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Background: Palliative care (PC) focuses on relieving pain and difficult symptoms rather than treating disease or delaying its progress. Palliative care views death as a natural process and allows patients to live the last phase of their existence in the best possible way, encouraging them to express their opinions and wishes for a good death. Interventions are advocated to control symptoms and distress and promote wellbeing and social functioning. A multidisciplinary approach to support patients receiving palliative care is encouraged. Objective: The aims of this study were to investigate the facilitators and barriers to PC in people with kidney disease from a nursing perspective and to explore predictive factors associated with nurse-perceived facilitators and barriers to PC in people with kidney disease. Design: This study is a survey that adopted a questionnaire created in 2021 with Delphi methology, which included 73 statements divided into 37 facilitators and 36 barriers to PC in patients with kidney disease, to be scored using a Likert scale. Participants and Measurements: Participants were obtained through the membership database of the European Dialysis and Transplant Nurses Association/European Renal Care Association (EDTNA/ERCA) of 2020. Inclusion criteria included being registered as a nurse, an EDTNA/ERCA member and understanding of the English language. The questionnaire was sent via email. Results: Three profiles of respondents were found: the first group was characterized by the highest agreement percentages of facilitators and with an average value of 53.7% in barriers; the second was characterized by a lower endorsement of facilitators and similar agreement to the first group for barriers; the third group had a high probability (>80%) of items endorsing both barriers and facilitators. Predictive variables were significantly associated with “Years in nephrology” and “macro geographic area”. Conclusions: This study demonstrates variation in PC practice across Europe. Some professionals identified fewer barriers to PC and appeared more confident when dealing with difficult situations in a patient’s care pathway, while others identified more barriers as obstacles to the implementation of adequate treatment. The number of years of nephrology experience and the geographical area of origin predicted how nurses would respond. This study was not registered.

Arsenic contamination poses a significant public health risk worldwide, with chronic exposure leading to various health issues. Detecting and monitoring arsenic exposure accurately remains challenging, necessitating the development of sensitive detection methods. In this study, we introduce a novel approach using fast-scan cyclic voltammetry (FSCV) coupled with carbon-fiber microelectrodes (CFMs) for the electrochemical detection of As3+. Through an in-depth pH study using tris buffer, we optimized the electrochemical parameters for both acidic and basic media. Our sensor demonstrated high selectivity, distinguishing the As3+ signal from those of As5+ and other potential interferents under ambient conditions. We achieved a limit of detection (LOD) of 0.5 μM (37.46 ppb) and a sensitivity of 2.292 nA/μM for bare CFMs. Microscopic data confirmed the sensor’s stability at lower, physiologically relevant concentrations. Additionally, using our previously reported double-bore CFMs, we simultaneously detected As3+-Cu2+ and As3+-Cd2+ in tris buffer, enhancing the LOD of As3+ to 0.2 μM (14.98 ppb). To our knowledge, this is the first study to use CFMs for the rapid and selective detection of As3+ via FSCV. Our sensor’s ability to distinguish As3+ from As5+ in a physiologically relevant pH environment showcases its potential for future in vivo studies.

Neurotoxic heavy metals, such as Cd2+, pose a significant global health concern due to their increased environmental contamination and subsequent detrimental health hazards they pose to human beings. These metal ions can breach the blood-brain barrierblood–brain barrier, leading to severe and often irreversible damage to the central nervous system and other vital organs. Therefore, developing a highly sensitive, robust, and rapid in vivo detection method for these hazardous heavy metal ions is of the utmost importance for early detection, thus initiating timely therapeutics. Detecting ultra-low levels of toxic metal ions in vivo and obtaining accurate speciation information remains a challenge with conventional analytical techniques. In this study, we fabricated a novel carbon carbon-fiber microelectrode (CFM)-based sensor that can detect Cd2+ ions using fast-scan cyclic voltammetry by electrodepositing gold nanoparticles (AuNP). We optimized electrochemical parameters that generate a unique cyclic voltammogram (CV) of Cd2+ at a temporal resolution of 100 ms with our novel sensor. All our experiments were performed in tris buffer that mimics the artificial cerebellum fluid. We established a calibration curve resulting in a limit of detection (LOD) of 0.01 µM with a corresponding sensitivity of 418.02 nA/ µM. The sensor’s selectivity was evaluated in the presence of other metal ions, and it was noteworthy to observe that the sensor retained its ability to produce the distinctive Cd2+ CV, even when the concentration of other metal ions was 200 times higher than that of Cd2+. We also found that our sensor could detect free Cd2+ ions in the presence of complexing agents. Furthermore, we analyzed the solution chemistry of each of those Cd2+–ligand solutions using a geochemical model, PHREEQC. The concentrations of free Cd2+ ions determined through our electrochemical data align well with geochemical modeling data, thus validating the response of our novel sensor. Furthermore, we reassessed our sensor’s LOD in tris buffer based on the concentration of free Cd2+ ions determined through PHREEQC analysis, revealing an LOD of 0.00132 µM. We also demonstrated the capability of our sensor to detect Cd2+ ions in artificial urine samples, showcasing its potential for application in actual biological samples. To the best of our knowledge, this is the first AuNP-modified, CFM-based Cd2+ sensor capable of detecting ultra-low concentrations of free Cd2+ ions in different complex matrices, including artificial urine at a temporal resolution of 100 ms, making it an excellent analytical tool for future real-time, in vivo detection, particularly in the brain.

Vanillin, one of the most widely used and appreciated flavoring agents worldwide, is the main constituent of vanilla bean extract, obtained from the seed pods of various members belonging to the Orchidaceae family. Due to the great demand in the food confectionery industry, as well as in the perfume industry, medicine, and more, the majority of vanillin used today is produced synthetically, and only less than one percent of the world’s vanilla flavoring market comes directly from the traditional natural sources. The increasing global demand for vanillin requires alternative and overall sustainable new production methods, and the recovery from biobased polymers, like lignin, is an environmentally friendly alternative to chemical synthesis. The present review provides firstly an overview of the different types of vanillin, followed by a description of the main differences between natural and synthetic vanillin, their preparation, the market of interest, and the authentication issues and the related analytical techniques. Then, the review explores the real potentialities of lignin for vanillin production, presenting firstly the well-assessed classical methods and moving towards the most recent promising approaches through chemical, biotechnological and photocatalytic methodologies, together with the challenges and the principal issues associated with each technique.

Bruna Scarcello Strini,1 Joyce Figueiredo de Lima Marques,1 Renata Pereira,1 Danielle Ferreira Sobral-Souza,2 Vanessa Gallego Arias Pecorari,3 Priscila Christiane Suzy Liporoni,4 Flávio Henrique Baggio Aguiar1 1Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil; 2Dental School, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil; 3Department of Biostatistics, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil; 4Department of Restorative Dentistry, University of Taubate, Taubaté, SP, BrazilCorrespondence: Joyce Figueiredo de Lima Marques, Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, Piracicaba, SP, 13414-903, Brazil, Tel +55 19 2106-5337 ; +55 84 99966-8539, Fax +55 19 3421-0144, Email jcinhafml@hotmail.comPurpose: Bulk-fill composite resins were developed to reduce time and facilitate the restorative procedure. However, considering their recent introduction on the market and the new formulations, their performance still requires evaluation. This study aimed to evaluate Knoop microhardness (KHN), diametral tensile strength (DTS) and degree of conversion (DC) of three Bulk-Fill composite resins and a conventional one.Materials and Methods: Sixty samples (n = 15; 8 mm ø x 4 mm height) were confectioned using a mold. Filtek Bulk-Fill (FBF), Tetric N-Ceram Bulk-Fill (TNC) and SonicFill 2 (SF2) were placed in 4 mm increments, and Filtek Z350 (FZ350) was placed in 2 mm increments. The KHN of top and bottom surfaces were tested using Knoop Hardness tester at 10 gf/10s. The DTS was tested under compressive load at 1.0 mm/min. The DC was measured by Fourier Transform Infrared (FTIR) spectroscopy. Differences in DTS and DC were analyzed by ANOVA and Tukey post hoc test. For KHN, Kruskal–Wallis and Wilcoxon tests were performed at α = 0.05.Results: Top surfaces of all composite resins had higher KHN than bottom surfaces. At top and bottom surfaces, FZ350 showed higher KHN than TNC and SF2. The highest DTS was obtained by FBF, followed by FZ350 and SF2. The highest DC was obtained by SF2, the lowest one was obtained by FBF.Conclusion: From Bulk-Fill composite resins, FBF presented the best KHN and DTS results. The SF2 showed the best DC. Further studies are required to ensure whether these differences can negatively influence the behavior of in vivo restorations.Keywords: composite resins, Bulk-Fill, FTIR, hardness, tensile strength

BackgroundThe Heartmate 3 (HM 3) is a left ventricular assist device featuring less shear stress, milder acquired von Willebrand syndrome, and fewer bleeding incidences than its predecessor the Heartmate II (HM II). The novel surface coating of the HM 3 suggests less contact activation of plasmatic coagulation. We hypothesized that patients with HM 3 exhibit fewer aberrations in their thrombin potential than patients with HM II. We compared these results with the thrombin potential of patients with heart transplantation (HTX).MethodsThrombin generation in plasma samples of patients with HM II (n = 16), HM 3 (n = 20), and HTX (n = 13) was analyzed 3 days after implantation/transplantation and after long-term support (3–24 months) with HM II (n = 16) or HM 3 (n = 12) using calibrated automated thrombography. Heparin in postoperative samples was antagonized with polybrene.ResultsThree days postoperatively HM II patients exhibited a lower endogenous thrombin potential (ETP) than HM 3 and HTX patients (HM II: 947 ± 291 nM*min; HM 3: 1231 ± 176 nM*min; HTX: 1376 ± 162 nM*min, p

Successful plant reproduction depends on the adequate development of floral organs controlled by cell proliferation and other processes. The Stigma/style cell-cycle inhibitor 1 (SCI1) gene regulates cell proliferation and affects the final size of the female reproductive organ. To unravel the molecular mechanism exerted by Nicotiana tabacum SCI1 in cell proliferation control, we searched for its interaction partners through semi- in vivo pull-down experiments, uncovering a cyclin-dependent kinase, NtCDKG;2. Bimolecular fluorescence complementation and co-localization experiments showed that SCI1 interacts with NtCDKG;2 and its cognate NtCyclin L in nucleoli and splicing speckles. The screening of a yeast two-hybrid cDNA library using SCI1 as bait revealed a novel DEAD-box RNA helicase (NtRH35). Interaction between the NtCDKG;2–NtCyclin L complex and NtRH35 is also shown. Subcellular localization experiments showed that SCI1, NtRH35, and the NtCDKG;2–NtCyclin L complex associate with each other within splicing speckles. The yeast two-hybrid screening of NtCDKG;2 and NtRH35 identified the conserved spliceosome components U2aʹ, NF-κB activating protein (NKAP), and CACTIN. This work presents SCI1 and its interactors, the NtCDKG;2–NtCyclin L complex and NtRH35, as new spliceosome-associated proteins. Our findings reveal a network of interactions and indicate that SCI1 may regulate cell proliferation through the splicing process, providing new insights into the intricate molecular pathways governing plant development. [ABSTRACT FROM AUTHOR]

To move towards a more sustainable concrete, the enhancement of its durability is strongly encouraged and, dealing in particular with reinforced concrete (RC), this mainly means to prevent the damage due to environmental actions, e.g. due to chloride-induced corrosion. Therefore, there is the need of models aimed at designing durable structures. Usually the service life design models consider concrete in uncracked condition. In real structures, however, several phenomena can generate cracks on concrete surface, leading to an acceleration of the corrosion of steel rebar. A number of studies have been recently carried out in order to evaluate the influence of cracks on reinforced concrete durability in chloride-contaminated environment, however the knowledge of the effect of cracks on the initiation and propagation periods is still lacking. Furthermore, few studies have considered additional protection strategies, such as the use of stainless steel rebar. In this work, experimental results are presented concerning the influence of cracks on the service life of reinforced concrete structures in order to evaluate if cracks lead to an earlier corrosion initiation induced by chlorides. Prismatic specimens, reinforced with carbon steel and 304L stainless steel bars, were longitudinally cracked and exposed to ponding with 3.5% NaCl solution. The monitoring of corrosion behaviour showed that when cracks reached the steel surface corrosion initiated immediately.

A Anatomia Humana estuda o corpo por diferentes métodos, incluindo as metodologias ativas. Este estudo objetivou relatar uma das metodologias utilizadas durante um Curso de Especialização latu sensu. Vinte alunos do citado curso foram divididos em quatro grupos para elaboração de um roteiro contendo nomes de estruturas ósseas, musculares e articulares da região de cabeça e pescoço. Em seguida, os roteiros foram repassados ao próximo grupo para registro fotográfico das estruturas anatômicas listadas. O mesmo roteiro foi então entregue para outros grupos para a identificação das estruturas nas imagens fotográficas e na sequência para a correção. Finalizou-se com a conferência e análise do grupo original que elaborou a lista de estruturas. Pode-se notar diferenças entre os grupos quanto à quantidade de estruturas selecionadas, gerando roteiros sucintos ou extensos. Conclui-se que tal método foi eficaz para complementação do estudo teórico e prático dos conteúdos e exige participação intensa dos alunos.

Abstract Background Globally, renal healthcare practitioners provide intensive and protracted support to a highly complex multi-morbid patient population however knowledge about the impact of COVID-19 on these practitioners is extremely limited. Objective This study aimed to explore the experiences of COVID-19 with renal healthcare practitioners during the first global lockdown between June 2020 and September 2020. Methods A multi-methods approach was carried out including a quantitative survey and qualitative interviews. This was a multinational study of renal healthcare practitioners from 29 countries. Quantitative: A self-designed survey on COVID-19 experiences and standardised questionnaires (General Health Questionnaire-12; Maslach Burnout Inventory). Descriptive statistics were generated for numerical data. Qualitative: Online semi-structured interviews were conducted. Data was subjected to thematic analysis. Renal healthcare practitioners (n = 251) completed an online survey. Thirteen renal healthcare practitioners took part in semi-structured interviews (12 nurses and 1 dietician). Results The majority of participants surveyed were female (86.9 %; n = 218), nurses (86.9 %; n = 218) with an average 21.5 (SD = 11.1) years’ experience since professional qualification, and 16.3 years (SD = 9.3) working in renal healthcare. Survey responses indicated a level of preparedness, training and satisfactory personal protective equipment during the pandemic however approximately 40.3 % experienced fear about attending work, and 49.8 % experienced mental health distress. The highest prevalence of burnout was emotional exhaustion (35.9 %). Three themes emerged from the qualitative analysis highlighting the holistic complexities in managing renal healthcare, a neglected specialist workforce, and the need for appropriate support at work during a pandemic. Conclusions Results have highlighted the psychological impact, in terms of emotional exhaustion and mental health distress in our sample of renal healthcare practitioners. As the pandemic has continued, it is important to consider the long-term impact on an already stretched workforce including the risk of developing mental health disorders. Future research and interventions are required to understand and improve the provision of psychological support for specialist medical and nursing personnel.

Background: The process to obtain valid informed consent in healthcare reflects many aspects. Healthcare professionals that take care of the patient must provide him all the necessary information and verify his understanding, considering individual characteristics. Nurses are one of the main participants in this process. Objective: This study assesses nurses’ perceptions of their role in the informed consent process. Material and Methods: An observational study involving 300 nurses operating in 13 wards of the Padua Hospital, through the submitting of a questionnaire in the period November–December 2018. Results: The final sample is made up of 206 nurses—27 males (13.11%) and 179 females (86.89%). Work experience, on average 15 years, is significant in determining the answers to questions about opinions and experiences. Age is significant in determining how often nurses provide information to the patient’s family members about the actions to be taken after discharge. The ward was decisive in the responses related to information provided to patients on the nursing care level and the actions to be taken after discharge, and the definition of the nurse’s duties. Conclusions: The data collected show the need for interventions to reduce the causes of difficult that the nurse has in informing patients.

Harvesting is one of the most important stages of the agricultural production process. However, the lack of monitoring during this operation and the absence of efficient methodologies to quantify losses have contributed to the decline in the quality of the operation. The objective of this study was to monitor mechanized soybean harvest by quantifying losses through two methodologies using statistical process control. The study was conducted in March 2016 in an agricultural area in the municipality of Ribeirão Preto, SP, using a John Deere harvester model 1470 with a tangential-type track system and separation by a straw-blower. The experimental design followed the standards established by statistical process control, and every 8 min of harvest, the total losses by the circular framework and rectangular framework methodologies were simultaneously quantified, totaling 40 points. Data were analyzed using descriptive statistics and statistical process control. The averages of the circular methodology framework were values above those found in the rectangular methodology framework, presenting greater representativeness of losses. The process was considered unable to maintain losses of soybeans at acceptable levels during mechanical harvest throughout the operation of the two frameworks. The circular framework for collecting samples at different locations resulted in higher reliability of data.

Background: Falls are recognized globally as a major public health problem. Although the elderly are the most affected population, it should be noted that the pediatric population is also very susceptible to the risk of falling. The fall risk approach is the assessment tool. There are different types of tools used in both clinical and territorial settings. Material and methods: In the month of January 2021, a literature search was undertaken of MEDLINE, CINHAL and The Cochrane Database, adopting as limits: last 10 years, abstract available, and English and Italian language. The search terms used were “Accidental Falls” AND “Risk Assessment” and “Fall Risk Assessment Tool” or “Fall Risk Assessment Tools”. Results: From the 115 selected articles, 38 different fall risk assessment tools were identified, divided into two groups: the first with the main tools present in the literature, and the second represented by tools of some specific areas, of lesser use and with less supporting literature. Most of these articles are prospective cohort or cross-sectional studies. All articles focus on presenting, creating or validating fall risk assessment tools. Conclusion: Due to the multidimensional nature of falling risk, there is no “ideal” tool that can be used in any context or that performs a perfect risk assessment. For this reason, a simultaneous application of multiple tools is recommended, and a direct and in-depth analysis by the healthcare professional is essential.

Nos últimos anos, acompanhamos uma democratização no acesso à universidade pública no país, o que permitiu a entrada de um novo perfil de aluno a esse ambiente antes povoado, quase que exclusivamente, pelos filhos das elites. Apesar deste importante passo em direção à superação das desigualdades sociais, diferenciações internas entre perfis permaneceram, refletindo, dentro das instituições, as desigualdades vivenciadas externamente. Esse artigo analisa o papel do programa Ciência sem Fronteiras na inclusão social de alunos de graduação (ex-bolsistas) da Unicamp, a partir da aplicação de uma metodologia que permitiu traçar o perfil dos beneficiários do programa de maneira interseccional. Os resultados revelam que, embora o programa contemple mecanismos que poderiam favorecer a inclusão social, na Unicamp, o programa continuou beneficiando um perfil muito específico de aluno - homem, branco, oriundo de escola particular no ensino médio, não beneficiário do Programa de Ação Afirmativa para Inclusão Social e sem necessidades especiais. Este também era o perfil mais frequente entre os programas já existentes de mobilidade internacional da instituição. Tais resultados reforçam a ideia de que a superação das desigualdades sociais e marginalidade por esse novo perfil de alunos não termina com o acesso à universidade e que existem outros obstáculos a serem superados.

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ObjectivesThe exact etiology of pruritus in chronic cholestasis is unknown. Pruritus intensity does not correlate with common biochemical indices and there is a lack of biomarkers guiding diagnosis and treatment. We explored profiles of bile acids (BA) and muricholic acids (MCA) as well as autotaxin (ATX) antigen levels as potential circulating biomarkers of pruritus in pediatric patients.MethodsIn 27 pediatric cholestatic patients [autoimmune sclerosing cholangitis (ASC) n = 20 (with pruritus n = 6, without pruritus n = 14); progressive familial intrahepatic cholestasis (PFIC) n = 7 (with pruritus n = 5, without pruritus n = 2)] and 23 age-matched controls pruritus was assessed by a visual analog scale of pruritus (PVAS). We obtained profiles of serum human BA including MCA using a mass-spectrometry assay and ATX antigen levels with a commercial ELISA.ResultsPFIC and ASC patients exhibited significantly higher BA-, and MCA levels, than healthy controls, but only PFIC patients showed elevated ATX antigen levels higher [median: 1,650 ng/ml, interquartile rang (IQR): 776.9–3,742] compared to controls (median: 315.9 ng/ml, IQR: 251.1–417.2; PFIC p = 0.0003). ASC patients with pruritus showed only a minor increase in total BA (tBA) levels (median: 76.5 μmol/L, IQR: 54.7–205), but strikingly higher T-conjugated BA (median: 16.4 μmol/L, IQR: 8.9–41.4) and total MCA (tMCA) (median: 1.15 μmol/L, IQR: 0.77–2.44) levels compared to ASC patients without pruritus (tBA median: 24.3 μmol/L, IQR: 16.2–80.8; p < 0.0408; T-conjugated BA median: 1.3 μmol/L, IQR: 0.8–4.9; p = 0.0023; tMCA median: 0.30 μmol/L, IQR: 0.13–0.64, p = 0.0033). BA/MCA profiles distinctly differed depending on presence/absence of pruritus. Different from PFIC patients, ATX antigen levels were not significantly elevated in ASC patients with (median: 665.8 ng/ml, IQR: 357.8–1,203) and without pruritus (median: 391.0 ng/ml, IQR: 283.2–485.6). In ASC patients, tBA, tMCA, and ATX antigen levels did not correlate with pruritus severity.ConclusionDespite the same underlying disease, pediatric ASC patients with pruritus exhibit significantly altered BA profiles and MCA levels compared to ASC patients without pruritus. ATX antigen levels seem to have little diagnostic or prognostic meaning in ASC patients. An increased ATX activity alone seems not to be causal for pruritus genesis in ASC patients.Clinical Trial Registration[www.drks.de], identifier [DRKS00026913].

The final shape and size of plant organs are determined by a network of genes that modulate cell proliferation and expansion. Among those, SCI1 (Stigma/style Cell-cycle Inhibitor 1) functions by inhibiting cell proliferation during pistil development. Alterations in SCI1 expression levels can lead to remarkable stigma/style size changes. Recently, we demonstrated that SCI1 starts to be expressed at the specification of the Nicotiana tabacum floral meristem and is expressed at all floral meristematic cells. To elucidate how SCI1 regulates cell proliferation, we screened a stigma/style cDNA library through the yeast two-hybrid (Y2H) system, using SCI1 as bait. Among the interaction partners, we identified the 14-3-3D protein of the Non-Epsilon group. The interaction between SCI1 and 14-3-3D was confirmed by pulldown and co-immunoprecipitation experiments. 14-3-3D forms homo- and heterodimers in the cytoplasm of plant cells and interacts with SCI1 in the nucleus, as demonstrated by Bimolecular Fluorescence Complementation (BiFC). Analyses of SCI1-GFP fluorescence through the cell-cycle progression revealed its presence in the nucleoli during interphase and prophase. At metaphase, SCI1-GFP fluorescence faded and was no longer detected at anaphase, reappearing at telophase. Upon treatment with the 26S proteasome inhibitor MG132, SCI1-GFP was stabilized during cell division. Site-directed mutagenesis of seven serines into alanines in the predicted 14-3-3 binding sites on the SCI1 sequence prevented its degradation during mitosis. Our results demonstrate that SCI1 degradation at the beginning of metaphase is dependent on the phosphorylation of serine residues and on the action of the 26S proteasome. We concluded that SCI1 stability/degradation is cell-cycle regulated, consistent with its role in fine-tuning cell proliferation.