FATORES ASSOCIADOS A RETENÇÃO E INTENCIONALIDADE DE EVASÃO NOS CURSOS DE FARMÁCIA DE UMA UNIVERSIDADE PÚBLICA DO NORDESTE BRASILEIRO

The study aimed to evaluate possible factors associated with retention and intentionality of avoidance of the Pharmacy course of a Public University of the Northeast. This is a cross-sectional study conducted between July and December 2019 with students from the two undergraduate courses in Pharmacy, from the Federal University of Sergipe. For data collection, an instrument was used that included: 1) Sociodemographic data and; 2) Factors related to the intentionality of evasion, questions about locking, and failure in modules/disciplines. The study participated in 335 students, 132 from the Lagarto campus and 203 students from São Cristóvão. Of these, 69.30% (n=232) were women, the majority (81.20%) aged between 18 and 24 years, 60.90% (n=204) declared themselves brown, 96.70% were single and 5.10% (n= 17) had children. Regarding failure and intentionality of evasion, 176 (52.50%) stated that they had already failed and 62,10% (n=208) had the intention to drop out of the course. Among the factors that have an impact on the intentionality of the evasion was: "schedule of the disciplines offered", "curriculum matrix", "teaching methodology", "form of evaluation", "relationship between student and teacher/coordinator", "interpersonal relationships", "student assistance", “low remuneration of the professional", "financial difficulties", "lack of study skills", "difficulties of adaptation to the university", "disenchantment or demotivation with the course", "learning difficulties, translated into disapproval and low frequency", "inadaptation with the course" and "mental health problem". The results reinforce the need for strategies that support students during graduation, in order to reduce the impact of retention and dropout in higher education.El estudio tenía como objetivo evaluar posibles factores asociados con la retención e intencionalidad de la evasión del curso de Farmacia de una Universidad Pública del Noreste. Estudio transversal realizado entre julio y diciembre de 2019 con estudiantes de los dos cursos de Farmacia de la Universidad Federal de Sergipe. Se recopilaron los siguientes datos: 1) datos sociodemográficos; 2) Factores relacionados con la intencionalidad de la evasión, preguntas sobre bloqueo y retención en módulos/disciplinas. Participó del estudio 335 estudiantes, 132 del campus de Lagarto y 203 de São Cristóvão. De ellos,  69,30% (n=232) eran mujeres, la mayoría (81,20%) entre 18 y 24 años, 60,90% (n=204) se declararon pardas, 96,70% eran solteros y 5,10% (n=17) tenían hijos. En cuanto al retención y la intencionalidad de la evasión, 176 (52,50%) afirmaron que ya habían reprobado y 62,10% (n=208) tenían la intención de evasión. Se destacaron los siguientes factores de intencionalidad de la evasión: "programa de las disciplinas ofrecidas", "matriz curricular", "metodología de enseñanza", "forma de evaluación", "relación entre estudiante y profesor/coordinador", "relaciones interpersonales", "asistencia al estudiante", “baja remuneración del profesional", "dificultades financieras", "falta de habilidades de estudio", "dificultades de adaptación a la universidad", "desencanto o desmotivación con el curso", "dificultades de aprendizaje, traducidas en desaprobación y baja frecuencia", "inadaptación con el curso" y "problema de salud mental". Los resultados refuerzan la necesidad de estrategias que apoyen a los estudiantes durante la graduación, con el fin de reducir el impacto en la retención escolar y la deserción escolar en la educación superior.O estudo objetivou avaliar possíveis fatores associados à retenção e à intencionalidade de evasão do curso de Farmácia de uma Universidade Pública do Nordeste. Trata-se de um estudo transversal realizado entre julho a dezembro de 2019 com estudantes dos dois cursos de graduação em Farmácia, da Universidade Federal de Sergipe. Para a coleta de dados utilizou-se um instrumento que contemplava: 1) Dados Sociodemográficos e; 2) Fatores ligados à intencionalidade de evasão questões, sobre trancamento e reprovação em módulos / disciplinas. Participaram da pesquisa 335 estudantes, sendo 132 do campus Lagarto e 203 estudantes de São Cristóvão.Destes, 69,30% (n = 232) eram mulheres, a maioria (81,20%) apresentava idade entre 18 e 24 anos, 60,90% (n = 204) se autodeclaram pardos, 96,70% eram solteiros e 5,10% (n = 17) possuíam filhos. Quanto a reprovação e intencionalidade de evasão, 176 (52,50%) afirmaram já ter reprovado e 62,10% (n = 208) a intenção de desistir do curso.Entre os fatores que impactam na intencionalidade da evasão destacou-se: “horário das disciplinas ofertadas”, “matriz curricular”, “metodologia de ensino”, “forma de avaliação”, “relação entre aluno e professor / coordenador”, “relações interpessoais ”,“ Assistência aos alunos ”,“ baixa renda do profissional ”,“ dificuldades financeiras ”,“ falta de habilidades de estudo ”,“ dificuldade de adaptação à universidade ”,“ desencanto ou desmotivação com o curso ”,“ dificuldades de aprendizagem, traduzidas em reprovação e baixa frequência ”,“ inadaptação com o curso ”e“ problema de saúde mental ”. Os resultados reforçam a necessidade de aplicar que subsidiem os estudantes durante a graduação

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Analysis of the genetic and immunoinformatics variability of glycosyltransferase from Ureaplasma diversum and its relationship with the constitution, antigenicity and immunogenicity of the capsular polysaccharide.

A economia do setor agro-industrial está diretamente relacionada à saúde dos rebanhos. A ocorrência de infertilidade, pode ser causada por micoplasmas e ureaplasmas, e pode levar a prejuízos. Ureaplasma diversum pode causar infecções e ativar a resposta imune e ativação de TLRs (Toll Like Receptors), bem como maturação de citocinas pró-inflamatórias. O recente sequenciamento do genoma de Ureaplasma diversum, permitiu aprimorar a compreensão da biologia molecular destas infecções e ampliar as possibilidades de desenvolvimento de novas alternativas diagnósticas e de prevenção. O objetivo deste estudo é avaliar a variabilidade genética e imunoinformática do gene da glicosiltransferase de U. diversum e sua relação com a constituição e antigenicidade e imunogenicidade do polissacarídeo capsular. Para tanto foi utilizada a cepa de referência de U. diversum ATCC 49782 e 52 isolados de swab vulvovaginal de bovinos. Foi realizada PCR para identificação do gene UD216, codificador da glicosiltransferase. Os amplicons foram sequenciados e construída uma árvore filogenética. As sequencias foram analisadas por meio de técnicas de bioinformática para predição de antigenicidade e características para expressão heteróloga. As análises de imuno e antigenicidade foram realizadas com cultura de PBMC bovinos. O ensaio de linfoproliferação foi feito por CFSE. Camundongos Balb/c foram usados para a produção de anticorpos policlonais. Foi avaliada a expressão gênica por qPCR de IL-1&#946, TNF-&#945, TLR2, TLR4 e iNOS. O nitrito foi dosado pelo método de Griess. Após a realização de PCR dos 52 isolados de U. diversum, 69% (n=36) foram positivas para o gene UD216, distribuidas nos diferentes estados brasileiros de coleta. Com o sequenciamento, as amostras formaram grupos de acordo com a proximidade gênica entre elas, compreendendo amostras coletadas em um mesmo lugar. As predições por bioinformática informaram que a sequência codificante do gene UD216 não possui características de antigenicidade mas tem capacidade de ligação a alelos de MHCI. As variações na sequencia e na composição de açúcares podem relacionar com mecanismos de variação antigênica e de escape a resposta imune. A presença do polissacarídeo capsular não induziu proliferação linfocitária em PBMC bovinos nem anticorpos específicos em camundongos. A expressão gênica de marcadores inflamatórios foi discreta, mas houve o aumento do nitrito nas culturas após a exposição ao CPS. Com os resultados obtidos será possível fomentar a discussão da importância e relevância do polissacarídeo capsular nas infecções por U. diversum, na reprodução e bovinocultura no cenário brasileiro e dar base para o desenvolvimento de ensaios diagnósticos e terapias mais eficientes.The economy of the agro-industrial sector is directly related to the health of the herds. The occurrence of infertility can be caused by mycoplasmas and ureaplasmas, and can lead to damage. Ureaplasma diversum can cause infections and activate the immune response and activation of TLR\'s (Toll Like Receptors), as well as maturation of pro-inflammatory cytokines. The recent sequencing of the genome of Ureaplasma diversum has improved the understanding of the molecular biology of these infections and expanded the possibilities for developing new diagnostic and prevention alternatives. The aim of this study is to evaluate the genetic and immunoinformatics variability of the glycosyltransferase gene from U. diversum and its relationship with the constitution and antigenicity and immunogenicity of the capsular polysaccharide. For this purpose, the reference strain of U. diversum ATCC 49782 and 52 isolates of vulvovaginal swab from bovines were used. PCR was performed to identify the UD216 gene, encoding the glycosyltransferase. Amplicons were sequenced and a phylogenetic tree constructed. The sequences were analyzed using bioinformatics techniques to predict antigenicity and characteristics for heterologous expression. Immunogenicity and antigenicity analyzes were performed with bovine PBMC cultures. The lymphoproliferation assay was performed by CFSE. Balb/c mice were used to produce polyclonal antibodies. Gene expression was evaluated by qPCR of IL-1&#946, TNF-&#945, TLR2, TLR4 and iNOS. Nitrite was measured using the Griess method. After PCR of the 52 U. diversum isolates, 69% (n=36) were positive for the UD216 gene, distributed in different brazilian states of collection. With the sequencing, the samples formed groups according to the genetic proximity between them, comprising samples collected in the same place. Bioinformatics predictions indicated that the coding sequence of the UD216 gene does not have antigenicity characteristics, but is capable of binding to MHCI alleles. Variations in the sequence and composition of sugars may relate to mechanisms of antigenic variation and immune response escape. The presence of capsular polysaccharide did not induce lymphocyte proliferation in bovine PBMC or specific antibodies in mice. Gene expression of inflammatory markers was discreet, but there was an increase in nitrite in cultures after exposure to CPS. With the results obtained, it will be possible to promote the discussion of the importance and relevance of the capsular polysaccharide in infections by U. diversum, in reproduction and cattle raising in the Brazilian scenario and provide a basis for the development of more efficient diagnostic tests and therapies

Response of macrophages and bovine blastocysts after exposure to Ureaplasma diversum.

Ureaplasma diversum pode causar infecções e ativar a resposta imune, estando relacionado com infertilidade em bovinos. Devido à importância dos macrófagos nessas infecções e a relação direta com blastocistos bovinos, o estudo teve o objetivo avaliar o perfil imune in vitro destas células após a infecção experimental por U. diversum. Demonstrou-se capaz de promover resposta inflamatória em macrófagos murinos e bovinos e blastocistos bovinos, com ativação do TLR2 e secreção de IL-1β e TNF-α. A ativação inflamatória pode estar relacionada com a presença de um componente de superfície capaz de induzir uma resposta desse tipo, como lipoproteínas associadas aos lipídeos de membrana (LAMPs), mas as de U. diversum ainda não foram totalmente caracterizadas. Estes resultados associados ao sequenciamento do genoma de U. diversum, permite avanço na compreensão da biologia molecular de infecções por micoplasma. Assim, fomenta-se a discussão da importância e relevância das micoplasmoses, especialmente por U. diversum, na reprodução e bovinocultura no cenário brasileiro.Ureaplasma diversum can cause infection and activate the immune response, and is associated with infertility in cattle. Due to the importance of macrophages in these infections and the direct relationship with bovine blastocysts, the study aimed to evaluate the immune profile in vitro of these cells after experimental infection U. diversum. It has been shown capable of promoting inflammatory response in murine and bovine macrophages and bovine blastocysts, with activation of TLR2 and IL-1β secretion and TNF-α. The inflammatory activation may be related to the presence of a surface component capable of inducing a response of that type, such as lipoproteins associated with lipid membrane (LAMP\'s), but U. diversum lipoproteins have not been fully characterized. These results associated with the sequencing of the U. diversum genome allows improvement in understanding the molecular biology of mycoplasma infections. Thus, encourages the discussion of the importance and relevance of mycoplasmosis, especially U. diversum, reproduction and cattle in the Brazilian scene

Heterologous Expression, Purification, and Immunomodulatory Effects of Recombinant Lipoprotein GUDIV-103 Isolated from Ureaplasma diversum

Ureaplasma diversum is a bacterial pathogen that infects cattle and can cause severe inflammation of the genital and reproductive systems. Lipid-associated membrane proteins (LAMPs), including GUDIV-103, are the main virulence factors in this bacterium. In this study, we heterologously expressed recombinant GUDIV-103 (rGUDIV-103) in Escherichia coli, purified it, and evaluated its immunological reactivity and immunomodulatory effects in bovine peripheral blood mononuclear cells (PBMCs). Samples from rabbits inoculated with purified rGUDIV-103 were analysed using indirect enzyme-linked immunosorbent assay and dot blotting to confirm polyclonal antibody production and assess kinetics, respectively. The expression of this lipoprotein in field isolates was confirmed via Western blotting with anti-rGUDIV-103 serum and hydrophobic or hydrophilic proteins from 42 U. diversum strains. Moreover, the antibodies produced against the U. diversum ATCC 49783 strain recognised rGUDIV-103. The mitogenic potential of rGUDIV-103 was evaluated using a lymphoproliferation assay in 5(6)-carboxyfluorescein diacetate succinimidyl ester–labelled bovine PBMCs, where it induced lymphocyte proliferation. Quantitative polymerase chain reaction analysis revealed that the expression of interleukin-1β, toll-like receptor (TLR)-α, TLR2, TLR4, inducible nitric oxide synthase, and caspase-3–encoding genes increased more in rGUDIV-103–treated PBMCs than in untreated cells (p < 0.05). Treating PBMCs with rGUDIV-103 increased nitric oxide and hydrogen peroxide levels. The antigenic and immunogenic properties of rGUDIV-103 suggested its suitability for immunobiological application

<i>Ureaplasma diversum</i> Genome Provides New Insights about the Interaction of the Surface Molecules of This Bacterium with the Host

<div><p>Whole genome sequencing and analyses of <i>Ureaplasma diversum</i> ATCC 49782 was undertaken as a step towards understanding <i>U</i>. <i>diversum</i> biology and pathogenicity. The complete genome showed 973,501 bp in a single circular chromosome, with 28.2% of G+C content. A total of 782 coding DNA sequences (CDSs), and 6 rRNA and 32 tRNA genes were predicted and annotated. The metabolic pathways are identical to other human ureaplasmas, including the production of ATP via hydrolysis of the urea. Genes related to pathogenicity, such as urease, phospholipase, hemolysin, and a Mycoplasma Ig binding protein (MIB)—Mycoplasma Ig protease (MIP) system were identified. More interestingly, a large number of genes (n = 40) encoding surface molecules were annotated in the genome (lipoproteins, multiple-banded antigen like protein, membrane nuclease lipoprotein and variable surface antigens lipoprotein). In addition, a gene encoding glycosyltransferase was also found. This enzyme has been associated with the production of capsule in mycoplasmas and ureaplasma. We then sought to detect the presence of a capsule in this organism. A polysaccharide capsule from 11 to 17 nm of <i>U</i>. <i>diversum</i> was observed trough electron microscopy and using specific dyes. This structure contained arabinose, xylose, mannose, galactose and glucose. In order to understand the inflammatory response against these surface molecules, we evaluated the response of murine macrophages J774 against viable and non-viable <i>U</i>. <i>diversum</i>. As with viable bacteria, non-viable bacteria were capable of promoting a significant inflammatory response by activation of Toll like receptor 2 (TLR2), indicating that surface molecules are important for the activation of inflammatory response. Furthermore, a cascade of genes related to the inflammasome pathway of macrophages was also up-regulated during infection with viable organisms when compared to non-infected cells. In conclusion, <i>U</i>. <i>diversum</i> has a typical ureaplasma genome and metabolism, and its surface molecules, including the identified capsular material, represent major components of the organism immunopathogenesis.</p></div

Gene synteny and phylogeny.

<p>(A) Syntenic maps of ureaplasma genomes. Sybil map used <i>U</i>. <i>diversum</i> ATCC 49782 as a reference genome. (B) Phylogenetic trees based on 32 concatenated proteins of <i>Mollicutes</i>.</p

Capsule of <i>U</i>. <i>diversum</i>.

<p>(A) Electron microscopy of cells <i>U</i>. <i>diversum</i> ATCC 49782 obtained in the cultured isolates from mucovulvovaginal bovine semen and treated with red ruthenium dye, showing polysaccharide materials (electrodense external region indicated with arrowheads). Bar 100 nm. (B) Percentage of monosaccharides in capsular components of <i>U</i>. <i>diversum</i> ATCC 49782.</p

Metabolic map of <i>U</i>. <i>diversum</i> ATCC 49782.

<p>A view of the transporters and main metabolism pathways. Metabolic products are shown in black and ureaplasma proteins in green. Enzymes that were not found in <i>U</i>. <i>diversum</i> are shown in red.</p

Coding DNA sequences (CDSs) of <i>Ureaplasma diversum</i> ATCC 49782 genome classified by TIGR role category.

<p>Coding DNA sequences (CDSs) of <i>Ureaplasma diversum</i> ATCC 49782 genome classified by TIGR role category.</p