Nuclear factor kappa-light-chain-enhancer of activated B cells gene expression involvement in porcine liver transplant experimental model.

PURPOSE: Gene expressions of vascular Endothelial Growth Factor Alpha (VEGFa), Nuclear Factor Kappa-Light-Chain-Enhancer of Activated B cells (NFkB) and cytokines could be useful for identifying potential therapeutic targets to alleviate ischemia-reperfusion injury after liver transplantation. Cytokine gene expressions, VEGFa and NFkB were investigated in a preclinical swine model of liver transplantation. METHODS: A total of 12 pigs were used as donors and recipients in liver transplantation without venovenous bypass or aortic clamping. NFkB, IL-6, IL-10, VEGFa and Notch1 gene expression were assessed. These samples were collected in two specific times: group 1 (n= 6) - control, samples were collected before recipient's total hepatectomy and group 2 - liver transplantation group (n=6), where the samples were collected one hour after graft reperfusion. RESULTS: Liver transplantation was successfully performed in all recipients. Liver enzymes were elevated in the transplantation group. NFkB gene expression was significantly decreased in the transplantation group in comparison with the control group (0.62±0.19 versus 0.39±0.08; p= 0.016). No difference was observed between groups Interleucine 6 (IL-6), interleucine 10 (IL-10), VEGFa and Notch homolog 1 (Notch1). CONCLUSIONS: In this survey a decreased NFkB gene expression in a porcine model of liver transplantation was observed.

Evidence of content validity of the nursing outcome "sexual functioning" from the nursing outcome classification.

PURPOSE: To evaluate the content validity evidence of the nursing outcome "sexual functioning" from the Nursing Outcomes Classification (NOC). METHODS: A multi-method study, including a methodological study analyzing the content validity evidence of the NOC outcome and sexual functioning, and a quantitative, descriptive, cross-sectional study. In the first phase, a literature review was conducted to map and identify clinical indicators associated with sexual functioning to construct the conceptual (CD) and operational definitions (ODs) of each outcome indicator. In the second phase, experts assessed the CD and OD for clarity, theoretical relevance, and theoretical pertinence. The critical validity ratio (CVR) was calculated for each indicator. In the third phase, a pilot test of sexual functioning measurement was conducted with 33 patients hospitalized for coronary artery disease. Internal consistency was calculated through Cronbach's alpha. RESULTS: The CD and OD were constructed based on 120 articles and analyzed by 13 experts; four rounds were required to achieve the critical CVR in each phase. In the pilot test, the nursing outcome achieved a Cronbach's alpha of 0.95, and the mean assessment time was 26 min. Indicators with the highest mean scores were related to knowledge of personal needs and capabilities and comfort with one's own body. CONCLUSION: The CD and OD developed for the NOC outcome, sexual functioning, had adequate evidence of content validity. The outcome content has high internal consistency. Further studies on the validity of the nursing outcome should be conducted to increase its validity. IMPLICATIONS FOR PRACTICE: The nursing outcome, sexual functioning, can be a tool used by nurses to evaluate the effect of nursing education and interventions on sexual functioning in the adult population.

PURPOSE: Desenvolver e avaliar as evidências de validade de conteúdo das definições conceituais e operacionais dos indicadores do resultado de Enfermagem "Funcionamento Sexual" da Classificação dos Resultados de Enfermagem (NOC). METHODS: Estudo metodológico dividido em três fases. Na primeira fase foi realizada uma revisão de literatura para mapear e identificar os indicadores clínicos associados ao funcionamento sexual para a construção das definições conceituais (DC) e operacionais (DO) de cada indicador do resultado de enfermagem em estudo. Na segunda fase foi realizada a análise das evidências de validade de conteúdo das DC e DO dos indicadores por meio da avaliação pelos especialistas. Na terceira fase foi realizada um pré­teste do resultado de enfermagem em 33 pacientes hospitalizados por doença arterial coronariana. RESULTS: Foram selecionados 120 artigos que serviram de base para a construção das definições conceituais e operacionais analisadas por 13 especialistas, necessário quatro rodadas para alcançar o coeficiente de validade de conteúdo crítico estabelecido para o número de juízes respondentes. pré­testeo resultado de enfermagem estudado um alfa de Cronbach de 0,95 e o tempo médio de aplicação foi de 26 minutos. Os indicadores com maiores médias estavam relacionados ao conhecimento das necessidades e capacidade pessoais e conforto com o próprio corpo. CONCLUSION: As DC e DO dos indicadores do resultado "Funcionamento Sexual" da NOC desenvolvidas apresentaram adequadas evidências de validade de conteúdo. O pré­teste o apresentou elevado nível de consistência interna. Outros estudos de evidências de validade do resultado estudado devem ser realizados visando o aumento no nível de validade do resultado. IMPLICATION FOR PRACTICE: O resultado estudado pode ser uma ferramenta utilizada pelo enfermeiro para avaliação do funcionamento sexual na população adulta visando a individualização das orientações e intervenções de enfermagem.

Plant Extract in the Control of Poultry Omphalitis.

Bacteria continue to disrupt poultry production and can cause resistant and persistent yolk sac infections to prevention efforts, known as omphalitis, resulting in poultry death. This literature review aims to demonstrate how plant extracts can help combat omphalitis in poultry. The Google Scholar database served as a resource for retrieving pertinent literature covering a wide range of search terms relevant to the scope of the research. The search strategy involved a combination of terms such as antimicrobials, chick embryo, omphalitis, plant extracts, poultry nutrition, and sanitization. The potential of plant extracts in preventing or treating infections in poultry, especially omphalitis, is mainly due to their antibacterial and safety properties. Sanitization and direct delivery of plant extracts to the internal contents of eggs, feed, or water are cutting-edge interventions to reduce the bacterial load in eggs and poultry, minimizing infection rates. For example, these interventions may include advanced treatment technologies or precise delivery systems focused on disease prevention in poultry.

Seasonal studies of aquatic humic substances from Amazon rivers: characterization and interaction with Cu (II), Fe (II), and Al (III) using EEM-PARAFAC and 2D FTIR correlation analyses.

Aquatic humic substances (AHS) are defined as an important components of organic matter, being composed as small molecules in a supramolecular structure and can interact with metallic ions, thereby altering the bioavailability of these species. To better understand this behavior, AHS were extracted and characterized from Negro River, located near Manaus city and Carú River, that is situated in Itacoatiara city, an area experiencing increasing anthropogenic actions; both were characterized as blackwater rivers. The AHS were characterized by 13C nuclear magnetic ressonance and thermochemolysis GC-MS to obtain structural characteristics. Interaction studies with Cu (II), Al (III), and Fe (III) were investigated using fluorescence spectroscopy applied to parallel factor analysis (PARAFAC) and two-dimensional correlation spectroscopy with Fourier transform infrared spectroscopy (2D-COS FTIR). The AHS from dry season had more aromatic fractions not derived from lignin and had higher content of alkyls moities from microbial sources and vegetal tissues of autochthonous origin, while AHS isolated in the rainy season showed more metals in its molecular architecture, lignin units, and polysacharide structures. The study showed that AHS composition from rainy season were able to interact with Al (III), Fe (III), and Cu (II). Two fluorescent components were identified as responsible for interaction: C1 (blue-shifted) and C2 (red-shifted). C1 showed higher complexation capacities but with lower complexation stability constants (KML ranged from 0.3 to 7.9 × 105) than C2 (KML ranged from 3.1 to 10.0 × 105). 2D-COS FTIR showed that the COO- and C-O in phenolic were the most important functional groups for interaction with studied metallic ions.

The role of living donor liver transplantation in treating intrahepatic cholangiocarcinoma.

Introduction: Intrahepatic cholangiocarcinoma (iCC) is the liver's second most common neoplasm. Until now, surgery is the only curative option, but only 35% of the cases are considered resectable at the diagnosis, with a post-resection survival of around 30%. Advancements in surgical techniques and perioperative care related to liver transplantation (LT) have facilitated the expansion of indications for hepatic neoplasms. Method: This study is a comprehensive review of the global experience in living donor LT (LDLT) for treating iCC and describes our first case of LDLT for an unresectable iCC. Results: While exploring LT for intrahepatic cholangiocarcinoma dates to the 1990s, the initial outcomes were discouraging, marked by poor survival and high recurrence rates. Nevertheless, contemporary perspectives underscore a reinvigorated emphasis on extending the frontiers of LT indications within the context of the "oncologic era." The insights gleaned from examining explants, wherein incidental iCC was categorized as hepatocellular carcinoma in the preoperative period, have demonstrated comparable survival rates to small hepatocellular carcinoma. These findings substantiate the potential viability of LT as a curative alternative for iCC. Another investigated scenario pertains to "unresectable tumors with favorable biological behavior," LT presents a theoretical advantage by providing free margins without the concern of a small future liver remnant. The constraint of organ shortage persists, particularly in nations with low donation rates. LDLT emerges as a viable and secure alternative for treating iCC. Conclusion: LDLT is an excellent option for augmenting the graft pool, particularly in carefully selected patients.

Liver Transplantation for Benign Massive Hepatomegaly: Results From a Single Center and Contribution of the Left-to-Right Piggyback Approach.

INTRODUCTION: Polycystic liver disease and giant hepatic hemangioma may present with severe symptom burden and indicate orthotopic liver transplantation. The left-to-right piggyback approach is a useful technique for performing total hepatectomy of enlarged livers. OBJECTIVE: The purpose of this study is to analyze the results of liver transplantation in patients with benign massive hepatomegaly. METHODS: This is a single-center retrospective study involving all adult patients who underwent liver transplantation due to benign massive hepatomegaly from January 2002 to June 2023. RESULTS: A total of 22 patients underwent liver transplantation (21 cases of polycystic live disease and 1 case of giant hepatic hemangioma). During the same time, there were 2075 transplants; therefore, benign massive hepatomegaly accounted for 1.06% of cases. Most patients (59.09%) were transplanted using the left-to-right piggyback technique. Seven patients had previous attempted treatment of hepatic cysts. Another patient previously underwent bilateral nephrectomy and living-donor kidney transplantation. Among these patients, in 5 cases there were massive abdominal adhesions with increased bleeding. Four of these 8 patients died in the very early perioperative period. In comparison to patients without previous cysts manipulation, massive adhesions and perioperative death were significantly higher in those cases (62.5 vs 0%, P = .002 and 50% vs 0%, P = .004, respectively). CONCLUSION: Liver transplantation due to polycystic liver disease and giant hemangioma is a rare event. Total hepatectomy is challenging due to the enlarged native liver. The left-to-right piggyback technique is useful, because it avoids vena cava twisting and avulsion of its branches. Massive adhesions due to previous cysts manipulation may lead to increased bleeding, being a risk factor for mortality.

Retransplantation for Late Hepatic Artery Thrombosis: Results from a Single Center.

BACKGROUND: Hepatic artery thrombosis is the most common vascular complication of liver transplantation. When occurring late in the postoperative course, it may have no clinical repercussions, and conservative treatment may be implemented. Some patients, however, will develop severe biliary complications due to ischemic cholangiopathy and require retransplantation. The aim of this study is to report the outcomes of retransplantation in this population. METHODS: This is a single-center retrospective study involving all adult patients who underwent liver retransplantation due to late hepatic artery thrombosis from January/2010 to December/2022. RESULTS: During the study period, 1378 liver transplants were performed in our center; 147 were retransplantations, with 13 cases of late hepatic artery thrombosis (0.94%). All had symptomatic ischemic cholangiopathy. Twelve of them had already presented previous cholangitis, bilomas, or liver abscesses and had undergone biliary stenting or percutaneous drainage. The median time between the first liver transplant and late hepatic artery thrombosis diagnosis and between this diagnosis and retransplantation were 73 and 50 days, respectively. Arterial reconstruction using splenic artery, celiac trunk, or arterial conduit from the aorta was performed in 7 cases, whereas biliary reconstruction was mostly done with choledochojejunostomy (n = 8). There were 4 perioperative deaths, 2 due to primary non-function and 2 due to refractory shock after exceedingly complex retransplants. CONCLUSION: Liver retransplantation due to late hepatic artery thrombosis is a rare condition that should be offered to patients who develop severe biliary complications and recurrent infections. It is nonetheless a challenging procedure associated with significant perioperative mortality.

Liver Transplantation for Adenomatosis: A Single-Center Experience.

BACKGROUND: Liver adenomatosis is characterized by multiple adenomas diffusely distributed throughout the liver parenchyma. Studies addressing liver transplantation for those cases are scarce, and the criteria used to indicate transplantation are still debatable. OBJECTIVE: To report a single-center experience of liver transplantation for diffuse adenomatosis. METHODS: Single-center retrospective study involving all adult patients who underwent liver transplantation due to adenomatosis from January/2010 to June/2023. RESULTS: A total of 13 patients were identified, corresponding to 0.89% of liver transplants performed during the study period. The mean age was 33 ± 6.55 years, and most of them were female (n = 9, 69.23%). There were 12 transplants with deceased donors and 1 with a right lobe from a living donor. The most frequent reason to preclude liver resection was multiple and large unresectable adenomas in patients without previous liver disease (n = 8, 61.58%), followed by underlying liver disease (Abernethy Malformation, n = 3, 23.07%) and recurrence after liver resection (n = 2, 15.38%). The indications for liver transplantation were high risk of malignant transformation (n = 7, 53.84%), increasing size and number of nodules (n = 3, 23.07%), confirmed malignant transformation (n = 2, 15.38%), and hemorrhage (n = 2, 15.38%). There was 1 perioperative death due to primary non-function. Another patient died during follow-up because of COVID-19. CONCLUSION: Liver adenomatosis is a rare indication for liver transplantation, with acceptable post-transplant outcomes. Unresectable adenomas with high-risk or confirmed malignant transformation are the main indications for transplant. Reasons for unresectability involve underlying liver disease, multiple and large high-risk nodules, and recurrence after previous resection.

Physical training minimizes immunological dysfunction, oxidative stress and tissue destruction on experimental periodontitis in rats.

The objective of this study is to investigate the effects of a moderate intensity physical training protocol, on alveolar bone morphology of rats submitted to ligature-induced periodontitis. Twenty-eight male Wistar rats were divided into four groups, considering the presence/absence of periodontitis and presence/absence of training. The training protocol was performed on a treadmill, 30 min/day, 5 days a week, for 4 weeks. In the experimental periodontal breakdown, with/without training, ligatures were placed on the lower first molars on the 14th day of the experiment, and were followed until the end of the protocol. At the end of the experiment, animals were euthanized and samples of plasma and mandibles were collected for immunoenzymatic evaluation of interleukins (IL)-1ß, IL-6, TNF-α and IL-10, evaluation of serum concentrations of C-reactive protein, analysis of lipid peroxidation (LPO) and reduced glutathione, histological and microtomographic analyses were performed. Physical training resulted in a reduced levels of IL-1ß, IL-6, TNF-α C-reactive protein and LPO and an increase in the levels of IL-10 in rats with periodontitis (p<0.05); a reduction in the inflammatory infiltrate and decreased fiber degradation was identified in histological analysis. Additionally, it was shown a decrease in vertical bone loss and an increase in the bone volume/trabecular volume ratio was identified in periodontitis+physical training group (p<0.05). Based on the results, the practice of frequent physical exercise, at moderate intensity, can contribute to the reduction of damage related to the disproportionate inflammatory response in periodontitis.

Effects of Detraining on Physical Capacity and Its Relationship With Depressive Symptoms, Quality of Life and Sedentary Behavior in Community-Dwelling Older Adults: A Longitudinal Study.

BACKGROUND: Detraining is the partial or complete loss of physical training-induced adaptations as a result of exercise interruption or reduction. The COVID-19 pandemic led to the discontinuation of many older adult exercise programs and led to increased depressive symptoms (DS), increased sedentary behavior (SB), and decreased quality of life (QoL). OBJECTIVE: To evaluate the effects of detraining, in the pandemic, on physical capacity and its relationship with DS, QoL, and SB of community-dwelling older adults. METHODS: The physical capacity (static balance, dynamic balance, and lower limb and handgrip strength) of 35 participants was assessed prepandemic and after 18 and 24 months of the pandemic. DS, QoL, and SB were evaluated only at 18-month period. The analysis of variance for repeated measures or the Friedman and Pearson or Spearman tests were used for statistical analysis. RESULTS: There was a decline in dynamic balance (p < .001) and strength in the lower limbs (p < .001) in the first 18 months, as well as maintenance in the following 6 months. The reduction in dynamic balance during the 18 months of the pandemic was associated with greater DS (p = .015; r = .414) and worse QoL (p = .024; r = -.381) in this period. More time spent on SB (p = .024; r = .386) in the 18th month was associated with worse dynamic balance in the following 6 months. CONCLUSION: Detraining in the pandemic setting led to long-lasting harmful effects, which can last for 2 years, on the physical capacity of community-dwelling older adults. IMPLICATION: Our findings highlight how periods of detraining can interfere in physical and mental health of older adults.

Life-Threatening Ruptured Hepatic Artery Pseudoaneurysm Post-Liver Transplant: A Case Report.

BACKGROUND: Hepatic artery pseudoaneurysm after liver transplantation is a rare condition that can lead to spontaneous bleeding, depending on its extent and location. Treatment involves endovascular and surgical approaches in addition to liver retransplantation in cases of graft failure. CASE REPORT: A 42-year-old female underwent deceased donor liver transplantation due to cryptogenic cirrhosis and schistosomiasis with an uneventful postoperative course. However, 18 days after the operation, she presented to the emergency department with abdominal pain, hypotension, and lipothymia. A computed tomography scan revealed a hepatic artery anastomotic pseudoaneurysm, and due to hemodynamic instability, emergency laparotomy was indicated. During the operation, the pseudoaneurysm was found to be ruptured, and the recipient's hepatic artery was ligated due to life-threatening bleeding. She later developed ischemic cholangiopathy and biliary complications, eventually undergoing retransplantation 7 months after the emergency operation. The patient remains well 11 months after the retransplantation. CONCLUSION: We report a rare case of life-threatening rupture of hepatic artery pseudoaneurysm, which required emergency ligation of the recipient's hepatic artery and subsequent liver retransplantation due to biliary complications.

Integrated occurrence of contaminants of emerging concern, including microplastics, in urban and agricultural watersheds in the State of São Paulo, Brazil.

Contaminants of emerging concern (CECs), including microplastics, have been the focus of many studies due to their environmental impact, affecting biota and human health. The diverse land uses and occupation of watersheds are important parameters driving the occurrence of these contaminants. CECs such as pesticides, drugs, hormones, and industrial-origin substances were analyzed in urban/industrial (Atibaia) and agricultural (Preto/Turvo) watersheds located in São Paulo state, Brazil. A total of 24 CECs were investigated, and, as a result, only 5 (caffeine, carbendazim, atrazine, ametrine and 2-hydroxytrazine) were responsible for 81.73 % of the statistical difference between watersheds contamination profile. The Atibaia watershed presented considerable concentrations of caffeine (ranging from 75 to 2025 ng L-1), while carbendazim (44 to 1144 ng L-1) and atrazine (3 to 266 ng L-1) presented highest levels in Preto/Turvo watershed. In all sampling points, the cumulative potential aquatic life risk assessed by the NORMAN database indicates some level of environmental concern associated to pesticides and caffeine (risk quotient >1). Microplastics had been analyzed in both watersheds, being the white/transparent fragments in size between 100 and 250 µm the most detected in this study. The estimated abundance in the Atibaia watershed ranged from 349 to 2898 items m-3 presenting some influence of pluviosity, while in Rio Preto/Turvo ranged from 169 to 6370 items m-3, being more abundant in the dam area without a clear influence of pluviosity. In both basins, polyethylene and polypropylene were the most detected polymers, probably due to the intense use of single-use plastics in urban areas. Possibly, due to the distinct physic-chemical properties of microplastics and organic CECs, no correlations were observed between their occurrence, which makes us conclude that they have different transport mechanism, behavior, and fate in the environment.

Açai (Euterpe oleracea Mart.) supplementation promotes histological and ultrastructural changes in rats' alveolar bone.

The açai juice contains high concentrations of phenolic compounds, including cyanidin-3-glucoside and others flavonoids. The aim of this study was to evaluate the impact of açai supplementation on healthy mandibular alveolar bone in male albino rats of the Wistar strain. 24 rats were divided into 3 groups, in which one group received a daily dose of saline solution and the other two groups were treated with daily doses of clarified açai juice for 14 or 28 days. After the experiment, hemimandibles were collected and analyzed using Scanning Electron Microscopy (SEM), histological assessments, and micro-CT. Results showed changes in the integrity of the alveolar bone as seen in SEM, increased osteocyte density and higher collagen matrix area in the açai group compared to the control group as seen in histological analysis, and increased bone volume, trabecular thickness and number, and cortical bone as seen in micro-CT analysis. The space between bone trabeculae showed no difference among the groups. These results suggest that açai supplementation may have a structural change effect on alveolar bone, but further research is needed to confirm these findings in humans and to determine the exact mechanisms behind these effects.

Duplex ultrasound and pedal acceleration time as tools to evaluate foot perfusion: a literature review.

Currently, the standard non-invasive test for diagnosing Peripheral Arterial Disease is the Ankle-Brachial Index. However, this test becomes unfeasible in a certain population. New evidence proposes the pedal acceleration time, an ultrasound index, as an alternative test. An integrative bibliographic review was carried out between June 3, 2022 and January 8, 2023, to investigate this new index as a tool to assess foot perfusion. Papers published in English, Portuguese, or Spanish between 2012 and 2022 were searched on PubMed, Google Scholar, and Scielo, using the keywords "Peripheral Arterial Disease" AND "Acceleration Time" AND (Pedal OR Plantar). Research that didn't assess foot perfusion using the methods of interest or did not present human data and also case series or reports were excluded. Seven out of the sixty-six articles identified in the searches were selected for the review, all of which had notable methodological limitations. Pedal acceleration time seems to be able to diagnose and stratify and may reflect prognosis.

Atualmente, o teste não invasivo padrão para diagnosticar a doença arterial periférica é o índice tornozelo-braquial, porém, em uma determinada população, este torna-se inviável. Novas evidências propõem o tempo de aceleração plantar, que é um índice ultrassonográfico, como alternativa. Para investigá-lo no contexto do estudo da perfusão do pé, uma revisão bibliográfica integrativa foi realizada entre 03/06/2022 e 08/01/2023. Artigos em inglês, português ou espanhol, publicados entre 2012 e 2022 foram pesquisados através das ferramentas PubMed, Google Scholar e SciELO, com as palavras-chave "Peripheral Arterial Disease" AND "Acceleration Time" AND (Pedal OR Plantar). Pesquisas que não avaliaram a perfusão do pé pelos métodos de interesse, sem dados em humanos e relatos ou séries de casos, foram excluídos. Dos 66 artigos, 7 foram selecionados; todos com notáveis limitações metodológicas. O tempo de aceleração plantar aparenta ser capaz de diagnosticar, estratificar e prognosticar os doentes.

Content analysis of NOC outcomes related to mechanical ventilation in people with COVID-19.

OBJECTIVE: To analyze the evidence of content validity of the Nursing Outcomes "Mechanical Ventilation Response: Adult" and "Mechanical Ventilation Weaning Response: Adult", for patients with severe COVID-19. METHOD: Methodological study developed in two stages: literature review to construct the definitions of the indicators and analysis of the evidence of content validity of the nursing outcomes by a focus group. RESULTS: All the conceptual and operational definitions developed for the 56 indicators were considered clear and precise. However, 17 indicators were excluded because they were deemed not to be relevant. The definitions of the magnitudes for 17 indicators of the Nursing Outcome "Mechanical Ventilation Response: Adult" and 22 indicators "Mechanical Ventilation Weaning Response: Adult" were thus constructed. CONCLUSION: The development of definitions and validation by experts makes the use of these outcomes and their indicators more understandable and precise, favoring their use in clinical practice and providing greater detail in assessment and recording.

Selective outcome reporting in randomized clinical trials using the third molar surgery model.

Selective outcome reporting (SOR) can threaten the validity of results found in clinical trials. Some studies in the literature have analyzed SOR in dentistry, but there is no study that has observed SOR in clinical trials in oral and maxillofacial surgery. Impacted third molar surgery is one of the most used models in clinical trials to study mainly analgesic and anti-inflammatory drug interventions. Our study aimed to evaluate the prevalence of SOR in publications employing the third molar extraction clinical trial model, and to verify whether there was an association between the statistical significance of outcomes and other characteristics that could lead to SOR. A systematic search was performed on the ClinicialTrials.gov platform for randomized clinical trial protocols, using the condition of third molar extraction. The corresponding published articles were sourced in PubMed, Scopus, and Embase databases, and compared with the registered protocols regarding the methodological data, in terms of: sample calculation, primary outcome identification, end-point periods, insertion of new outcomes in the publication, and results of outcomes. 358 protocol records were retrieved; 87 presented their corresponding articles. SOR was identified in 28.74% of the publications, and had a significant relationship with changes in the protocol, insertions of new outcomes, and discrepancies in the types of study. General risk of bias was found to be low. There were associations between SOR and the discrepancies in terms of the type of study, the choice of new outcome, and changes in the history of protocol records. The prevalence of SOR in clinical research using the third molar extraction surgery model is moderate. The quality of the scientific reporting of the results and, consequently, the certainty of evidence relating to the intervention tested can be overstated, increasing the chances of misinterpretation by health professionals.

Obtaining Microbiologically Safe Hatching Eggs from Hatcheries: Using Essential Oils for Integrated Sanitization Strategies in Hatching Eggs, Poultry Houses and Poultry.

Essential oils are liquids containing non-toxic compounds that are unfavorable to the growth of microorganisms. They are sold globally at affordable or very high prices, depending on the availability and type of plant, the scale of production, the extraction method, costs associated with logistics and electricity consumption, among other variables. Each year, the quantity of research dedicated to the antimicrobial potential of essential oils in poultry farming is expanding. Researchers consensually relay that this increase is due to the growing resistance of microorganisms to traditional antimicrobials and concerns about the toxicity of these products. This review proposes an analysis of the antimicrobial feasibility of using essential oils to address microbial challenges in poultry farms, aiming to ensure the production and supply of microbiologically safe hatching eggs. Based on the findings in the literature, in addition to following other necessary precautions in the daily routines of poultry farming practices, developing an antimicrobial control program with essential oils that integrates poultry facilities, poultry and hatching eggs, adapted to the particularities of each context seems to be extremely effective.

Evidence of validity of the Smoking Cessation Counseling scale - Brazilian version.

OBJECTIVE: to evaluate the evidence of validity of the internal structure and reliability of the Brazilian version of the Smoking Cessation Counseling instrument. METHOD: psychometric study of confirmatory factor analysis and reliability carried out on 250 nurses in clinical practice. For the analysis of the convergent validity of the factor model, Average Variance Extracted values were calculated, and discriminant analysis was carried out using the Fornell-Larcker criterion. Reliability was examined using Cronbach's alpha coefficient and composite reliability. RESULTS: it was necessary to exclude seven items from the Advanced Counseling domain and one item from the Basic Counseling domain in order to properly obtain the Average Variance Extracted values and the Fornell-Larcker criterion. The composite reliability ranged from 0.76 to 0.86 and the overall Cronbach`s alpha coefficient was 0.86, ranging from 0.53 to 0.84 depending on the domain assessed. The final version of the instrument was made up of 16 items divided into 4 domains. CONCLUSION: the Brazilian version of Smoking Cessation Counseling obtained adequate psychometric evidence of validity and reliability. Further studies are needed to refine the instrument. BACKGROUND: (1) Instrument shows adequate internal consistency and validity. BACKGROUND: (2) Evaluate counseling practices and their impact on patient care. BACKGROUND: (3) Instrument for evaluating smoking cessation counseling. BACKGROUND: (4) Provides important information for planning nursing care.

Control of Escherichia coli in Poultry Using the In Ovo Injection Technique.

Pathogens, such as Escherichia coli (E. coli), have been identified as significant causes of poultry mortality. Poultry can serve as potential sources of E. coli transmission, even when asymptomatic, posing a substantial threat to food safety and human health. The in ovo administration of antimicrobials is crucial for preventing and/or effectively combating acute and chronic infections caused by poultry pathogens. To achieve this goal, it is critical that antimicrobials are properly injected into embryonic fluids, such as the amnion, to reach target tissues and trigger robust antimicrobial responses. Several protocols based on antimicrobials were evaluated to meet these requirements. This review analyzed the impacts of antimicrobial substances injected in ovo on the control of E. coli in poultry. The reduction in infection rates, resulting from the implementation of in ovo antimicrobials, combined with efforts aimed at hygienic-sanitary action plans in poultry sheds, reinforces confidence that E. coli can be contained before causing large scale damage. For example, antimicrobial peptides and probiotics have shown potential to provide protection to poultry against infections caused by E. coli. Issues related to the toxicity and bacterial resistance of many synthetic chemical compounds represent challenges that need to be overcome before the commercial application of in ovo injection protocols focused on microbiological control.