Predicción del éxito de la desfibrilación mediante entropía difusa en términos de recuperación de ritmo cardíaco regular, pulso y supervivencia

El objetivo de este trabajo es evaluar la capacidad predictiva de la entropía difusa (FuzzEn) para la predicción del éxito de la desfibrilación definida de tres formas diferentes: recuperación de ritmos con QRS, retorno de la circulación espontanea (RCE) y supervivencia del paciente. Se han analizado 450 descargas de 174 episodios de parada cardiorrespiratoria extrahospitalaria (PCREH). FuzzEn se calculó tomando 5-seg de fibrilación ventricular (FV) previos a la descarga. Se evaluó la capacidad de predicción en términos de área bajo la curva (AUC), para las primeras tres descargas. Para ello se ajustó un clasificador basado en regresión logística usando una partición 60/40 por pacientes para ajustar el modelo (desarrollo) y evaluar el AUC (validación). Los valores de AUC obtenidos para predicción de aparición de ritmos con QRS y supervivencia para las tres primeras descargas fueron: 0.81/0.70, 0.84/0.87 y 0.95/0.95, respectivamente. FuzzEn permite predecir la supervivencia del paciente y la predictibilidad mejora en descargas sucesivas

Desenvolvimento da competência cultural na formação dos estudantes de enfermagem

The aim was to identify and map the strategies for the development of cultural competence during the training of students in nursing education institutions. For the elaboration of this Integrative Literature Review, the PCC method was used to develop the research question: What are the strategies used by Nursing Education Institutions to develop cultural competence during the training of students? To answer the question asked, a search was carried out, using the EBSCO-host and PubMed search engines, and the respective databases Cumulative Index to Nursing and Allied Health Literature and MedLine. No time horizon limits were applied. The established languages ​​were Portuguese, English and Spanish. For the assessment of methodological quality, we used a critical assessment instrument, specific for each type of study (qualitative and quantitative). Seven studies were included in the selection, which after being analyzed showed that there are strategies through which students can develop CC, but the most used are: Mobility Programs and Cultural Competence Courses. These results provide evidence of the potential use of educational strategies for the development of CC in nursing students.Objetivou-se identificar e mapear as estratégias de desenvolvimento da competência cultural durante a formação dos estudantes nas instituições de ensino de enfermagem. Para a elaboração da presente Revisão Integrativa da Literatura, recorreu-se ao método PCC, de forma a desenvolver a questão de investigação: Quais são as estratégias utilizadas pelas Instituições de Ensino de Enfermagem para Desenvolvimento da competência cultural durante a formação dos estudantes? De modo a dar resposta à questão formulada, realizou-se uma pesquisa, com recurso aos motores de busca EBSCO-host e PubMed, e às respectivas bases de dados Cumulative Index to Nursing and Allied Health Literature e MedLine. Não foram aplicados limites de horizonte temporal. Os idiomas estabelecidos foram, português, inglês e espanhol. Para a avaliação da qualidade metodológica, utilizamos um instrumento de avaliação crítica, específico para cada tipo de estudo (qualitativo e quantitativo). Sete estudos foram incluídos na seleção, que após analisados demonstraram que há estratégias através das quais os estudantes podem desenvolver CC, porém as mais utilizadas são: os Programas de Mobilidade e os Cursos de Competência Cultural. Estes resultados fornecem evidências do potencial da utilização das estratégias educativas relativamente ao desenvolvimento da CC nos estudantes de Enfermagem

Desenvolvimento da competência cultural na formação dos estudantes de enfermagem

The aim was to identify and map the strategies for the development of cultural competence during the training of students in nursing education institutions. For the elaboration of this Integrative Literature Review, the PCC method was used to develop the research question: What are the strategies used by Nursing Education Institutions to develop cultural competence during the training of students? To answer the question asked, a search was carried out, using the EBSCO-host and PubMed search engines, and the respective databases Cumulative Index to Nursing and Allied Health Literature and MedLine. No time horizon limits were applied. The established languages ​​were Portuguese, English and Spanish. For the assessment of methodological quality, we used a critical assessment instrument, specific for each type of study (qualitative and quantitative). Seven studies were included in the selection, which after being analyzed showed that there are strategies through which students can develop CC, but the most used are: Mobility Programs and Cultural Competence Courses. These results provide evidence of the potential use of educational strategies for the development of CC in nursing students.Objetivou-se identificar e mapear as estratégias de desenvolvimento da competência cultural durante a formação dos estudantes nas instituições de ensino de enfermagem. Para a elaboração da presente Revisão Integrativa da Literatura, recorreu-se ao método PCC, de forma a desenvolver a questão de investigação: Quais são as estratégias utilizadas pelas Instituições de Ensino de Enfermagem para Desenvolvimento da competência cultural durante a formação dos estudantes? De modo a dar resposta à questão formulada, realizou-se uma pesquisa, com recurso aos motores de busca EBSCO-host e PubMed, e às respectivas bases de dados Cumulative Index to Nursing and Allied Health Literature e MedLine. Não foram aplicados limites de horizonte temporal. Os idiomas estabelecidos foram, português, inglês e espanhol. Para a avaliação da qualidade metodológica, utilizamos um instrumento de avaliação crítica, específico para cada tipo de estudo (qualitativo e quantitativo). Sete estudos foram incluídos na seleção, que após analisados demonstraram que há estratégias através das quais os estudantes podem desenvolver CC, porém as mais utilizadas são: os Programas de Mobilidade e os Cursos de Competência Cultural. Estes resultados fornecem evidências do potencial da utilização das estratégias educativas relativamente ao desenvolvimento da CC nos estudantes de Enfermagem

Predicción del éxito de la desfibrilación mediante entropía difusa en términos de recuperación de ritmo cardíaco regular, pulso y supervivencia

El objetivo de este trabajo es evaluar la capacidad predictiva de la entropía difusa (FuzzEn) para la predicción del éxito de la desfibrilación definida de tres formas diferentes: recuperación de ritmos con QRS, retorno de la circulación espontanea (RCE) y supervivencia del paciente. Se han analizado 450 descargas de 174 episodios de parada cardiorrespiratoria extrahospitalaria (PCREH). FuzzEn se calculó tomando 5-seg de fibrilación ventricular (FV) previos a la descarga. Se evaluó la capacidad de predicción en términos de área bajo la curva (AUC), para las primeras tres descargas. Para ello se ajustó un clasificador basado en regresión logística usando una partición 60/40 por pacientes para ajustar el modelo (desarrollo) y evaluar el AUC (validación). Los valores de AUC obtenidos para predicción de aparición de ritmos con QRS y supervivencia para las tres primeras descargas fueron: 0.81/0.70, 0.84/0.87 y 0.95/0.95, respectivamente. FuzzEn permite predecir la supervivencia del paciente y la predictibilidad mejora en descargas sucesivas

A Metal-Repressed Promoter From Gram-Positive Bacillus subtilis Is Highly Active and Metal-Induced in Gram-Negative Cupriavidus metallidurans

A synthetic version of the metal-regulated gene A (mrgA) promoter from Bacillus subtilis, which in this Gram-positive bacterium is negatively regulated by manganese, iron, cobalt, or copper turned out to promote high level of basal gene expression that is further enhanced by Co(II), Cd(II), Mn(II), Zn(II), Cu(II), or Ni(II), when cloned in the Gram-negative bacterium Cupriavidus metallidurans. Promoter activity was monitored by expression of the reporter gene coding for the enhanced green fluorescent protein (EGFP), and cellular intensity fluorescence was quantified by flow cytometry. Expression levels in C. metallidurans driven by the heterologous promoter, here called pan, ranged from 20- to 53-fold the expression level driven by the Escherichia coli lac promoter (which is constitutively expressed in C. metallidurans), whether in the absence or presence of metal ions, respectively. The pan promoter did also function in E. coli in a constitutive pattern, regardless of the presence of Mn(II) or Fe(II). In conclusion, the pan promoter proved to be a powerful tool to express heterologous proteins in Gram-negative bacteria, especially in C. metallidurans grown upon high levels of toxic metals, with potential applications in bioremediation. Biotechnol. Bioeng. 2010; 107: 469-477. (C) 2010 Wiley Periodicals, Inc.Brazilian VALE mining companyBrazilian VALE mining compan

Synthetic Phytochelatin Surface Display in Cupriavidus metallidurans CH34 for Enhanced Metals Bioremediation

This work describes the effects of the cell surface display of a synthetic phytochelatin in the highly metal tolerant bacterium Cupriavidus metallidurans CH34. The EC20sp synthetic phytochelatin gene was fused between the coding sequences of the signal peptide (SS) and of the autotransporter beta-domain of the Neisseria gonorrhoeae IgA protease precursor (IgA beta), which successfully targeted the hybrid protein toward the C. metallidurans outer membrane. The expression of the SS-EC20sp-IgA beta gene fusion was driven by a modified version of the Bacillus subtilis mrgA promoter showing high level basal gene expression that is further enhanced by metal presence in C. metallidurans. The recombinant strain showed increased ability to immobilize Pb2+, Zn2+, Cu2+, Cd2+, Mn2+, and Ni2+ ions from the external medium when compared to the control strain. To ensure plasmid stability and biological containment, the MOB region of the plasmid was replaced by the E. coli hok/sok coding sequence.Brazilian mining company VALEBrazilian mining company VALEBrazilian funding agency Conselho Nacional de Pesquisas (CNPq)Brazilian funding agency Conselho Nacional de Pesquisas (CNPq

Autolytic Mycobacterium leprae Hsp65 fragments may act as biological markers for autoimmune diseases

Investigating the proteolytic activity of the recombinant Mycobacterium leprae Heat Shock Protein of 65 kDa (rHsp65), chaperonin 2 (cpn2), we observed that it displays high instability. The fragmentation process starts at the C-terminus followed by progressive degradation of the N-terminus, which leads to a stable fragment comprising the middle region of the molecule. Urea was able to prevent autolysis, probably due to its denaturing action, while EDTA increased degradation levels indicating the need for metal ions. Peptides originated from autolysis were purified and analyzed by mass spectrometry, generating a continuous map. Since the bacteria and mammalian Hsp60 are known to be targets of the immune response and have been implicated in autoimmune diseases and chronic inflammation, the in vivo effect of rHsp65 peptides was evaluated in the spontaneous Systemic Lupus Erythematosus (SLE) model developed by the (NZB/NZW)F(1) mouse hybrids, and their individual anti-rHsp65 IgG2a/IgG1 antibody titer ratio was determined. The results showed orientation toward a T(H)1 responsiveness, and the treatment with the rHsp65 peptides diminished the environmental variance of the survival time of treated animals. These results outline the fact that environmental factors may also act through the modified stability expression of Heat Shock Proteins intervening during autoimmune processes. (C) 2011 Elsevier Ltd. All rights reserved.FAPESP (Fundacao de Amparo a Pesquisa do Estado de Sao Paulo)[2008/2899-2]Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Avaliação do extrato etanólico de casca de Punica granatum (romã) na diminuição da replicação viral do BoHV-1 Colorado em embriões murinos experimentalmente infectados

RESUMO O objetivo do trabalho foi avaliar a diminuição da replicação viral (BoHV-1 Colorado) em embriões murinos após tratamento do extrato etanólico da casca de Punica granatum (EEPg). Camundongos fêmeas Swiss com idade entre 6 e 8 semanas foram superovuladas com 0,2 mL a 5 UI de hormônios (eCG e hCG), e acasaladas com machos da mesma idade. Após 18 horas, as fêmeas sofreram eutanásia em câmara de CO2 e, através de abertura no peritônio, os zigotos foram coletados e lavados com solução de pronase 0,5%.Os zigotos foram divididos em quatro grupos: G1 (controle), G2 (expostos aos vírus BoHV-1 Colorado a 108 TCID50/mL), G3 (expostos ao EEPg) e G4 (expostos aos vírus e ao EEPg). Os grupos foram mantidos a 37,5ºC em meio TCM199 (100µL) com 10% de soro fetal bovino em estufa a 5% de CO2 e 95% de umidade. Após 24 h, analisamos a taxa de clivagem (teste exato de Fisher; p<0,05), a morfologia (por microscopia óptica), a nested-PCR e a titulação dos embriões em cocultura com células MDBK após mais 72 h do tratamento (teste de Mann-Whitney; p<0,05) e microscopia eletrônica de transmissão (ME). Os embriões murinos tratados com EEPg apresentaram resultados satisfatórios: sem alterações morfológicas, taxa de clivagem semelhante ao controle e, apesar da detecção da presença do vírus pela nested-PCR e ME, houve diminuição do título viral após tratamentos com esse extrato, o que sugere interferência desse tratamento no ciclo viral do BoHV-1 Colorado sem alterar o desenvolvimento dos embriões

Hepatitis D and B virus genotypes in chronically infected patients from the Eastern Amazon Basin

Hepatitis D virus (HDV) is a defective hepatotropic virus whose infectivity is dependent on hepatitis B virus (HBV). HDV super- or co-infiection leads to an increased risk of fulminant hepatitis or progression to severe chronic liver disease in HBV infected patients. The Brazilian Amazon Basin has been reported to be endemic for HBV and HDV, especially in the Western Amazon Basin. In this region, HDV infection is frequently associated with acute fulminant hepatitis with characteristic histologic features. HDV is classified into seven major clades (HDV-1 to HDV-7) and HBV is subdivided into eight genotypes (A-H). HDV and HBV genotypes have been shown to have a distinct geographic distribution. The aim of this study was to determine the HBV and HDV genotypes harbored by chronically infected patients from the Eastern Amazon Basin, Brazil. We studied 17 serum samples from HBV and HDV chronically infected patients admitted to a large public hospital (Santa Casa de Misericordia) at Belem, state of Para, Brazil, between 1994 and 2002. HDV-3 and HBV genotype A (subtype adw2) have been identified in all cases, in contrast to previous studies from other regions of the Amazon, where HBV genotype F has been found co-infecting patients that harbored HDV-3. The HDV-3/HBV-A co-infection suggests that there is not a specific interaction between HBV and HDV genotypes, and co-infection might merely reflect the most frequent genotypes found in a particular geographic area. The analysis of the carboxy-terminal region of the large hepatitis D antigen (L-HDAg), which interacts with the hepatitis B surface antigen (HBsAg) and is essential for HDV assembly, showed some diversity between the different isolates from the Eastern Amazon. This diversity is not observed among HDV-3 sequences from other South American regions. (C) 2008 Elsevier B.V. All rights reserved

Weight change later in life and colon and rectal cancer risk in participants in the EPIC-PANACEA study

Background: A moderate association exists between body mass index (BMI) and colorectal cancer. Less is known about the effect of weight change. Objective: We investigated the relation between BMI and weight change and subsequent colon and rectal cancer risk. Design: This was studied among 328,781 participants in the prospective European Prospective Investigation into Cancer Physical Activity, Nutrition, Alcohol, Cessation of Smoking, Eating study (mean age: 50 y). Body weight was assessed at recruitment and on average 5 y later. Self-reported weight change (kg/y) was categorized in sex-specific quintiles, with quintiles 2 and 3 combined as the reference category (men: -0.6 to 0.3 kg/y; women: -0.4 to 0.4 kg/y). In the subsequent years, participants were followed for the occurrence of colon and rectal cancer (median period: 6.8 y). Multivariable Cox proportional hazards regression analyses were used to study the association. Results: A total of 1261 incident colon cancer and 747 rectal cancer cases were identified. ME at recruitment was statistically significantly associated with colon cancer risk in men (HR: 1.04; 95% CI: 1.02, 1.07). Moderate weight gain (quintile 4) in men increased risk further (HR: 1.32; 95% CI: 1.04, 1.68), but this relation did not show a clear trend. In women, BMI or weight gain was not related to subsequent risk of colon cancer. No statistically significant associations for weight loss and colon cancer or for BMI and weight changes and rectal cancer were found. Conclusions: BMI attained at adulthood was associated with colon cancer risk. Subsequent weight gain or loss was not related to colon or rectal cancer risk in men or women