Assessing and documenting dark skin tones in stoma care.

The stoma care nurse (SCN) assesses peristomal skin during each patient intervention. Living in a diverse multicultural society, the SCN needs to consider dark skin tones and how these are documented. This article looks at how the literature on peristomal skin assessment and available tools discuss skin colour, and compare this with the tissue viability literature.

An anatomical appraisal of dynamic muscle transfer of the orbicularis oculi muscle.

Facial nerve palsy can cause significant distress for patients. We investigated the innervation of the orbicularis oculi muscle (OOM) and assessed the viability of unipedicle contralateral muscle transfer to restore symmetrical and spontaneous blinking. Cadaveric dissection and measurements were performed on lite fixed cadavers (n = 15).

The Development of a Daily Comprehensive and Multidisciplinary Health Care Leadership Huddle.

Introduction: Consistent and concise communication in a large health care organization that is geographically dispersed is a challenge. Issues often are not addressed with the appropriate individuals in the most timely and effective manner, which results in patient flow disruptions, service gaps, and provider and administrator frustration.

Case Presentation: This report describes the development of a daily leadership huddle with regional leadership and middle management to inform of daily operations, safety, quality, and service concerns, in order to allow for quicker action and issue resolution.

Selecting convexity to improve and maintain peristomal skin integrity.

Each person with a stoma is an individual who may react differently when faced with similar situations and, as such, each patient needs to be considered on a person-by-person basis to address their needs, support their acceptance of living with a stoma, as well as to encourage their rehabilitation. This article discusses the benefits that a convex flange can offer ostomates to reduce and minimise leakage episodes and in doing so support peristomal skin integrity and, in particular, the benefits of a convex pouch with a hydrocolloid flange containing medical grade Manuka honey. It reports on the findings of an independent nurse study, which included discussions about the varying types of convexity offered to ostomates, following an assessment of patients' needs.

Clinical governance for ostomates at risk of peristomal skin complications.

This clinical study focuses on peristomal skin complications (PSCs). For many patients, the causative factor behind peristomal moisture-associated skin damage was contact dermatitis caused by effluent leakage, resulting in sore and excoriated skin. PSCs are costly to the patient in relation to pain, time and worry and also impact nursing activity levels and healthcare costs.

Treating the locoregional lymph nodes with radiation and/or surgery significantly improves outcome in dogs with high-grade mast cell tumours.

High-grade canine mast cell tumours (HG-MCT) have a high rate of locoregional relapse. In this study, dogs with HG-MCT treated with radiation therapy (RT) were retrospectively evaluated to determine the benefit associated with treating the locoregional lymph nodes (LNs). Forty-two dogs were included.

Discovery of short-course antiwolbachial quinazolines for elimination of filarial worm infections.

Parasitic filarial nematodes cause debilitating infections in people in resource-limited countries. A clinically validated approach to eliminating worms uses a 4- to 6-week course of doxycycline that targets , a bacterial endosymbiont required for worm viability and reproduction. However, the prolonged length of therapy and contraindication in children and pregnant women have slowed adoption of this treatment.

Wolbachia and host germline components compete for kinesin-mediated transport to the posterior pole of the Drosophila oocyte.

Widespread success of the intracellular bacterium Wolbachia across insects and nematodes is due to efficient vertical transmission and reproductive manipulations. Many strains, including wMel from Drosophila melanogaster, exhibit a specific concentration to the germplasm at the posterior pole of the mature oocyte, thereby ensuring high fidelity of parent-offspring transmission. Transport of Wolbachia to the pole relies on microtubules and the plus-end directed motor kinesin heavy chain (KHC).

Commercialization, Altruism, Clinical Practice: Seeking Explanation for Similarities and Differences in Californian and Canadian Gestational Surrogacy Outcomes.

Background: Surrogacy is growing worldwide. Although recently some countries have sought to ban it, between 2010 and 2014 the number of babies born to gestational surrogates having in vitro fertilization treatment in California doubled, and in Canada it grew by 35%. This work seeks to fill identified knowledge gaps about the similarities and differences in the practices and outcomes of gestational surrogacy, which in California operates on a commercial basis, whereas in Canada it is illegal to pay a surrogate.

Platelets from pulmonary hypertension patients show increased mitochondrial reserve capacity.

Accumulating evidence suggests that altered cellular metabolism is systemic in pulmonary hypertension (PH) and central to disease pathogenesis. However, bioenergetic changes in PH patients and their association with disease severity remain unclear. Here, we hypothesize that alteration in bioenergetic function is present in platelets from PH patients and correlates with clinical parameters of PH.

"One for Sorrow, Two for Joy?": American embryo transfer guideline recommendations, practices, and outcomes for gestational surrogate patients.

In January 2016, Melissa Cook, a California gestational surrogate experiencing a multiple-birth pregnancy following the in vitro fertilization (IVF) transfer of three embryos comprised of donor eggs and sperm provided by the intended father, went to the media when the intended father requested that she undergo a fetal reduction because twins were less expensive to raise than triplets. Much of the legal interest in this case to date has centered on the enforceability of surrogacy contracts. However, the Cook case also raises troubling issues about fertility treatment practices involving gestational surrogates, twin preference, and third-party reproduction medical decision-making.

Reliance of on High Rates of Host Proteolysis Revealed by a Genome-Wide RNAi Screen of Cells.

are gram-negative, obligate, intracellular bacteria carried by a majority of insect species worldwide. Here we use a -infected cell line and genome-wide RNA interference (RNAi) screening to identify host factors that influence titer. By screening an RNAi library targeting 15,699 transcribed host genes, we identified 36 candidate genes that dramatically reduced titer and 41 that increased titer.

Mechanisms of Horizontal Cell-to-Cell Transfer of Wolbachia spp. in Drosophila melanogaster.

is an intracellular endosymbiont present in most arthropod and filarial nematode species. Transmission between hosts is primarily vertical, taking place exclusively through the female germ line, although horizontal transmission has also been documented. The results of several studies indicate that spp.

Acute hemodynamic effects of inhaled sodium nitrite in pulmonary hypertension associated with heart failure with preserved ejection fraction.

Background: Pulmonary hypertension (PH) is associated with poor outcomes, yet specific treatments only exist for a small subset of patients. The most common form of PH is that associated with left heart disease (Group 2), for which there is no approved therapy. Nitrite has shown efficacy in preclinical animal models of Group 1 and 2 PH, as well as in patients with left heart failure with preserved ejection fraction (HFpEF).

SINGLE INSTITUTION VARIABILITY IN INTENSITY MODULATED RADIATION TARGET DELINEATION FOR CANINE NASAL NEOPLASIA.

Contouring variability is a significant barrier to the accurate delivery and reporting of radiation therapy. The aim of this descriptive study was to determine the variation in contouring radiation targets and organs at risk by participants within our institution. Further, we also aimed to determine if all individuals contoured the same normal tissues.

Hidden from view: Canadian gestational surrogacy practices and outcomes, 2001-2012.

This paper raises some troubling questions about the fertility treatments provided to Canadian gestational surrogates, women not genetically related to the child that they carry. Using information published between 2003 and 2012 by Canada's Assisted Reproduction Registry, the paper traces the growing incidence of births to gestational surrogates. The transfer of more than one embryo increases the chance of pregnancy and the incidence of multiple births, and while the incidence of multiple births has declined overall since 2010, gestational surrogates consistently experience a higher proportion of multiple births and experienced higher levels of multiple embryo transfers.

Increased Butyrate Production During Long-Term Fermentation of In Vitro-Digested High Amylose Cornstarch Residues with Human Feces.

An in vitro semi-continuous long-term (3 wk) anaerobic incubation system simulating lower gut fermentation was used to determine variability in gut microbial metabolism between 4 predigested high amylose-resistant starch residues (SR): SRV, SRVI, SRVII, and SRGEMS in human fecal samples. Subjects participated twice, 5 mo apart: 30 in Phase I (15 lean, 9 overweight and 6 obese), 29 in Phase II (15 lean, 9 overweight, 5 obese); 13 of 15 lean subjects participated in both phases. Of the 4 SRs, SRV displayed the highest gelatinization temperature, peak temperature, enthalpy changes, and the least digestibility compared with the other SRs.

Preference for language of instruction of an English language learner with autism.

Objective: To use a preference assessment to identify the preferred language of instruction (English or Spanish) for a child with autism living in a Spanish-speaking home and receiving school services in English only.

Methods: We used a concurrent chains method to evaluate the participant's preference for English or Spanish instruction. Colored microswitches represented English instruction, Spanish instruction and no instruction (control).

The impact of host diet on Wolbachia titer in Drosophila.

While a number of studies have identified host factors that influence endosymbiont titer, little is known concerning environmental influences on titer. Here we examined nutrient impact on maternally transmitted Wolbachia endosymbionts in Drosophila. We demonstrate that Drosophila reared on sucrose- and yeast-enriched diets exhibit increased and reduced Wolbachia titers in oogenesis, respectively.

Molecular imaging biomarkers of resistance to radiation therapy for spontaneous nasal tumors in canines.

Purpose: Imaging biomarkers of resistance to radiation therapy can inform and guide treatment management. Most studies have so far focused on assessing a single imaging biomarker. The goal of this study was to explore a number of different molecular imaging biomarkers as surrogates of resistance to radiation therapy.

Clinical vignettes improve performance in anatomy practical assessment.

Although medical curricula now adopt an integrated teaching approach, this is not adequately reflected in assessment of anatomy knowledge and skills. In this study, we aimed to explore the impact of the addition of clinical vignette to item stems on students' performance in anatomy practical examinations. In this study, 129 undergraduate medical students of Durham University took part in a 30-item anatomy practical test consisting of those with and without clinical stem, in a crossover design.

Ethnicity reporting practices for empirical research in three autism-related journals.

This review examines ethnicity reporting in three autism-related journals (Autism, Focus on Autism and Other Developmental Disabilities, and Journal of Autism and Developmental Disorders) over a 6-year period. A comprehensive multistep search of articles is used to identify ethnicity as a demographic variable in these three journals. Articles that identified research participants' ethnicity were further analyzed to determine the impact of ethnicity as a demographic variable on findings of each study.