A experiência da tentativa de suicídio na perspectiva de adultos

Objetivo: analisar a experiência da tentativa de suicídio na perspectiva de adultos que tentaram suicídio. Método: estudo qualitativo com oito adultos brasileiros assistidos em serviço de saúde mental. Os dados foram coletados em 2018 por entrevistas semidirigidas sobre a experiência da tentativa de suicídio e encontros grupais. O Interacionismo Simbólico foi o referencial teórico utilizado. Os dados foram submetidos à análise temática. Resultados: identificamos três temas: Ambiente intrapsíquico: representação e comunicação com o self (generalização de fracassos e expectativas negativas na construção de significados atribuídos ao self, à vida e às relações); Relações interpessoais (necessidade de vínculo, pertença, reconhecimento, acolhimento e sentirem necessários para outras pessoas); e Representações da tentativa de suicídio: a fuga e o encontro com a dor (a tentativa de suicídio é motivada pelo desejo de aliviar a dor, mas resulta no encontro com a dor, e instiga a busca por novos métodos, a evitação do suicídio por medo ou a reconstrução de significados). Conclusão: o estudo fornece importantes achados a serem explorados na prática clínica, no delineamento de protocolos, políticas institucionais, bem como na formação de profissionais.Objective: to analyze the experience of attempted suicide from the perspective of adults who attempted suicide. Method: a qualitative study with eight Brazilian adults assisted in a mental health service. Data was collected in 2018 through semi-directed interviews about the experience of the suicide attempt and group meetings. Symbolic Interactionism was the theoreticalframework used. Data was submitted to thematic analysis. Results: we identified three themes: Intrapsychic environment: representation and communication with the self (generalization of failures and negative expectations in the construction of meanings attributed to the self, lifeand relationships); Interpersonal relationships (need to bond, belong, recognize, welcome and feel necessary for other people); and Representations of the suicide attempt: escape and theencounter with pain (the suicide attempt is motivated by the desire to relieve pain, but results in the encounter with pain, and instigates the search for new methods, the avoidance of suicide for fear or the reconstruction of meanings). Conclusion: the study provides important findings to be explored in the clinical practice, in the design of protocols, institutional policies, as well as in the qualification of the professionals.Objetivo: analizar la experiencia del intento de suicidio la perspectiva de los adultos que intentaron suicidarse. Método: estudio cualitativo con ocho adultos brasileños asistidos en un servicio de salud mental. Los datos se recopilaron en 2018, entrevistas semidirigidas sobre experienciadel intento de suicidio y las reuniones grupales. Se utilizó el marco teórico del interaccionismo simbólico. Los datos fueron sometidos a análisis temático. Resultados: identificamos tres temas:Entorno intrapsíquico: representación y comunicación con el “yo” (generalización de fracasos y expectativas negativas en la construcción de significados atribuidos al yo, la vida y las relaciones);Relaciones interpersonales (necesidad de establecer vínculo, pertenencia, reconocimiento, aceptación y de sentirse necesario para otras personas); Representaciones del intento de suicidio: la fuga y el encuentro con el dolor (el intento de suicidio está motivado por el deseo de aliviar el dolor, pero resulta en el encuentro con el dolor e instiga a la búsqueda de nuevos métodos, la evitación de suicidio por miedo o la reconstrucción de significados). Conclusiones: el estudio brinda hallazgos importantes que deben ser explorados por la práctica clínica, en el diseño de protocolos, políticas institucionales, así como en la capacitación de profesionales

The molecular chaperone Hsp90 is a component of the cap-binding complex and interacts with the translational repressor Cup during Drosophila oogenesis

In metazoa, the spatio-temporal translation of diverse mRNAs is essential to guarantee proper oocyte maturation and early embryogenesis. The eukaryotic translation initiation factor 4E (eIF4E), which binds the 5′ cap structure of eukaryotic mRNAs, associates with either stimulatory or inhibitory factors to modulate protein synthesis. In order to identify novel factors that might act at the translational level during Drosophila oogenesis, we have undertaken a functional proteomic approach and isolated the product of the Hsp83 gene, the evolutionarily conserved chaperone Hsp90, as a specific component of the cap-binding complex. Here we report that Hsp90 interacts in vitro with the translational repressor Cup. In addition, we show that Hsp83 and cup interact genetically, since lowering Hsp90 activity enhances the oogenesis alterations linked to diverse cup mutant alleles. Hsp90 and Cup co-localize in the cytoplasm of the developing germ-line cells within the germarium, thus suggesting a common function from the earliest stages of oogenesis. Taken together, our data start elucidating the role of Hsp90 during Drosophila female germ-line development and strengthen the idea that Cup has multiple essential functions during egg chamber development

Fabrication and characterization of biomimetic hydroxyapatite thin films for bone implants by direct ablation of a biogenic source

Biomimetic bone apatite coatings were realized for the first time by the novel Ionized Jet Deposition technique. Bone coatings were deposited on titanium alloy substrates by pulsed electron ablation of deproteinized bovine bone shafts in order to resemble bone apatite as closely as possible. The composition, morphology and mechanical properties of the coatings were characterized by GI-XRD, FT-IR, SEM-EDS, AFM, contact angle measurements, micro-scratch and screw-insertion tests. Different post-treatment annealing conditions (from 350 °C to 425 °C) were investigated. Bone apatite coatings exhibited a nanostructured surface morphology and a composition closely resembling that of the deposition target (i.e. natural bone apatite), also regarding the presence of magnesium and sodium ions. Crystallinity and composition of the coatings were strongly influenced by annealing temperature and duration; in particular, upon annealing at 400 °C and above, a crystallinity similar to that of bone was achieved. Finally, adhesion to the titanium substrate and hydrophilicity were significantly enhanced upon annealing, all characteristics being known to have a strong positive impact on promoting host cells attachment, proliferation and differentiation

Novel structural-scale uncertainty measures and error retention curves: application to multiple sclerosis

This paper focuses on the uncertainty estimation for white matter lesions (WML) segmentation in magnetic resonance imaging (MRI). On one side, voxel-scale segmentation errors cause the erroneous delineation of the lesions; on the other side, lesion-scale detection errors lead to wrong lesion counts. Both of these factors are clinically relevant for the assessment of multiple sclerosis patients. This work aims to compare the ability of different voxel- and lesion-scale uncertainty measures to capture errors related to segmentation and lesion detection, respectively. Our main contributions are (i) proposing new measures of lesion-scale uncertainty that do not utilise voxel-scale uncertainties; (ii) extending an error retention curves analysis framework for evaluation of lesion-scale uncertainty measures. Our results obtained on the multi-center testing set of 58 patients demonstrate that the proposed lesion-scale measure achieves the best performance among the analysed measures. All code implementations are provided at https://github.com/NataliiaMolch/MS_WML_uncsComment: 4 pages, 2 figures, 3 tables, ISBI preprin

Structural-Based Uncertainty in Deep Learning Across Anatomical Scales: Analysis in White Matter Lesion Segmentation

This paper explores uncertainty quantification (UQ) as an indicator of the trustworthiness of automated deep-learning (DL) tools in the context of white matter lesion (WML) segmentation from magnetic resonance imaging (MRI) scans of multiple sclerosis (MS) patients. Our study focuses on two principal aspects of uncertainty in structured output segmentation tasks. Firstly, we postulate that a good uncertainty measure should indicate predictions likely to be incorrect with high uncertainty values. Second, we investigate the merit of quantifying uncertainty at different anatomical scales (voxel, lesion, or patient). We hypothesize that uncertainty at each scale is related to specific types of errors. Our study aims to confirm this relationship by conducting separate analyses for in-domain and out-of-domain settings. Our primary methodological contributions are (i) the development of novel measures for quantifying uncertainty at lesion and patient scales, derived from structural prediction discrepancies, and (ii) the extension of an error retention curve analysis framework to facilitate the evaluation of UQ performance at both lesion and patient scales. The results from a multi-centric MRI dataset of 172 patients demonstrate that our proposed measures more effectively capture model errors at the lesion and patient scales compared to measures that average voxel-scale uncertainty values. We provide the UQ protocols code at https://github.com/Medical-Image-Analysis-Laboratory/MS_WML_uncs.Comment: Preprint submitted to the journa

Case Report: Crossing a rugged road in a primary immune regulatory disorder

over the last decades, Inborn errors of immunity (IEI) characterized by an immune dysregulatory picture, isolated or combined with infections, have been increasingly identified and referred as primary immune regulatory disorders (PIRD). PIRD diagnosis may be difficult due to heterogeneity of time onset, sequence of clinical manifestations and laboratory abnormalities. moreover, the dissection of a PIRD vs. a secondary immunodeficiency (SID) might be a real challenge since the same indications for immunosuppressant treatments might represent per se a PIRD clinical expression. here we report a female patient with a history of recurrent respiratory and urinary tract infections since early infancy and a diagnosis of rheumatoid arthritis in adulthood. after poor response to several biologicals she was treated with rituximab and sent to immunology referral for a severe hypogammaglobulinemia. clinical and immunological features matched a diagnosis of common variable immunodeficiency and when IgG replacement therapy and antibiotic prophylaxis were added a good infectious control was obtained. hh next generation sequencing analysis has revealed a novel heterozygous VUS in the IKBKB gene (c.1465A > G; p.Ser489Gly). functional analysis has shown a reduced capacity of B lymphocytes and CD4 positive T cells in inducing I kappa B alpha degradation, with negative impact on NF-kB pathway. due to recurrent infections attributed to a common condition in childhood and to an exclusive autoimmunity-centered approach in adulthood, both diagnosis and suitable treatment strategies have suffered a significant delay. to reduce the diagnostic delay, pediatricians, general practitioners and specialists should be aware of IEI and the challenges to differentiate them from SID. furthermore, genetic characterization and functional analysis may contribute to a personalized approach, in a perspective of targeted or semi-targeted therapy

Encontrar un nuevo significado a través de la música después de un intento de suicidio

Listening to music can trigger unpleasant feelings or bring meaning to our lives, both from the cognitive and psychic perspectives. Thus, music can attribute meanings to our personal experiences and act as a regulator of emotions when living these experiences.Songlyrics can often influence behaviours while helping to work on processes of resilience, autonomy, empowerment, and psychosocial rehabilitation.This study aims to analyse the possibilities of music in the process of resignification of life through the discursive productions of individuals after a suicide attempt.A qualitative study was conducted with eight Brazilian adults assisted in a mental health service,in 2018, through semi-structured interviews.The Symbolic Interactionism theoretical framework was used, and the data weresubmitted for thematic analysis.Three categories were identified: ‘Spirituality as an empowering agent’;‘Sense of belonging and identification’, and ‘The importance of music as a sensitizer of reasons for living and an instrument of verbalization of feelings.The study provides important findings that merit further investigation regarding interventions and possibilities related to music as a healing method in the process of resignification oflife after a suicide attemptOuvir música pode desencadear sentimentos desagradáveis ou trazer sentido às nossas vidas, tanto do ponto de vista cognitivo quanto psíquico. Assim, a música pode atribuir significados às nossas experiências pessoaise atuar como reguladora das emoções ao viver essas experiências. As letras das músicas muitas vezes podem influenciar comportamentos ao mesmo tempo em que ajudam a trabalhar processos de resiliência,autonomia, empoderamento e reabilitação psicossocial.Esse estudo tem como objetivo analisar as possibilidades da música no processo de ressignificação da vida por meio das produções discursivas de indivíduos após uma tentativa de suicídio.Foi realizado um estudo qualitativo com oito adultos brasileiros atendidos em um serviço de saúde mental, em2018, por meio de entrevistas semiestruturadas. Foi utilizado o referencial teórico do Interacionismo Simbólico e os dados foram submetidos à análise temática. Foram identificadas três categorias: “A espiritualidade como agente empoderador”; “Senso de pertencimento e identificação” e “A importância da música como sensibilizadora das razões de viver e instrumento de verbalização de sentimentos”. O estudo traz achados importantes que merecem maiores investigações sobre intervenções e possibilidades relacionadas à música como método de cura no processo de ressignificação da vida após uma tentativa de suicídioEscuchar música puede desencadenar sentimientos desagradables o dar sentido a nuestra vida, tanto a nivel cognitivo como psíquico. Así, la música puede asignar significados a nuestras experiencias personales y actuar como regulador de las emociones al vivir estas experiencias. Las letras de las canciones a menudo pueden influir en los comportamientos mientras ayudan a trabajar en los procesos de resiliencia, autonomía, empoderamiento y rehabilitación psicosocial. Este estudio tiene como objetivo analizar las posibilidades de la música en el proceso de resignificación de la vida a través de las producciones discursivas de los individuos después de un intento de suicidio. Se realizó un estudio cualitativo con ocho adultos brasileños atendidos en un servicio desalud mental, en 2018, a través de entrevistas semiestructuradas.Se utilizó el referencial teórico del Interaccionismo Simbólico y los datos fueron sometidos a análisis temático. Se identificaron tres categorías: “Espiritualidad como agente de empoderamiento”; “Sentido de pertenencia e identificación” y “La importanciade la música como sensibilizadora de razones de vivir e instrumento para verbalizar sentimientos”. El estudio trae importantes hallazgos que merecen mayor investigación sobre intervencionesy posibilidades relacionadascon la música como método de sanación en el proceso de sanación resignificación de la vida después de un intento de suicidio.info:eu-repo/semantics/publishedVersio

Cyclin E correlates with manganese superoxide dismutase expression and predicts survival in early breast cancer patients receiving adjuvant epirubicin-based chemotherapy.

Anthracycline-based chemotherapy represents a milestone in the treatment of breast cancer. We previously demonstrated in an in vitro model that cyclin E overexpression is associated with increased expression of manganese superoxide dismutase (MnSOD) and resistance to doxorubicin. In the present study, immunohistochemical expression of cyclin E and MnSOD was evaluated in 134 early breast cancer patients receiving adjuvant epirubicin-based chemotherapy regimens containing epirubicin. Both parameters were correlated with the available clinicopathological parameters and with the outcome of patients. Overexpression of cyclin E and MnSOD was detected in 46 (34.3%) and 56 (41.8%) patients, respectively, and expression levels of the two proteins were related. Disease-free and alive patients displayed a lower mean percentage of cyclin E-expressing cells than relapsed and dead patients, respectively. Kaplan-Meier survival analysis demonstrated a significant separation between high versus low cyclin E-expressing tumors in terms of overall survival (P = 0.038 by log-rank). Similar results were obtained considering the subset of node-negative patients separately. No significant relationship with patient outcome was observed for MnSOD expression levels. At multivariate analysis cyclin E failed to demonstrate an independent prognostic value. In conclusion, the results of the present study support previous evidence that increased cyclin E expression is associated with higher MnSOD expression levels and poorer outcome, at least as evaluated in terms of overall survival. Further studies are warranted to evaluate the usefulness of cyclin E as a prognostic marker to identify breast cancer patients at higher risk of death from the disease when treated with adjuvant anthracycline-based therapy

A Comprehensive Microstructural and Compositional Characterization of Allogenic and Xenogenic Bone: Application to Bone Grafts and Nanostructured Biomimetic Coatings

Bone grafts and bone-based materials are widely used in orthopedic surgery. However, the selection of the bone type to be used is more focused on the biological properties of bone sources than physico-chemical ones. Moreover, although biogenic sources are increasingly used for deposition of biomimetic nanostructured coatings, the influence of specific precursors used on coating’s morphology and composition has not yet been explored. Therefore, in order to fill this gap, we provided a detailed characterization of the properties of the mineral phase of the most used bone sources for allografts, xenografts and coating deposition protocols, not currently available. To this aim, several bone apatite precursors are compared in terms of composition and morphology. Significant differences are assessed for the magnesium content between female and male human donors, and in terms of Ca/P ratio, magnesium content and carbonate substitution between human bone and different animal bone sources. Prospectively, based on these data, bone from different sources can be used to obtain bone grafts having slightly different properties, depending on the clinical need. Likewise, the suitability of coating-based biomimetic films for specific clinical musculoskeletal application may depend on the type of apatite precursor used, being differently able to tune surface morphology and nanostructuration, as shown in the proof of concepts of thin film manufacturing here presented

PERCEPTIONS OF NURSES IN BASIC HEALTH UNITS REGARDING THEIR ACTIONS IN CASES OF DEPRESSION

Objective: To understand how nurses deal with depression in basic health units.Method: Qualitative research was carried out in 2020 through an open interview with 15 nurses working in basic health units in a municipality in the Brazilian Midwest region. The interviews were subjected to content analysis.Results: It was possible to see that nurses have multifactorial difficulties in dealing with cases of depression. However, they point out strategies that indicate ways to qualify their clinical practice, such as the importance of professional training and strengthening teamwork, so they are prepared and qualified to offer effective and humanized nursing care to people with depression.Conclusion: Even in the face of the challenges that have arisen, the continuity of nursing actions aimed at patients with depression and other mental disorders is fundamental, especially in contexts with a weakened mental health care network