The clinical effectiveness of an integrated multidisciplinary evidence-based program to prevent intraoperative pressure injuries in high-risk children undergoing long-duration surgical procedures: a quality improvement study

The prevention of hospital-acquired pressure injuries (HAPIs) in children undergoing long-duration surgical procedures is of critical importance due to the potential for catastrophic sequelae of these generally preventable injuries for the child and their family. Long-duration surgical procedures in children have the potential to result in high rates of HAPI due to physiological factors and the difficulty or impossibility of repositioning these patients intraoperatively. We developed and implemented a multi-modal, multi-disciplinary translational HAPI prevention quality improvement program at a large European Paediatric University Teaching Hospital. The intervention comprised the establishment of wound prevention teams, modified HAPI risk assessment tools, specific education, and the use of prophylactic dressings and fluidized positioners during long-duration surgical procedures. As part of the evaluation of the effectiveness of the program in reducing intraoperative HAPI, we conducted a prospective cohort study of 200 children undergoing long-duration surgical procedures and compared their outcomes with a matched historical cohort of 200 children who had undergone similar surgery the previous year. The findings demonstrated a reduction in HAPI in the intervention cohort of 80% (p < 0.01) compared to the comparator group when controlling for age, pathology, comorbidity, and surgical duration. We believe that the findings demonstrate that it is possible to significantly decrease HAPI incidence in these highly vulnerable children by using an evidence-based, multi-modal, multidisciplinary HAPI prevention strategy

Global Diversity of Sponges (Porifera)

With the completion of a single unified classification, the Systema Porifera (SP) and subsequent development of an online species database, the World Porifera Database (WPD), we are now equipped to provide a first comprehensive picture of the global biodiversity of the Porifera. An introductory overview of the four classes of the Porifera is followed by a description of the structure of our main source of data for this paper, the WPD. From this we extracted numbers of all ‘known’ sponges to date: the number of valid Recent sponges is established at 8,553, with the vast majority, 83%, belonging to the class Demospongiae. We also mapped for the first time the species richness of a comprehensive set of marine ecoregions of the world, data also extracted from the WPD. Perhaps not surprisingly, these distributions appear to show a strong bias towards collection and taxonomy efforts. Only when species richness is accumulated into large marine realms does a pattern emerge that is also recognized in many other marine animal groups: high numbers in tropical regions, lesser numbers in the colder parts of the world oceans. Preliminary similarity analysis of a matrix of species and marine ecoregions extracted from the WPD failed to yield a consistent hierarchical pattern of ecoregions into marine provinces. Global sponge diversity information is mostly generated in regional projects and resources: results obtained demonstrate that regional approaches to analytical biogeography are at present more likely to achieve insights into the biogeographic history of sponges than a global perspective, which appears currently too ambitious. We also review information on invasive sponges that might well have some influence on distribution patterns of the future

First record of the sponge genera Crambe and Discorhabdella for the eastern Pacific, with description of three new species

16 páginas, 3 figuras, 1 tabla.Three new sponge species are described from the Pacific coast of Panama, namely Crambe panamensis n. sp., Discorhabdella urizae n. sp. and Discorhabdella littoralis n. sp. This is the first record of the genera Crambe and Discorhabdella for the eastern Pacific, which represents not only a considerable expansion in their known biogeographical distribution, but also empirical support for their Tethyan origin. The new species provide a better understanding of the skeletal evolution in these peculiar genera, representing a lineage in which aster-derived spicules occur within a typical poecilosclerid skeleton. The skeleton of C. panamensis consists of ectosomal subtylostyles, choanosomal tylostyles with smooth tyle, basal desmas of astroclone type only, and anchorate isochelae. The skeleton of D. urizae consists of ectosomal subtylostyles, choanosomal tylostyles with tuberose tyle, basal acanthostyles with aster-like tyle, anchorate isochelae, sigmas, and distinctive twisted microxeas. The skeleton of D. littoralis consists of ectosomal tylostyles, choanosomal tylostyles that occasionally show remains of tubercles in the tyle, basal acanthostyles with a tyle intermediate between aster-like and regular morphology, and sigmas. The skeletal affinities of Crambe and Discorhabdella with the genera Lithochela and Monanclwra are discussed, and a new family concept based on all four genera is proposed. The name Crambeidae is proposed for such a family, to replace the pre-occupied name Crambidae.This research has been partially supported by a postdoctoral Fulbright fellowship (FU93-2207057), European Community funds provided by the LSF Program (1998) of the Natural History Museum of London, and grant of the Spanish Government (MEC-PB98-0485).Peer reviewe

First record of the sponge genera Crambe and Discorhabdella for the eastern Pacific, with description of three new species

16 páginas, 3 figuras, 1 tabla.Three new sponge species are described from the Pacific coast of Panama, namely Crambe panamensis n. sp., Discorhabdella urizae n. sp. and Discorhabdella littoralis n. sp. This is the first record of the genera Crambe and Discorhabdella for the eastern Pacific, which represents not only a considerable expansion in their known biogeographical distribution, but also empirical support for their Tethyan origin. The new species provide a better understanding of the skeletal evolution in these peculiar genera, representing a lineage in which aster-derived spicules occur within a typical poecilosclerid skeleton. The skeleton of C. panamensis consists of ectosomal subtylostyles, choanosomal tylostyles with smooth tyle, basal desmas of astroclone type only, and anchorate isochelae. The skeleton of D. urizae consists of ectosomal subtylostyles, choanosomal tylostyles with tuberose tyle, basal acanthostyles with aster-like tyle, anchorate isochelae, sigmas, and distinctive twisted microxeas. The skeleton of D. littoralis consists of ectosomal tylostyles, choanosomal tylostyles that occasionally show remains of tubercles in the tyle, basal acanthostyles with a tyle intermediate between aster-like and regular morphology, and sigmas. The skeletal affinities of Crambe and Discorhabdella with the genera Lithochela and Monanclwra are discussed, and a new family concept based on all four genera is proposed. The name Crambeidae is proposed for such a family, to replace the pre-occupied name Crambidae.This research has been partially supported by a postdoctoral Fulbright fellowship (FU93-2207057), European Community funds provided by the LSF Program (1998) of the Natural History Museum of London, and grant of the Spanish Government (MEC-PB98-0485).Peer reviewe

Phylomitogenomics bolsters the high-level classification of Demospongiae (phylum Porifera)

International audienceClass Demospongiae is the largest in the phylum Porifera (Sponges) and encompasses nearly 8,000 accepted species in three subclasses: Keratosa, Verongimorpha, and Heteroscleromorpha. Subclass Heteroscleromorpha contains ∼90% of demosponge species and is subdivided into 17 orders. The higher level classification of demosponges underwent major revision as the result of nearly three decades of molecular studies. However, because most of the previous molecular work only utilized partial data from a small number of nuclear and mitochondrial (mt) genes, this classification scheme needs to be tested by larger datasets. Here we compiled a mt dataset for 136 demosponge species—including 64 complete or nearly complete and six partial mt-genome sequences determined or assembled for this study—and used it to test phylogenetic relationships among Demospongiae in general and Heteroscleromorpha in particular. We also investigated the phylogenetic position of Myceliospongia araneosa , a highly unusual demosponge without spicules and spongin fibers, currently classified as Demospongiae incertae sedis , for which molecular data were not available. Our results support the previously inferred sister-group relationship between Heteroscleromorpha and Keratosa + Verongimorpha and suggest five main clades within Heteroscleromorpha: Clade C0 composed of order Haplosclerida; Clade C1 composed of Scopalinida, Sphaerocladina, and Spongillida; Clade C2 composed of Axinellida, Biemnida, Bubarida; Clade C3 composed of Tetractinellida; and Clade C4 composed of Agelasida, Clionaida, Desmacellida, Merliida, Suberitida, Poecilosclerida, Polymastiida, and Tethyida. The inferred relationships among these clades were (C0(C1(C2(C3+C4)))). Analysis of molecular data from M. araneosa placed it in the C3 clade as a sister taxon to the highly skeletonized tetractinellids Microscleroderma sp. and Leiodermatium sp. Molecular clock analysis dated divergences among the major clades in Heteroscleromorpha from the Cambrian to the Early Silurian, the origins of most heteroscleromorph orders in the middle Paleozoic, and the most basal splits within these orders around the Paleozoic to Mesozoic transition. Overall, the results of this study are mostly congruent with the accepted classification of Heteroscleromorpha, but add temporal perspective and new resolution to phylogenetic relationships within this subclass

Conservation and phylogeny of a novel family of non-Hox genes of the Antp class in demospongiae (Porifera)

A survey across the most basal animal phylum, the Porifera, for the presence of homeobox-containing genes led to the isolation of 24 partial or complete homeobox sequences from 21 sponge species distributed in 15 families and 6 orders of Demospongiae. All the new sequences shared a high identity/similarity with EmH-3 (Ephydatia muelleri), a non-Hox gene from the Antp class. The Demox sequences, EmH-3, and related homeodomains formed a well-supported clade with no true affinity with any known bilaterian family, including the Tlx/Hox11 family, suggesting that the EmH-3 family of genes, comprising 31 members, represents a novel family of non-Hox genes, called the Demox family, widespread among Demospongiae. The presence of the Tlx/Hox11 specific signature in the Demox family and common regulatory elements suggested that the Demox and Tlx/Hox11 families are closely related. In the phylogenetic analyses, freshwater Haplosclerida appeared as monophyletic, and Haplosclerida and Halichondrida as polyphyletic, with a clade comprising Agelas species and Axinella corrugata. As for their expression, high levels of Demox transcripts were found in adult tissues. Our data add to the number of published poriferan homeobox sequences and provide independent confirmation of the current Demospongiae phylogenies. © Springer Science+Business Media, Inc. 2006.SCOPUS: re.jinfo:eu-repo/semantics/publishe