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La evidencia demuestra que la formación de las enfermeras de cuidados críticos en la prevención de la neumonía asociada a ventilación mecánica (NVM) y la bacteriemia relacionada con catéter (BRC) disminuye la estancia y la mortalidad en la UCI. El Consejo Asesor de los Proyectos de Seguridad «Tolerancia Zero», del Ministerio de Sanidad, propone promover dicha formación, y la metodología docente de la simulación emerge como óptima para entrenar las habilidades y los conocimientos necesarios. El aprendizaje basado en la simulación es una metodología docente centrada en el estudiante que promueve un feedback inmediato y participativo entre profesores y participantes, conocido como debriefing. El objetivo es desarrollar habilidades técnicas (necesarias para llevar a cabo un procedimiento concreto) o habilidades no técnicas (comunicación, liderazgo, trabajo en equipo, consciencia situacional, toma de decisiones, uso de los recursos, práctica segura y disminución de eventos adversos). El curso SIMULAZERO se basa en una prueba de Evaluación Clínica Objetiva Estructurada (ECOE) integrada por dos escenarios de baja fidelidad para la formación en la técnica de aspiración de secreciones y la inserción de un catéter, respectivamente, y un escenario de alta fidelidad para el desarrollo de habilidades no técnicas. Se describe cómo preparar cada escenario (caso clínico, guion para los actores y material necesario) para que se pueda implementar la formación en la propia unidad de cuidados intensivos, así como el instrumento NEUMOBACT, la parrilla de evaluación en la que basarse para desarrollar el debriefing., Evidence shows that training critical care nurses in the prevention of ventilator-associated pneumonia (VAP) and catheter-associated bacteremia (CBB) reduces ICU length of stay and mortality. The Advisory Council of the «Zero Tolerance» Safety Projects of the Ministry of Health proposes to promote such training and the teaching methodology of simulation emerges as optimal for training the necessary skills and knowledge. Simulation-based learning is a student-centered teaching methodology that promotes immediate and participatory feedback between teachers and participants, known as debriefing. The objective is to develop technical skills (necessary to carry out a specific procedure) or non-technical skills (communication, leadership, teamwork, situational awareness, decision making, use of resources, safe practice and reduction of adverse events). The SIMULAZERO course is based on a Objective structured clinical examination (OSCE) composed of two low-fidelity scenarios for training in secretion aspiration technique and catheter insertion respectively and a high-fidelity scenario for the development of non-technical skills. We describe how to prepare each scenario (clinical case, script for the actors and necessary material) so that the training can be implemented in the intensive care unit itself, as well NEUMOBACT instrument, as the evaluation grid on which to base the development of the debriefing., Depto. de Enfermería, Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub

N-methyl D-aspartate receptor (NMDAR) hypofunction is a pathophysiological mechanism relevant for schizophrenia. Acute administration of the NMDAR antagonist phencyclidine (PCP) induces psychosis in patients and animals while subchronic PCP (sPCP) produces cognitive dysfunction for weeks. We investigated the neural correlates of memory and auditory impairments in mice treated with sPCP and the rescuing abilities of the atypical antipsychotic drug risperidone administered daily for two weeks. We recorded neural activities in the medial prefrontal cortex (mPFC) and the dorsal hippocampus (dHPC) during memory acquisition, short-term, and long-term memory in the novel object recognition test and during auditory processing and mismatch negativity (MMN) and examined the effects of sPCP and sPCP followed by risperidone. We found that the information about the familiar object and its short-term storage were associated with mPFC→dHPC high gamma connectivity (phase slope index) whereas long-term memory retrieval depended on dHPC→mPFC theta connectivity. sPCP impaired short-term and long-term memories, which were associated with increased theta power in the mPFC, decreased gamma power and theta-gamma coupling in the dHPC, and disrupted mPFC-dHPC connectivity. Risperidone rescued the memory deficits and partly restored hippocampal desynchronization but did not ameliorate mPFC and circuit connectivity alterations. sPCP also impaired auditory processing and its neural correlates (evoked potentials and MMN) in the mPFC, which were also partly rescued by risperidone. Our study suggests that the mPFC and the dHPC disconnect during NMDAR hypofunction, possibly underlying cognitive impairment in schizophrenia, and that risperidone targets this circuit to ameliorate cognitive abilities in patients.

Dyslipidemia in gestational diabetes has been associated with worse perinatal outcomes. The ANGPTL3-4-8 axis regulates lipid metabolism, especially in the transition from fasting to feeding. In this study, we evaluated the response of ANGPTL3, 4, and 8 after the intake of a mixed meal in women with normal glucose tolerance and gestational diabetes, and we assessed their gene expressions in different placental locations. Regarding the circulating levels of ANGPTL3, 4, and 8, we observed an absence of ANGPTL4 response after the intake of the meal in the GDM group compared to its presence in the control group. At the placental level, we observed a glucose tolerance-dependent expression pattern of ANGPTL3 between the two placental sides. When we compared the GDM pregnancies with the control pregnancies, a downregulation of the maternal side ANGPTL3 expression was observed. This suggests a dysregulation of the ANGPTL3–4–8 axis in GDM, both at the circulating level after ingestion and at the level of placental expression. Furthermore, we discerned that the expressions of ANGPTL3, 4, and 8 were related to birth weight and placental weight in the GDM group, but not in the control group, which suggests that they may play a role in regulating the transplacental passage of nutrients.

The human response to the COVID-19 pandemic set in motion an unprecedented shift in human activity with unknown long-term effects. The impacts in marine systems are expected to be highly dynamic at local and global scales. However, in comparison to terrestrial ecosystems, we are not well-prepared to document these changes in marine and coastal environments. The problems are two-fold: 1) manual and siloed data collection and processing, and 2) reliance on marine professionals for observation and analysis. These problems are relevant beyond the pandemic and are a barrier to understanding rapidly evolving blue economies, the impacts of climate change, and the many other changes our modern-day oceans are undergoing. The “Our Ocean in COVID-19″ project, which aims to track human-ocean interactions throughout the pandemic, uses the new eOceans platform (eOceans.app) to overcome these barriers. Working at local scales, a global network of ocean scientists and citizen scientists are collaborating to monitor the ocean in near real-time. The purpose of this paper is to bring this project to the attention of the marine conservation community, researchers, and the public wanting to track changes in their area. As our team continues to grow, this project will provide important baselines and temporal patterns for ocean conservation, policy, and innovation as society transitions towards a new normal. It may also provide a proof-of-concept for real-time, collaborative ocean monitoring that breaks down silos between academia, government, and at-sea stakeholders to create a stronger and more democratic blue economy with communities more resilient to ocean and global change.

Brain activity and behavior are constantly changing (Puig et al., 2014; Disney, 2021). Recent studies in both animal models and humans have revealed that such variations are not random in nature but controlled through slow-acting neuromodulatory systems...

Stimulating lifestyles have powerful effects on cognitive abilities, especially when they are experienced early in life. Cognitive therapies are widely used to improve cognitive impairment due to intellectual disability, aging, and neurodegeneration, however the underlying neural mechanisms are poorly understood. We investigated the neural correlates of memory amelioration produced by postnatal environmental enrichment (EE) in diploid mice and the Ts65Dn mouse model of Down syndrome (trisomy 21). We recorded neural activities in brain structures key for memory processing, the hippocampus and the prefrontal cortex, during rest, sleep and memory performance in mice reared in non-enriched or enriched environments. Enriched wild-type animals exhibited enhanced neural synchrony in the hippocampus across different brain states (increased gamma oscillations, theta-gamma coupling, sleep ripples). Trisomic females showed increased theta and gamma rhythms in the hippocampus and prefrontal cortex across different brain states along with enlarged ripples and disrupted circuit gamma signals that were associated with memory deficits. These pathological activities were attenuated in their trisomic EE-reared peers. Our results suggest distinct neural mechanisms for the generation and rescue of healthy and pathological brain synchrony, respectively, by EE and put forward hippocampal-prefrontal hypersynchrony and miscommunication as major targets underlying the beneficial effects of EE in intellectual disability.