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Article ; Online: The P-A-C-I-E-N-T-E Protocol: An instrument for breaking bad news adapted to the Brazilian medical reality.

Pereira, Carolina Rebello / Calônego, Marco Antônio Marchetti / Lemonica, Lino / Barros, Guilherme Antonio Moreira de

Revista da Associacao Medica Brasileira (1992)

2017 Volume 63, Issue 1, Page(s) 43–49

Abstract: ... nurses on the bad news communication techniques based on the P-A-C-I-E-N-T-E ("patient," in Portuguese ... considered the proposed P-A-C-I-E-N-T-E Protocol as a useful and appropriate communication tool ... Conclusion: The P-A-C-I-E-N-T-E Protocol proved to be suitable to the Brazilian context. ...

Abstract	Objective: There are plenty of published tools for breaking bad medical news; however, none of them is culturally appropriate to our reality or published in the Brazilian literature. This study proposes a genuinely Brazilian communication tool and evaluates its acceptance among doctors and nurses. Method: This was a prospective study. The data were collected after specific training of doctors and nurses on the bad news communication techniques based on the P-A-C-I-E-N-T-E ("patient," in Portuguese) Protocol. This instrument is in accordance with the Brazilian reality and was based on the SPIKES communication tool. Results: The worst task to be performed during communication is "talking about death" followed by "discussing the end of curative treatment attempts" and "diagnosis" itself. Among the respondents, 48% reported they did not receive formal training for communicating. Also, 52% of respondents do not use any systematic approach in their daily practice when communicating with patients, but 97% considered the proposed P-A-C-I-E-N-T-E Protocol as a useful and appropriate communication tool. Conclusion: The P-A-C-I-E-N-T-E Protocol proved to be suitable to the Brazilian context.
MeSH term(s)	Abbreviations as Topic ; Adult ; Attitude of Health Personnel ; Brazil ; Communication ; Cultural Competency ; Female ; Humans ; Male ; Middle Aged ; Physician-Patient Relations ; Prospective Studies ; Truth Disclosure
Language	English
Publishing date	2017-01-01
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	2027973-5
ISSN	1806-9282 ; 0104-4230
ISSN (online)	1806-9282
ISSN	0104-4230
DOI	10.1590/1806-9282.63.01.43
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Article ; Online: A Socioecological Examination of the Challenges Associated With Young Widowhood: A Systematic Review.

Barros-Lane, Liza / Germany, Andrea / Smith, Patricia / Stovall, Tyrian

Omega

2024 , Page(s) 302228241227996

Abstract: This systematic review employs a socio-ecological framework to investigate the challenges that arise due to early spousal loss. The research team conducted a systematic review of studies published between 2013 and 2023 to uncover factors that influence ... ...

Abstract	This systematic review employs a socio-ecological framework to investigate the challenges that arise due to early spousal loss. The research team conducted a systematic review of studies published between 2013 and 2023 to uncover factors that influence the grieving process in bereaved spouses. The results reveal that concurrent with the grief and devastation associated with partner loss, young widows and widowers also face a harsh reality filled with secondary losses, financial difficulty, mental health distress, emotional anguish, and identity crises. These hardships are exacerbated by social norms that disenfranchise the grief of young widows and widowers. These norms are then enacted interpersonally and codified in policy. The review's findings underscore the necessity for increased community grief education and support, focused clinical attention, and policy advocacy.
Language	English
Publishing date	2024-04-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	207363-8
ISSN	1541-3764 ; 0030-2228
ISSN (online)	1541-3764
ISSN	0030-2228
DOI	10.1177/00302228241227996
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Article ; Online: Thermodynamics of Soil Microbial Metabolism

Nieves Barros

Applied Sciences, Vol 11, Iss 4962, p

Applications and Functions

2021 Volume 4962

Abstract: The thermodynamic characterization of soils would help to study and to understand their strategies for survival, as well as defining their evolutionary state. It is still a challenging goal due to difficulties in calculating the thermodynamic state ... ...

Abstract	The thermodynamic characterization of soils would help to study and to understand their strategies for survival, as well as defining their evolutionary state. It is still a challenging goal due to difficulties in calculating the thermodynamic state variables (enthalpy, Gibbs energy, and entropy) of the reactions taking place in, and by, soils. Advances in instrumentation and methodologies are bringing options for those calculations, boosting the interest in this subject. The thermodynamic state variables involve considering the soil microbial functions as key channels controlling the interchange of matter and energy between soil and the environment, through the concept of microbial energy use efficiency. The role of microbial diversity using the energy from the soil organic substrates, and, therefore, the who, where, with whom, and why of managing that energy is still unexplored. It could be achieved by unraveling the nature of the soil organic substrates and by monitoring the energy released by the soil microbial metabolism when decomposing and assimilating those substrates. This review shows the state of the art of these concepts and the future impact of thermodynamics on soil science and on soil ecology.
Keywords	thermodynamics ; soil ; microbial metabolism ; microbial diversity ; Technology ; T ; Engineering (General). Civil engineering (General) ; TA1-2040 ; Biology (General) ; QH301-705.5 ; Physics ; QC1-999 ; Chemistry ; QD1-999
Language	English
Publishing date	2021-05-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
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Article ; Online: Unveiling the consequences of early human saliva contamination on membranes for guided bone regeneration.

Kunrath, Marcel F / Giraldo-Osorno, Paula Milena / Mendes, Karina / Gomes, Ana T P C / Rosa, Nuno / Barros, Marlene / Dahlin, Christer

Journal of periodontal research

2024

Abstract: ... significantly (p < .05) reduced following saliva interaction with biodegradable membranes. Saliva contamination ...

Abstract	Aims: GBR membranes have various surface properties designed to elicit positive responses in regenerative clinical procedures; dental clinicians attempt to employ techniques to prevent the direct interaction of contaminated oral fluids with these biomaterials. However, saliva is uninterruptedly exhibited in oral surgical procedures applying GBR membranes, suggesting a persistent interaction with biomaterials and the surrounding oral tissues. This fundamental study aimed to investigate potential alterations in the physical, chemical, and key biological properties of membranes for guided bone regeneration (GBR) caused by isolated early interaction with human saliva. Methods: A reproducible step-by-step protocol for collecting and interacting human saliva with membranes was developed. Subsequently, membranes were evaluated for their physicochemical properties, protein quantification, DNA, and 16S rRNA levels viability of two different cell lines at 1 and 7 days, and ALP activity. Non-interacted membranes and pure saliva of donors were applied as controls. Results: Qualitative morphological alterations were noticed; DNA extraction and 16S quantification revealed significantly higher values. Furthermore, the viability of HGF-1 and MC3T3-E1 cells was significantly (p < .05) reduced following saliva interaction with biodegradable membranes. Saliva contamination did not prejudice PTFE membranes significantly in any biological assay. Conclusions: These outcomes demonstrated a susceptible response of biodegradable membranes to isolated early human saliva interaction, suggesting impairment of structural morphology, reduced viability to HGF-1 and MC3T3-E1, and higher absorption/adherence of DNA/16S rRNA. As a result, clinical oral procedures may need corresponding refinements.
Language	English
Publishing date	2024-04-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	390953-0
ISSN	1600-0765 ; 0022-3484
ISSN (online)	1600-0765
ISSN	0022-3484
DOI	10.1111/jre.13266
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Zs.A 599: Show issues

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Article: Neurodegeneration, oxidative stress and lipid metabolism plasma biomarkers to differentiate Parkinson's disease from atypical parkinsonian syndromes.

Schneider, V / Vejux, A / Nury, T / Dupont, G / Pais de Barros, J P / Lakomy, D / Lizard, G / Moreau, T

Revue neurologique

2023 Volume 179, Issue 9, Page(s) 961–966

Abstract: ... group. Plasma levels of NFL, MDA and 24S-HC differed significantly between the APS and PD groups (P=0 ... 003; P=0.009; P=0.032, respectively). NFL, MDA and 24S-HC discriminated between PD and APS (AUC=0 ... 628nmol/mL (OR: 8.67, P=0.001), NFL level≥47.2pg/mL (OR: 11.92, P<0.001) or 24S-HC level≤33.4pmol/mL (OR ...

Abstract	Introduction: The identification of blood biomarkers appears to be a means of improving diagnosis accuracy in Parkinson's disease (PD) and atypical parkinsonian syndromes (APS). We, therefore, evaluate the performance of neurodegeneration, oxidative stress and lipid metabolism plasma biomarkers to distinguish PD from APS. Methods: This was a monocentric study with a cross-sectional design. Plasma levels and discriminating power of neurofilament light chain (NFL), malondialdehyde (MDA) and 24S-Hydroxycholesterol (24S-HC) were assessed in patients with clinical diagnoses of PD or APS. Results: In total, 32 PD cases and 15 APS cases were included. Mean disease durations were 4.75 years in PD group and 4.2 years in APS group. Plasma levels of NFL, MDA and 24S-HC differed significantly between the APS and PD groups (P=0.003; P=0.009; P=0.032, respectively). NFL, MDA and 24S-HC discriminated between PD and APS (AUC=0.76688; AUC=0.7375; AUC=0.6958, respectively). APS diagnosis significantly increased with MDA level≥23.628nmol/mL (OR: 8.67, P=0.001), NFL level≥47.2pg/mL (OR: 11.92, P<0.001) or 24S-HC level≤33.4pmol/mL (OR: 6.17, P=0.008). APS diagnosis considerably increased with the combination of NFL and MDA levels beyond cutoff values (OR: 30.67, P<0.001). Finally, the combination of NFL and 24S-HC levels, or MDA and 24S-HC levels, or all three biomarkers' levels beyond cutoff values systematically classified patients in the APS group. Conclusion: Our results suggest that 24S-HC and especially MDA and NFL could be helpful for differentiating PD from APS. Further studies will be needed to reproduce our findings on larger, prospective cohorts of patients with parkinsonism evolving for less than 3 years.
MeSH term(s)	Humans ; Parkinson Disease/diagnosis ; Parkinson Disease/metabolism ; Prospective Studies ; Cross-Sectional Studies ; Lipid Metabolism ; Parkinsonian Disorders/diagnosis ; Biomarkers ; Oxidative Stress
Chemical Substances	Biomarkers
Language	English
Publishing date	2023-06-14
Publishing country	France
Document type	Journal Article
ZDB-ID	4593-7
ISSN	2213-0004 ; 0035-3787
ISSN (online)	2213-0004
ISSN	0035-3787
DOI	10.1016/j.neurol.2022.12.015
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Article ; Online: Clinical outcomes of 77 TESE treatment cycles in non-mosaic Klinefelter syndrome patients.

Barros, Pedro / Cunha, Mariana / Barros, Alberto / Sousa, Mário / Dória, Sofia

JBRA assisted reproduction

2022 Volume 26, Issue 3, Page(s) 412–421

Abstract: ... Test, 2-sided, for rates, and the Independent Samples T-test for equality of means, 2-sided.: Results ... 63.5% vs. 41.6%, p=0.000), implantation (37% vs. 13.2%, p=0.014), clinical pregnancy (60.9% vs. 19 ... p=0.005) and live birth (65.2% vs. 23.8%, p=0.006) rates were higher with fresh testicular ...

Abstract	Objective: The current study aimed to present the clinical outcomes of 76 azoospermic patients with non-mosaic Klinefelter syndrome (KS), treated with testicular spermatozoa extraction (TESE) followed by intracytoplasmic sperm injection (ICSI) using either fresh or cryopreserved testicular spermatozoa. Methods: We retrospectively evaluated 76 patients with non-mosaic KS belonging to a special group of cases that besides infertility did not present the classical signs and symptoms of testosterone deficiency. One of the patients repeated the TESE procedure (76 patients, 77 TESE cycles). Sixty of these 76 patients accepted to undergo TESE associated with ovarian stimulation, while 16 patients underwent TESE followed by testicular spermatozoa cryopreservation. Aneuploidy screening of the offspring was performed by Multiplex ligation-dependent probe amplification and by amniotic fluid karyotyping. Statistical analysis used the Chi-Squared Test, Fisher's Exact Test, 2-sided, for rates, and the Independent Samples T-test for equality of means, 2-sided. Results: Testicular spermatozoa were recovered in 31 (40.3%) of the attempts. The patients underwent 47 ICSI cycles, 25 with fresh testicular spermatozoa and 22 with cryopreserved testicular spermatozoa. Fertilization (63.5% vs. 41.6%, p=0.000), implantation (37% vs. 13.2%, p=0.014), clinical pregnancy (60.9% vs. 19%, p=0.005) and live birth (65.2% vs. 23.8%, p=0.006) rates were higher with fresh testicular spermatozoa. Chromosome analysis of the 21 newborns was normal. Conclusions: The present data adds further information regarding the recovery rate of spermatozoa after TESE and the embryological and clinical outcomes with fresh and cryopreserved testicular spermatozoa, besides reassuring the safety concerning chromosomal transmission of KS from parents to their offspring.
MeSH term(s)	Female ; Humans ; Infant, Newborn ; Klinefelter Syndrome/genetics ; Klinefelter Syndrome/therapy ; Male ; Pregnancy ; Retrospective Studies ; Semen ; Sperm Retrieval ; Spermatozoa/physiology
Language	English
Publishing date	2022-08-04
Publishing country	Brazil
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2856226-4
ISSN	1518-0557 ; 1517-5693
ISSN (online)	1518-0557
ISSN	1517-5693
DOI	10.5935/1518-0557.20210081
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Article ; Online: Effect of different strategies for excluding duplicate cultures on the correlation between hospital resistance rates and antibiotic consumption.

Reyes Barros, Tomás / Gutiérrez Torres, Waldo / García Cañete, Patricia / Cerda Lorca, Jaime

The Journal of antimicrobial chemotherapy

2024 Volume 79, Issue 4, Page(s) 774–778

Abstract: ... duplicates from RRs affects the correlation of antibiotics consumption with RRs in P. aeruginosa. Including ...

Abstract	Introduction: Studies may underestimate the impact of antibiotics on bacterial resistance when correlating hospital antibiotic use with resistance rates (RRs) that exclude duplicate cultures as duplicates usually include more resistant isolates. Comparing correlations between antibiotic consumption and RRs resulting from different strategies for excluding duplicates could help explore how their exclusion affects such correlations. Methods: We obtained antibiotics consumption and Pseudomonas aeruginosa susceptibility data from 2017 to 2021 for seven antibiotics and for carbapenems as a group in a university hospital. We calculated RRs using seven different time criteria for excluding duplicates. We assessed the correlations of antibiotic consumption to the same-year and next-year RR rates for the three most distinct rates. Results: Duplicate cultures represented 53.45% of total cultures. RRs were higher when duplicates were included. We compared RRs resulting from excluding all duplicates, excluding duplicates monthly or admitting one culture per day. All antibiotics except meropenem showed a correlation with same-year RRs, either positive or negative, whereas all antibiotics showed a positive correlation with next-year RRs. For same-year and next-year correlations, the criteria with fewer duplicates (and therefore fewer resistant strains) found more correlations. However, the inclusion of duplicates taken at least 1 month apart found the most correlations. Admitting one culture per day found the fewest correlations. Conclusions: Excluding duplicates from RRs affects the correlation of antibiotics consumption with RRs in P. aeruginosa. Including at least some duplicate cultures in correlation analyses, such as those taken 1 month apart, should be considered.
MeSH term(s)	Humans ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Carbapenems/pharmacology ; Carbapenems/therapeutic use ; Meropenem/pharmacology ; Pseudomonas Infections/drug therapy ; Pseudomonas Infections/microbiology ; Hospitals ; Pseudomonas aeruginosa
Chemical Substances	Anti-Bacterial Agents ; Carbapenems ; Meropenem (FV9J3JU8B1)
Language	English
Publishing date	2024-02-09
Publishing country	England
Document type	Journal Article
ZDB-ID	191709-2
ISSN	1460-2091 ; 0305-7453
ISSN (online)	1460-2091
ISSN	0305-7453
DOI	10.1093/jac/dkae019
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Article: Anorectal melanoma: a rare entity.

Relvas, Luís Miguel / Gago, Tânia / Velasco, Francisco / Barros, Sónia / Carvalho, Isabel / Caldeira, Paulo

Revista espanola de enfermedades digestivas

2024

Abstract: Anorectal melanoma is a rare malignant tumor with the potential of simulating a benign anorectal disease, making its diagnosis difficult. We describe a case of anorectal melanoma, in which the interpretation of symptoms as hemorrhoidal disease delayed ... ...

Abstract	Anorectal melanoma is a rare malignant tumor with the potential of simulating a benign anorectal disease, making its diagnosis difficult. We describe a case of anorectal melanoma, in which the interpretation of symptoms as hemorrhoidal disease delayed diagnosis and appropriate intervention.
Language	English
Publishing date	2024-02-12
Publishing country	Spain
Document type	Journal Article
ZDB-ID	1070381-0
ISSN	1130-0108 ; 0212-7512
ISSN	1130-0108 ; 0212-7512
DOI	10.17235/reed.2024.10243/2024
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Article ; Online: Endovascular therapy for posterior cerebral artery occlusion: systematic review with meta-analysis.

Oliveira, Marta / Barros, Pedro / Rodrigues, Marta / Ribeiro, Manuel / Afreixo, Vera / Gregório, Tiago

Internal and emergency medicine

2024

Abstract: Endovascular therapy (EVT) is a highly effective stroke treatment, but trials validating this intervention did not include patients with posterior cerebral artery (PCA) occlusion. The aim of this systematic review with meta-analysis was to assess the ... ...

Abstract	Endovascular therapy (EVT) is a highly effective stroke treatment, but trials validating this intervention did not include patients with posterior cerebral artery (PCA) occlusion. The aim of this systematic review with meta-analysis was to assess the efficacy and safety of EVT for acute PCA occlusion. PubMed, Scopus, ISI, and CENTRAL were searched for studies assessing EVT in adult patients with PCA occlusion. Outcomes of interest were recanalization, symptomatic intracerebral haemorrhage (sICH), mortality, functional independence, and excellent functional outcome at 90 days. Frequencies and odds ratios (ORs) were pooled using random effect models and heterogeneity was measured using the I
Language	English
Publishing date	2024-04-11
Publishing country	Italy
Document type	Journal Article ; Review
ZDB-ID	2454173-4
ISSN	1970-9366 ; 1828-0447
ISSN (online)	1970-9366
ISSN	1828-0447
DOI	10.1007/s11739-024-03581-z
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Article ; Online: Exploring Optimization of Zeolites as Adsorbents for Rare Earth Elements in Continuous Flow by Machine Learning Techniques.

Barros, Óscar / Parpot, Pier / Neves, Isabel C / Tavares, Teresa

Molecules (Basel, Switzerland)

2023 Volume 28, Issue 24

Abstract: Unsupervised machine learning (ML) techniques are applied to the characterization of the adsorption of rare earth elements (REEs) by zeolites in continuous flow. The successful application of principal component analysis (PCA) and K-Means algorithms from ...

Abstract	Unsupervised machine learning (ML) techniques are applied to the characterization of the adsorption of rare earth elements (REEs) by zeolites in continuous flow. The successful application of principal component analysis (PCA) and K-Means algorithms from ML allowed for a wide range assessment of the adsorption results. This global approach permits the evaluation of the different stages of the sorption cycles and their optimization and improvement. The results from ML are also used for the definition of a regression model to estimate other REEs' recoveries based on the known values of the tested REEs. Overall, it was possible to remove more than 70% of all REEs from aqueous solutions during the adsorption assays and to recover over 80% of the REEs entrapped on the zeolites using an optimized desorption cycle.
Language	English
Publishing date	2023-12-06
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	1413402-0
ISSN	1420-3049 ; 1431-5165 ; 1420-3049
ISSN (online)	1420-3049
ISSN	1431-5165 ; 1420-3049
DOI	10.3390/molecules28247964
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