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RESUMO O programa de transplante de fígado teve início em nosso centro em 1992, e pacientes em pós-operatório de transplante hepático ainda são admitidos à unidade de terapia intensiva. Uma curva de aprendizado do médico intensivista teve então início, com aquisição de habilidades e estabelecimento de uma prática específica. Contudo, muitos dos conceitos se modificaram com o tempo, o que conduziu a uma melhora nos cuidados proporcionados a esses pacientes. A abordagem prática varia entre diferentes centros de transplante de fígado, segundo especificidades locais. Assim, ensejamos apresentar nossa prática para estimular o debate entre diferentes equipes dedicadas, o que tem potencial de permitir a introdução de novas ideias e, possivelmente, melhorar o padrão de cuidados em cada instituição. ABSTRACT The liver transplant program in our center started in 1992, and post-liver transplant patients are still admitted to the intensive care unit. For the intensive care physician, a learning curve started then, skills were acquired, and a specific practice was established. Throughout this time, several concepts changed, improving the care of these patients. The practical approach varies between liver transplant centers, according to local specificities. Hence, we wanted to present our routine practice to stimulate the debate between dedicated teams, which can allow the introduction of new ideas and potentially improve each local standard of care.

New approaches to deal with the growing concern associated with antibiotic-resistant bacteria are emerging daily. Essential oils (EOs) are natural antimicrobial substances with great potential to mitigate this situation. However, their volatile nature, in their liquid-free form, has restricted their generalized application in biomedicine. Here, we propose the use of cellulose acetate (CA)/polycaprolactone (PCL) wet-spun fibers as potential delivery platforms of selected EOs to fight infections caused by Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli). Twenty EOs were selected and screened for their minimal inhibitory concentration (MIC), using the antibiotic ampicillin as positive control. The cinnamon leaf oil (CLO), cajeput oil (CJO), and the clove oil (CO) were the most effective EOs, against the Gram-positive (MIC &lt, 22.38 mg/mL) and the Gram-negative (MIC &lt, 11.19 mg/mL) bacteria. Uniform microfibers were successfully wet-spun from CA/PCL with an averaged diameter of 53.9 &plusmn, 4.5 &micro, m, and then modified by immersion with CLO, CJO and CO at 2 &times, MIC value. EOs incorporation was confirmed by UV-visible spectroscopy, Fourier-transformed infrared spectroscopy, and thermal gravimetric analysis. However, while microfibers contained ampicillin at MIC (control) after the 72 h modification, the CLO, CO and CJO-loaded fibers registered &asymp, 14%, 66%, and 76% of their MIC value, respectively. Data showed that even at small amounts the EO-modified microfibers were effective against the tested bacteria, both by killing bacteria more quickly or by disrupting more easily their cytoplasmic membrane than ampicillin. Considering the amount immobilized, CLO-modified fibers were deemed the most effective from the EOs group. These results indicate that CA/PCL microfibers loaded with EOs can be easily produced with increased antibacterial action, envisioning their use as scaffolding materials for the treatment of infections.

Nowadays, tissue engineering is described as an interdisciplinary field that combines engineering principles and life sciences to generate implantable devices to repair, restore and/or improve functions of injured tissues. Such devices are designed to induce the interaction and integration of tissue and cells within the implantable matrices and are manufactured to meet the appropriate physical, mechanical and physiological local demands. Biodegradable constructs based on polymeric fibers are desirable for tissue engineering due to their large surface area, interconnectivity, open pore structure, and controlled mechanical strength. Additionally, biodegradable constructs are also very sought-out for biomolecule delivery systems with a target-directed action. In the present review, we explore the properties of some of the most common biodegradable polymers used in tissue engineering applications and biomolecule delivery systems and highlight their most important uses., Authors acknowledge the Portuguese Foundation for Science and Technology (FCT), FEDER funds by means of Portugal 2020 Competitive Factors Operational Program (POCI) and the Portuguese Government (OE) for funding the project PEPTEX with reference PTDC/CTM-TEX/28074/2017 (POCI-01-0145- FEDER-028074). Authors also acknowledge project UID/CTM/00264/2020 of Centre for Textile Science and Technology (2C2T), funded by national funds through FCT/MCTES.

Este volume pretende constituir-se como um espaço de debate sobre temas centrais à formação de professores, debatendo temas relativos à supervisão pedagógica e à importância que essa supervisão tem para a construção de uma profissionalidade docente. Mais do que encontrar receitas para a formação de professores, pretendemos suscitar o debate e proporcionar um espaço de reflexão sobre temas centrais da formação de professores para o século XXI. Os textos - da autoria de um leque de especialistas em ciências da educação e supervisão pedagógica, associados a um vasto conjunto de instituições de ensino superior do país – articulam-se em torno de três eixos de análise: i) Supervisão pedagógica e desenvolvimento profissional docente; ii) Ética e profissionalidade na formação inicial de professores e, iii) Supervisão na formação inicial de professores.

"Paper presented at the ICON2019 conferences in Çorlu, Tekirdağ, Turkey April 17-19, 2019", Novel coatings containing silver nanoparticles (AgNPs) with strong bonding and controllable antibacterial activity on polyamide 6,6 fabric were produced by dielectric barrier discharge (DBD) plasmaassisted deposition at atmospheric pressure and hexamethyldisiloxane (HMDSO) layers. Silver ion release was tuned using a “sandwich” coating structure to prolong the antibacterial effect. The novel spray-assisted deposition increased deposition rates of AgNPs using atmospheric pressure DBD plasma treatment when an HMDSO layer was applied. An increase in AgNPs deposition in plasma treated samples and antimicrobial activity against Gram-negative (Escherichia coli) for samples with an additional HMDSO layer was observed. These coatings allow the development of new and safe wound dressings able to switch the antimicrobial effect against Gram- positive and Gram-negative bacteria by washing the dressing at high temperature (75 oC) before application., This work was funded by European Regional Development funds (FEDER) through the Competitiveness and Internationalization Operational Program (POCI) – COMPETE and by National Funds through Portuguese Fundação para a Ciência e Tecnologia (FCT) under the project UID/ CTM/00264/2019. Ana Ribeiro acknowledges FCT for its doctoral grant SFRH/BD/137668/2018. Andrea Zille also acknowledges fnancial support of the FCT through an Investigator FCT Research contract (IF/00071/2015) and the project PTDC/CTM-TEX/28295/2017 fnanced by FCT, FEDER, and POCI in the frame of the Portugal 2020 program.

Background: ECare-COPD is a project that aims to improve the nurse’s skills for the promotion of self-management of the disease in people with COPD. We developed an e-learning training programme (sponsored by the European Union). This innovative e-learning programme integrates education modules on self-management, pulmonary rehabilitation, supported by video and a web clinical virtual simulator (CVS). Method: Participatory action research based on a cyclical process divided into five phases: diagnosis, action planning, implementation, assessment and identification of what was acquired. A systematic literature review and scientometric analysis were performed to identify the contents to be included in the programme. These programme contents and clinical scenarios for the CVS (n=8) were organized and developed with the collaboration of a group of nurses with respiratory expertise. We assessed the easiness, usefulness and intention of nurses and nursing students to use the programme. Results: The training programme was made available in three modules. The initial programme for nursing degree students was organized in 6 modules with 18 lessons; the intermediate programme for nurses was organized in 13 modules with 61 lessons; and the advanced programme for nursing specialists was organized in 19 modules with 82 lessons. The training programme was supported by more than 90 videos. The users showed easiness, usefulness and intention to use this programme in their nursing education. Conclusion: This training programme responds to the demand for the dematerialization of nursing education and the intention of nurses to use information and communication technologies in education and lifelong learning.

A game within a game, original, fun, and packed full of surprises that will keep you guessing along the way. Pixel Ripped truly is a nostalgic, mad trip down memory lane. Search for retro-Easter eggs as you fight the mundane distractions of life and get down to what's most important - gaming!

Introduction Medical imaging is the main source of artificial radiation exposure. Evidence, however, suggests that patients are poorly informed about radiation exposure when attending diagnostic scans. This review provides an overview of published literature with a focus on nuclear medicine patients on the level of awareness of radiation exposure from diagnostic imaging. Methods A review of available literature on awareness, knowledge and perception of ionising radiation in medical imaging was conducted. Articles that met the inclusion criteria were subjected to critical appraisal using the Mixed Methods Appraisal Tool. Results 140 articles identified and screened for eligibility, 24 critically assessed and 4 studies included in synthesis. All studies demonstrated that patients were generally lacking awareness about radiation exposure and highlighted a lack of communication between healthcare professionals and patients with respect to radiation exposure. Conclusion Studies demonstrate a need to better inform patients about their radiation exposure, and further studies focusing on nuclear medicine patients are particularly warranted. Implications for practice Adequate and accurate information is crucial to ensure the principle of informed consent is present.

Relatório final do estágio profissionalizante do 6.º ano.

Free heme is cytotoxic as exemplified by hemolytic diseases and genetic deficiencies in heme recycling and detoxifying pathways. Thus, intracellular accumulation of heme has not been observed in mammalian cells to date. Here we show that mice deficient for the heme transporter SLC48A1 (also known as HRG1) accumulate over ten-fold excess heme in reticuloendothelial macrophage lysosomes that are 10 to 100 times larger than normal. Macrophages tolerate these high concentrations of heme by crystallizing them into hemozoin, which heretofore has only been found in blood-feeding organisms. SLC48A1 deficiency results in impaired erythroid maturation and an inability to systemically respond to iron deficiency. Complete heme tolerance requires a fully-operational heme degradation pathway as haplo insufficiency of HMOX1 combined with SLC48A1 inactivation causes perinatal lethality demonstrating synthetic lethal interactions between heme transport and degradation. Our studies establish the formation of hemozoin by mammals as a previously unsuspected heme tolerance pathway., eLife digest Specialized cells, known as red blood cells, are responsible for transporting oxygen to various organs in the body. Each red blood cell contains over a billion molecules of heme which make up the iron containing portion of the hemoglobin protein that binds and transports oxygen. When red blood cells reach the end of their life, they are degraded, and the heme and iron inside them is recycled to produce new red blood cells. Heme, however, is highly toxic to cells, and can cause severe tissue damage if not properly removed. Scavenger cells called macrophages perform this recycling role in the spleen, liver and bone marrow. Collectively, macrophages can process around five million red blood cells every second or about 100 trillion heme molecules. But, it is unclear how they are able to handle such enormous volumes. Macrophages isolated from human and mice have been shown to transport heme from damaged red blood cells using a protein called HRG1. To investigate the role HRG1 plays in heme-iron recycling, Pek et al. used a gene editing tool known an CRISPR/Cas9 to remove the gene for HRG1 from the macrophages of mice. If HRG1 is a major part of this process, removing the gene should result in a build-up of toxic heme and eventual death of the mouse. But, rather than dying of heme-iron overload as expected, these mutant mice managed to survive. Pek et al. found that despite being unable to recycle heme, these mice were still able to make new red blood cells as long as they had a diet that was rich in iron. However, the darkening color of the spleen, bone marrow, and liver in these HRG1 deficient mice indicated that these mice were still accumulating high levels of heme. Further experiments revealed that these mice protected themselves from toxicity by converting the excess heme into crystals called hemozoin. This method of detoxification is commonly seen in blood-feeding parasites, and this is the first time it has been observed in a mammal. These crystals invite new questions about how mammals recycle heme and what happens when this process goes wrong. The next step is to ask whether humans also start to make hemozoin if the gene for HRG1 is faulty. If so, this could open a new avenue of exploration into treatments for red blood cell diseases like anemia and iron overload.

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Candida can adhere and form biofilm on biomaterials commonly used in medical devices which is a key attribute that enhances its ability to cause infections in humans. Furthermore, biomaterial-related infections represent a major therapeutic challenge since Candida biofilms are implicated in antifungal therapies failure. The goals of the present work were to investigate the effect of three 5-aminoimidazole-4-carbohydrazonamides, namely (Z)-5-amino-1-methyl-N'-aryl-1H-imidazole-4-carbohydrazonamides [aryl = phenyl (1a), 4-fluorophenyl (1b), 3-fluorophenyl (1c)], on Candida albicans and Candida krusei biofilm on nanohydroxyapatite substrate, a well-known bioactive ceramic material. To address these goals, both quantitative methods (by cultivable cell numbers) and qualitative evaluation (by scanning electron microscopy) were used. Compounds cytocompatibility towards osteoblast-like cells was also evaluated after 24 h of exposure, through resazurin assay. The three tested compounds displayed a strong inhibitory effect on biofilm development of both Candida species as potent in vitro activity against C. albicans sessile cells. Regarding cytocompatibility, a concentration-dependent effect was observed. Together, these findings indicated that the potent activity of imidazole derivatives on Candida spp. biofilms on nanohydroxyapatite substrate, in particular compound 1c, is worth further investigating., Portuguese NMR network (PTNMR, Bruker Avance III 400-Univ. Minho), Chemistry Research Centre of the University of Minho (UID/QUI/00686/2016 e UID/QUI/00686/2018)

The coastal habit and site fidelity reported for Sotalia guianensis make this species especially vulnerable to human activities. Thus, ecological studies focusing on the habitat use of the populations are essential for S. guianensis protection, as it helps to identify critical areas for conservation. The present study aims to analyze the habitat use by Sotalia guianensis in three bays in southeastern Brazil: Guanabara Bay (GB 1 ), Sepetiba Bay (SB 2 ) and Ilha Grande Bay (IGB 3 ). From 2017 to 2019, four surveys per month were carried out in each bay on board of outboard-powered boats. After locating a group of dolphins, researchers recorded data every five minutes, applying the focal-group method. Information collected included geographical position, time of day, group size and composition, predominant behavioral state, and local depth in meters. The ArcGIS software was selected to create distribution maps and estimate the area use using the fixed Kernel Density method (KDE). The variables collected were statistically compared within and between populations. Feeding was the predominant behavior (frequency of 84.2% in GB, 73.3% in SB and 52.2% in IGB), but behavior frequencies differed between populations (X 2 = 57 . 622 , df=2, p H 2,732 = 68 . 479 , p H 2,732 = 85 . 311 , p

Depositing nanoparticles in textiles have been a promising strategy to achieve multifunc- tional materials. Particularly, antimicrobial properties are highly valuable due to the emergence of new pathogens and the spread of existing ones. Several methods have been used to functionalize textile materials with gold nanoparticles (AuNPs). Therefore, this review highlighted the most used methods for AuNPs preparation and the current studies on the topic in order to obtain AuNPs with suitable properties for antimicrobial applications and minimize the environmental concerns in their production. Reporting the detailed information on the functionalization of fabrics, yarns, and fibers with AuNPs by different methods to improve the antimicrobial properties was the central objective. The studies combining AuNPs and textile materials have opened valuable opportunities to develop antimicrobial materials for health and hygiene products, as infection control and barrier material, with improved properties. Future studies are needed to amplify the antimicrobial effect of AuNPs onto textiles and minimize the concerns related to the synthesis., FEDER funds through the Operational Competitiveness Program—COMPETE and by National Funds through Fundação para a Ciência e Tecnologia (FCT)—under the project POCI-01-0145-FEDER-007136 and UID/CTM/00264/2019. I.R. (SFRH/BD/137668/2018) acknowledges FCT, Portugal, for its doctoral grant financial support. A.Z. also acknowledges financial support of the FCT project PTDC/CTM-TEX/28295/2017 financed by FCT, FEDER, and POCI

Economic impact assessment methodology was applied to UK fisheries data to better understand the implications of European Commission proposal for regulations to fishing for deep-sea stocks in the North-East Atlantic (EC COM 371 Final 2012) under the Common Fisheries Policy (CFP). The aim was to inform the on-going debate to develop the EC proposal, and to assist the UK fishing industry and Government in evaluating the most effective options to manage deep sea fish stocks. Results indicate that enforcing the EC proposal as originally drafted results in a number of implications for the UK fleet. Because of the proposed changes to the list of species defined as being deep sea species, and a new definition of what constitutes a vessel targeting deep sea species, a total of 695 active UK fishing vessels would need a permit to fish for deep sea species. However, due to existing and capped capacity limits many vessels would potentially not be able to obtain such a permit. The economic impact of these changes from the status quo reveals that in the short term, landings would decrease by 6540 tonnes, reducing gross value added by £3.3 million. Alternative options were also assessed that provide mitigation measures to offset the impacts of the proposed regulations whilst at the same time providing more effective protection of deep sea Vulnerable Marine Ecosystems (VMEs). The options include setting a 400 m depth rule that identifies a depth beyond which vessels would potentially be classified as fishing for deep sea species and designating ‘core areas’ for deep sea fishing at depths > 400 m to minimise the risk of further impacts of bottom fishing gear on deep sea habitats. Applying a 400 m depth limit and ‘core fishing’ area approach deeper than 400 m, the impact of the EC proposal would essentially be reduced to zero, that is, on average no vessels (using the status quo capacity baseline) would be impacted by the proposal.

Wet-spinning is a non-solvent induced phase inversion technique that allows the production of continuous polymeric microfibers, with a uniform morphology, based on the principle of precipitation. It allows the production of 3D fibrous constructs with an intricated architecture that facilitates cell infiltration, something that is very limited in electrospun nanofibrous mats, thus increasing its interest in biomedicine. Wet-spun scaffolds are also more easily processed and can be loaded with a variety of biomolecules of interest. Antimicrobial agents that display a broad spectrum of activity against bacteria, fungi and viruses have been combined with such constructs demonstrating great potential to fight infections. In the present work, we explore the use of wet-spinning to process both natural and synthetic biodegradable polymers in the form of microfibers, and the necessary processes to modify their surface to increase their antimicrobial profile. The synergistic potential of specialized biomolecules within wet-spun fibrous architectures are also highlighted.

In this study, a low concentration (10 &mu, g&middot, mL&minus, 1) of poly(N-vinylpyrrolidone) (PVP)-coated silver nanoparticles (AgNPs) were deposited by spray and exhaustion (30, 70 and 100 &deg, C) methods onto untreated and dielectric barrier discharge (DBD) plasma-treated polyamide 6,6 (PA66) fabric. DBD plasma-treated samples showed higher AgNP deposition than untreated ones for all methods. After five washing cycles, only DBD plasma-treated samples displayed AgNPs on the fabric surface. The best-performing method was exhaustion at 30 &deg, C, which exhibited less agglomeration and the best antibacterial efficacy against S. aureus (4 log reduction). For E. coli, the antimicrobial effect showed good results in all the exhaustion samples (5 log reduction). Considering the spray method, only the DBD plasma-treated samples showed some bacteriostatic activity for both strains, but the AgNP concentration was not enough to have a bactericidal effect. Our results suggest DBD plasma may be a low cost and chemical-free method for the preparation of antibacterial textiles, allowing for the immobilization of a very low&mdash, but effective&mdash, concentration of AgNPs.

The main objective of this research was to study the influence of organic matter and carbonate on UV/H2O2 disinfection, and also to start up the UV/H2O2 reactor to conduct disinfection experiments and to analyze the amount of bacteria (total coliforms and E. coli) during the treatment. The analyzes were carried out with samples from the secondary effluent treatment plant of Faculdade de Tecnologia da Unicamp, the Águas da Serra sewage treatment plant in the city of Limeira and with pure water. The experiments consisted in the treatment of secondary effluent samples ana verify the performance to disinfect analising bacterias in four different times. The relation between the organic matter of the effluent and the disinfection process was studied making a relationship between the bactaria inactivatin and the COD of the effluent. The start up of the UV/H2O2 reactor was positive and allowed the accomplishment of disinfection experiments and later the analysis of concentration of bacteria. For samples from the Águas da Serra effluent, which presented COD of 79 mg/l, the disinfection was extremely efficient with different concentrations of peroxide and there was no indication of the presence of coliforms from the first 10 minutes of treatment.

Introdução: A palpação da fontanela anterior permite avaliar o volume e pressão intracranianos. Uma fontanela tensa numa criança tranquila e observada em posição vertical sugere hipertensão intracraniana, que pode ter várias etiologias, nomeadamente processos neoformativos. Caso clínico: Uma lactente do sexo feminino, de dois meses de idade, recorreu a consulta na sua Unidade de Saúde Familiar por tumefação na fontanela anterior. Objetivou-se a presença de tumefação nodular, de consistência mole, com cerca de 1 cm de maior diâmetro. A ecografia transfontanelar revelou um provável quisto epidermoide. A lactente foi referenciada para Cirurgia Pediátrica, tendo realizado ecografia de controlo após dois meses, que revelou crescimento da lesão, motivo pelo qual foi referenciada para Neurocirurgia. Efetuou ressonância magnética encefálica, que confirmou o diagnóstico ecográfico e excluiu comunicação da lesão com estruturas endocranianas. A lactente manteve seguimento por Neurocirurgia e foi decidido manter vigilância até a fontanela encerrar para realização da cirurgia de exérese. O exame histológico confirmou o diagnóstico de quisto dermoide. Discussão: A vigilância clínica e os achados dos exames imagiológicos demonstraram o carácter benigno da lesão, permitindo adiar a intervenção cirúrgica. Introduction: Palpation of the anterior fontanelle allows to investigate intracranial pressure and volume. Swelling of anterior fontanelle in a quiet baby examined in a supine position indicates high intracranial pressure, which may have distinctive causes, namely neoplasms. Case report: A female infant, two months old, attended an emergency consultation at the Family Health Unit due to swelling in the anterior fontanelle. A soft nodular swelling with approximately one centimeter in diameter was observed at the fontanelle. Transfontanellar ultrasound revealed a potential epidermal cyst. The infant was referred to the Pediatric Surgery Department. Ultrasound was repeated two months later and revealed lesion growth. The infant was referred to the Neurosurgery Department, and a brain magnetic resonance imaging was performed. Absence of communication with endocranial structures was confirmed. Surveillance was maintained until fontanelle closure, aiming at later excision. Histological examination confirmed the diagnosis of dermoid cyst. Discussion: Regular clinical follow-up supported by imaging studies revealed the benign nature of the lesion, allowing to postpone surgery.

Background: Self-management enhances autonomy, quality of life and control over the disease. However, there is still little evidence focusing on contents of nurse-led interventions. Our aim is to identify the most effective contents of nurse-led interventions for the promotion of self-management in COPD patients. Method: A Systematic Literature Review based on Cochrane conceptual model registered in PROSPERO. We used the PICOT method with the main starting question: what are the contents of the most effective nurse-led interventions for the promotion of self-management? Database search was conducted before November 24, 2017, in CINAHL; MEDLINE; EMBASE and Web of Science. Results: A total of 563 records were identified with 130 repeated records. After title and abstract analysis, 394 studies were excluded. A total of 55 retrieved studies were selected for full reading. For the final qualitative synthesis, three records were included. Nurse-led interventions are effective for the promotion of quality of life, knowledge related to disease and in reducing tobacco consumption. Additionally, interventions focused on physical activity maintenance are very likely to improve dyspnoea over time. Conclusion: Studies on self-management promotion in COPD patients should carefully address the characterization of nurse-led interventions in terms of contents and approaches. An in-depth description will support the definition of more accurate nurse intervention guidelines, supporting the enhancement of the nurse’s contribution for integrated care programmes worldwide.

Background: This project aims to improve the skills of current and future nurses for the promotion of self-management of the disease in people with COPD. We have been developing an e-learning training programme (sponsored by the European Union) targeted at first and second study cycles’ students and nurses. This innovative e-learning programme integrates a web clinical virtual simulator (CVS) to develop nurses’ clinical reasoning education. Method: Participatory action research based on a cyclical process divided into five phases. Based on the PROSPERO protocol, a systematic literature review was performed to identify the contents and approaches to include in the programme. Contents were analysed and organized by a group of nurses with respiratory expertise. We defined and designed the decision tree of eight clinical scenarios to be integrated into the CVS. The contents were made available in the e-learning platform, also supported by videos and CVS. Results: The programme was divided into three modules: initial, intermediate and advanced. Ecare-COPD is supported by an e-learning strategy with multimedia content (twenty videos), and a CVS incorporated in the e-learning platform. Conclusion: The implementation of this project has a double impact. Firstly, it enhances the quality and safety of nursing care provided to the person with COPD and, secondly, it responds to the demand for the dematerialization of teaching and to the students and nurses’ intention to use information and communication technologies in education and lifelong learning.

BACKGROUND In the field of health care, knowledge and clinical reasoning are key with regard to quality and confidence in decision making. The development of knowledge and clinical reasoning is influenced not only by students’ intrinsic factors but also by extrinsic factors such as satisfaction with taught content, pedagogic resources and pedagogic methods, and the nature of the objectives and challenges proposed. Nowadays, professors play the role of learning facilitators rather than simple “lecturers” and face students as active learners who are capable of attributing individual meanings to their personal goals, challenges, and experiences to build their own knowledge over time. Innovations in health simulation technologies have led to clinical virtual simulation. Clinical virtual simulation is the recreation of reality depicted on a computer screen and involves real people operating simulated systems. It is a type of simulation that places people in a central role through their exercising of motor control skills, decision skills, and communication skills using virtual patients in a variety of clinical settings. Clinical virtual simulation can provide a pedagogical strategy and can act as a facilitator of knowledge retention, clinical reasoning, improved satisfaction with learning, and finally, improved self-efficacy. However, little is known about its effectiveness with regard to satisfaction, self-efficacy, knowledge retention, and clinical reasoning. OBJECTIVE This study aimed to evaluate the effect of clinical virtual simulation with regard to knowledge retention, clinical reasoning, self-efficacy, and satisfaction with the learning experience among nursing students. METHODS A randomized controlled trial with a pretest and 2 posttests was carried out with Portuguese nursing students (N=42). The participants, split into 2 groups, had a lesson with the same objectives and timing. The experimental group (n=21) used a case-based learning approach, with clinical virtual simulator as a resource, whereas the control group (n=21) used the same case-based learning approach, with recourse to a low-fidelity simulator and a realistic environment. The classes were conducted by the usual course lecturers. We assessed knowledge and clinical reasoning before the intervention, after the intervention, and 2 months later, with a true or false and multiple-choice knowledge test. The students’ levels of learning satisfaction and self-efficacy were assessed with a Likert scale after the intervention. RESULTS The experimental group made more significant improvements in knowledge after the intervention (P=.001; d=1.13) and 2 months later (P=.02; d=0.75), and it also showed higher levels of learning satisfaction (P CONCLUSIONS The introduction of clinical virtual simulation in nursing education has the potential to improve knowledge retention and clinical reasoning in an initial stage and over time, and it increases the satisfaction with the learning experience among nursing students.

In the present work, we investigated the combined effect of poly (styrene-methyl methacrylate-acrylic acid) [P(St-MMA-AA)] PCs with the disperse dye C.I. Disperse Red 343, on the photonic crystals (PCs) shape, distribution, organization, iridescence, chemical structure, thermal stability and reflectance. PCs were successfully produced in the form of highly spherical, monodisperse colloidal structures. Presence of dye in the PCs inner core-shell structure was confirmed via Fourier-transformed infrared spectroscopy. The PCs brightness and iridescent effect was enhanced by the presence of the dyestuff, which also promoted the self-assembly of the colloidal nanospheres in the form of arrays. The P(St-MMA-AA) PCs thermal stability did not alter with the introduction of the dye. In a side experiment, dyed PCs were also coated onto dyed polyamide fabrics. Data reported successful coating of the textile fabric and an improvement of its reflectance. Fabric immobilization fostered the self-assembling of the dyed colloidal nanospheres in the form of well-organized face-centered cubic, closed-packed arrays. This is the simplest and most energy favorable organization for PCs. The combination of disperse dyes with PCs is a very recent and challenging idea and could open new ways to understand the influence the PCs photonic-band structure may exert on the photoluminescence properties of the dyes embedded in the PCs inner space, and vice-versa., The authors acknowledge the Portuguese Foundation for Science and Technology (FCT) for funding the project UID/CTM/00264/2013, and FEDER funds by means of COMPETE 2020 – Programa Operacional Competitividade e Internacionalização (POCI), with the reference project POCI-01-0145-FEDER-007136., info:eu-repo/semantics/publishedVersion

Objective To adapt and validate a widely used set of moral dilemmas to European Portuguese, which can be applied to assess decision-making. Moreover, the classical formulation of the dilemmas was compared with a more focused moral probe. Finally, a shorter version of the moral scenarios was tested. Methods The Portuguese version of the set of moral dilemmas was tested in 53 individuals from several regions of Portugal. In a second study, an alternative way of questioning on moral dilemmas was tested in 41 participants. Finally, the shorter version of the moral dilemmas was tested in 137 individuals. Results Results evidenced no significant differences between English and Portuguese versions. Also, asking whether actions are “morally acceptable” elicited less utilitarian responses than the original question, although without reaching statistical significance. Finally, all tested versions of moral dilemmas exhibited the same pattern of responses, suggesting that the fundamental elements to the moral decision-making were preserved. Conclusions We found evidence of cross-cultural validity for moral dilemmas. However, the moral focus might affect utilitarian/deontological judgments. Resumo Objetivos Validar e adaptar para português europeu um conjunto de dilemas morais amplamente utilizado, que poderá ser aplicado para avaliar a tomada de decisão moral. Além disso, comparou-se a formulação clássica dos dilemas com uma versão alternativa, que incluía uma questão mais focada na moralidade. Finalmente, testou-se uma versão reduzida dos cenários morais. Métodos A versão portuguesa dos dilemas morais foi testada em 53 participantes de várias regiões de Portugal, e a versão alternativa foi testada em 41 sujeitos. Finalmente, a versão reduzida dos dilemas morais foi testada numa amostra de 137 participantes. Resultados Não houve diferenças significativas entre a versão portuguesa e a inglesa. A pergunta “É moralmente aceitável...?” evocou menos respostas utilitárias que a versão original, embora não tenham sido obtidas diferenças significativas. A versão portuguesa original, a alternativa e a reduzida evidenciaram o mesmo padrão de respostas, sugerindo que os elementos fundamentais para a tomada de decisão moral estão preservados. Conclusões Encontramos evidências para a validade intercultural dos dilemas morais. No entanto, o foco moral colocado na questão final pode afetar os juízos utilitários/deontológicos.

Damage control refers to those actions made towards minimizing damage or loss. Depending on the context, these can range from emergency procedures dealing with the sinking of a ship or to a surgery dealing with severe trauma or even to an imaginary company in Marvel comics, which repairs damaged property arising from conflicts between super heroes and villains. In the context of host microbe interactions, tissue damage control refers to an adaptive response that limits the extent of tissue damage associated with infection. Tissue damage control can limit the severity of infectious diseases without interfering with pathogen burden, conferring disease tolerance to infection. This contrasts with immune-driven resistance mechanisms, which although essential to protect the host from infection, can impose tissue damage to host parenchyma tissues. This damaging effect is countered by stress responses that confer tissue damage control and disease tolerance to infection. Here we discuss how the stress response regulated by the transcription factor nuclear factor-erythroid 2-related factor 2 (Nrf2) acts in such a manner.

Several methods for silver nanoparticles (AgNPs) deposition on dielectric barrier discharge (DBD) plasma treated and not treated polyamide 6,6 fabric were tested for the production of durable antibacterial textiles. Ultrasound-assisted, dip-coating, exhaustion at 70 ̊C and spray deposition methods were applied. The treated fabrics were analysed in terms of coating uniformity, plasma effect, nanoparticles concentration onto the fabrics and nanoparticles release. Scanning electron microscope (SEM), energy dispersive X-ray (EDX), atomic absorption spectroscopy (AAS), inductively coupled plasma optical emission spectrometry (ICP-OES) and reflectance spectroscopy(%R) were performed. In the fabrics impregnated with AgNPs by dip coating or spray methods there are no significant differences in the plasma treated and untreated samples. Ultrasound tip and exhaustion at 70 ̊C presented higher AgNPs loading. Better AgNPs distribution, higher concentration and less agglomeration were observed in the plasma treated samples and an improved controlled release as well. The plasma treated fabrics with AgNPs deposited with the ultrasound method showed the highest concentration of nanoparticles onto the fabrics as well as the lowest NPs agglomeration. However, this deposition is limited to certain areas of the fabric, the samples were not uniform. The exhaustion method showed the best equilibrium between the NPs distribution and state of agglomeration., Andrea Zille acknowledge FCT through the Investigator FCT Research contract (IF/00071/2015) and the project POCI-01-0145-FEDER-007136 and UID/CTM/00264 under the COMPETE and FCT/MCTES (PIDDAC) co-financed by European funds (FEDER) through the PT2020 program., info:eu-repo/semantics/publishedVersion

We would like to thank Prof. Ira Tabas (Columbia University, New York, NY, USA) for providing the L929 cell line, Prof. Herbert Virgin (Washington University, St. Louis, MO, USA) for providing p62-KO mice legs, Dr. H. Girao (CNC. IBILI, Univ. of Coimbra) for the E1-inhibitor and T. Pereira for technical assistance with microscopy. This work was supported by the Foundation for Science and Technology of the Portuguese Ministry of Science and Higher Education [HMSP-ICT/0024/2010, co-founded by the European Union (FEDER - Fundo Europeu de Desenvolvimento Regional) through COMPETE - Programa Operacional Factores de Competitividade and QREN - Quadro de Referencia Estrategico], iNOVA4Health - UID/Multi/04462/2013, a program financially supported by FCT through national funds and co-funded by FEDER under the PT2020 Partnership Agreement and FCT to OVV. PhD fellowships SFRH/BD/62197/2009, SFRH/BD/90258/2012 and SFRH/BD/51877/2012 and SFRH/BD/52293/2013. PTDC/SAU-TOX/116627/2010, HMSP-ICT/0022/2010, European Community 7th Framework Grant ERC-2011-AdG 294709-DAMAGECONTROL to MPS. Editor Erythrophagocytosis, the phagocytic removal of damaged red blood cells (RBC), and subsequent phagolysosome biogenesis are important processes in iron/heme metabolism and homeostasis. Phagolysosome biogenesis implies the interaction of nascent phagosomes with endocytic compartments and also autophagy effectors. Here, we report that besides recruitment of microtubule-associated protein-1-light chain 3 (LC3), additional autophagy machinery such as sequestosome 1 (p62) is also acquired by single-membrane phagosomes at very early stages of the phagocytic process and that its acquisition is very important to the outcome of the process. In bone marrow-derived macrophages (BMDM) silenced for p62, RBC degradation is inhibited. P62, is also required for nuclear translocation and activation of the transcription factor Nuclear factor E2-related Factor 2 (NRF2) during erythrophagocytosis. Deletion of the Nrf2 allele reduces p62 expression and compromises RBC degradation. In conclusion, we reveal that erythrophagocytosis relies on an interplay between p62 and NRF2, potentially acting as protective mechanism to maintain reactive oxygen species at basal levels and preserve macrophage homeostasis. © 2017 The Author(s). publishersversion published

Objective To adapt and validate a widely used set of moral dilemmas to European Portuguese, which can be applied to assess decision-making. Moreover, the classical formulation of the dilemmas was compared with a more focused moral probe. Finally, a shorter version of the moral scenarios was tested. Methods The Portuguese version of the set of moral dilemmas was tested in 53 individuals from several regions of Portugal. In a second study, an alternative way of questioning on moral dilemmas was tested in 41 participants. Finally, the shorter version of the moral dilemmas was tested in 137 individuals. Results Results evidenced no significant differences between English and Portuguese versions. Also, asking whether actions are “morally acceptable” elicited less utilitarian responses than the original question, although without reaching statistical significance. Finally, all tested versions of moral dilemmas exhibited the same pattern of responses, suggesting that the fundamental elements to the moral decision-making were preserved. Conclusions We found evidence of cross-cultural validity for moral dilemmas. However, the moral focus might affect utilitarian/deontological judgments. Resumo Objetivos Validar e adaptar para português europeu um conjunto de dilemas morais amplamente utilizado, que poderá ser aplicado para avaliar a tomada de decisão moral. Além disso, comparou-se a formulação clássica dos dilemas com uma versão alternativa, que incluía uma questão mais focada na moralidade. Finalmente, testou-se uma versão reduzida dos cenários morais. Métodos A versão portuguesa dos dilemas morais foi testada em 53 participantes de várias regiões de Portugal, e a versão alternativa foi testada em 41 sujeitos. Finalmente, a versão reduzida dos dilemas morais foi testada numa amostra de 137 participantes. Resultados Não houve diferenças significativas entre a versão portuguesa e a inglesa. A pergunta “É moralmente aceitável...?” evocou menos respostas utilitárias que a versão original, embora não tenham sido obtidas diferenças significativas. A versão portuguesa original, a alternativa e a reduzida evidenciaram o mesmo padrão de respostas, sugerindo que os elementos fundamentais para a tomada de decisão moral estão preservados. Conclusões Encontramos evidências para a validade intercultural dos dilemas morais. No entanto, o foco moral colocado na questão final pode afetar os juízos utilitários/deontológicos.

A mild and simple method was developed to prepare a series of fifteen 5-aminoimidazole 4-carboxamidrazones, starting from the easily accessible 5-amino-4-cyanoformimidoyl imidazoles. The antimicrobial activity of these novel amidrazones was screened against Gram positive (Staphylococcus aureus) and Gram negative (Escherichia coli, Pseudomonas aeruginosa) bacteria and Candida sp. (Candida albicans, Candida krusei, Candida parapsilosis). Only a subset of compounds displayed fair-moderate activity against S. aureus and E. coli but all exhibited activity against Candida sp. The three most potent antifungal compounds were further tested against Cryptococcus neoformans, Aspergillus fumigatus and three dermatophytes (Trichophyton rubrum, Trichophyton mentagrophytes, Microsporum gypseum). These three hit compounds strongly inhibited C. krusei and C. neoformans growth, although their activity on filamentous fungi was very weak when compared to the activity on yeasts.

Climate changes implicate an increase in climate instability and the occurrence of extreme temperature in the environment. In this context, the differential triggering of cold tolerance mechanisms among coffee plants, highlighting the existence of important genetic variability, is of up most importance to be exploited in genotype screening and breeding programs. This review deals with the identification and triggering of acclimation mechanisms that shield key functions and structures of photosynthesis, with a particular emphasis on experiments under environ- mental controlled conditions. These mechanisms allow plants to perform metabolic and structural adjustments, particularly under conditions of a gradual cold exposure, simulating the effects happening in the field under cold periods. Detailed attention is given to the strengthening of the antioxidative system and to the dynamics of the lipid matrix components in chloroplast membranes, since they were found to constitute crucial traits to an effective long-term acclimation and, therefore, to guarantee the economic sustainability of this important tropical cash crop, particularly in cultivation areas prone to the occur- rence of low positive temperatures.

Immune Mobilising Monoclonal TCRs Against Cancer (ImmTAC) molecules are a new class of bi-specific biologic specifically designed to recognize and eradicate cancer cells. ImmTAC molecules are composed of an affinity-enhanced T-cell receptor (TCR) fused to an anti-CD3 effector function engineered to recognize peptides presented by human leukocyte antigen (HLA) and induce T-cell activation and T-cell mediated killing of tumor cells. TCR-based immunotherapeutic strategies offer distinct advantages over traditional antibody-based therapies, most notably providing access to up to nine-fold more cancer targets by targeting intracellularly processed peptides presented by HLA as opposed to cell surface proteins. Preclinical testing of ImmTAC molecules can prove particularly challenging as these molecules are exquisitely human-specific, requiring a human peptidome and intact human immune system; thus the use of conventional animal models is inappropriate. Given that these molecules harness the full force of the immune system, robust preclinical testing is essential to predict safety and efficacy and inform on clinical dosing for first-in-human studies. Here we present, to our knowledge, the first entirely in vitro preclinical package that comprises a range of cellular and molecular assays to assess the efficacy, safety and specificity of ImmTAC molecules. To exemplify our approach, we draw upon the preclinical testing of multiple ImmTAC molecules, including IMCgp100, the first ImmTAC molecule to reach the clinic. We propose that this preclinical package can be applied to the testing of other TCR-based therapies to deliver a more physiologically relevant model. Citation Format: Ana Ribeiro, Tomasz Dobrzycki, Jane Harper, Giovanna Bossi, Debbie Wright, Andrea Stacey, Nicole Bedke, Ruth Martinez-Hague, Dan Blat, Laure Humbert, Zoe Donellan, Samantha Paston, Luise Weigand, Martina Canestraro, Sophie Botta Gordon-Smith, Bent K. Jakobsen, Joseph Dukes. An in vitro preclinical package to assess the safety and efficacy of ImmTAC™ molecules [abstract]. In: Proceedings of the Fourth CRI-CIMT-EATI-AACR International Cancer Immunotherapy Conference: Translating Science into Survival; Sept 30-Oct 3, 2018; New York, NY. Philadelphia (PA): AACR; Cancer Immunol Res 2019;7(2 Suppl):Abstract nr A214.

Background and objectives: On the perioperative period, cardiovascular disease represents one of the most important causes of morbidity and mortality. The prevalence of cardiovascular risk factors ischemic heart disease and heart failure is increasing alongside with life expectancy. Case report: We present a patient scheduled for laryngeal biopsies of a neoformation suspected of malignancy under general anesthesia. We describe the use of lidocaine in converting an atrial fibrillation with limited ventricular tachycardia episodes into sinus rhythm, in a patient with an Implantable Cardioverter Defibrillator. Discussion: Lidocaine is an anti-arrhythmic drug due to its effect on blockade sodium channel. In this case, it allowed the pharmacological cardioversion into sinus rhythm, avoiding the postponement of the surgery. Further investigation should be conducted to confirm the authors’ anesthetic approach in similar cases.

The development of new multifunctional textiles containing nanoparticles (NPs) has a special interest in several applications for pharmaceutical and medical products. Cu, Zn and Ag are the most promising antimicrobial NPs, exhibiting strong antibacterial activities. However, most of antimicrobial textiles coated with NPs are not able to perform a controlled release of NPs because of the high degree of aggregation. The aim of this study is to assess the effect of NPs stabilizers such as citrate, alginate and polyvinyl alcohol (PVA) in Cu, Zn and Ag NPs dispersions. The obtained dispersions were used to develop a new class of antibacterial NPs coatings onto polyamide 6,6 (PA66) and polyester fabrics (PES) by Double Dielectric Barrier (DBD) plasma discharge. Dynamic light scattering (DLS) was used to evaluate the best dispersing agent in terms of size, polydispersity index and zeta potential. Coating efficiency was evaluated by SEM, XPS and FTIR. The washing fastness of the coatings developed was also tested. The results show that the best dispersions were obtained using 2.5% of citrate for ZnO, 5% Alginate for Cu and 2.5% alginate for Ag NPs. SEM, XPS and FTIR analysis shows that DBD is an efficient deposition technique only for Ag and Cu NPs and that better perform in PA66 than PES fabric. The DBD deposition in air display similar results in term of NPS deposition of usually more efficient plasma jets using carrier gas such as N2 and Ar., FEDER -Federación Española de Enfermedades Raras, info:eu-repo/semantics/publishedVersion

© 2017 The Authors. Published by the Royal Society under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, provided the original author and source are credited, Zebrafish are able to regenerate the spinal cord and recover motor and sensory functions upon severe injury, through the activation of cells located at the ependymal canal. Here, we show that cells surrounding the ependymal canal in the adult zebrafish spinal cord express Foxj1a. We demonstrate that ependymal cells express Foxj1a from their birth in the embryonic neural tube and that Foxj1a activity is required for the final positioning of the ependymal canal. We also show that in response to spinal cord injury, Foxj1a ependymal cells actively proliferate and contribute to the restoration of the spinal cord structure. Finally, this study reveals that Foxj1a expression in the injured spinal cord is regulated by regulatory elements activated during regeneration. These data establish Foxj1a as a pan-ependymal marker in development, homeostasis and regeneration and may help identify the signals that enable this progenitor population to replace lost cells after spinal cord injury., This research was supported by FCT (Portugal) grants (PTDC/BIM-MED/1375/2012 and PTDC/BIM-MED/3295/2014) given to L.S. L.S. was supported by an IF contract from FCT (Portugal). A.R. was supported by a postdoctoral fellowship of the FCT (Portugal) (SFRH/BPD/100162/2014) and EMBO (605-2012)