RESUMEN
Open, reproducible, and replicable research practices are a fundamental part of science. Training is often organized on a grassroots level, offered by early career researchers, for early career researchers. Buffet style courses that cover many topics can inspire participants to try new things; however, they can also be overwhelming. Participants who want to implement new practices may not know where to start once they return to their research team. We describe ten simple rules to guide participants of relevant training courses in implementing robust research practices in their own projects, once they return to their research group. This includes (1) prioritizing and planning which practices to implement, which involves obtaining support and convincing others involved in the research project of the added value of implementing new practices; (2) managing problems that arise during implementation; and (3) making reproducible research and open science practices an integral part of a future research career. We also outline strategies that course organizers can use to prepare participants for implementation and support them during this process.
RESUMEN
Eicosanoids are cellular metabolites, which shape the immune response, including inflammatory processes in macrophages. The effects of these lipid mediators on inflammation and bacterial pathogenesis are not clearly understood. Certain eicosanoids are suspected to act as molecular sensors for the recruitment of neutrophils, while others regulate bacterial uptake. In this study, gene expression analyses indicated that genes involved in eicosanoid biosynthesis including COX-1, COX-2, DAGL, and PLA-2 are differentially regulated in THP-1 human macrophages infected with Salmonella enterica Typhimurium or Yersinia enterocolitica. By using targeted metabolomics approach, we found that the eicosanoid precursor, arachidonic acid (AA) as well as its derivatives, including prostaglandins (PGs) PGF2α or PGE2/PGD2, and thromboxane TxB2, are rapidly secreted from macrophages infected with these Gram-negative pathogenic bacteria. The magnitude of eicosanoid biosynthesis in infected host cells depends on the presence of virulence factors of Y. enterocolitica and S. Typhimurium strains, albeit in an opposite way in Y. enterocolitica compared to S. Typhimurium infection. Trials with combinations of EP2/EP4 PGE2 receptor agonists and antagonists suggest that PGE2 signaling in these infection models works primarily through the EP4 receptor. Downstream of EP4 activation, PGE2 enhances inflammasome activation and represses M2 macrophage polarization while inducing key M1-type markers. PGE2 also led to a decreased numbers of Y. enterocolitica within macrophages. To summarize, PGE2 is a potent autocrine/paracrine activator of inflammation during infection in Gram-negative bacteria, and it affects macrophage polarization, likely controlling bacterial clearance by macrophages.
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In paediatric clinical care, what is said to a parent or carer as well as when, where, and how it is said, directly advances or diminishes parents' capacities to understand available options and to contribute to decisions about treatment for their child. This makes interprofessional and patient communication an ethical endeavour. Social workers are uniquely situated to observe, participate in, and provide an active link in the communication between families and other health team members. This article reports phenomenological research exploring ethical issues encountered by social workers in their everyday practice communicating with families and other health professionals in a paediatric hospital context in Australia. Data were collected via semi-structured interviews with nine social workers and analysed thematically. Participants described two main communication-based roles: to support families through information provision and to contribute collaboratively to the interprofessional team involved in caring for a child and family. We grouped participants' descriptions of conflict between these roles into five main "communication challenges": (1) holding troublesome knowledge; (2) the need for diplomacy; (3) conciliation; (4) every man and his dog in family meetings; and (5) systems and processes presenting a brick wall. The five communication challenges provide empirically derived examples of how communication occurring within interprofessional health teams and between individual clinicians and parents can act to diminish or enhance parents' experience of care for their hospitalised child. Identifying these challenges may help to inform how communication within interprofessional teams and between clinicians and patients can benefit children and their parents.
Asunto(s)
Comunicación , Hospitales Pediátricos/ética , Hospitales Pediátricos/organización & administración , Relaciones Interprofesionales , Servicio Social , Adulto , Australia , Familia/psicología , Femenino , Procesos de Grupo , Humanos , Persona de Mediana Edad , Grupo de Atención al Paciente , Relaciones Profesional-Familia , Investigación CualitativaAsunto(s)
Accidentes de Tránsito , Airbags/efectos adversos , Quemaduras Químicas/etiología , Conjuntiva/lesiones , Conjuntivitis/etiología , Quemaduras Oculares/inducido químicamente , Hidróxido de Sodio , Anciano , Antibacterianos/administración & dosificación , Antioxidantes/administración & dosificación , Ácido Ascórbico/administración & dosificación , Quemaduras Químicas/diagnóstico , Quemaduras Químicas/tratamiento farmacológico , Cloranfenicol/administración & dosificación , Conjuntivitis/diagnóstico , Conjuntivitis/tratamiento farmacológico , Edema Corneal/diagnóstico , Edema Corneal/tratamiento farmacológico , Edema Corneal/etiología , Quemaduras Oculares/diagnóstico , Quemaduras Oculares/tratamiento farmacológico , Femenino , Glucocorticoides/administración & dosificación , Humanos , Lubricantes/administración & dosificación , Masculino , Soluciones Oftálmicas/administración & dosificación , Prednisolona/administración & dosificación , Prednisolona/análogos & derivadosAsunto(s)
Fascitis/diagnóstico por imagen , Seno Frontal/patología , Enfermedades Orbitales/diagnóstico por imagen , Enfermedades de los Senos Paranasales/diagnóstico por imagen , Niño , Diagnóstico Diferencial , Diplopía/diagnóstico , Exoftalmia/diagnóstico , Fascitis/patología , Fascitis/cirugía , Hueso Frontal/patología , Humanos , Imagen por Resonancia Magnética , Masculino , Enfermedades Orbitales/patología , Enfermedades Orbitales/cirugía , Enfermedades de los Senos Paranasales/patología , Enfermedades de los Senos Paranasales/cirugía , Tomografía Computarizada por Rayos X , Agudeza Visual/fisiologíaAsunto(s)
Úlcera de la Córnea/etnología , Infecciones Bacterianas del Ojo/etnología , Infecciones Fúngicas del Ojo/etnología , Nativos de Hawái y Otras Islas del Pacífico/etnología , Adulto , Australia/epidemiología , Bacterias/aislamiento & purificación , Córnea/microbiología , Úlcera de la Córnea/microbiología , Infecciones Bacterianas del Ojo/microbiología , Infecciones Fúngicas del Ojo/microbiología , Femenino , Estudios de Seguimiento , Hongos/aislamiento & purificación , Humanos , Masculino , Estudios Retrospectivos , Factores de Riesgo , Agudeza Visual/fisiologíaAsunto(s)
Absceso/microbiología , Infecciones Bacterianas del Ojo/microbiología , Nocardiosis/microbiología , Nocardia/aislamiento & purificación , Enfermedades de la Retina/microbiología , Absceso/diagnóstico , Absceso/tratamiento farmacológico , Anciano de 80 o más Años , Amicacina/uso terapéutico , Antibacterianos/uso terapéutico , Absceso Encefálico/diagnóstico , Absceso Encefálico/tratamiento farmacológico , Absceso Encefálico/microbiología , Ceftriaxona/uso terapéutico , Quimioterapia Combinada , Infecciones Bacterianas del Ojo/diagnóstico , Infecciones Bacterianas del Ojo/tratamiento farmacológico , Humanos , Imagen por Resonancia Magnética , Masculino , Pruebas de Sensibilidad Microbiana , Nativos de Hawái y Otras Islas del Pacífico , Nocardiosis/diagnóstico , Nocardiosis/tratamiento farmacológico , Enfermedades de la Retina/diagnóstico , Enfermedades de la Retina/tratamiento farmacológico , Combinación Trimetoprim y Sulfametoxazol/uso terapéutico , VitrectomíaRESUMEN
BACKGROUND: Re-operative surgery is stressful for patients and is an additional burden to an already stretched public health system. Intraoperative confirmation of breast cancer metastases in sentinel lymph nodes (SLNs) provides the necessary information for the surgeon to proceed with immediate axillary dissection, avoiding the need for a second operation, its associated cost, morbidity and adjuvant treatment delays. Our challenge was to implement a technique that was rapid, inexpensive and had a negligible false positive rate. The aim of this study was to determine whether touch imprint cytology (TIC) could reduce returns to theatre without compromising patient safety and pathology department and operating theatre efficiency. METHODS: Intraoperative TIC was performed on bisected SLNs from 134 patients. Post-operatively, specimens were examined as haematoxylin and eosin-stained, paraffin-embedded 2-mm sections. Further sectioning and immunohistochemisty was performed on negative SLNs. RESULTS: The sensitivity of TIC for metastases was 23.8%, the specificity was 100% and the accuracy was 76.1%. Ten patients with macrometastases and none with micrometastastes were detected intraoperatively. The sensitivity of TIC for detecting macrometastases was 34.5%, the accuracy was 78.4% and the specificity was 100%. CONCLUSION: Ten patients avoided a subsequent surgery. The technique caused no theatre delays and the minimal cost was compensated for by the avoidance of a second procedure for a third of patients who definitively required axillary clearance. No patients had an unnecessary axillary clearance and no patients with micrometastases or isolated tumour cells were subjected to an immediate axillary clearance. It would be justifiable to continue this simple, low-cost and non-disruptive approach.