Avaliação do descarte de resíduos de medicamentos em unidades pediátricas

OBJETIVO Verificar o descarte dos resíduos de medicamentos realizado em unidades pediátricas. MÉTODO Estudo descritivo e observacional, realizado em um hospital universitário. A amostra de conveniência foi constituída pelos medicamentos descartados durante o período de estudo. Observaram-se a manipulação e o descarte durante o preparo e a administração. A coleta dos dados ocorreu em horários preestabelecidos e realizada por meio de instrumento pré-validado. RESULTADOS Identificaram-se 356 descartes de medicamentos (35,1% na clínica, 31,8% na unidade de cuidados intensivos, 23,8% na cirúrgica e 9,3% na infectologia). As classes farmacológicas mais descartadas foram: 22,7% antimicrobianos, 14,8% eletrólitos, 14,6% analgésicos, 9,5% diuréticos e 6,7% antiulcerosos. Vias mais utilizadas: caixa descartável para perfurocortante com saco amarelo (30,8%), ralo da pia (28,9%), caixa de perfurocortante com saco laranja (14,3%) e lixeira infectante com saco branco (10,1%). Não foi identificado descarte após a administração dos fármacos. CONCLUSÃO Faz-se necessária a discussão de medidas que contribuam para a redução do volume de resíduos, com o intuito de engajar a atuação reflexiva da equipe e o descarte adequado.OBJECTIVE To verify the disposal of pharmaceutical waste performed in pediatric units. METHOD A descriptive and observational study conducted in a university hospital. The convenience sample consisted of pharmaceuticals discarded during the study period. Handling and disposal during preparation and administration were observed. Data collection took place at pre-established times and was performed using a pre-validated instrument. RESULTS 356 drugs disposals were identified (35.1% in the clinic, 31.8% in the intensive care unit, 23.8% in the surgical unit and 9.3% in the infectious diseases unit). The most discarded pharmacological classes were: 22.7% antimicrobials, 14.8% electrolytes, 14.6% analgesics/pain killers, 9.5% diuretics and 6.7% antiulcer agents. The most used means for disposal were: sharps’ disposable box with a yellow bag (30.8%), sink drain (28.9%), sharps’ box with orange bag (14.3%), and infectious waste/bin with a white bag (10.1%). No disposal was identified after drug administration. CONCLUSION A discussion of measures that can contribute to reducing (healthcare) waste volume with the intention of engaging reflective team performance and proper disposal is necessary.OBJETIVO Verificar el descarte de los resíduos de fármacos realizado en unidades pediátricas. MÉTODO Estudio descriptivo y observacional, realizado en un hospital universitario. La muestra de conveniencia estuvo constituida de los fármacos descartados durante el período de estudio. Se observaron la manipulación y el descarte durante la preparación y la administración. La recolección de datos ocurrió en horarios prestablecidos y fue llevada a cabo mediante instrumento pre validado. RESULTADOS Se identificaron 356 descartes de fármacos (el 35,1% en la clínica, el 31,8% en la unidad de cuidados intensivos, el 23,8% en la quirúrgica y el 9,3% en la infectología). Las clases farmacológicas más descartadas fueron: el 22,7% de antimicrobianos, el 14,8% de electrolitos, el 14,6% de analgésicos, el 9,5% de diuréticos y el 6,7% de antiulcerosos. Medios más utilizados: caja desechable para punzocortante con bolsa amarilla (30,8%), rebosadero del lavabo (28,9%), caja de punzocortante con bolsa naranja (14,3%) y basurero infectante con bolsa blanca (10,1%). No se identificó descarte tras la administración de los medicamentos. CONCLUSIÓN Se hace necesaria la discusión de medidas que contribuyan a la reducción del volumen de resíduos a fin de involucrar la actuación reflexiva del equipo y el descarte adecuado

A Novel ILP Framework for Summarizing Content with High Lexical Variety

Summarizing content contributed by individuals can be challenging, because people make different lexical choices even when describing the same events. However, there remains a significant need to summarize such content. Examples include the student responses to post-class reflective questions, product reviews, and news articles published by different news agencies related to the same events. High lexical diversity of these documents hinders the system's ability to effectively identify salient content and reduce summary redundancy. In this paper, we overcome this issue by introducing an integer linear programming-based summarization framework. It incorporates a low-rank approximation to the sentence-word co-occurrence matrix to intrinsically group semantically-similar lexical items. We conduct extensive experiments on datasets of student responses, product reviews, and news documents. Our approach compares favorably to a number of extractive baselines as well as a neural abstractive summarization system. The paper finally sheds light on when and why the proposed framework is effective at summarizing content with high lexical variety.Comment: Accepted for publication in the journal of Natural Language Engineering, 201

Gestão de custos como fator de vantagem competitiva na Indústria Metalmecânica da Região AMAI

As constantes mudanças que as organizações estão sofrendo trazem um aumento na competitividade. Dessa forma, para sobreviver num mercado globalizado, manter um alto nível de qualidade e planejamento focado, desenvolvendo estratégias que resultem numa posição de vantagem da empresa em relação aos concorrentes.Tendo em vista a problemática e as dificuldades para alcançar resultado eficaz e uma posição vantajosa, o presente estudo tem como objetivo  analisar como as empresas do setor metalmecânico da região da AMAI – Associação dos Municípios do Alto Irani, gerenciam seus custos para obter vantagem competitiva no mercado. Elaborou-se uma pesquisa bibliográfica sobre os conceitos da gestão de custos, em conceitos de estratégia e competividade, além do gerenciamento de custos conforme o Guia PMBOK®.A partir disso, foi realizada uma pesquisa com abordagem qualitativa, tendo como instrumento de coleta de dados um questionário estruturado e para a análise e interpretação dos dados,foram utilizadas categorias de análise e gráficos. O recorte da pesquisa envolveu uma amostra com vinte das maiores empresas classificadas no cálculo do retorno econômico da AMAI.Observou-se que, para atender um consumidor cada vez mais mutável, que exige flexibilidade, produtos e serviços personalizados, preço “bom” (custo-benefício) e principalmente, novidade; encontra-se como alternativa a combinação das estratégias de liderança em custo, resultando em grandes benefícios para a competitividade das empresas

RNA interference-mediated knockdown of CD49e (α5 integrin chain) in human thymic epithelial cells modulates the expression of multiple genes and decreases thymocyte adhesion

Background: The thymus is a central lymphoid organ, in which bone marrow-derived T cell precursors undergo a complex process of maturation. Developing thymocytes interact with thymic microenvironment in a defined spatial order. A component of thymic microenvironment, the thymic epithelial cells, is crucial for the maturation of T-lymphocytes through cell-cell contact, cell matrix interactions and secretory of cytokines/chemokines. There is evidence that extracellular matrix molecules play a fundamental role in guiding differentiating thymocytes in both cortical and medullary regions of the thymic lobules. The interaction between the integrin alpha 5 beta 1 (CD49e/CD29; VLA-5) and fibronectin is relevant for thymocyte adhesion and migration within the thymic tissue. Our previous results have shown that adhesion of thymocytes to cultured TEC line is enhanced in the presence of fibronectin, and can be blocked with anti-VLA-5 antibody. Results: Herein, we studied the role of CD49e expressed by the human thymic epithelium. For this purpose we knocked down the CD49e by means of RNA interference. This procedure resulted in the modulation of more than 100 genes, some of them coding for other proteins also involved in adhesion of thymocytes; others related to signaling pathways triggered after integrin activation, or even involved in the control of F-actin stress fiber formation. Functionally, we demonstrated that disruption of VLA-5 in human TEC by CD49e-siRNA-induced gene knockdown decreased the ability of TEC to promote thymocyte adhesion. Such a decrease comprised all CD4/CD8-defined thymocyte subsets. Conclusion: Conceptually, our findings unravel the complexity of gene regulation, as regards key genes involved in the heterocellular cell adhesion between developing thymocytes and the major component of the thymic microenvironment, an interaction that is a mandatory event for proper intrathymic T cell differentiation

Dermatopathy Caused by Enterobacter aerogenes and Pseudomonas aeruginosa in Boa constrictor amarali

Background: Bacterial diseases are the main cause of the high mortality rates of snakes, especially those caused by gramnegative agents. However, studies on dermatopathy caused by these bacterial agents in snakes are scarce; and no reports have been found on Enterobacter aerogenes as causative agent of dermatopathy in snake species. Thus, the objective of this study was to describe the clinical signs, and lesion evolution of a dermatopathy in a male snake (Boa constrictor amarali) specimen of approximately seven years old; and to describe the isolation and identification of the Enterobacter aerogenes and Pseudomonas aeruginosa agents involved in the cause of this disease.Case: The Boa constrictor amarali evaluated presented blackened cutaneous lesions in the dorsal, snout-vent and tail regions; and well-defined subcutaneous nodules of 2.0-3.0 cm diameter, with soft consistency, reddish color, cutaneous flaccidity, and areas of scale ulceration in the dorsolateral region. The clinical evaluation of the animal showed dehydration signs and pale mucous membranes. The blackened lesions were subjected to mycological analysis - after procedure of deep scale scraping - which showed presence of septate hyphae. The nodule was punctured for microbiological and biochemical analysis. The sample was collected with a sterilized alginate cotton tip swab, and was stored in a plastic tube containing a semi-solid Stuart transport medium, for microbiological analysis. Then, this sample was incubated in a bacteriological oven at 37°C for 24 h. Typical colonies of Pseudomonas and Enterobacter grew on MacConkey agar medium; these bacteria were identified by the colony morphology and their typical odor. The colonies grown in MacConkey agar were also identified through biochemical tests in the mediums: Phenol red, Lysine, Phenylalanine, Citrate, Urea and SIM (Sulfide, Indole, Motility). The results of these tests were able to confirm and identify the P. aeruginosa and E. aerogenes species. The animal died within 36 h, before the identification of the causative agents of the disease, thus, no pharmacological interference was possible.Discussion: Immunodepression, malnutrition, and temperatures and humidity outside the animal thermal comfort zone, are predisposing factors for the development of bacterial diseases in reptiles. Little information about pathogen agents affecting Boa constrictor specimens in their native area is available; however, captive snakes are subject to a wide variety of diseases - most of which caused or intensified by the captivity conditions. Among the bacteria involved in reptile diseases, few are primary causative agents. In general, clinical bacterial infections tend to be secondary to viral infections. The bacterial agents found in this study are commonly described in scientific literature with location in the oral cavity, differently from the results found in this study. Moreover, the bacterium E. aerogenes has not yet been described in other studies as a causative agent of dermatopathy. Reptiles are considered reservoirs of important zoonotic microorganisms, such as P. aeruginosa, which can be transmitted by fecal contact, bites and wounds. However, the little information on P. aeruginosa in captive reptiles indicates the need for further studies to establish its zoonotic potential. A most adequate management conditions for the snake species could have decreased the severity of the lesions. The occurrence of P. aeruginosa and E. aerogenes found in this work may alert professionals for future clinical suspicions and adequate therapeutic management

How to dissect viral infections and their interplay with the host-proteome by immunoaffinity and mass spectrometry: A tutorial

The capabilities of bioanalytical mass spectrometry to (i) detect and differentiate viruses at the peptide level whilst maintaining high sample throughput and (ii) to provide diagnosis and prognosis for infected patients are presented as a tutorial in this work to aid analytical chemists and physicians to gain insights into the possibilities offered by current high-resolution mass spectrometry technology and bioinformatics. From (i) sampling to sample treatment; (ii) Matrix-Assisted Laser Desorption Ionization- to Electrospray Ionization -based mass spectrometry; and (iii) from clustering to peptide sequencing; a detailed step-by-step guide is provided and exemplified using SARS-CoV-2 Spike Y839 variant and the variant of concern SARS-CoV-2 Alpha (B.1.1.7 lineage), Influenza B, and Influenza A subtypes AH1N1pdm09 and AH3N2.Highlights: - Immunohistochemistry with magnetic core nanoparticles to isolate viruses. - The use of MALDI-MS for rapid virus detection is explained in detail; - The use of ESI-MS/MS to pinpoint host-patient crosstalk is explained in detail. - The absolute quantitative MS is explained for large-scale protein quantitation.This work received financial support from PT national funds (FCT/MCTES) through the projects UIDB/50006/2020 and UIDP/50006/2020 and from PROTEOMASS Scientific Society through the projects #PM001/2019 and #PM003/2016.info:eu-repo/semantics/publishedVersio

A tutorial

PM003/2016. Publisher Copyright: © 2022 The Author(s)The capabilities of bioanalytical mass spectrometry to (i) detect and differentiate viruses at the peptide level whilst maintaining high sample throughput and (ii) to provide diagnosis and prognosis for infected patients are presented as a tutorial in this work to aid analytical chemists and physicians to gain insights into the possibilities offered by current high-resolution mass spectrometry technology and bioinformatics. From (i) sampling to sample treatment; (ii) Matrix-Assisted Laser Desorption Ionization- to Electrospray Ionization -based mass spectrometry; and (iii) from clustering to peptide sequencing; a detailed step-by-step guide is provided and exemplified using SARS-CoV-2 Spike Y839 variant and the variant of concern SARS-CoV-2 Alpha (B.1.1.7 lineage), Influenza B, and Influenza A subtypes AH1N1pdm09 and AH3N2.publishersversionpublishe

Phylogenomics of Xanthomonas field strains infecting pepper and tomato reveals diversity in effector repertoires and identifies determinants of host specificity

Citation: Schwartz, A. R., Potnist, N., Milsina, S., Wilson, M., Patane, J., Martins, J., . . . Staskawicz, B. J. (2015). Phylogenomics of Xanthomonas field strains infecting pepper and tomato reveals diversity in effector repertoires and identifies determinants of host specificity. Frontiers in Microbiology, 6, 17. https://doi.org/10.3389/fmicb.2015.00535Bacterial spot disease of pepper and tomato is caused by four distinct Xanthomonas species and is a severely limiting factor on fruit yield in these crops. The genetic diversity and the type Ill effector repertoires of a large sampling of field strains for this disease have yet to be explored on a genomic scale, limiting our understanding of pathogen evolution in an agricultural setting. Genomes of 67 Xanthomonas euvesicatoria (Xe), Xanthomonas perforans (Xp), and Xanthomonas gardneri (Kg) strains isolated from diseased pepper and tomato fields in the southeastern and midwestern United States were sequenced in order to determine the genetic diversity in field strains. Type Ill effector repertoires were computationally predicted for each strain, and multiple methods of constructing phylogenies were employed to understand better the genetic relationship of strains in the collection. A division in the Xp population was detected based on core genome phylogeny, supporting a model whereby the host-range expansion of Xp field strains on pepper is due, in part, to a loss of the effector AvrBsT. Xp-host compatibility was further studied with the observation that a double deletion of AvrBsT and XopQ allows a host range expansion for Nicotiana benthamiana. Extensive sampling of field strains and an improved understanding of effector content will aid in efforts to design disease resistance strategies targeted against highly conserved core effectors.Additional Authors: Goss, E.;Bart, R. S.;Setubal, J. C.;Jones, J. B.;Staskawicz, B. J

Fatores associados à contribuição dos cuidadores para o autocuidado na insuficiência cardíaca

Objetivo: analisar a contribuição do cuidador para o autocuidado na insuficiência cardíaca e variáveis preditoras desta contribuição. Método: estudo transversal descritivo e analítico, com a participação de 140 díades (pacientes e cuidadores). A contribuição para o autocuidado foi avaliada por meio do Caregiver Contribution to Self-Care of Heart Failure Index. Cuidadores e pacientes foram entrevistados separadamente para obtenção dos dados. A regressão linear múltipla foi utilizada para verificar variáveis preditoras da contribuição do cuidador. Resultados: a pontuação média de contribuição para o autocuidado de manutenção foi 62,7 (DP=7,1), de manejo, 62,9 (DP=20,4) e na confiança foi 63,3 (DP=22,1). A variáveis número de medicamentos do paciente, cuidador ter parentesco com o paciente, percepção social do cuidador, qualidade de vida relacionada à saúde do paciente e a confiança do cuidador na contribuição para o autocuidado foram preditoras da contribuição do cuidador para o autocuidado de manutenção ou de manejo. Conclusão: a contribuição do cuidador foi insuficiente. O apoio social percebido pelo cuidador, cuidador ter ou não parentesco com o paciente, número de medicamentos utilizados pelo paciente, bem como a confiança do cuidador em contribuir para o autocuidado são variáveis que devem ser consideradas para avaliar o risco de contribuição insuficiente do cuidador.Objetivo: analizar la contribución del cuidador para el autocuidado en la insuficiencia cardiaca y las variables predictoras de esa contribución. Método: estudio transversal descriptivo y analítico, con la participación de 140 díadas (pacientes y cuidadores). La contribución para el autocuidado fue evaluada por medio del Caregiver Contribution to Self-Care of Heart Failure Index. Los cuidadores y pacientes fueron entrevistados separadamente para obtención de los datos. La regresión linear múltiple fue utilizada para verificar variables predictoras de la contribución del cuidador. Resultados: la puntuación media de contribución para el autocuidado de manutención fue 62,7 (DE=7,1), de administración fue 62,9 (DE=20,4) y de confianza fue 63,3 (DE=22,1). Las variables: número de medicamentos del paciente, cuidador tener parentesco con el paciente, percepción social del cuidador, calidad de vida relacionada a la salud del paciente y la confianza del cuidador en la contribución para el autocuidado, fueron predictoras de la contribución del cuidador para el autocuidado de manutención o de administración. Conclusión: la contribución del cuidador fue insuficiente. El apoyo social percibido por el cuidador, el cuidador tener o no parentesco con el paciente, el número de medicamentos utilizados por el paciente y la confianza del cuidador en contribuir para el autocuidado, son variables que deben ser consideradas para evaluar el riesgo de contribución insuficiente del cuidador.Objective: to analyze the caregiver’s contribution to self-care in heart failure and the predictor variables of this contribution. Method: a cross-sectional descriptive and analytical study, with the participation of 140 dyads (patients and caregivers). The contribution to self-care was assessed using the Caregiver Contribution to Self-Care of Heart Failure Index. Caregivers and patients were interviewed separately to obtain the data. Multiple linear regressions were used to verify predictor variables of caregiver contribution. Results: the mean score for contribution to maintenance self-care was 62.7 (SD=7.1), for management, 62.9 (SD=20.4) and for confidence was 63.3 (SD=22.1). The variables number of patient’s medications, caregiver being related to the patient, social perception of caregiver, health-related quality of life of the patient and caregiver’s confidence in contributing to self-care were predictors of caregiver’s contribution to maintenance or management self-care. Conclusion: the caregiver’s contribution was insufficient. The social support perceived by the caregiver, the type of relationship the caregiver to the patient, the number of medications used by the patient, as well as the caregiver’s confidence in contributing to self-care are variables that should be considered to assess the risk of insufficient contribution of the caregiver

Escala de Confiança no Autocuidado do SCHFI 6.2 - Versão Brasileira: análise psicométrica pelo modelo de Rasch

Objetivo: avaliar as propriedades psicométricas da Escala de Confiança no Autocuidado na insuficiência cardíaca da versão brasileira do Self-Care Heart Failure Index, versão 6.2, usando os critérios do modelo Rasch. Método: estudo secundário, de análise psicométrica, pelo modelo de Rasch, dos seis itens da escala. A amostra foi constituída por 409 pacientes com insuficiência cardíaca em tratamento ambulatorial [idade média de 57,9 (desvio-padrão=11,6) anos, 54,8% do sexo masculino]. Resultados: do total de seis itens, um (“De maneira geral, você está confiante sobre estar livre dos sintomas de insuficiência cardíaca?”) apresentou desajuste ao modelo (Infit=1,84 e Outfit=1,99). Após a exclusão desse item, os demais apresentaram bom ajuste, compuseram uma dimensão e explicaram 55% da variância nos dados; as categorias de resposta aos itens foram adequadas, os valores de separação e confiabilidade das pessoas foram 2,13 e 0,82, respectivamente, e o alfa de Cronbach foi 0,87. Foram identificados os itens de extremos de dificuldade e que não há funcionamento diferencial dos itens em relação a sexo. Conclusão: com a exclusão do primeiro item, a Escala de Confiança no Autocuidado apresentou boas propriedades psicométricas, recomendando-se cautela na interpretação dos resultados da escala com seis itens.Objetivo: evaluar las propiedades psicométricas de la Escala de Confianza en el Autocuidado, de la insuficiencia cardíaca, de la versión brasileña del Self Care Heart Failure Index versión 6.2, usando los criterios del modelo Rasch. Método: estudio secundario de análisis psicométrica de los seis ítems de la escala del modelo de Rasch. La muestra fue constituida por 409 pacientes, con insuficiencia cardíaca, en tratamiento de ambulatorio [edad media de 57,9 (desviación estándar=11,6) años; 54,8% del sexo masculino]. Resultados: del total de seis ítems, uno (“De maneira geral, você está confiante sobre estar livre dos sintomas de insuficiência cardíaca?”) presentó desajuste (Infit=1,84 y Outfit=1,99) en el modelo utilizado. Después de la exclusión de ese ítem, los demás presentaron buen ajuste, compusieron una dimensión y explicaron 55% de la varianza de los datos; las categorías de respuesta a los ítems fueron consideradas adecuadas; los valores de separación y confiabilidad de las personas fueron 2,13 y 0,82, respectivamente; y, el alfa de Cronbach fue 0,87. Fueron identificados los ítems extremos identificados como difíciles dificultad. No hubo funcionamiento diferencial de los ítems en relación al sexo. Conclusión: con la exclusión del primer ítem, la Escala de Confianza en el Autocuidado presentó buenas propiedades psicométricas; por esa razón, se recomienda tener cautela en la interpretación de los resultados de la escala con los seis ítems.Objective: to evaluate the psychometric properties of the Self-Care Confidence Scale in heart failure in the Brazilian version of the Self Care Heart Failure Index, version 6.2, using the Rasch model criteria. Method: secondary study, of psychometric analysis, using the Rasch model, of the six items of the scale. The sample consisted of 409 patients with heart failure undergoing outpatient treatment [mean age 57.9 (standard deviation = 11.6) years, 54.8% male]. Results: of the total of six items, one (“De maneira geral, você está confiante sobre estar livre dos sintomas de insuficiência cardíaca?”) presented maladjustment to the model (Infit = 1.84 and Outfit = 1.99). After the exclusion of this item, the others showed a good fit, composed one dimension and explained 55% of the variance in the data; the categories of response to the items were adequate, the values of separation and reliability of person were 2.13 and 0.82, respectively, and Cronbach’s alpha was 0.87. Items of extreme difficulty were identified and there is no differential functioning of the items in relation to sex. Conclusion: with the exclusion of the first item, the Self-Care Confidence Scale showed good psychometric properties, with caution in interpreting the results of the six-item scale