Dysthanasia: nursing professionals' perception

Dysthanasia means slow and painful death without quality of life. This study aimed to know whether nurses identify dysthanasia as part of the final process of the lives of terminal patients hospitalized at an adult ICU. This is an exploratory-qualitative study. Data were collected through semi-structured interviews with ten nurses with at least one year of experience in an ICU, and interpreted through content analysis. Results indicate that nurses understand and identify dysthanasia, do not agree with it and recognize elements of orthonasia as the adequate procedure for terminal patients. We conclude that nurses interpret dysthanasia as extending life with pain and suffering, while terminal patients are submitted to futile treatments that do not benefit them. They also identify dysthanasia using elements of orthonasia to explain it.Distanasia significa muerte lenta, con sufrimiento y sin calidad de vida. En esta investigación se buscó conocer si los enfermeros identifican la distanasia como parte del proceso final de la vida de personas en estado terminal, internadas en una UTI para adultos. El estudio es de naturaleza exploratoria, con abordaje cualitativo. Los datos fueron recolectados por medio de entrevista semiestructurada con 10 enfermeros con un mínimo de un año de experiencia en UTI; los datos fueron interpretados por el análisis de contenido. Se obtuvo como resultado que los enfermeros comprenden e identifican la distanasia y se oponen a la misma, presentando elementos de ortotanasia como procedimiento adecuado para pacientes en estado terminal. Se concluye que los enfermeros interpretan la distanasia como el prolongamiento de la vida con dolor y sufrimiento, en el cual los pacientes terminales son sometidos a tratamientos fútiles que no traen beneficios. También identifican la distanasia, usando elementos de la ortotanasia para hacerla explicita.Distanásia significa morte lenta, sofrida e sem qualidade de vida. Nesta pesquisa buscou-se conhecer se os enfermeiros identificam a distanásia como parte do processo final da vida de pessoas em terminalidade, internadas em UTI adulto. O estudo é de natureza exploratória, com abordagem qualitativa. Os dados foram coletados por meio de entrevista semiestruturada com 10 enfermeiros com, no mínimo, um ano de experiência em UTI, e interpretados pela análise de conteúdo. Teve-se como resultado que os enfermeiros compreendem e identificam a distanásia e se opõem à mesma, trazendo elementos da ortotanásia como procedimento adequado para pacientes em terminalidade. Conclui-se que os enfermeiros interpretam a distanásia como o prolongamento de vida com dor e sofrimento, onde os pacientes terminais são submetidos a tratamentos fúteis que não trazem benefícios. E também identificam a distanásia, usando elementos da ortotanásia para explicitá-la

Output from VIP cells of the mammalian central clock regulates daily physiological rhythms

The suprachiasmatic nucleus (SCN) circadian clock is critical for optimising daily cycles in mammalian physiology and behaviour. The roles of the various SCN cell types in communicating timing information to downstream physiological systems remain incompletely understood, however. In particular, while vasoactive intestinal polypeptide (VIP) signalling is essential for SCN function and whole animal circadian rhythmicity, the specific contributions of VIP cell output to physiological control remains uncertain. Here we reveal a key role for SCN VIP cells in central clock output. Using multielectrode recording and optogenetic manipulations, we show that VIP neurons provide coordinated daily waves of GABAergic input to target cells across the paraventricular hypothalamus and ventral thalamus, supressing their activity during the mid to late day. Using chemogenetic manipulation, we further demonstrate specific roles for this circuitry in the daily control of heart rate and corticosterone secretion, collectively establishing SCN VIP cells as influential regulators of physiological timing

Identification of a Novel Aminopeptidase P-Like Gene (OnAPP) Possibly Involved in Bt Toxicity and Resistance in a Major Corn Pest (Ostrinia nubilalis)

Studies to understand the Bacillus thuringiensis (Bt) resistance mechanism in European corn borer (ECB, Ostrinia nubilalis) suggest that resistance may be due to changes in the midgut-specific Bt toxin receptor. In this study, we identified 10 aminopeptidase-like genes, which have previously been identified as putative Bt toxin receptors in other insects and examined their expression in relation to Cry1Ab toxicity and resistance. Expression analysis for the 10 aminopeptidase-like genes revealed that most of these genes were expressed predominantly in the larval midgut, but there was no difference in the expression of these genes in Cry1Ab resistant and susceptible strains. This suggested that altered expression of these genes was unlikely to be responsible for resistance in these ECB strains. However, we found that there were changes in two amino acid residues of the aminopeptidase-P like gene (OnAPP) involving Glu305 to Lys305 and Arg307 to Leu307 in the two Cry1Ab-resistant strains as compared with three Cry1Ab-susceptible strains. The mature OnAPP contains 682 amino acid residues and has a putative signal peptide at the N-terminus, a predicted glycosylphosphatidyl-inositol (GPI)-anchor signal at the C-terminal, three predicted N-glycosylation sites at residues N178, N278 and N417, and an O-glycosylation site at residue T653. We used a feeding based-RNA interference assay to examine the role of the OnAPP gene in Cry1Ab toxicity and resistance. Bioassays of Cry1Ab in larvae fed diet containing OnAPP dsRNA resulted in a 38% reduction in the transcript level of OnAPP and a 25% reduction in the susceptibility to Cry1Ab as compared with larvae fed GFP dsRNA or water. These results strongly suggest that the OnAPP gene could be involved in binding the Cry1Ab toxin in the ECB larval midgut and that mutations in this gene may be associated with Bt resistance in these two ECB strains