[Implementation of nurse practioner role in an emergency department].

The major challenges facing our healthcare system foster the emergence of new inter-professional roles such as the Specialized Nurse Practitioner. These professionals, recognized by a legal framework, hold advanced practice medical and nursing skills obtained after a 120-credit Master's-level university training. In 2018, the Emergency Department (ED) of the Centre Hospitalier Universitaire Vaudois was one of the first departments in Switzerland to implement such a role.

Digital Coaching to Address Health, Wellness, and Burnout Among Healthcare Workers: Pilot Study Results.

Background: Healthcare worker (HCW) well-being is essential for safe, high-quality patient care, but clinicians and front-line staff continue to experience alarming rates of burnout. This pilot study evaluated a novel 6-week program of remote wellness coaching supported by daily digital messaging to reduce burnout and increase well-being among HCWs.

Methods: In spring 2023, staff from a large community health center in California were invited to participate in this single-group pretest-posttest study in an academic-practice partnership.

Guidelines for the use and interpretation of Alzheimer's disease biomarkers in clinical practice in Brazil: recommendations from the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology.

In recent years, the diagnostic accuracy of Alzheimer's disease has been enhanced by the development of different types of biomarkers that indicate the presence of neuropathological processes. In addition to improving patient selection for clinical trials, biomarkers can assess the effects of new treatments on pathological processes. However, there is concern about the indiscriminate and poorly supported use of biomarkers, especially in asymptomatic individuals or those with subjective cognitive decline.

Use of anti-amyloid therapies for Alzheimer's disease in Brazil: a position paper from the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology.

Novel therapies for Alzheimer's disease, particularly anti-amyloid drugs like lecanemab and donanemab, have shown modest clinical benefits but also significant risks. The present paper highlights the challenges of access to diagnosis, cost-effectiveness, safety, and the need for more representation of diverse populations in clinical trials. Recommendations include careful patient selection, risk-benefit analysis, and the importance of proven amyloid pathology for treatment.

"Minho Technique" for Laparoscopic Radical Cystectomy with Intracorporeal Ileal Conduit.

Objective: Radical cystectomy (RC) with ileal conduit (IC) remains a main treatment for muscle-invasive bladder cancer (MIBC). Laparoscopy in this multistage surgery is quite demanding, so laparoscopic RC (LRC) with intracorporeal IC (IIC) is a technically exceptional procedure. We aim to simplify it, demonstrating our technique, step-by-step.

Prediction of Successful Amorphous Solid Dispersion Pairs through Liquid State Nuclear Magnetic Resonance.

Amorphous solid dispersions (ASDs) function in part via a "parachute effect", i.e., polymer-enabled prolonged drug supersaturation, presumably through drug-polymer interactions in the liquid state.

Comparisons of cumulative live birth rates after embryo transfers at day 2/3 versus day 5/6: a French national study.

Research Question: Are there significant differences between cumulative live birth rates (CLBR) after short or extended embryo culture when comparisons are performed per cycle?

Design: This French national study included all IVF cycles performed from January 2016 to December 2019 with at least one cleaved embryo at day 2. The day 2/3 and day 5/6 groups were identified using the National Biomedicine Agency register. Only attempts involving the vitrification method were included.

Beyond COP28: Brazil must act to tackle the global climate and biodiversity crisis.

Extreme weather has made 2023 virtually certain to be the warmest year on record, signaling unprecedented climate and biodiversity crises. Brazil, the world’s most biodiverse country, with two hotspots and complex social and economic layers, has experienced escalating environmental degradation over the past years. Alarming rates of native vegetation loss, wildfires, severe and prolonged droughts, and heatwaves have adversely impacted several Brazilian ecosystems and societies.

Amyloid profile is associated with sleep quality in preclinical but not in prodromal Alzheimer's disease older adults.

Background: Few studies have assessed whether neuropathological markers of AD in the preclinical and prodromal stages are associated with polysomnographic changes and obstructive sleep apnea (OSA).

Methods: This was a cross-sectional, case-control study of older adults (≥60 years) without relevant clinical and psychiatric comorbidities selected randomly from a cohort of individuals without dementia in a tertiary university hospital in São Paulo, Brazil. They underwent neuropsychological evaluation for clinical diagnosis and were allocated into two samples: cognitively unimpaired (CU) and mild cognitive impairment (MCI).

Young-Onset Alzheimer Dementia Due to a Novel Pathogenic Variant Initially Misdiagnosed as Autoimmune Encephalitis.

Objectives: Pathogenic variants in presenilin 1 are related to early-onset Alzheimer disease (AD) and may occur as de novo variants. In comparison with sporadic forms, it can present with psychiatric manifestations, seizures, myoclonus, and focal presentation. Because PSEN1 can occur in young patients who lack a family history of neurologic disorders and because these symptoms are also frequent in autoimmune encephalitis (AE), diagnosis may be overlooked.

Teeth and alveolar bones as tracers of metals and radionuclides in inhabitants of a uranium region.

Biodosimetry can define risks in inhabitants of areas with potential contaminants, ensuring environmental protection and living conditions due to toxic and radioactive effects. This study aimed to evaluate metals and radionuclides in dental structures and alveolar bones in residents of a uranium area in Paraíba and Pernambuco, Brazil. Eighty-nine specimens were pulverized, fractionated, and chemically prepared for analysis by EDXRF, FAAS, and ICP-MS.

O armário: Fruiting phenology data for 4,462 plant taxa in Portugal (1926-2013).

Species phenology - the timing of key life events - is being altered by ongoing climate changes with yet underappreciated consequences for ecosystem stability. While flowering is generally occurring earlier, we know much less about other key processes such as the time of fruit ripening, largely due to the lack of comprehensive long-term datasets. Here we provide information on the exact date and site where seeds of 4,462 taxa were collected for the Index Seminum (seed exchange catalogue) of the Botanic Garden of the University of Coimbra, between 1926 and 2013.

Conformational Dynamic Studies of Prokaryotic Potassium Channels Explored by Homo-FRET Methodologies.

Fluorescence techniques have been widely used to shed light over the structure-function relationship of potassium channels for the last 40-50 years. In this chapter, we describe how a Förster resonance energy transfer between identical fluorophores (homo-FRET) approach can be applied to study the gating behavior of the prokaryotic channel KcsA. Two different gates have been described to control the K flux across the channel's pore, the helix-bundle crossing and the selectivity filter, located at the opposite sides of the channel transmembrane section.

Relative Performance of Volume of Distribution Prediction Methods for Lipophilic Drugs with Uncertainty in LogP Value.

Purpose: The goal was to assess, for lipophilic drugs, the impact of logP on human volume of distribution at steady-state (VD) predictions, including intermediate fut and Kp values, from six methods: Oie-Tozer, Rodgers-Rowland (tissue-specific Kp and only muscle Kp), GastroPlus, Korzekwa-Nagar, and TCM-New.

Method: A sensitivity analysis with focus on logP was conducted by keeping pKa and fup constant for each of four drugs, while varying logP. VD was also calculated for the specific literature logP values.

Aortitis and Recurrent Staphylococcus aureus Bacteremia.

Infectious aortitis is a rare entity with high mortality and should be considered in the presence of persistent bacteremia, especially in the absence of endocarditis. We present the clinical case of a woman who developed aortitis due to methicillin-sensitive , complicated with mycotic aneurysm and recurrent bacteremia, even under appropriate treatment. Given the concomitant probable diagnosis of malignant pancreatic neoplasia, the hypothesis of a possible relationship or contribution to bacteremia is raised.

Percutaneous nephrostomy versus ureteral stent in hydronephrosis secondary to obstructive urolithiasis: A systematic review and meta-analysis.

Objective: To assess if there is a preferable intervention between retrograde ureteral stent (RUS) and percutaneous nephrostomy (PCN) tube, in cases of upper urinary tract stone obstruction with complications requiring urgent drainage, by evaluating outcomes regarding urinary symptoms, quality of life (QoL), spontaneous stone passage, and length of hospital stays, since there is no literature stating the superiority of one modality over the other.

Methods: We searched MEDLINE and other sources for relevant articles in June 2019 without any date restrictions or filters applied. The selection was done first by the title and abstract screening and then by full-text assessment for eligibility.

Unveiling the Nuances of Adult Female Acne: A Comprehensive Exploration of Epidemiology, Treatment Modalities, Dermocosmetics, and the Menopausal Influence.

Previously considered a skin disease exclusively affecting adolescents, characterized by inflammatory and non-inflammatory skin lesions, acne vulgaris is now increasingly observed in adult life, including post-menopause. Today, adult female acne (AFA) is a common chronic inflammatory disease of the pilosebaceous unit, with polymorphic lesions presenting as open or closed comedones, papules, pustules, and even nodules or cysts, often with the presence of sequelae. AFA may persist from adolescence or manifest de novo in adulthood.

Cortical microinfarcts in adults with Down syndrome assessed with 3T-MRI.

Background: Cortical microinfarcts (CMI) were attributed to cerebrovascular disease and cerebral amyloid angiopathy (CAA). CAA is frequent in Down syndrome (DS) while hypertension is rare, yet no studies have assessed CMI in DS.

Methods: We included 195 adults with DS, 63 with symptomatic sporadic Alzheimer's disease (AD), and 106 controls with 3T magnetic resonance imaging.

Arginine Supplementation in MELAS Syndrome: What Do We Know about the Mechanisms?

MELAS syndrome, characterized by mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes, represents a devastating mitochondrial disease, with the stroke-like episodes being its primary manifestation. Arginine supplementation has been used and recommended as a treatment for these acute attacks; however, insufficient evidence exists to support this treatment for MELAS. The mechanisms underlying the effect of arginine on MELAS pathophysiology remain unclear, although it is hypothesized that arginine could increase nitric oxide availability and, consequently, enhance blood supply to the brain.

INSL3 Variation in Dogs Following Suppression and Recovery of the HPG Axis.

Insulin-like peptide 3 (INSL3) is a constitutive product of mature, adult-type Leydig cells of the testes and consequently in most mammals is an ideal biomarker with which to monitor pubertal development. A new heterologous time-resolved fluorescence immunoassay was developed and validated to measure circulating INSL3 in the blood of adult male dogs. Compared to other species, INSL3 concentration is low with marked variation between individuals, which appears to be independent of breed, age, or weight.

Prognostic Value of Preoperative Electrocardiogram in Low-Risk Patients Undergoing Surgical Intervention and General Anesthesia.

Background: Patients aged over 50 years require four times more surgical interventions than younger groups. Many guidelines recommend the performance of preoperative electrocardiogram (ECG) in this population.

Objectives: To determine the value of preoperative ECG in patients aged over 50 years and classified as ASA I-II (surgical risk).