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Pressure ulcers (PUs) develop as a result of immobility. While PU incidence is largely associated with the elderly, or those with neurological impairment, there has been an increasing awareness that women in labour are equally at risk of PU development. In particular, those women who have had an epidural are often required to spend long periods of time immobile and with reduced or absent sensation. It has been suggested that sensory loss is a more important risk factor in PU development than paralysis. However, in many establishments the provision of mattresses for this client group would appear to be inadequate, with the women being nursed on marble-covered NHS mattresses. This product focus describes how the need for pressure reducing mattresses that could also manage the other requirements of a birthing mattress, led to the development of the Medical Support Systems Ltd maternity mattress. [ABSTRACT FROM AUTHOR]

Whole-genome duplications (WGD) have been considered as springboards that potentiate lineage diversification through increasing functional redundancy. Divergence in gene regulatory elements is a central mechanism for evolutionary diversification, yet the patterns and processes governing regulatory divergence following events that lead to massive functional redundancy, such as WGD, remain largely unknown. We studied the patterns of divergence and strength of natural selection on regulatory elements in the Atlantic salmon (Salmo salar) genome, which has undergone WGD 100-80 Ma. Using ChIPmentation, we first show that H3K27ac, a histone modification typical to enhancers and promoters, is associated with genic regions, tissue-specific transcription factor binding motifs, and with gene transcription levels in immature testes. Divergence in transcription between duplicated genes from WGD (ohnologs) correlated with difference in the number of proximal regulatory elements, but not with promoter elements, suggesting that functional divergence between ohnologs after WGD is mainly driven by enhancers. By comparing H3K27ac regions between duplicated genome blocks, we further show that a longer polyploid state post-WGD has constrained regulatory divergence. Patterns of genetic diversity across natural populations inferred from resequencing indicate that recent evolutionary pressures on H3K27ac regions are dominated by largely neutral evolution. In sum, our results suggest that post-WGD functional redundancy in regulatory elements continues to have an impact on the evolution of the salmon genome, promoting largely neutral evolution of regulatory elements despite their association with transcription levels. These results highlight a case where genome-wide regulatory evolution following an ancient WGD is dominated by genetic drift., (© The Author(s) 2021. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.)

Background: Analysis of cell-free fetal DNA in maternal plasma is very promising for early diagnosis of monogenic diseases. However, it has been limited by the need to set up patient- or disease-specific custom-made approaches. Here we propose a universal test based on fluorescent multiplex PCR and size fragment analysis for an indirect diagnosis of cystic fibrosis (CF)., Methods: The test, based on haplotyping, includes nine intra- and extragenic short tandem repeats of the CFTR locus, the coamplification of p.Phe508del (the most frequent mutation in CF patients worldwide), and a specific SRY sequence. The assay is able to determine the inherited paternal allele., Results: Our simple approach was successfully applied to 30 couples and provided clear results from the maternal plasma. The mean rate of informative markers was sufficient to propose it for use in indirect diagnosis., Conclusions: This noninvasive prenatal diagnosis test, focused on indirect diagnosis of CF, offers many advantages over current methods: it is simple, rapid, and cost-effective. It allows for the testing of a large number of couples with high risk of CF, whatever the familial mutation of the CFTR gene. It provides an alternative method to reduce the number of invasive tests., (© 2018 S. Karger AG, Basel.)

Background: Analysis of circulating cell-free fetal DNA (cffDNA) in maternal plasma is very promising for early diagnosis of monogenic diseases. However, this approach is not yet available for routine use and remains technically challenging because of the low concentration of cffDNA, which is swamped by the overwhelming maternal DNA., Methods: To make clinical applications more readily accessible, we propose a new approach based on mutant enrichment with 3'-modified oligonucleotides (MEMO) PCR along with real-time PCR to selectively amplify from the maternal blood the paternally inherited fetal allele that is not present in the maternal genome., Results: The first proof of concept of this strategy was displayed for cystic fibrosis by the accuracy of our detection of the p.Gly542* mutation used as the initial developmental model. Subsequently, a retrospective study of plasmas originating from two pregnant women carrying a fetus with private mutation confirmed the effectiveness of our method. We confirmed the presence of cffDNA in the studied samples by the identification of a tri-allelic DNA profile using a miniSTR kit., Conclusions: This new non-invasive prenatal diagnosis test offers numerous advantages over current methods: it is simple, cost effective, time efficient and does not require complex equipment or bioinformatics settings. Moreover, our assays for different private mutations demonstrate the viability of this approach in clinical settings for monogenic disorders.

Quadruply bonded metal complexes of rhenium and molybdenum have been prepared with tetrachlorocatechol. Structural characterization on the [Re(2)(Cl(4)Cat)(4)](2-) anion has shown that it consists of distorted square-planar Re(Cl(4)Cat)(2) units linked by a short (2.2067 A) quadruple Re-Re bond. The addition of tetrachlorocatechol to molybdenum acetate was used to prepare the isoelectronic molybdenum analogue "[Mo(2)(Cl(4)Cat)(4)](4-)". This complex was found to be far more reactive than the rhenium dimer. A dimer containing a Mo-Mo double bond, [(Cl(4)Cat)(2)Mo(mu-O)(mu-OCH(3))Mo(Cl(4)Cat)(2)](3-), was obtained as the methanolysis product of the complex formed initially, and the oxomolybdenum(V) monomer [MoO(Cl(4)Cat)(2)](-) was formed under more oxidative conditions. Both complexes are oxygen-sensitive, giving [MoO(2)(Cl(4)Cat)(2)](2-) as the final air-stable complex product.

By contrast with a multitude of laboratory studies on the social organization of fish, relatively little is know about the size, composition and dynamics of free-ranging fish shoals. We give an overview of the available information on fish shoals and assess to what degree the predictions made from laboratory studies are consistent with field data. The section on shoal choice behaviour in the laboratory is structured so that the evidence for different shoaling preferences is discussed in the context of their mechanisms and functions. Predictions based on experiments in captivity regarding preferences for conspecifics, individuals of similar body length and unparasitized fish were highly consistent with field observations on free-ranging shoals whereas preferences for familiar conspecifics and kin remain to be conclusively demonstrated in the field. In general, there is a shortage of studies in which shoaling preferences have been investigated both in the laboratory and the field, and field studies have so far been largely descriptive revealing little about the underlying mechanisms of observed patterns. Given the great importance of fish shoals both in fundamental and applied research, an advancement of our knowledge of their social organization should significantly contribute to a better understanding of a whole range of topics including reciprocal altruism, group-living and self-organization.

There are many proposed routes for the origin of premating reproductive isolation, but few systematic studies aimed at testing their relative importance. Accumulated information about the biogeographical history of the European meadow grasshopper, Chorthippus parallelus, has allowed us to make a planned series of comparisons among populations aimed at distinguishing the contributions of some of these hypotheses. We have compared the effects on assortative mating of long-term isolation in glacial refugia, founder events during postglacial colonization, and sympatry with a closely related species. A likelihood-based analysis allowed us to separate effects of variation in male and female mating propensity among populations from variation in mate choice leading to assortative mating. All three effects contributed significantly to the overall variation in mating pattern in a set of 21 pairwise comparisons among seven populations. Male cuticular composition, but not other candidate signals, was significantly associated with the level of assortative mating. Of the hypotheses for the origin of reproductive isolation, only the predictions of the founder hypothesis explained a significant amount of the variation in assortative mating. This does not rule out the possiblity that there may be some other explanation. Having established the pattern of divergence, it is possible to generate hypotheses that explain our results at least as well as the founder hypothesis. However, because many such post hoc hypotheses are possible, they cannot be tested with this dataset. On this basis, our results favor the hypothesis that some aspect of the colonization process tends to accelerate divergence in mating signals leading to premating reproductive isolation. This could be accomplished through any one of several mechanisms. Colonization involves many bottlenecks as new populations are established at the edge of the range by long-distance migrants. Genetic effects may be important, but these bottlenecks may also alter the conditions under which mates are found and chosen, as suggested by Kaneshiro. At the same time, the colonizing populations may encounter novel environmental challenges.

This article looks at the use of Biatain Adhesive, a new foam dressing from Coloplast which is manufactured by incorporating 3D polymer structures within the central pad. It is now available on the Drug Tariff. The article discusses the treatment of exuding wounds and highlights the benefits of Biatain Adhesive by focusing on the case of an 84-year-old woman who had a history of long-standing leg ulcers where previous dressings had failed to promote healing.

An inter-district audit was carried out on the benefit to children of universal school entry medical examination, the appropriate use of professional time and to establish a baseline against which to measure future changes in services to under-fives and schoolchildren. The school health records of 1127 Cheshire schoolchildren, a random 10% sample, were scrutinised. There were significant district variations. Overall, 45% of children had problems not previously noted: 21% were serious enough to be referred; 11% could have had their problems managed by a well-trained school nurse but 9.8% would have required a medical examination for detection and assessment. These included conditions such as undescended testes, heart murmurs, squints and hernias and 8% required immediate action. The selection criteria, based on the absence of a three-year health check and/or parental or nurse concern, would have failed to identify 217 of the 491 children with new problems, some of which were serious. Targeting only an area of high deprivation or poor health would equally miss significant conditions. The inter-district variation of the numbers and diagnoses of new problems detected at school entry, and the difficulty in predicting which children will have important conditions, provide a good case for the continuation of the school entry medical examination for all children.

1. Many infection control concerns are the same for both hospitals and long-term care facilities (LTCFs), but some are unique to LTCFs. The unique concerns seem to be in the area of "caring." 2. The Association for Practitioners in Infection Control (APIC) offers many educational opportunities for infection control practitioners (ICPs) in LTCFs. 3. The APIC Guideline for Infection Prevention and Control in the Long-Term Care Facility and interpretive assistance for implementing the Guideline in a variety of LTCF settings are available for ICPs.

1. Difficulty with the early recognition of infection is a problem when caring for patients in an extended care facility. 2. The ability to quickly differentiate between asymptomatic bacteriuria and actual infection in male extended care patients is useful for guiding antibiotic therapy. 3. The nurse-administered nitrite test proved reliable as an indicator or urinary tract infection.

1. Because MRSA is commonly carried asymptomatically, colonized patients and caregivers are usually not recognized. During outbreaks, colonized and infected patients act as reservoirs and caregivers become transient carriers. 2. Because universal precautions and body substance isolation were originally developed in response to the AIDS epidemic to meet the safety needs of hospital caregivers, the use of universal precautions in extended care facilities should be further studied and refined. 3. In planning for effective training, enforcement, and compliance with universal precautions, it is essential that employees understand not only the importance of protecting themselves, but also the need to prevent cross-infection. 4. If a patient has an MRSA respiratory tract infection, the environment, including the air, may become heavily contaminated. Caregivers should wear masks to prevent nasal colonization.

Specific standards of nursing care developed by postanesthesia nurses at The Mary Imogene Bassett Hospital, Cooperstown, NY, are presented in this article. Eight separate standards, addressing ventilation, hemostasis and circulation, consciousness, fluid and electrolyte balance, safety, emotional and spiritual needs, comfort, and continuity of care, define the minimal standard of competent nursing practice in our PACU. Standards of nursing care can serve as the center of all unit activities, including formulation of policies and procedures, unit orientation, evaluation of nursing care, and quality assurance monitoring. These standards can be used in any PACU.