Association of longitudinal changes in patient-reported health status with return to work in the first 2 years after traumatic injury:A prospective cohort study in the Netherlands

OBJECTIVES: To determine the prognostic value of time driven changes in health status on return to work (RTW) in the first 2 years after traumatic injury. DESIGN: A prospective longitudinal cohort study. All patient-reported outcomes were measured at 1 week, 1, 3, 6, 12 and 24 months after injury. SETTING: Ten participating hospitals in the Netherlands. PARTICIPANTS: Employed adult clinical injury patients admitted to the hospital between August 2015 and November 2016 (N=1245 patients). MAIN OUTCOME MEASURES: Data about (first) RTW were used from the patient-reported questionnaires (1=yes, 0=no). RTW was measured as the first time a patient started working after hospital admission. Time until RTW was calculated in weeks. Health status was measured with the EuroQol Five Dimensions-3 Levels (EQ5D) including a dimension to measure cognition. RESULTS: At 24 months, 88.5% (n=1102) of the patients had returned to work. The median time to RTW was 6.6 weeks (IQR: 2–13). Patients’ health status was found to be an independent prognostic factor for RTW: a 0.1-unit increase in EQ5D (scale 0–1) translated into RTW being four times more likely (95% CI 1.60 to 11.94). Patients who had moderate or severe problems (0=no problems, 1=moderate or severe problems) with mobility (HR 0.91, 95% CI 0.84 to 0.98), anxiety/depression (HR 0.86, 95% CI 0.80 to 0.91), usual activities (HR 0.91, 95% CI 0.83 to 0.98), self-care (HR 0.90, 95% CI 0.79 to 0.99) and cognition (HR 0.90, 95% CI 0.85 to 0.94) were significantly less likely to RTW compared with patients with no problems. CONCLUSION: Increased self-reported health status over time is associated with a higher likelihood of RTW, independent of baseline risk factors, such as injury severity or education. Knowledge on patient-reported outcomes can contribute to the development of tailored RTW treatments. Furthermore, patient-reported outcomes could be used as monitoring tool to guide postinjury care in the clinical setting and RTW process. TRIAL REGISTRATION NUMBER: NCT02508675; Results

Performance of the modified TRISS for evaluating trauma care in subpopulations: A cohort study

Introduction: Previous research showed that there is no agreement on a practically applicable model to use in the evaluation of trauma care. A modification of the Trauma and Injury Severity Score (modified TRISS) is used to evaluate trauma care in the Netherlands. The aim of this study w

Intracellular delivery of mRNA in adherent and suspension cells by vapor nanobubble photoporation

Efficient and safe cell engineering by transfection of nucleic acids remains one of the long-standing hurdles for fundamental biomedical research and many new therapeutic applications, such as CAR T cell-based therapies. mRNA has recently gained increasing attention as a more safe and versatile alternative tool over viral- or DNA transposon-based approaches for the generation of adoptive T cells. However, limitations associated with existing nonviral mRNA delivery approaches hamper progress on genetic engineering of these hard-to-transfect immune cells. In this study, we demonstrate that gold nanoparticle-mediated vapor nanobubble (VNB) photoporation is a promising upcoming physical transfection method capable of delivering mRNA in both adherent and suspension cells. Initial transfection experiments on HeLa cells showed the importance of transfection buffer and cargo concentration, while the technology was furthermore shown to be effective for mRNA delivery in Jurkat T cells with transfection efficiencies up to 45%. Importantly, compared to electroporation, which is the reference technology for nonviral transfection of T cells, a fivefold increase in the number of transfected viable Jurkat T cells was observed. Altogether, our results point toward the use of VNB photoporation as a more gentle and efficient technology for intracellular mRNA delivery in adherent and suspension cells, with promising potential for the future engineering of cells in therapeutic and fundamental research applications

Health status and psychological outcomes after trauma: A prospective multicenter cohort study

Introduction Survival after trauma has considerably improved. This warrants research on non-fatal outcome. We aimed to identify characteristics associated with both short and long-term health status (HS) after trauma and to describe the recovery patterns of HS and psychological outcomes during 24 months of follow-up. Methods Hospitalized patients with all types of injuries were included. Data were collected at 1 week 1, 3, 6, 12, and 24 months post-trauma. HS was assessed with the EuroQol-5D-3L (EQ-5D3L) and the Health Utilities Index Mark 2 and 3 (HUI2/3). For the screening of symptoms of post-traumatic stress, anxiety and depression, the Impact of Event Scale (IES) and the Hospital Anxiety and Depression Scale (HADS) subscale anxiety (HADSA) and subscale depression (HADSD) were used. Recovery patterns of HS and psychological outcomes were examined with linear mixed model analyses. Results A total of 4,883 patients participated (median age 68 (Interquartile range 53–80); 50% response rate). The mean (Standard Deviation (SD)) pre-injury EQ-5D-3L score was 0.85 (0.23). One week post-trauma, mean (SD) EQ-5D-3L, HUI2 and HUI3 scores were 0.49 (0.32), 0.61 (0.22) and 0.38 (0.31), respectively. These scores significantly improved to 0.77 (0.26), 0.77 (0.21) and 0.62 (0.35), respectively, at 24 months. Most recovery occurred up until 3 months. At long-term follow-up, patients of higher age, with comorbidities, longer hospital stay, lower extremity fracture and spine injury showed lower HS. The mean (SD) scores of the IES, HADSA and HADSD were respectively 14.80 (15.80), 4.92 (3.98) and 5.00 (4.28), respectively, at 1 week post-trauma and slightly improved over 24 months post-trauma to 10.35 (14.72), 4.31 (3.76) and 3.62 (3.87), respectively. Discussion HS and psychological symptoms improved over time and most improvements occurred within 3 months post-trauma. The effects of severity and type of injury faded out over time. Patients frequently reported symptoms of post-traumatic stress. Trial registration ClinicalTrials.gov identifier: NCT02508675

RegaDB: Community-driven data management and analysis for infectious diseases

Summary: RegaDB is a free and open source data management and analysis environment for infectious diseases. RegaDB allows clinicians to store, manage and analyse patient data, including viral genetic sequences. Moreover, RegaDB pr

ARIA digital anamorphosis : Digital transformation of health and care in airway diseases from research to practice

Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed.Peer reviewe

Ontologías en disputa: Diálogos entre la antropología y la arqueología para la problematización de paisajes regionals

Objetivo/contexto: Hacia finales del siglo XX, el dualismo ontológico con el que antropólogos y arqueólogos nos hemos formado teórica y metodológicamente ha sido cuestionado y puesto en debate. En este contexto, nuestro objetivo es exponer críticamente los trabajos que se están realizando y que contribuyen a problematizar los paisajes enredados de existencias, materialidades, saberes, sentidos o prejuicios pasados y presentes, y con ello a restablecer el diálogo entre la antropología social y la arqueología. Metodología: Exponemos el estado actual de la apertura ontológica en clave latinoamericana. Problematizamos la noción de paisaje como concepto que permite diálogos teórico-metodológicos entre la antropología y la arqueología, así como con otras disciplinas. También presentamos ejes de comunicación y diálogo entre los artículos que forman parte del presente dossier para finalizar con los desafíos por delante en cuanto a traspasar fronteras disciplinarias, temporales y espaciales. Conclusiones: En contextos de históricas relaciones de poder, de profundas crisis socio-ambientales, los principales desafíos de la apertura ontológica serían: 1) generar referentes teóricos permeables a diversas disciplinas y saberes; 2) consolidar metodologías que integren lo etnográfico con lo arqueológico; 3) alentar diálogos constructivos hacia y con otras disciplinas y saberes, y 4) propiciar la comprensión del entramado político actual y la generación de políticas públicas que permitan diversas formas de relacionamiento con el entorno. Originalidad: El restablecimiento de diálogos entre la arqueología y la antropología social desde las aperturas ontológicas tiene el potencial de discutir cómo en determinados contextos se concretan y/o disputan paisajes y modos hegemónicos de habitar en el mundo, así como se problematizan los usos políticos del pasado y las políticas de uso del espacio y el ambiente.Objective/context: Towards the end of the 20th century, the ontological dualism with which anthropologists and archaeologists have trained us theoretically and methodologically has been questioned and debated. In this context, our objective is to critically expose the works that are being carried out and that contribute to problematizing the landscapes entangled with past and present existences, materialities, knowledge, senses or prejudices, and, with it, to re-establish the dialogue between social anthropology and archaeology. Methodology: We expose the current state of the ontological opening in Latin American code. We problematize the notion of landscape as a concept that allows theoretical-methodological dialogues between anthropology and archaeology, as well as with other disciplines. We also present axes of communication and dialogue between the articles that are part of this dossier, to end with the challenges ahead in terms of crossing disciplinary, temporal and spatial borders. Conclusions: In contexts of historical power relations, of deep socio-environmental crises, the main challenges for an ontological opening would be: 1) to generate theoretical referents permeable to various disciplines and fields of knowledge; 2) to consolidate methodologies that integrate the ethnographic with the archaeological; 3) to encourage constructive dialogues towards and with other disciplines and fields of knowledge; and 4) to propitiate the understanding of the current political framework and the generation of public policies that allow for diverse forms of relation with the environment. Originality: The re-establishment of dialogues between archaeology and social anthropology from ontological openings has the potential to discuss how, in certain contexts, landscapes and hegemonic ways of living are concretized and/or disputed, as well as the political uses of the past and the policies of use of space and the environment.Objetivo/contexto: No final do século XX, o dualismo ontológico com o qual antropólogos e arqueólogos se formaram teórica e metodologicamente vem sendo questionado e colocado em debate. Nesse contexto, nosso objetivo é expor criticamente os trabalhos que estão sendo realizados e que contribuem para problematizar as paisagens permeadas de existências, materialidades, saberes, sentidos ou preconceitos passados e presentes, e, com isso, reestabelecer o diálogo entre a antropologia social e a arqueologia. Metodologia: Expomos o estado atual da abertura ontológica no âmbito latino-americano. Problematizamos a noção de paisagem como conceito que permite diálogos teórico-metodológicos entre a antropologia e a arqueologia, assim como outras disciplinas. Também apresentamos eixos de comunicação e diálogo entre os artigos que fazem parte do presente dossiê para finalizar com os desafios que temos adiante sobre ultrapassar fronteiras disciplinares, temporais e espaciais. Conclusões: Em contextos de históricas relações de poder, de profundas crises socioambientais, os principais desafios para uma abertura ontológica seriam: 1) gerar referentes teóricos permeáveis a diversas disciplinas e saberes; 2) consolidar metodologias que integrem o etnográfico com o arqueológico; 3) promover diálogos construtivos com outras disciplinas e saberes; e 4) propiciar a compreensão da estrutura política atual e a geração de políticas públicas que permitam as diversas formas de relacionamentos com o ambiente. Originalidade: O reestabelecimento de diálogos entre a arqueologia e a antropologia social a partir das aberturas ontológicas tem o potencial de discutir como, em determinados contextos, se concretizam e/ou disputam paisagens e modos hegemônicos de habitar, bem como se problematizam os usos políticos do passado e as políticas de uso do espaço e do ambiente.Fil: Saldi, Leticia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Provincia de Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Universidad Nacional de Cuyo. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales; ArgentinaFil: Mafferra, Luis Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Provincia de Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Universidad Nacional de Cuyo. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales; ArgentinaFil: Barrientos Salinas, J. Alejandro. Universidad Mayor de San Andrés; Bolivi

Uywasiña in Aymara cosmopraxis: Ontogenesis and attentionality

This article revolves around the theoretical and ethnographic experiences of an ongoing anthropological study with contemporary Aymara families about how “education by attention” is produced throughout their cosmopraxis. At the same time, it explores how an anthropology of life and in particular Tim Ingold’s fight for a recalibration of anthropology in a biosocially integrated sense are of intrinsically political-ethical interest, considering the messy and misaligned times we humans have worked ourselves into. Beyond romantic interpretations and essentialist representations, a committed inquiry into indigenous practices that habilitate people for ecological-cultural “correspondence” and affective reciprocity—uywasiña—enables the exploration of important educational attitudes and habits that can lead to necessary realignments of human relations with the world/earth. I discuss these enskilling practices through a conversation with theorizations of attentionality, agencement (the “doing-undergoing” of habit, in Ingold’s terms), and affectionality