bluuebunny/crossref_metadata_2025 huggingface dataset:
Cellulose synthesis complexes are homo-oligomeric and hetero-oligomeric inPhyscomitrium patens
Authors: Li Xingxing , Chaves Arielle M , Dees Dianka C T , Mansoori Nasim , Yuan Kai , Speicher Tori L , Norris Joanna H , Wallace Ian S , Trindade Luisa M , Roberts Alison W
Published: January 2022

The common ancestor of seed plants and mosses contained homo-oligomeric cellulose synthesis complexes (CSCs) composed of identical subunits encoded by a single CELLULOSE SYNTHASE (CESA) gene. Seed plants use different CESA isoforms for primary and secondary cell wall deposition. Both primary and secondary CESAs form hetero-oligomeric CSCs that assemble and function in planta only when all the required isoforms are present. The moss Physcomitrium (Physcomitrella) patens has seven CESA genes that can be grouped into two functionally and phylogenetically distinct classes. Previously, we showed that PpCESA3 and/or PpCESA8 (class A) together with PpCESA6 and/or PpCESA7 (class B) form obligate hetero-oligomeric complexes required for normal secondary cell wall deposition. Here, we show that gametophore morphogenesis requires a member of class A, PpCESA5, and is sustained in the absence of other PpCESA isoforms. PpCESA5 also differs from the other class A PpCESAs as it is able to self-interact and does not co-immunoprecipitate with other PpCESA isoforms. These results are consistent with the hypothesis that homo-oligomeric CSCs containing only PpCESA5 subunits synthesize cellulose required for gametophore morphogenesis. Analysis of mutant phenotypes also revealed that, like secondary cell wall deposition, normal protonemal tip growth requires class B isoforms (PpCESA4 or PpCESA10), along with a class A partner (PpCESA3, PpCESA5, or PpCESA8). Thus, P. patens contains both homo-oligomeric and hetero-oligomeric CSCs.
Challenges to self-isolation among contacts of cases of COVID-19: a national telephone survey in Wales
Authors: Isherwood Kate R , Kyle Richard G , Gray Benjamin J , Davies Alisha R
Published: January 2022

Background

Self-isolation is challenging and adherence is dependent on a range of psychological, social and economic factors. We aimed to identify the challenges experienced by contacts of coronavirus disease 2019 (COVID-19) cases to better target support and minimize the harms of self-isolation.

Methods

The Contact Adherence Behavioural Insights Study (CABINS) was a 15-minute telephone survey conducted with confirmed contacts of COVID-19 (N = 2027), identified through the NHS Wales Test Trace Protect (TTP) database.

Results

Younger people (aged 18–29 years) were three times more likely to report mental health concerns (adjusted odds ratio [aOR]: 3.16, 95% confidence interval [CI]: 2.05–4.86) and two times more likely to report loneliness (aOR: 1.96, CI: 1.37–2.81) compared to people aged over 60 years. Women were 1.5 times more likely to experience mental health concerns (aOR: 1.51, 95% CI: 1.20–1.92) compared to men. People with high levels of income precarity were eight times more likely to report financial challenges (aOR: 7.73, CI: 5.10–11.74) and three times more likely to report mental health concerns than their more financially secure counterparts (aOR: 3.08, CI: 2.22–4.28).

Conclusion

Self-isolation is particularly challenging for younger people, women and those with precarious incomes. Providing enhanced support is required to minimize the harms of self-isolation.
Hand and foot MRI in contemporary undifferentiated arthritis: in which patients is MRI valuable to detect rheumatoid arthritis early? A large prospective study
Authors: den Hollander Nikolet K , Verstappen Marloes , Sidhu Navkiran , van Mulligen Elise , Reijnierse Monique , van der Helm-van Mil Annette H M
Published: January 2022

Objectives

Identifying patients that will develop RA among those presenting with undifferentiated arthritis (UA) remains a clinical dilemma. Although MRI is helpful according to EULAR recommendations, this has only been determined in UA patients not fulfilling 1987 RA criteria, while some of these patients are currently considered as RA because they fulfil the 2010 criteria. Therefore, we studied the predictive value of MRI for progression to RA in the current UA population, i.e. not fulfilling RA classification criteria (either 1987 or 2010 criteria) and not having an alternate diagnosis. Additionally, the value of MRI was studied in patients with a clinical diagnosis of UA, regardless of the classification criteria.

Methods

Two UA populations were studied: criteria-based UA as described above (n = 405) and expert-opinion-based UA (n = 564), i.e. UA indicated by treating rheumatologists. These patients were retrieved from a large cohort of consecutively included early arthritis patients that underwent contrast-enhanced MRI scans of hand and foot at baseline. MRIs were scored for osteitis, synovitis and tenosynovitis. Patients were followed for RA development during the course of 1 year. Test characteristics of MRI were determined separately for subgroups based on joint involvement and autoantibody status.

Results

Among criteria-based UA patients (n = 405), 21% developed RA. MRI-detected synovitis and MRI-detected tenosynovitis were predictive for progression to RA. MRI-detected tenosynovitis was independently associated with RA progression (odds ratio (OR) 2.79; 95% CI 1.40, 5.58), especially within ACPA-negative UA patients (OR 2.91; 95% CI 1.42, 5.96). Prior risks of RA development for UA patients with mono-, oligo- and polyarthritis were 3%, 19% and 46%, respectively. MRI results changed this risk most within the oligoarthritis subgroup: positive predictive value was 27% and negative predictive value 93%. Similar results were found in expert-opinion-based UA (n = 564).

Conclusion

This large cohort study showed that MRI is most valuable in ACPA-negative UA patients with oligoarthritis; a negative MRI could aid in preventing overtreatment.
NATIONWIDE SURVEY OF RADIATION EXPOSURE FOR RADIOFREQUENCY CATHETER ABLATION FOR PULMONARY VEIN ISOLATION AND NONPULMONARY VEIN ISOLATION IN JAPAN
Authors: Ishibashi Toru , Masuda Takanori , Kato Mamoru , Yamashita Yukari , Takei Yasutaka , Tsukamoto Atsuko , Matsumoto Kazuma , Sakamoto Hajime
Published: January 2022

To propose typical values for the arrhythmia region between pulmonary vein isolation (PVI) and nonpulmonary vein isolation (non-PVI) in Japan.

A nationwide questionnaire was posted to 343 facilities, to which 125 facilities (36.4%) responded.

Results is the median for PVI and non-PVI were in terms of Ka,r (317 and 196 mGy), PKA (40.8 and 26.3 Gy.cm2), FT (43.0 and 27.3 min), and CI (326 and 102 images). When comparing PVI and non-PVI procedures, there were significant differences in Ka, r, PKA, FT, and CI (p < 0.05).

In other words, by classifying into two types, PVI and non-PVI, we contributed to the establishment of typical values in Japan’s RFCA.
Does Long-Term Post-Bariatric Weight Change Differ Across Antidepressants?
Authors: Arterburn David E. , Maciejewski Matthew L. , Berkowitz Theodore S. Z. , Smith Valerie A. , Mitchell James E. , Liu Chuan-Fen , Adeyemo Adenike , Bradley Katharine A. , Olsen Maren K.
Published: January 2022

Objectives:

We sought to evaluate whether weight change up to 5 years after bariatric surgery differed by antidepressant class taken before surgery.

Background:

Bariatric surgery induces significant weight loss, but outcomes are highly variable. The specific type of antidepressant used prior to surgery may be an important factor in long-term weight loss.

Methods:

This retrospective cohort study from 2000 to 2016 compared the 5-year weight loss of 556 Veterans who were taking antidepressant monotherapy (bupropion, selective serotonin reuptake inhibitors [SSRIs], or serotonin-norepinephrine reuptake inhibitors [SNRIs]) before bariatric surgery (229 sleeve gastrectomy and 327 Roux-en-Y gastric bypass) versus 556 matched nonsurgical controls.

Results:

Patients taking bupropion before sleeve gastrectomy had greater differential weight loss between surgical patients and matched controls than those taking SSRIs at 1 (8.9 pounds; 95% confidence interval [CI], 1.6–16.3; P = 0.02) and 2 years (17.6 pounds; 95% CI, 5.9–29.3; P = 0.003), but there was no difference at 5 years (11.9 pounds; 95% CI, –8.9 to 32.8; P = 0.26). Findings were similar for gastric bypass patients taking bupropion compared to SSRIs at 1 (9.7 pounds; 95% CI, 2.0–17.4; P = 0.014), 2 (12.0 pounds; 95% CI, –0.5 to 24.5; P = 0.06), and 5 years (4.8 pounds; 95% CI, –16.7 to 26.3; P = 0.66). No significant differences were observed comparing patients taking SNRI versus SSRI medications.

Conclusions:

Sleeve gastrectomy and gastric bypass patients taking bupropion had greater weight loss than those taking SSRIs, although these differences may wane over time. Bupropion may be the first-line antidepressant of choice among patients with severe obesity considering bariatric surgery.
Factors Associated with Patient-Reported Outcomes Following a Humeral Shaft Fracture: Nonunion Results in a Poorer Outcome Despite Union after Surgical Fixation
Authors: Oliver William M. , Searle Henry K. C. , Molyneux Samuel G. , White Timothy O. , Clement Nicholas D. , Duckworth Andrew D.
Published: January 2022

Objectives:

The primary aim was to assess patient-reported outcomes ≥1 year following a humeral diaphyseal fracture. The secondary aim was to compare outcomes of patients who united after initial management (operative/nonoperative) with those who united after nonunion fixation (NU-ORIF).

Design:

Retrospective.

Setting:

University teaching hospital.

Patients and intervention:

From 2008 to 2017, 291 patients [mean age, 55 years (17–86 years), 58% (n = 168/291) female] were available to complete an outcomes survey. Sixty-four (22%) were initially managed operatively and 227 (78%) nonoperatively. After initial management, 227 (78%) united (n = 62 operative, n = 165 nonoperative), 2 had a delayed union (both nonoperative), and 62 (21%) had a nonunion (n = 2 operative, n = 60 nonoperative). Fifty-two patients (93%, n = 52/56) united after NU-ORIF.

Main Outcome Measures:

QuickDASH, EuroQol-5 Dimension (EQ-5D)/EuroQol-Visual Analogue Scale (EQ-VAS), 12-item Short Form Physical (PCS) and Mental Component Summary (MCS).

Results:

At a mean of 5.5 years (range, 1.2–11.0 years) postinjury, the mean QuickDASH was 20.8, EQ-5D was 0.730, EQ-VAS was 74, PCS was 44.8 and MCS was 50.2. Patients who united after NU-ORIF reported worse function (QuickDASH, 27.9 vs. 17.6; P = 0.003) and health-related quality of life (HRQoL; EQ-5D, 0.639 vs. 0.766; P = 0.008; EQ-VAS, 66 vs. 76; P = 0.036; PCS, 41.8 vs. 46.1; P = 0.036) than those who united primarily. Adjusting for confounders, union after NU-ORIF was independently associated with a poorer QuickDASH (difference, 8.1; P = 0.019) and EQ-5D (difference, −0.102; P = 0.028).

Conclusions:

Humeral diaphyseal union after NU-ORIF resulted in poorer patient-reported outcomes compared with union after initial management. Targeting early operative intervention to at-risk patients may mitigate the potential impact of nonunion on longer-term outcome.

Level of Evidence:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Intraoperative Comparative Femoral Rotation Imaging: Do not Overlook Parallax
Authors: Kagan Benjamin D. , Roberts Michael S. , Haimes Mark A. , Blankstein Michael , Schottel Patrick C.
Published: January 2022

Objective:

To investigate the degree of error due to parallax during intraoperative rotational imaging involving the distal femur.

Methods:

Twelve, fresh-frozen, lower-extremity cadaveric specimens were studied. The limbs were positioned supine and rotated until the posterior femoral condyles were superimposed using a C-arm. The C-arm was then repositioned to place the femoral condyles at the anterior and posterior margins of the image intensifier. The rotation necessary to resuperimpose the femoral condyles due to parallax was recorded. A second C-arm was then used from the contralateral side to simulate the rotational imaging technique to determine the magnitude and directionality of combined parallax.

Results:

All 12 specimens demonstrated parallax, resulting in rotational discrepancies. Compared with central field of view alignment, the mean rotational discrepancy was 5.6 and 5.5 degrees for anterior and posterior positions, respectively. Contralateral imaging resulted in an additive effect with rotational differences of 9.0 and 12.6 degrees for bilateral anterior and posterior positions, respectively.

Conclusions:

Parallax causes rotational discrepancies with fluoroscopic imaging of the distal femur when the posterior femoral condyles are off-center in the imaging field of view. If femoral condyles are not centered when obtaining intraoperative rotational imaging of the uninjured and injured femurs, parallax can result in potentially clinically significant rotational deformity even if the femurs seem perfectly matched at the conclusion of surgery. We recommend perfectly centering of the posterior femoral condyles in the imaging field of view when obtaining lateral images of the distal femur to prevent this potentially overlooked contribution to malrotation.
Detailed Anatomy and Reconstructive Approach of a Wassel VI Thumb Duplication
Authors: Kareh Aurora M. , Firouzbakht Peter K. , Rowe Amanda G. , Plikaitis Christina M.
Published: January 2022

Thumb duplication is a congenital hand difference that occurs in 0.08 of every 1000 live births and is categorized by level of duplication by the Wassel classification system. The anatomy and reconstruction of type VI thumb duplication is not well described, likely due to its rarity. In this report, we detail the anatomy and reconstruction of an ulnar-dominant Wassel VI thumb duplication, with particular attention paid to management of the first CMC joint and intrinsic muscle rebalancing of the preserved digit.
Intention to Stay in Specialist Trauma Nurses: Relationship With Role Conflict, Stress, and Organizational Support
Authors: Yoon Jeong Eun , Cho Ok-Hee
Published: January 2022

BACKGROUND:

Specialist trauma nurses contribute to shortening hospital stay, lowering intensive care unit readmission rates, and improving treatment outcomes through early detection and management of health problems in trauma patients. However, Korean specialist trauma nurses have a higher turnover rate than other nurses due to negative factors like unclear job descriptions and inconsistent job activities.

OBJECTIVE:

This study aimed to examine the levels of and relationships among role conflict, occupational stress, perceived organizational support, and intent to stay in Korean specialist trauma nurses.

METHODS:

We enrolled 53 specialist trauma nurses from eight regional trauma centers in Korea. Data on role conflict, occupational stress, perceived organizational support, and intent to stay were collected using a structured questionnaire. Mann–Whitney U test, Kruskal–Wallis test, and Bonferroni post hoc tests were conducted to examine differences in intent to stay. Spearman's correlation coefficients were used to examine correlations between the key variables.

RESULTS:

High intent to stay was associated with periodic job training, job satisfaction, and perceived high workload. Role conflict was positively correlated with occupational stress, whereas both were negatively correlated with perceived organizational support. Intent to stay was negatively correlated with occupational stress and positively correlated with perceived organizational support.

CONCLUSIONS:

Effective improvement measures that lower occupational stress and increase perceived organizational support will help maintain the positions of specialist trauma nurses. These results highlight the need to specify the scope of practice and implement practical measures like career development programs that enhance professional nursing competencies to retain specialist trauma nurses.
Navigating Hemostasis of Bleeding Among Children With β-Thalassemia
Authors: El-Beshlawy Amal , Rabah Fatma , Hamed Hanan M. , Mahmoud Amina Abdel-Salam , Al-Wakeel Hanan A.-H. , Abdelhamid Enas M. , El-Sonbaty Marwa M. , El Sissy Maha
Published: January 2022

Bleeding phenotype is reported in β-thalassemia patients. However, the underlying etiology remains elusive. We aimed to assess coagulation profile and the platelet aggregation in β-thalassemia children with bleeding diathesis. Fifty β-thalassemia children with a positive bleeding history were recruited. Bleeding phenotype was explored through full history taking and thorough clinical examination. Complete blood count, prothrombin time, international normalized ratio, and platelets aggregometry were performed for children with negative workup. Mucosal bleeding was manifest among most of our patients (96%). Two-third of patients had decreased aggregation with ristocetin (68%), adenine di-phosphate (64%), and arachidonic acid (64%). While half of the patients (48%) had deficient response to epinephrine. Collagen, ristocetin, and arachidonic acid induced aggregation were negatively correlated to frequency of blood transfusion (P=0.021, r=−0.325; P<0.001, r=−0.465; P=0.018, r=−0.333, respectively). Aggregation to collagen and epinephrine demonstrated a negative correlation with age (P=0.04, r=−0.287; P=0.03, r=−0.315). Deferiprone was associated with a deficient response to ristocetin and collagen when compared with deferasirox or no chelation (P=0.021 and 0.006, respectively). Impaired ristocetin response was linked to hydroxyurea (P=0.035). Platelets function defect should be considered in β-thalassemia patients with bleeding symptoms.
Factors Associated With the Intention to Use HIV Preexposure Prophylaxis for Young and Older Men Who Have Sex With Men
Authors: Hulstein Sebastiaan H. , Zimmermann Hanne M.L. , de la Court Feline , Matser Amy A. , Schim van der Loeff Maarten F. , Hoornenborg Elske , Davidovich Udi , Prins Maria , de Vries Henry J.C.
Published: January 2022

Background

The uptake of preexposure prophylaxis (PrEP) against HIV is low among young men who have sex with men (MSM) in the Netherlands. Studying the intention to use PrEP among non-PrEP using young and older MSM can guide health authorities in developing new prevention campaigns to optimize PrEP uptake.

Methods

We investigated the sociodemographic, behavioral, and psychosocial factors associated with a high PrEP use intention in the coming 6 months among 93 young MSM (aged ≤25 years), participating in an online survey, and 290 older MSM (aged ≥26 years), participating in an open, prospective cohort in 2019 to 2020.

Results

Perceiving PrEP as an important prevention tool was associated with a high PrEP use intention among young and older MSM. Among young MSM, a high level of PrEP knowledge and believing that PrEP users take good care of themselves and others were associated with a high PrEP use intention. Among older MSM, 2 or more anal sex partners, chemsex, high HIV risk perception, and believing PrEP increases sexual pleasure were associated with a high PrEP use intention. Believing PrEP leads to adverse effects was associated with a low intention to use PrEP among older MSM.

Conclusions

To conclude, we showed that both behavioral and psychosocial factors were associated with a high PrEP use intention among young and older MSM. In addition to focusing on sexual behavior and HIV risk, future prevention campaigns and counseling on PrEP could incorporate education, endorsing positive beliefs, and disarming negative beliefs to improve the uptake of PrEP in young and older MSM.
Rates of Appropriate Treatment and Follow-Up Testing After a Gonorrhea and/or Chlamydia Infection in an Urban Network of Federally Qualified Health Center Systems
Authors: McWhirter Laura , Lou Yingbo , Reingold Sarah , Warsh Sarah , Thomas-Gale Tara , Haynes Christine , Rinehart Deborah , Wendel Karen A. , Frost Holly M.
Published: January 2022

Background

Reinfection and partner transmission are common with Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT). We assessed treatment and follow-up laboratory testing for GC and CT and evaluated associations with patient- and system-level factors.

Methods

The analysis included positive GC and/or CT nucleic acid amplification test results from patients aged 14 to 24 years at a federally qualified health center system site in Denver, CO, from January 2018 to December 2019. Outcomes assessed include treatment within 14 days, HIV/syphilis testing within 6 months, and repeat GC and CT testing within 2 to 6 months. Bivariate and multivariable regression modeling assessed associated factors.

Results

Among 27,168 GC/CT nucleic acid amplification tests performed, 1.8% (484) were positive for GC and 7.8% (2125) were positive for CT. Within the assessed time frames, 87% (2275) of patients were treated, 54.1% (1411) had HIV testing, 50.1% (1306) had syphilis testing, and 39.9% (1040) had GC and CT retesting. Older patients were more likely to receive treatment (adjusted odds ratio 1.13; 95% confidence interval, 1.00–1.27; P = 0.05) than younger patients, whereas males were less likely to receive GC and CT retesting (adjusted odds ratio, 0.19; 95% confidence interval, 0.11–0.33; P < 0.001) than females. Patients treated on the day of testing were less likely to receive follow-up laboratory tests than those treated 2 to 14 days after.

Conclusions

Although most patients received antibiotic treatment, only about half received HIV/syphilis testing and less than half received GC and CT retesting. It is critical to find innovative strategies to improve treatment and follow-up management of these infections to decrease complications, reduce transmission, and combat the rising rates of sexually transmitted infections.
The Importance of Fifth Anterior Intercostal Vessels following Nipple-Sparing Mastectomy
Authors: Nahabedian Maurice Y. , Angrigiani Claudio , Rancati Alberto , Irigo Marcelo , Acquaviva Juan , Rancati Agustin
Published: January 2022

Background:

The authors describe the vascular anatomy of the fifth anterior intercostal artery perforator and its role for perfusion of the nipple-areola complex following nipple-sparing mastectomy.

Methods:

Twenty fresh cadavers were injected with 20 cc of colored latex through the internal mammary artery. The catheter was placed at the level of the second intercostal space after removal of the rib. The fifth intercostal space was dissected under magnification to observe the origin and trajectory of the fifth anterior intercostal artery perforator. Six selective computed tomographic angiograms of the fifth intercostal artery perforator were performed. A clinical case of nipple-sparing mastectomy in a woman with mammary hypertrophy is provided to demonstrate the utility of preserving the fifth anterior intercostal artery perforator.

Results:

The fifth anterior intercostal artery perforator was consistently observed in all the cases and confirmed by angiography. The perforator gives rise to several branches that traverse in all directions. The ascending branches of the fifth anterior intercostal artery perforator are directed toward the nipple-areola complex and course within the subcutaneous layer between the skin and the parenchyma. The fourth and fifth anterior intercostal artery perforators are independent of one another.

Conclusion:

The main ascending branch of the fifth anterior intercostal artery perforator reaches the nipple-areola complex by the subcutaneous tissue independently of the Würinger fascia.
Intense 68Ga-FAPI-46 Activity in Lesions of Recurrent Ovarian Clear Cell Carcinoma That Were Negative on FDG PET/CT Study
Authors: Siripongsatian Dheeratama , Promteangtrong Chetsadaporn , Kunawudhi Anchisa , Kiatkittikul Peerapon , Chotipanich Chanisa
Published: January 2022

A 55-year-old woman with recurrent ovarian clear cell carcinoma who underwent complete surgical staging and completed chemotherapy session approximately 7 months before. She presented with increased CA-125 levels. 68Ga-FAPI-46 PET showed significantly higher tumor-to-background contrast of recurrent intra-abdominal node metastases and distant metastases, which were undetectable in the 18F-FDG PET. These findings changed the patient management. Larger studies with comparisons with other imaging modalities are required to validate the diagnostic performance.
Time to OR for patients with abdominal gunshot wounds: A potential process measure to assess the quality of trauma care?
Authors: Thomas Arielle C. , Campbell Brendan T. , Subacius Haris , Bilimoria Karl Y. , Stey Anne M. , Hamad Doulia , Nasca Brian , Nathens Avery B.
Published: January 2022

BACKGROUND

Abdominal gunshot wounds (GSWs) require rapid assessment and operative intervention to reduce the risk of death and complications. We sought to determine if time to the operating room (OR) might be a useful process measure for the assessment of trauma care quality. We evaluated the facility benchmark time to OR for patients with serious injury and whether this was associated with lower rates of complications and mortality.

METHODS

We evaluated time to OR for adult patients with an abdominal GSW presenting in shock to American College of Surgeons Trauma Quality Improvement Program centers from 2015 to 2020. We calculated the 75th percentile time to the OR for each center and characterized centers as average, slow, or fast. We compared patient and facility characteristics across outlier status, as well as risk-adjusted complications and mortality using hierarchical multivariable logistic regression models.

RESULTS

There were 4,027 patients in 230 centers that met the inclusion criteria. Mortality was 28%. There were 61 (27%) fast and 52 (23%) slow centers. The median time for slow centers was 83 minutes (68–94 minutes) compared with fast centers, 35 minutes (32–38 minutes). Injury Severity Score and emergency department vital signs were similar across centers. Fast hospitals had higher total case volumes, more cases per surgeon, and were more likely to be Level I centers. Patients cared for in these centers had similar risk-adjusted rates of complications and mortality.

CONCLUSION

Time to OR for patients with abdominal GSWs and shock might be a useful process measure to evaluate rapid decision making and OR access. Surgeon and center experience as measured by annual case volumes, coupled with a rapid surgical response required through Level I trauma center standards might be contributory. There was no association between outlier status and complications or mortality suggesting other factors apart from time to the OR are of greater significance.

LEVEL OF EVIDENCE

Therapeutic/care management, Level IV.
The ICEBERG: A score and visual representation to track the severity of traumatic brain injury: Design principles and preliminary results
Authors: Vallée Fabrice , Nougue Hélène , Cartailler Jérome , Koundé Paul Robert , Mebazaa Alexandre , Gayat Etienne , Azouvi Philippe , Mateo Joaquim
Published: January 2022

BACKGROUND

Establishing neurological prognoses in traumatic brain injury (TBI) patients remains challenging. To help physicians in the early management of severe TBI, we have designed a visual score (ICEBERG score) including multimodal monitoring and treatment-related criteria. We evaluated the ICEBERG scores among patients with severe TBI to predict the 28-day mortality and long-term disability (Extended Glasgow Outcome Scale score at 3 years). In addition, we made a preliminary assessment of the nurses and doctors on the uptake and reception to the use of the ICEBERG visual tool.

METHODS

This study was part of a larger prospective cohort study of 207 patients with severe TBI in the Parisian region (PariS-TBI study). The ICEBERG score included six variables from multimodal monitoring and treatment-related criteria: cerebral perfusion pressure, intracranial pressure, body temperature, sedation depth, arterial partial pressure of CO2, and blood osmolarity. The primary outcome measures included the ICEBERG score and its relationship with hospital mortality and Extended Glasgow Outcome Score.

RESULTS

The hospital mortality was 21% (45/207). The ICEBERG score baseline value and changes during the 72nd first hours were more strongly associated with TBI prognosis than the ICEBERG parameters measured individually. Interestingly, when the clinical and computed tomography parameters at admission were combined with the ICEBERG score at 48 hours using a multimodal approach, the predictive value was significantly increased (area under the curve = 0.92). Furthermore, comparing the ICEBERG visual representation with the traditional numerical readout revealed that changes in patient vitals were more promptly detected using ICEBERG representation (p < 0.05).

CONCLUSION

The ICEBERG score could represent a simple and effective method to describe severity in TBI patients, where a high score is associated with increased mortality and disability. In addition, ICEBERG representation could enhance the recognition of unmet therapeutic goals and dynamic evolution of the patient's condition. These preliminary results must be confirmed in a prospective manner.

LEVEL OF EVIDENCE

Diagnostic Tests or Criteria; Level III.
Developing a National Trauma Research Action Plan: Results from the Neurotrauma Research Panel Delphi Survey
Authors: Stein Deborah M. , Braverman Maxwell A. , Phuong Jimmy , Shipper Edward , Price Michelle A. , Bixby Pamela J. , Adelson P. David , Ansel Beth M. , Cifu David X. , DeVine John G. , Galvagno Samuel M. , Gelb Daniel E. , Harris Odette , Kang Christopher S. , Kitagawa Ryan S. , McQuillan Karen A. , Patel Mayur B. , Robertson Claudia S. , Salim Ali , Shutter Lori , Valadka Alex B. , Bulger Eileen M.
Published: January 2022

BACKGROUND

In 2016, the National Academies of Science, Engineering and Medicine called for the development of a National Trauma Research Action Plan. The Department of Defense funded the Coalition for National Trauma Research to generate a comprehensive research agenda spanning the continuum of trauma and burn care. Given the public health burden of injuries to the central nervous system, neurotrauma was one of 11 panels formed to address this recommendation with a gap analysis and generation of high-priority research questions.

METHODS

We recruited interdisciplinary experts to identify gaps in the neurotrauma literature, generate research questions, and prioritize those questions using a consensus-driven Delphi survey approach. We conducted four Delphi rounds in which participants generated key research questions and then prioritized the importance of the questions on a 9-point Likert scale. Consensus was defined as 60% or greater of panelists agreeing on the priority category. We then coded research questions using an National Trauma Research Action Plan taxonomy of 118 research concepts, which were consistent across all 11 panels.

RESULTS

Twenty-eight neurotrauma experts generated 675 research questions. Of these, 364 (53.9%) reached consensus, and 56 were determined to be high priority (15.4%), 303 were deemed to be medium priority (83.2%), and 5 were low priority (1.4%). The research topics were stratified into three groups—severe traumatic brain injury (TBI), mild TBI (mTBI), and spinal cord injury. The number of high-priority questions for each subtopic was 46 for severe TBI (19.7%), 3 for mTBI (4.3%) and 7 for SCI (11.7%).

CONCLUSION

This Delphi gap analysis of neurotrauma research identified 56 high-priority research questions. There are clear areas of focus for severe TBI, mTBI, and spinal cord injury that will help guide investigators in future neurotrauma research. Funding agencies should consider these gaps when they prioritize future research.

LEVEL OF EVIDENCE

Diagnostic Test or Criteria, Level IV.
Trauma surgeon–performed peripheral arterial repairs are associated with equivalent outcomes when compared with vascular surgeons
Authors: Karam Basil S. , Haberman Kathryn , Nguyen Peter , Eddine Savo Bou Zein , Boyle Kelly , Baskaran Archit , Figueroa Juan , Milia David , Carver Thomas , Somberg Lewis , Webb Travis , Davis Christopher S. , Dodgion Chris , Elegbede Anuoluwapo , de Moya Marc A.
Published: January 2022

BACKGROUND

Civilian extremity trauma with vascular injury carries a significant risk of morbidity, limb loss, and mortality. We aim to describe the trends in extremity vascular injury repair and compare outcomes between trauma and vascular surgeons.

METHODS

We performed a single-center retrospective review of patients 18 years or older with extremity vascular injury requiring surgical intervention between January 2009 and December 2019. Demographics, injury characteristics, operative course, and hospital course were analyzed. Descriptive statistics were used to examine management trends, and outcomes were compared for arterial repairs. Multivariate regression was used to evaluate surgeon specialty as a predictor of complications, readmission, vascular outcomes, and mortality.

RESULTS

A total of 231 patients met our inclusion criteria; 80% were male with a median age of 29 years. The femoral vessels were most commonly injured (39.4%), followed by the popliteal vessels (26.8%). Trauma surgeons performed the majority of femoral artery repairs (82%), while vascular surgeons repaired the majority of popliteal artery injuries (84%). Both had a similar share of brachial artery repairs (36% vs. 39%, respectively). There were no differences in complications, readmission, vascular outcomes, and mortality. Median time from arrival to operating room was significantly shorter for trauma surgeons. There was a significant downward trend between 2009 and 2017 in the proportion of total and femoral vascular procedures performed by trauma surgeons. On multivariate regression, surgical specialty was not a significant predictor of need for vascular reintervention, prophylactic or delayed fasciotomies, postoperative complications, or readmissions.

CONCLUSION

Traumas surgeons arrived quicker to the operating and had no difference in short-term clinical outcomes of brachial and femoral artery repairs compared with patients treated by vascular surgeons. Over the last decade, there has been a significant decline in the number of open vascular repairs done by trauma surgeons.

LEVEL OF EVIDENCE

Therapeutic/Care Management, Level IV.
Aggression, rank and power: why hens (and other animals) do not always peck according to their strength
Authors: Lewis Rebecca J.
Published: January 2022

Thorlief Schjelderup-Ebbe's seminal paper on the ‘pecking’ order of chickens inspired numerous ethologists to research and debate the phenomenon of dominance. The expansion of dominance to the broader concept of power facilitated disentangling aggression, strength, rank and power. Aggression is only one means of coercing other individuals, and can sometimes highlight a lack of power. The fitness advantages of aggression may only outweigh the costs during periods of uncertainty. Effective instruments of power also include incentives and refusals to act. Moreover, the stability of the power relationship might vary with the instruments used if different means of power vary in the number and types of outcomes achieved, as well as the speed of accomplishing those outcomes. In well-established relationships, actions or physiological responses in the subordinate individual may even be the only indicator of a power differential. A focus on strength, aggression and fighting provides an incomplete understanding of the power landscape that individuals actually experience. Multiple methods for constructing hierarchies exist but greater attention to the implications of the types of data used in these constructions is needed. Many shifts in our understanding of power were foreshadowed in Schjelderup-Ebbe's discussion about deviations from the linear hierarchy in chickens.

This article is part of the theme issue ‘The centennial of the pecking order: current state and future prospects for the study of dominance hierarchies’.
Neural systems that facilitate the representation of social rank
Authors: Dwortz Madeleine F. , Curley James P. , Tye Kay M. , Padilla-Coreano Nancy
Published: January 2022

Across species, animals organize into social dominance hierarchies that serve to decrease aggression and facilitate survival of the group. Neuroscientists have adopted several model organisms to study dominance hierarchies in the laboratory setting, including fish, reptiles, rodents and primates. We review recent literature across species that sheds light onto how the brain represents social rank to guide socially appropriate behaviour within a dominance hierarchy. First, we discuss how the brain responds to social status signals. Then, we discuss social approach and avoidance learning mechanisms that we propose could drive rank-appropriate behaviour. Lastly, we discuss how the brain represents memories of individuals (social memory) and how this may support the maintenance of unique individual relationships within a social group.

This article is part of the theme issue ‘The centennial of the pecking order: current state and future prospects for the study of dominance hierarchies’.
The dynamics of dominance: open questions, challenges and solutions
Authors: Strauss Eli D. , Shizuka Daizaburo
Published: January 2022

Although social hierarchies are recognized as dynamic systems, they are typically treated as static entities for practical reasons. Here, we ask what we can learn from a dynamical view of dominance, and provide a research agenda for the next decades. We identify five broad questions at the individual, dyadic and group levels, exploring the causes and consequences of individual changes in rank, the dynamics underlying dyadic dominance relationships, and the origins and impacts of social instability. Although challenges remain, we propose avenues for overcoming them. We suggest distinguishing between different types of social mobility to provide conceptual clarity about hierarchy dynamics at the individual level, and emphasize the need to explore how these dynamic processes produce dominance trajectories over individual lifespans and impact selection on status-seeking behaviour. At the dyadic level, there is scope for deeper exploration of decision-making processes leading to observed interactions, and how stable but malleable relationships emerge from these interactions. Across scales, model systems where rank is manipulable will be extremely useful for testing hypotheses about dominance dynamics. Long-term individual-based studies will also be critical for understanding the impact of rare events, and for interrogating dynamics that unfold over lifetimes and generations.

This article is part of the theme issue ‘The centennial of the pecking order: current state and future prospects for the study of dominance hierarchies’.
Transcriptional response of Wolbachia-transinfected Aedes aegypti mosquito cells to dengue virus at early stages of infection
Authors: Leitner Michael , Etebari Kayvan , Asgari Sassan
Published: January 2022

Mosquito-borne flaviviruses are responsible for viral infections and represent a considerable public health burden. Aedes aegypti is the principal vector of dengue virus (DENV), therefore understanding the intrinsic virus–host interactions is vital, particularly in the presence of the endosymbiont Wolbachia, which blocks virus replication in mosquitoes. Here, we examined the transcriptional response of

Wolbachia

-transinfected Ae. aegypti Aag2 cells to DENV infection. We identified differentially expressed immune genes that play a key role in the activation of anti-viral defence such as the Toll and immune deficiency pathways. Further, genes encoding cytosine and N6-adenosine methyltransferases and SUMOylation, involved in post-transcriptional modifications, an antioxidant enzyme, and heat-shock response were up-regulated at the early stages of DENV infection and are reported here for the first time. Additionally, several long non-coding RNAs were among the differentially regulated genes. Our results provide insight into

Wolbachia

-transinfected Ae. aegypti’s initial virus recognition and transcriptional response to DENV infection.
A native chemical chaperone in the human eye lens
Authors: Serebryany Eugene , Chowdhury Sourav , Woods Christopher N. , Thorn David C. , Watson Nicki E. , McClelland Arthur , Klevit Rachel E. , Shakhnovich Eugene I.
Published: January 2022

Cataract is one of the most prevalent protein aggregation disorders and still the most common cause of vision loss worldwide. The metabolically quiescent core region of the human lens lacks cellular or protein turnover; it has therefore evolved remarkable mechanisms to resist light-scattering protein aggregation for a lifetime. We now report that one such mechanism involves an unusually abundant lens metabolite,myo-inositol, suppressing aggregation of lens crystallins. We quantified aggregation suppression using our previously well-characterizedin vitroaggregation assays of oxidation-mimicking human γD-crystallin variants and investigatedmyo-inositol’s molecular mechanism of action using solution NMR, negative-stain TEM, differential scanning fluorometry, thermal scanning Raman spectroscopy, turbidimetry in redox buffers, and free thiol quantitation. Unlike many known chemical chaperones,myo-inositol’s primary target was neither the native nor the unfolded state of the protein, nor the final aggregated state, but rather the rate-limiting bimolecular step on the aggregation pathway. Given recent metabolomic evidence that it is severely depleted in human cataractous lenses compared to age-matched controls, we suggest that maintaining or restoring healthy levels ofmyo-inositol in the lens may be a simple, safe, and globally accessible strategy to prevent or delay lens opacification due to age-onset cataract.
The emergence, spread and vanishing of a French SARS-CoV-2 variant exemplifies the fate of RNA virus epidemics and obeys the Black Queen rule
Authors: Colson Philippe , Gautret Philippe , Delerce Jeremy , Chaudet Hervé , Pontarotti Pierre , Forterre Patrick , Tola Raphael , Bedotto Marielle , Delorme Léa , Levasseur Anthony , Lagier Jean-Christophe , Million Matthieu , Yahi Nouara , Fantini Jacques , La Scola Bernard , Fournier Pierre-Edouard , Raoult Didier
Published: January 2022

The nature and dynamics of mutations associated with the emergence, spread and vanishing of SARS-CoV-2 variants causing successive waves are complex1-5. We determined the kinetics of the most common French variant (“Marseille-4”) for 10 months since its onset in July 20205. Here, we analysed and classified into subvariants and lineages 7,453 genomes obtained by next-generation sequencing. We identified two subvariants, Marseille-4A, which contains 22 different lineages of at least 50 genomes, and Marseille-4B. Their average lifetime was 4.1±1.4 months, during which 4.1±2.6 mutations accumulated. Growth rate was 0.079±0.045, varying from 0.010 to 0.173. All the lineages exhibited a “gamma” distribution. Several beneficial mutations at unpredicted sites initiated a new outbreak, while the accumulation of other mutations resulted in more viral heterogenicity, increased diversity and vanishing of the lineages. Marseille-4B emerged when the other Marseille-4 lineages vanished. Its ORF8 gene was knocked out by a stop codon, as reported in several mink lineages and in the alpha variant. This subvariant was associated with increased hospitalization and death rates, suggesting that ORF8 is a nonvirulence gene. We speculate that the observed heterogenicity of a lineage may predict the end of the outbreak.
Effectiveness of lower limb rehabilitation protocol using mobile health on quality of life, functional strength and functional capacity among knee osteoarthritis patients who were overweight and obese: A randomized controlled trial
Authors: Rafiq Muhammad Tariq , Abdul Hamid Mohamad Shariff , Hafiz Eliza
Published: January 2022

Objective

This study aimed to investigate the effectiveness of the lower limb rehabilitation protocol (LLRP) using mobile health (mHealth) on quality of life (QoL), functional strength, and functional capacity among knee OA patients who were overweight and obese.

Materials and Methods

In the current trial, 114 patients were recruited and randomized into either the rehabilitation group with mobile health (RGw-mHealth) receiving reminders by using mHealth to carry on the strengthening exercises of LLRP and instructions of daily care (IDC), the rehabilitation group without mobile health (RGwo-mHealth) following the strengthening exercises of LLRP and instructions of daily care (IDC) and control group (CG) only following the IDC for duration of 12-weeks. The reminders for using mHealth were provided two times a day for three days a week. Primary outcome measures were QoL assessed by the Western Ontario and McMaster Universities Osteoarthritis Index summary score, and functional strength by Five-Repetition Sit-To-Stand Test. Secondary outcome measure was functional capacity assessed by the Gait Speed Test. The assessments of QoL, functional strength, and functional capacity were taken at baseline and posttest after 12-weeks of intervention.

Results

After 12 weeks of intervention, patients in all three groups had statistically significant improvement in QoL within groups (p < 0.05). Furthermore, patients in the RGw-mHealth and RGwo-mHealth had statistically significant improvement in functional strength and walking gait speed within groups (p < 0.05). The pairwise between-group comparisons (Bonferroni post hoc test) of the mean changes in QoL, functional strength, and functional capacity at posttest assessments revealed that patients in the RGw-mHealth had statistically significant greater mean change in QoL, functional strength and functional capacity relative to both the RGwo-mHealth and CG (p < 0.001).

Conclusion

Improvement in QoL, functional strength, and functional capacity was larger among patients in the RGw-mHealth compared with the RGwo-mHealth or CG.

TRIAL REGISTRATION

Chinese Clinical Trial Registry: ChiCTR1900028600

Date of registration: 28-12-2019

Registration Status: Prospective

URL:http://www.chictr.org.cn
New insights on the role of HCN in root hair elongation through single cell proteomics
Authors: Arenas-Alfonseca Lucía , Yamada Masashi , Romero Luis C. , García Irene
Published: January 2022

Root hairs are specialized structures involved in water and nutrient uptake by plants. They elongate from epidermal cells following a complex developmental program. ß-cyanoalanine synthase (CAS), which is mainly involved in hydrogen cyanide (HCN) detoxification in Arabidopsis thaliana, plays a role in root hair elongation, as evidenced by the fact that cas-c1 mutants show a severe defect in root hair shape. In addition to root hairs, CAS C1 is expressed in the quiescent center and meristem. However, the cas-c1 mutation has no visible effect on either tissue, in both control and nutrient-deprivation conditions. To identify its role in root hair formation, we conducted single cell proteomics analysis by isolating root hair cells using Fluorescence-Activated Cell Sorting (FACS) from wild type and cas-c1 mutants. We also analyzed the presence of S-cyanylation, a protein post-translational modification (PTM) mediated by HCN and affecting cysteine residues and protein activity, in proteins of wild type and cas-c1 mutants. We found that several proteins involved in root hair development, related to the receptor kinase FERONIA signaling and to DNA methylation, are modified by this new post-translational modification.

One sentence summary

Arabidopsis root hair proteomics unveals that several proteins involved in root hair development are susceptible of modification by S-cyanylation.