La experiencia de los pacientes que necesitan trasplante renal en espera de un órgano compatible

The aim of this study was to understand the experience of patients with chronic renal failure, who were included in a list of subjects waiting for a kidney transplant. This is an exploratory, descriptive, and qualitative study, with phenomenology as theoretical basis. Twenty patients have undergone hemodialysis as a renal replacement therapy. These subjects were active while they waited for a kidney transplant. Analysis of material obtained in this study allowed us to understand the fear and insecurity of these patients in view of both dialysis treatment and the possibility that a compatible donor is not found. They have shown faith strength and courage while using self-care to stay well when transplanting arrived. They idealized a new life, a fresh start, away from the machine for hemodialysis. The present study has detected a need for monitoring, by an interdisciplinary team, of patients included in waiting lists in order to help them experiencing such wait.El estudio tuvo como objetivo comprender la vivencia del paciente con insuficiencia renal crónica en lista de espera por un trasplante renal. Tratase de una pesquisa exploratoria, descriptiva de naturaleza cualitativa, que uso como referencial teórico la fenomenología. Los sujetos del estudio fueron veinte pacientes sometidos a hemodiálisis como terapia substitutiva, que esperaban en la lista por un trasplante renal y que estaban activos en la lista de espera. El análisis del material obtenido nos permitió entender el miedo y la inseguridad de los pacientes ante la diálisis y la posibilidad de encontrar un donante compatible. Revelando fuerza y coraje, a través de auto cuidado de mantener bien a la llegada del trasplante. La elaboración de una nueva vida, un nuevo comienzo alejado de la máquina de hemodiálisis. El presente estudio ha revelado la necesidad de acompañamiento del paciente en lista por el equipo interdisciplinario para ayudarle a vivenciar esa espera.O estudo teve como objetivo compreender a vivência do paciente com insuficiência renal crônica em lista de espera por um transplante renal. Trata-se de uma pesquisa exploratória, descritiva, de natureza qualitativa, tendo como referencial teórico a fenomenologia. Os sujeitos do estudo foram vinte pacientes submetidos à hemodiálise como terapia renal substutiva, que aguardavam em lista por um transplante e que estavam ativos na lista de espera. A análise do material obtido possibilitou compreender o medo e a insegurança dos pacientes diante do tratamento dialítico e da possibilidade de não encontrar um doador compatível. Revelando força e coragem, por meio do autocuidado em manter-se bem para a chegada do transplante. Idealizando uma nova vida, um recomeço longe da máquina de hemodiálise. O presente estudo revelou a necessidade de acompanhamento do paciente em lista de espera por equipe interdisciplinar, no sentido de auxiliá-lo a vivenciar essa espera.UNIDAVIHospital Maria AuxiliadoraUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de EnfermagemUNIFESP Escola Paulista de EnfermagemUNIFESP, Escola Paulista de Enfermagem (EPE)UNIFESP, EPESciEL

Collectively Improving Our Teaching: Attempting Biology Department–wide Professional Development in Scientific Teaching

Many efforts to improve science teaching in higher education focus on a few faculty members at an institution at a time, with limited published evidence on attempts to engage faculty across entire departments. We created a long-term, department-wide collaborative professional development program, Biology Faculty Explorations in Scientific Teaching (Biology FEST). Across 3 years of Biology FEST, 89% of the department's faculty completed a weeklong scientific teaching institute, and 83% of eligible instructors participated in additional semester-long follow-up programs. A semester after institute completion, the majority of Biology FEST alumni reported adding active learning to their courses. These instructor self-reports were corroborated by audio analysis of classroom noise and surveys of students in biology courses on the frequency of active-learning techniques used in classes taught by Biology FEST alumni and nonalumni. Three years after Biology FEST launched, faculty participants overwhelmingly reported that their teaching was positively affected. Unexpectedly, most respondents also believed that they had improved relationships with departmental colleagues and felt a greater sense of belonging to the department. Overall, our results indicate that biology department-wide collaborative efforts to develop scientific teaching skills can indeed attract large numbers of faculty, spark widespread change in teaching practices, and improve departmental relations

Rheumatoid arthritis - treatment: 180. Utility of Body Weight Classified Low-Dose Leflunomide in Japanese Rheumatoid Arthritis

Background: In Japan, more than 20 rheumatoid arthritis (RA) patients died of interstitial pneumonia (IP) caused by leflunomide (LEF) were reported, but many of them were considered as the victims of opportunistic infection currently. In this paper, efficacy and safety of low-dose LEF classified by body weight (BW) were studied. Methods: Fifty-nine RA patients were started to administrate LEF from July 2007 to July 2009. Among them, 25 patients were excluded because of the combination with tacrolimus, and medication modification within 3 months before LEF. Remaining 34 RA patients administered 20 to 50 mg/week of LEF were followed up for 1 year and enrolled in this study. Dose of LEF was classified by BW (50 mg/week for over 50 kg, 40 mg/week for 40 to 50 kg and 20 to 30 mg/week for under 40 kg). The average age and RA duration of enrolled patients were 55.5 years old and 10.2 years. Prednisolone (PSL), methotrexate (MTX) and etanercept were used in 23, 28 and 2 patients, respectively. In case of insufficient response or adverse effect, dosage change or discontinuance of LEF were considered. Failure was defined as dosages up of PSL and MTX, or dosages down or discontinuance of LEF. Last observation carried forward method was used for the evaluation of failed patients at 1 year. Results: At 1 year after LEF start, good/ moderate/ no response assessed by the European League Against Rheumatism (EULAR) response criteria using Disease Activity Score, including a 28-joint count (DAS28)-C reactive protein (CRP) were showed in 14/ 10/ 10 patients, respectively. The dosage changes of LEF at 1 year were dosage up: 10, same dosage: 5, dosage down: 8 and discontinuance: 11 patients. The survival rate of patients in this study was 23.5% (24 patients failed) but actual LEF continuous rate was 67.6% (11 patients discontinued) at 1 year. The major reason of failure was liver dysfunction, and pneumocystis pneumonia was occurred in 1 patient resulted in full recovery. One patient died of sepsis caused by decubitus ulcer infection. DAS28-CRP score was decreased from 3.9 to 2.7 significantly. Although CRP was decreased from 1.50 to 0.93 mg/dl, it wasn't significant. Matrix metalloproteinase (MMP)-3 was decreased from 220.0 to 174.2 ng/ml significantly. Glutamate pyruvate transaminase (GPT) was increased from 19 to 35 U/l and number of leukocyte was decreased from 7832 to 6271 significantly. DAS28-CRP, CRP, and MMP-3 were improved significantly with MTX, although they weren't without MTX. Increase of GPT and leukopenia were seen significantly with MTX, although they weren't without MTX. Conclusions: It was reported that the risks of IP caused by LEF in Japanese RA patients were past IP history, loading dose administration and low BW. Addition of low-dose LEF is a potent safe alternative for the patients showing unsatisfactory response to current medicines, but need to pay attention for liver function and infection caused by leukopenia, especially with MTX. Disclosure statement: The authors have declared no conflicts of interes

Photography-based taxonomy is inadequate, unnecessary, and potentially harmful for biological sciences

The question whether taxonomic descriptions naming new animal species without type specimen(s) deposited in collections should be accepted for publication by scientific journals and allowed by the Code has already been discussed in Zootaxa (Dubois & Nemésio 2007; Donegan 2008, 2009; Nemésio 2009a–b; Dubois 2009; Gentile & Snell 2009; Minelli 2009; Cianferoni & Bartolozzi 2016; Amorim et al. 2016). This question was again raised in a letter supported by 35 signatories published in the journal Nature (Pape et al. 2016) on 15 September 2016. On 25 September 2016, the following rebuttal (strictly limited to 300 words as per the editorial rules of Nature) was submitted to Nature, which on 18 October 2016 refused to publish it. As we think this problem is a very important one for zoological taxonomy, this text is published here exactly as submitted to Nature, followed by the list of the 493 taxonomists and collection-based researchers who signed it in the short time span from 20 September to 6 October 2016

Die Keimbelastung von wiederaufbereitbaren Desinfektionsmitteltuchspendersystemen zur Flächendesinfektion an der Universitätsklinik Ulm

Die Flächendesinfektion spielt zur Vermeidung von nosokomialen Infektionen im Krankenhaus eine immer größer werdende Rolle. Hierzu werden von der Industrie wiederaufbereitbare Desinfektionsmitteltuchspendersysteme angeboten, die sich dank einfachen, praktischen und zeitsparenden Handlings auch beim Klinikpersonal immer größerer Beliebtheit erfreuen und dadurch die Compliance bei der Flächendesinfektion fördern. Um die Sicherheit in der Anwendung der o.g. gebrauchsfertigen Desinfektionsmitteltücher zu kontrollieren, wurden diese am Uniklinikum Ulm auf die bakterielle Kontamination untersucht. Hierbei wurden jeweils das oberste Vliestuch des Spenders mittels Abklatschpräparat und die im Eimer befindliche Desinfektionsmittellösung (Glucoprotamin, quartäre Ammoniumverbindungen oder Alkohol) mittels Filtration und Bebrüten auf Keimbelastung analysiert. Ein Wachstum von Umgebungskeimen (Aerobe Sporenbilder, Mikrokokken, Koagulase negative Staphylokokken, Corynebakterien und einmal Staphylokokkus aureus) konnte in 27,3% der Abklatschpräparate und in 4,6% der Desinfektionsmittellösungen nachgewiesen werden. Multiresistente oder gramnegative Erreger wurden nicht nachgewiesen. Eine Kontamination trat gehäuft in offenen oder falsch verschlossenen (26,1%), bzw. bei nicht oder nicht lesbar beschrifteten Tuchspendern (35,4%) auf (gegenüber 19,8% der korrekt benutzten Tuchspendern). Daher lässt sich als erster und größter Optimierungsfaktor der Umgang des Personals mit den wiederaufbereitbaren Desinfektionsmitteltuchspendern zur Flächendesinfektion nennen, um das Risiko von nosokomialen Infektionen weiter zu senken.For the prevention of nosocomial infection in hospitals, surface disinfection plays an ever increasing role. Industry offers reusable dispensers for surface disinfection wipes. These dispensers provide convenience and practicality that have earned them popularity among clinical nursing staff, thereby supporting compliance with environmental disinfection. To control reliability and safety during handling of above mentioned disinfection-wipes, the tissues were tested for bacterial contamination. The first wipe of the dispenser was, in each case, probed with a contact plate, and the disinfection agent (glucoprotamin, quaternary ammonium compounds or alcohol) was checked by filtration and incubation for signs of germs. In 27.3% of the contact plates and in 4.6% of the disinfection agents, growth of environmental germs (aerobic spore forming bacteria, micrococci, KNS, corynebacteria and, in one case, staphylococcus aureus) were found. Multiresistant or gram-negative germs were not found. Bacterial contamination accumulated in open or improperly closed dispensers (26.1%), as well as in unlabeled or indecipherable dispensers (35.4%) (compared to the bacterial contamination found in 19.8% of correctly used dispensers). Thus, the largest and foremost factor in reducing the risk of nosocomial infections is the clinical staff's handling of the reusable dispensers for surface disinfection wipes

Soil Metabolomics Predict Microbial Taxa as Biomarkers of Moisture Status in Soils from a Tidal Wetland

We present observations from a laboratory-controlled study on the impacts of extreme wetting and drying on a wetland soil microbiome. Our approach was to experimentally challenge the soil microbiome to understand impacts on anaerobic carbon cycling processes as the system transitions from dryness to saturation and vice-versa. Specifically, we tested for impacts on stress responses related to shifts from wet to drought conditions. We used a combination of high-resolution data for small organic chemical compounds (metabolites) and biological (community structure based on 16S rRNA gene sequencing) features. Using a robust correlation-independent data approach, we further tested the predictive power of soil metabolites for the presence or absence of taxa. Here, we demonstrate that taking an untargeted, multidimensional data approach to the interpretation of metabolomics has the potential to indicate the causative pathways selecting for the observed bacterial community structure in soils