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Objective: To describe the difficulties in applying the Therapeutic Relationship in the care of patients suffering from mental illness, admitted to a Prison Psychiatric Center. Method: Narrativity as an instrument to resize and reflect on nursing care practice, from the perspective of the relationship of help in the care of patients with mental illness. Results: The elaboration of this first-person account has contributed to show that the nursing professionals in Penitentiary Psychiatric Centers work to achieve visibility and avoid being institutionalized. Conclusions: Through the narrative the initial purpose of describing the different difficulties in the application of the Therapeutic Relationship in the care of patients suffering from mental illness, admitted to a Prison Psychiatric Center, has been reached. The narrative constitutes a pertinent instrument for the reflection on the practice of the nursing specialist in Mental Health.

Grafting is a method used in agriculture to improve crop production and tolerance to biotic and abiotic stress. This technique is widely used in tomato, Solanum lycopersicum L.; however, the effects of grafting on changes in gene expression associated with stress tolerance in shoot apical meristem cells are still under-discovered. To clarify the effect of grafting, we performed a transcriptomic analysis between non-grafted and grafted tomatoes using the tomato variety Momotaro-scion and rootstock varieties, TD1, GS, and GF. Drought tolerance was significantly improved not only by a combination of compatible resistant rootstock TD1 but also by self-grafted compared to non-grafted lines. Next, we found the differences in gene expression between grafted and non-grafted plants before and during drought stress treatment. These altered genes are involved in the regulation of plant hormones, stress response, and cell proliferation. Furthermore, when comparing compatible (Momo/TD1 and Momo/Momo) and incompatible (Momo/GF) grafted lines, the incompatible line reduced gene expression associated with phytohormones but increased in wounding and starvation stress-response genes. These results conclude that grafting generates drought stress tolerance through several gene expression changes in the apical meristem.

Motor neuron diseases (MNDs) include sporadic and hereditary neurological disorders characterized by progressive degeneration of motor neurons (MNs). Sigma-1 receptor (Sig-1R) is a protein enriched in MNs, and mutations on its gene lead to various types of MND. Previous studies have suggested that Sig-1R is a target to prevent MN degeneration. In this study, two novel synthesized Sig-1R ligands, coded EST79232 and EST79376, from the same chemical series, with the same scaffold and similar physicochemical properties but opposite functionality on Sig-1R, were evaluated as neuroprotective compounds to prevent MN degeneration. We used an in vitro model of spinal cord organotypic cultures under chronic excitotoxicity and two in vivo models, the spinal nerve injury and the superoxide dismutase 1 (SOD1)G93A mice, to characterize the effects of these Sig-1R ligands on MN survival and modulation of glial reactivity. The antagonist EST79376 preserved MNs in vitro and after spinal nerve injury but was not able to improve MN death in SOD1G93A mice. In contrast, the agonist EST79232 significantly increased MN survival in the three models of MN degeneration evaluated and had a mild beneficial effect on motor function in SOD1G93A mice. In vivo, Sig-1R ligand EST79232 had a more potent effect on preventing MN degeneration than EST79376. These data further support the interest in Sig-1R as a therapeutic target for neurodegeneration.

La conformación del territorio de la Norpatagonia Andina históricamente conlleva conflictos de índole territorial. En la realidad socio-espacial contemporánea se han multiplicado las territorialidades que configuran estos territorios producto de los flujos, movilidades e intereses provocados por el turismo a diversas escalas. Se trata de territorialidades que entran en disputa por las diversas lógicas de apropiación territorial y desarrollo que expresan. Entendiendo esto, el artículo se propone indagar, a partir de dos experiencias comunitarias en la Norpatagonia Andina, las estrategias de resistencia y re-existencia que materializan grupos sociales en donde el territorio es el eje del conflicto y/o (re)apropiación. Se caracterizan, por un lado, las acciones de la Asamblea socio ambiental de San Martín de los Andes en la provincia de Neuquén, como protagonista de la resistencia frente al conflicto en el Cerro Chapelco. Por otro lado, el caso del barrio Villa Los Coihues de Bariloche, provincia de Río Negro, como forma de re-existencia frente a lógicas hegemónicas establecidas. Si bien estas experiencias locales son diferentes desde su génesis, comparten formas de apropiación del territorio a partir de sus modos de concebirlo y habitarlo, que van desde reclamos colectivos hasta prácticas comunitarias que implican nuevos procesos de reterritorialización que desafían los poderes hegemónicos.

This work tries to help overcome the lack of relevant translational screening assays, as a limitation for the identification of novel analgesics for neuropathic pain. Hyperexcitability and neurite shortening are common adverse effects of antiviral and antitumor drugs, leading to neuropathic pain. Now, as seen in the drug screening that we developed here, a high-content microscopy-based assay with immortalized dorsal root ganglia (DRG) neurons (differentiated F11 cells) allowed to identify drugs able to protect against the iatrogenic neurite shortening induced by the antitumor drug vincristine and the antiviral drug rilpivirine. We observed that vincristine and rilpivirine induced a significant reduction in the neurite length, which was reverted by α-lipoic acid. We had also evidenced protective effects of pregabalin and melatonin, acting through the α2δ-2 subunit of the voltage-dependent calcium channels and the MT1 receptor, respectively. Additionally, two hits originated from a previous primary screening aimed to detect inhibitors of hyperexcitability to inflammatory mediators in DRG neurons (nitrendipine and felodipine) also prevented neurite shortening in our model. In summary, in this work we developed a novel secondary assay for identifying hits with neuroprotective effect against iatrogenic neurite shortening, consistent with the anti-hyperexcitability action previously tested: highlighting nitrendipine and felodipine against iatrogenic damage in DRG neurons.

Introdução e Objetivos: Neurocriptococose é uma doença fúngica que acomete principalmente pacientes imunocomprometidos. Casos em pacientes imunocompetentes tem sido descrito em alguns relatos de casos; no entanto, por não ser uma doença de notificação compulsória, ainda pouco se sabe sobre sua epidemiologia no sul do Brasil. O presente estudo teve como objetivo descrever aspectos epidemiológicos relacionados a doença em pacientes supostamente imunocompetente. Métodos: Trata-se de uma série de casos atendidos entre 2018 a 2019 em um hospital público de Joinville, Santa Catarina. Pacientes com diagnóstico clínico confirmado pela presença do fungo do gênero Cryptococcus spp pelo método tinta da China no líquor cefalorraquidiano foram avaliados quanto aspectos clínicos, tratamento e complicações durante o período de internação. Resultados: Houve 2 pacientes em 2018 e 6 pacientes em 2019 com diagnóstico confirmado. Todos sem aparente fatores para imuncomprometimento e sem fator de risco ambiental evidente. A maioria eram homens e média de idade de 39 anos. Febre e confusão mental foi a achado mais comum na apresentação. A variante C. neoformans foi encontrada em 75% dos casos. Todos receberam Anfotericina B no mínimo por 13 dias associado ou não a fluconazol. Seis pacientes apresentaram nefrotoxicidade pela Anfotericina B, 2 evoluiram para óbtio intrahhospitalar e 2 permaneceram com sequela neurológica. Conclusão: Neurocriptococose em pacientes imunocompetentes apresenta mortalidade e complicações relevantes. A inclusão da doença entre as patologias de notificação compulsória poderia aprimorar dados epidemiológicos para melhor entendimento desta doença. Descritores: Meningite Criptocócica; Meningite Fúngica, Epidemiologia; Imunocompetência.

Resumen: El síndrome de Goodpasture (SGP) es un trastorno autoinmune raro, de etiología desconocida, con una incidencia de 0,1 casos por millón de habitantes. Se caracteriza por la asociación de hemorragia alveolar, glomerulonefritis rápidamente progresiva y positividad para anticuerpos anti-membrana basal glomerular (anticuerpos anti-MBG). Un tercio de los pacientes con SGP presentan anticuerpos anticitoplasma de neutrófilo (ANCA), en su mayoría p-ANCA. Para el diagnóstico clínico es necesaria la presencia de manifestaciones renales y pulmonares, apareciendo por lo general primero los síntomas pulmonares (siendo la hemoptisis el más frecuente). El síndrome se sospecha en pacientes con hemoptisis o hematuria, y se confirma por la presencia de anticuerpos anti-MBG en la sangre o en una muestra de biopsia renal. El tratamiento actual incluye plasmaféresis, corticoides e inmunodepresores, y está orientado al manejo de las complicaciones por sangrado, como son la anemia o la inestabilidad hemodinámica, y a la disminución de la cantidad de anticuerpos circulantes. En cuanto al pronóstico, la mayoría de los casos progresan a insuficiencia renal terminal; si bien cuando el tratamiento se inicia antes de la aparición de insuficiencia respiratoria o renal) el pronóstico es bueno. La afectación del sistema nervioso central (SNC) en el SGP es extremadamente infrecuente en ausencia de ANCA; solo se han descrito 4 casos en la bibliografía, y todos ellos —con o sin hemoptisis— presentaron crisis convulsivas recurrentes relacionadas con vasculitis cerebral. El objetivo de esta nota clínica es presentar y discutir el caso de un paciente de 81 años de edad que, tras comenzar con hemoptisis, fue diagnosticado de SGP y desarrolló deterioro progresivo del nivel de conciencia e insuficiencia hepática aguda que culminó con el fallecimiento del paciente a los 19 días de haber ingresado en el hospital. Abstract: Goodpasture syndrome (GPS) is a rare autoimmune disorder whose aetiology is still unknown, with an incidence of .1 cases per million inhabitants. It is characterized by the association of alveolar haemorrhage, rapidly progressive glomerulonephritis and anti-glomerular basement membrane antibodies (anti-MBG antibodies). A third of patients with GSP have anti-neutrophil cytoplasmic antibodies (ANCA), mostly p-ANCA. For clinical diagnosis the presence of renal and pulmonary manifestations is required, of which pulmonary symptoms (most commonly haemoptysis) usually precede renal manifestations. The syndrome is suspected in patients with haemoptysis or haematuria and is confirmed by the presence of anti-MBG antibodies in the blood or in a renal biopsy sample. Current treatment includes plasmapheresis, corticosteroids and immunosuppressants, and is aimed at the management of bleeding complications, such as anaemia or haemodynamic instability, and the decrease in the amount of circulating antibodies. In terms of prognosis, most patients will invariably progress to end-stage renal failure; however, prognosis is better if treatment is started before the onset of respiratory or renal failure. Central nervous system (CNS) involvement in GPS is extremely rare in the absence of ANCA antibodies; there have only been four cases described in the literature and all of them —with or without haemoptysis— reported recurrent seizures crisis related to cerebral vasculitis. The aim of this case report is to describe and discuss the case of an 81-year-old patient who debuted with haemoptysis and was subsequently diagnosed with SGP and developed progressive deterioration of consciousness, as well as acute liver failure that ended up with the death of the patient 19 days after being admitted to hospital.

High levels of crop species diversity are considered beneficial. However, increasing diversity might be difficult because of environmental constraints and the reliance on a few major crops for most food supply. Here we introduce a theoretical framework of hierarchical levels of crop diversity, in which the environmental requirements of crops limit potential diversity, and the demand for agricultural products further constrain attainable crop diversity. We estimated global potential, attainable, and current crop diversity for grid cells of 86 km ^2 . To do so, we first estimated cropland suitability values for each of 171 crops, with spatial distribution models to get estimations of relative suitability and with a crop model to estimate absolute suitability. We then used a crop allocation algorithm to distribute the required crop area to suitable cropland. We show that the attainable crop diversity is lower in temperate and continental areas than in tropical and coastal regions. The diversity gap (the difference between attainable and current crop diversity) is particularly large in most of the Americas and relatively small in parts of Europe and East Asia. By filling these diversity gaps, crop diversity could double on 84% of the world’s agricultural land without changing the aggregate amount of global food produced. It follows that while there are important regional differences in attainable diversity, specialization of farms and regions is the main reason for low levels of local crop diversity across the globe, rather than our high reliance on a few crops.

The emergence of antimicrobial resistance due to the overuse of antimicrobials together with the existence of naturally untreatable infections well demonstrates the need for new instruments to fight microbes. Antimicrobial peptides (AMPs) are a promising family of molecules in this regard, because they abundantly occur in nature and the results of preliminary studies of their clinical potential have been encouraging. However, further progress will benefit from the standardization of research methods to assess the antimicrobial properties of AMPs. Here we review the diverse methods used to study the antimicrobial power of AMPs and recommend a pathway to explore new molecules. The use of new methodologies to quantitatively evaluate the physical effect on bacterial biofilms such as force spectroscopy and surface cell damage evaluation, constitute novel approaches to study new AMPs.

BACKGROUND: The practice environment influences the quality of care and the nursing outcomes achieved in their workplaces. AIMS: To examine the perception of the clinical practice environment among nurses working in mental health units in the context of their participation in an action research study aimed at improving the nurse–patient relationship. METHOD: An explanatory sequential mixed methods study was designed. The data were collected in three phases in 18 mental health units (n = 95 nurses). Quantitative data were collected through the Practice Environment Scale of the Nursing Work Index, and qualitative data were collected through reflective diaries and focus groups in the context of participatory action research. RESULTS: The nurses' assessment of their practice environment shifted from positive to negative. Nurse manager leadership was the aspect that worsened the most. In addition, the perception of their participation in the affairs of the center and nursing foundations for quality of care decreased. The nurses considered it essential to be able to influence decision-making bodies and that the institution should promote a model of care that upholds the therapeutic relationship in actual clinical practice. CONCLUSIONS: Nurses perceived that they should be involved in organizational decisions and required more presence and understanding from managers. Furthermore, nurses stated that institutions should promote nursing foundations for quality of care. This study contributes to understanding how nurses in mental health units perceive their work environment and how it affects the improvement of the nurse–patient relationship in clinical practice. [ABSTRACT FROM AUTHOR]

Systemic antibiotics are routinely prescribed in implant procedures, but the lack of consensus causes large differences between clinicians regarding antibiotic prophylaxis regimens. The objectives of this systematic review are to assess the need to prescribe antibiotics to prevent early implant failure and find the most appropriate antibiotic prophylaxis regimen. The electronic search was conducted in PubMed/MEDLINE, Scielo and Cochrane Central Trials Database for randomized clinical trials of at least 3 months of follow-up. Eleven studies were included in the qualitative analysis. Antibiotics were found to statistically significantly reduce early implant failures (RR = 0.30, 95% CI: 0.19–0.47, p < 0.00001; heterogeneity I2 = 0%, p = 0.54). No differences were seen between preoperative or both pre- and postoperative antibiotic regimens (RR = 0.57, 95% CI: 0.21–1.55, p = 0.27; heterogeneity I2 = 0%, p = 0.37). A single preoperative antibiotic prophylaxis dose was found to be enough to significantly reduce early implant failures compared to no antibiotic (RR = 0.34, 95% CI: 0.21–0.53, p < 0.00001; heterogeneity I2 = 0%, p = 0.61). In conclusion, in healthy patients a single antibiotic prophylaxis dose is indicated to prevent early implant failure.

Loss of motor neurons (MNs) after spinal root injury is a drawback limiting the recovery after palliative surgery by nerve or muscle transfers. Research based on preventing MN death is a hallmark to improve the perspectives of recovery following severe nerve injuries. Sigma-1 receptor (Sig-1R) is a protein highly expressed in MNs, proposed as neuroprotective target for ameliorating MN degenerative conditions. Here, we used a model of L4–L5 rhizotomy in adult mice to induce MN degeneration and to evaluate the neuroprotective role of Sig-1R ligands (PRE-084, SA4503 and BD1063). Lumbar spinal cord was collected at 7, 14, 28 and 42 days post-injury (dpi) for immunohistochemistry, immunofluorescence and Western blot analyses. This proximal axotomy at the immediate postganglionic level resulted in significant death, up to 40% of spinal MNs at 42 days after injury and showed markedly increased glial reactivity. Sig-1R ligands PRE-084, SA4503 and BD1063 reduced MN loss by about 20%, associated to modulation of endoplasmic reticulum stress markers IRE1α and XBP1. These pathways are Sig-1R specific since they were not produced in Sig-1R knockout mice. These findings suggest that Sig-1R is a promising target for the treatment of MN cell death after neural injuries.

Abstract The analysis of stem cell hierarchies in human cancers has been hampered by the impossibility of identifying or tracking tumor cell populations in an intact environment. To overcome this limitation, we devised a strategy based on editing the genomes of patient‐derived tumor organoids using CRISPR/Cas9 technology to integrate reporter cassettes at desired marker genes. As proof of concept, we engineered human colorectal cancer (CRC) organoids that carry EGFP and lineage‐tracing cassettes knocked in the LGR5 locus. Analysis of LGR5‐EGFP+ cells isolated from organoid‐derived xenografts demonstrated that these cells express a gene program similar to that of normal intestinal stem cells and that they propagate the disease to recipient mice very efficiently. Lineage‐tracing experiments showed that LGR5+ CRC cells self‐renew and generate progeny over long time periods that undergo differentiation toward mucosecreting‐ and absorptive‐like phenotypes. These genetic experiments confirm that human CRCs adopt a hierarchical organization reminiscent of that of the normal colonic epithelium. The strategy described herein may have broad applications to study cell heterogeneity in human tumors.