unusual chemical mechanism of the complex DszA enzyme, with obvious implications for understanding the puzzling chemistry of flavin-mediated catalysis, the result is crucial for the rational engineering of DszA, contributing to making biodesulfurization attractive for the oil refining industry.

Massive Pilomatrixoma of the Scalp: A Case Report.

Pilomatrixoma, also called epithelioma of Malherbe, is a benign neoplasm derived from hair follicle matrix cells. It usually presents as a solitary mass in the head and neck region and is more frequent in children and young adults, females, and the Caucasian population. Lesions equal to or greater than 5 cm are categorized as giant pilomatrixomas. We present a case of a 75-year-old female, with no known medical history, who was brought to the emergency department (ED) after falling on the street. She had a giant soft head tissue tumor, severe anemia due to intralesional chronic small hemorrhages and folates and cobalamin deficiencies, and delirant speech. The anatomopathological result of the biopsy of the tumor revealed to be a pilomatrixoma. The patient was then referred to plastic surgery, with complete excision of the tumor. After surgery, she was transferred to the psychiatric team, who assumed the delirant speech to be in the context of schizophrenia. She was discharged four months after admission.

Aphasia assessment: impact of material on naming performance.

BACKGROUND: Naming and lexical retrieval difficulties are common symptoms of aphasia. Naming abilities are usually evaluated by means of real objects or pictures or line drawings that are printed. OBJECTIVE: The aim of this study was to investigate whether the ability to name objects among individuals with aphasia is influenced by the dimensions of the visual stimuli and to understand whether the order of presentation of the stimuli, number of years of education and length of time post-onset are involved in the success of naming. METHODS: The naming abilities of healthy controls and patients with acute or chronic aphasia due to stroke were assessed through presentation of two sets of 24 stimuli consisting of real objects and color photographs of the same objects presented on a screen. The results obtained under these two conditions were compared by means of within-subject paired ANOVA, controlling for presentation order. RESULTS: 40 patients (62.4 ± 17.3 years old; 70% females; mean education level of 8.5 ± 5.3 years; and 60% evaluated within the first eight days after stroke) and 50 controls that were age, gender and education-matched were included. Object naming was significantly better than naming color photographs among the patients (p = 0.001), but no differences were observed among the controls. Age, education, length of time post-onset and presentation sequence did not have any impact on naming performance. CONCLUSION: These results suggest that use of digital color photographs for naming objects in assessment of aphasia may be associated with lower naming performance, compared with use of real objects. This needs to be taken into account when different forms of stimuli are presented in sequential aphasia evaluations.

Aphasia assessment: impact of material on naming performance / Avaliação da afasia: impacto do material no desempenho da nomeação

ABSTRACT Background: Naming and lexical retrieval difficulties are common symptoms of aphasia. Naming abilities are usually evaluated by means of real objects or pictures or line drawings that are printed. Objective: The aim of this study was to investigate whether the ability to name objects among individuals with aphasia is influenced by the dimensions of the visual stimuli and to understand whether the order of presentation of the stimuli, number of years of education and length of time post-onset are involved in the success of naming. Methods: The naming abilities of healthy controls and patients with acute or chronic aphasia due to stroke were assessed through presentation of two sets of 24 stimuli consisting of real objects and color photographs of the same objects presented on a screen. The results obtained under these two conditions were compared by means of within-subject paired ANOVA, controlling for presentation order. Results: 40 patients (62.4 ± 17.3 years old; 70% females; mean education level of 8.5 ± 5.3 years; and 60% evaluated within the first eight days after stroke) and 50 controls that were age, gender and education-matched were included. Object naming was significantly better than naming color photographs among the patients (p = 0.001), but no differences were observed among the controls. Age, education, length of time post-onset and presentation sequence did not have any impact on naming performance. Conclusion: These results suggest that use of digital color photographs for naming objects in assessment of aphasia may be associated with lower naming performance, compared with use of real objects. This needs to be taken into account when different forms of stimuli are presented in sequential aphasia evaluations.

RESUMO Antecedentes: As dificuldades de nomeação e de evocação lexical são sintomas comuns de afasia. A nomeação é geralmente avaliada por objetos reais, imagens ou desenhos de contorno, impressos. Objetivo: Este estudo visa investigar se a capacidade de nomear objetos em pessoas com afasia é influenciada pelas dimensões dos estímulos visuais e compreender se a ordem de apresentação dos estímulos, os anos de escolaridade e o tempo de evolução estão envolvidos no sucesso da nomeação. Métodos: A nomeação de pessoas saudáveis e pessoas com afasia, em fase aguda ou crónica, por AVC foi avaliada com dois conjuntos de 24 estímulos, objetos reais e fotografias a cores, dos mesmos objetos, apresentadas num ecrã. Os resultados obtidos nas duas condições foram comparados por uma ANOVA para amostras emparelhadas, controlando para a ordem de apresentação. Resultados: Foram incluídos 40 sujeitos com afasia (62,4±17,3 anos de idade, 70% mulheres, com uma escolaridade média de 8,5±5,3 anos, 60% avaliados nos primeiros 8 dias após o acidente vascular cerebral) e um grupo de controlo de 50 pessoas saudáveis, emparelhadas para a idade, sexo e escolaridade. A nomeação de objetos foi significativamente melhor do que a nomeação de fotografias a cores (p=.001), mas isso não se verificou nos controles. A idade, a escolaridade, o tempo de evolução e a sequência de apresentação não tiveram impacto na nomeação dos dois tipos de estímulos. Conclusão: Estes resultados sugerem que a utilização de fotografias digitais a cores para avaliar a nomeação de objetos na afasia pode ser associada a um pior desempenho quando comparada com objetos reais. Isto deve ser tido em conta quando são apresentadas diferentes formas de estímulos nas reavaliações.

Comprometimento e promoção do sono em unidades de terapia intensiva: revisão integrativa / Comprometimiento y promoción del sueño en unidades de cuidados intensivos: revisión integradora / Sleep impairment and sleep promotion in intensive care units: an integrative review

Resumo Objetivo: Identificar, nas bases de dados científicas, as evidências que comprometem o sono e as intervenções de enfermagem promotoras do sono em Unidades de Terapia Intensiva. Métodos: Revisão integrativa da literatura, realizada nas bases de dados MEDLINE, CINAHL e Cochrane Database of Systematic Reviews, para responder às questões norteadoras do estudo, de acordo com o formato PICo, nos meses de maio e junho de 2019. Os idiomas considerados foram o inglês, português e espanhol. Resultados: Identificou-se 110 estudos e 12 foram considerados elegíveis para a revisão. A análise reporta que o comprometimento do sono é multicausal, sendo este influenciado sobretudo por desconforto ambiental e físico do paciente. As intervenções de enfermagem, tais como a gestão do ambiente, no âmbito do ruído e da luminosidade, o agrupamento da prestação de cuidados, o controle da dor e da ansiedade do paciente internado, são fundamentais para a qualidade do sono. Conclusão: A produção científica evidencia que as intervenções de Enfermagem identificadas, sobretudo no âmbito da promoção do conforto ambiental e físico do paciente, contribuem para a qualidade do sono em Unidades de Terapia Intensiva, contudo a promoção do conforto psicoespiritual e social do paciente ainda é superficial, tendo em conta o foco e as prioridades nesta tipologia de internamento.

Resumen Objetivo: Identificar, en bases de datos científicas, las evidencias que comprometen el sueño y las intervenciones de enfermería para promover el sueño en unidades de cuidados intensivos. Métodos: Revisión integradora de literatura, realizada en las bases de datos MEDLINE, CINAHL y Cochrane Database of Systematic Reviews para responder las preguntas orientadoras del estudio, de acuerdo con el formato PICO, en los meses de mayo y junio de 2019. Los idiomas considerados fueron inglés, portugués y español. Resultados: Se identificaron 110 estudios y 12 fueron considerados elegibles para la revisión. El análisis reporta que el comprometimiento del sueño es multicausal y lo que más influye en el sueño es la incomodidad ambiental y física del paciente. Las intervenciones de enfermería, tales como el manejo del ambiente respecto al ruido y a la luminosidad, el agrupamiento de la prestación de cuidados y el control del dolor y de la ansiedad del paciente internado, son fundamentales para la calidad del sueño. Conclusión: La producción científica evidencia que las intervenciones de enfermería identificadas, sobre todo respecto a la promoción del bienestar ambiental y físico del paciente, contribuyen con la calidad del sueño en unidades de cuidados intensivos. No obstante, la promoción del bienestar piscoespiritual y social del paciente aún es superficial, teniendo en cuenta dónde se centra la atención y cuáles son las prioridades en este tipo de internación.

Abstract Objective: To identify, in the scientific databases, evidence of factors that impair sleep and nursing interventions to promote sleep in Intensive Care Units. Methods: An integrative literature review was conducted across the databases MEDLINE and CINAHL and the Cochrane Database of Systematic Reviews between May and June 2019 using the PICO framework, seeking to answer the guiding questions of the study. The languages included in the literature review were English, Portuguese, and Spanish. Results: One hundred and ten studies were identified, twelve of which were considered eligible for review. The analysis of the articles found that sleep impairment is multicausal, being influenced mainly by the patient's environmental and physical discomfort. Nursing interventions, such as environmental management of noise and light, grouping of care procedures, and control of pain and anxiety in the hospitalized patient, are fundamental for sleep quality. Conclusion: The academic literature shows that the nursing interventions identified, particularly those that promote the patient's environmental and physical comfort, contribute to the quality of sleep in Intensive Care Units. However, promotion of the patient's psychospiritual and social comfort is still lacking, given the focus and priorities of this type of hospitalization.