Activating Transcription Factor 3, a Useful Marker for Regenerative Response after Nerve Root Injury

Activating transcription factor 3 (ATF3) is induced in various tissues in response to stress. In this experiment, ATF3 expression was studied in adult rats subjected either to a dorsal or ventral root avulsion (VRA; L4-6), or sciatic nerve transection (SNT). Post-operative survival times varied between 1.5 h and 3 weeks. In additional experiments an avulsed ventral root was directly replanted to the spinal cord. Dorsal root ganglias (DRGs) from humans exposed to traumatic dorsal root avulsions were also examined. After SNT ATF3 immunoreactivity (ATF3 IR) was detected in a few DRG neurons already 6 h after the lesion. After 24 h the number had clearly increased and still at 3 weeks DRG neurons remained labeled. In the ventral horn, ATF3 IR in motoneurons (MN) was first detected 24 h after the SNT, and still 3 weeks post-operatively lesioned MN showed ATF3 labeling. After a VRA many spinal MN showed ATF3 IR already after 3 h, and after 6 h all MN were labeled. At 3 weeks a majority of the lesioned MN had died, but all the remaining ones were labeled. When an avulsed ventral root was directly replanted, MN survived and were still labeled at 5 weeks. In DRG, a few neurons were labeled already at 1.5 h after a dorsal root avulsion. At 24 h the number had increased but still only a minority of the neurons were labeled. At 3 days the number of labeled neurons was reduced, and a further reduction was at hand at 7 days and 3 weeks. In parallel, in humans, 3 days after a traumatic dorsal root avulsion, only a few DRG neurons showed ATF3 IR. At 6 weeks no labeled neurons could be detected. These facts imply that ATF3 response to axotomy involves a distance-dependent mechanism. ATF3 also appears to be a useful and reliable neuronal marker of nerve lesions even in humans. In addition, ATF3 up-regulation in both motor and sensory neurons seems to be linked to regenerative competence

On Acute Gene Expression Changes after Ventral Root Replantation

Replantation of avulsed spinal ventral roots has been show to enable significant and useful regrowth of motor axons in both experimental animals and in human clinical cases, making up an interesting exception to the rule of unsuccessful neuronal regeneration in central nervous system. Compared to avulsion without repair, ventral root replantation seems to rescue lesioned motoneurons from death. In this study we have analyzed the acute response to ventral root avulsion and replantation in adult rats with gene arrays combined with cluster analysis of gene ontology search terms. The data show significant differences between rats subjected to ventral replantation compared to avulsion only. Even though number of genes related to cell death is similar in the two models after 24 h, we observed a significantly larger number of genes related to neurite growth and development in the rats treated with ventral root replantation, possibly reflecting the neuroregenerative capacity in the replantation model. In addition, an acute inflammatory response was observed after avulsion, while effects on genes related to synaptic transmission were much more pronounced after replantation than after avulsion alone. These data indicate that the axonal regenerative response from replantation is initiated at an earlier stage than the possible differences in terms of neuron survival. We conclude that this type of analysis may facilitate the comparison of the acute response in two types of injury

Bottentrålning - effekter på marina ekosystem och åtgärder för att minska bottenpåverkan

Under senare år har nya modeller för att detaljerat beskriva fiskets rumsliga utbredning och intensitet tagits fram. Metoder har utvecklats för hur detta fisketryck kan påverka ekosystemen via habitatens och bottendjurens känslighet för bottentrålning. Arbetet har bedrivits bl.a. genom det EU-finansierade forskningsprojektet BENTHIS och Internationella Havsforskningsrådet (ICES) och resultaten har tillämpats i ICES rådgivning till EU om indikatorer för bl.a. Havsmiljödirektivet. Denna rapport är kunskapssammanställning som bygger på detta arbete och fokuserar på den fysiska interaktionen mellan bottentrålfiske och havsbotten och indirekta effekter av bottentrålning kopplade till näringsväven. Rapporten går också igenom möjliga åtgärder för att minska bottentrålningens fysiska påverkan på havsbotten. I uppdraget från Havs- och vattenmyndigheten, som ligger till grund för denna rapport, ingick även att utreda bottentrålningens effekter i skyddade områden. Särskilt fokus har därför lagts på att identifiera och sammanfatta de studier som genomförts i svenska marina skyddade områden. Slutligen summeras översiktligt andelen av olika habitat som befinner sig inom områden med bottentrålningsförbud, samt var bottentrålningen bedrivs inom svensk ekonomisk zon i relation till den svenska trålgränsen

Estimating seabed pressure from demersal trawls, seines, and dredges based on gear design and dimensions

This study assesses the seabed pressure of towed fishing gears and models the physical impact (area and depth of seabed penetration) from trip-based information of vessel size, gear type, and catch. Traditionally fishing pressures are calculated top-down by making use of large-scale statistics such as logbook data. Here, we take a different approach starting from the gear itself (design and dimensions) to estimate the physical interactions with the seabed at the level of the individual fishing operation. We defined 14 distinct towed gear groups in European waters (eight otter trawl groups, three beam trawl groups, two demersal seine groups, and one dredge group), for which we established gear “footprints”. The footprint of a gear is defined as the relative contribution from individual larger gear components, such as trawl doors, sweeps, and groundgear, to the total area and severity of the gear's impact. An industry-based survey covering 13 countries provided the basis for estimating the relative impact-area contributions from individual gear components, whereas sediment penetration was estimated based on a literature review. For each gear group, a vessel size–gear size relationship was estimated to enable the prediction of gear footprint area and sediment penetration from vessel size. Application of these relationships with average vessel sizes and towing speeds provided hourly swept-area estimates by métier. Scottish seining has the largest overall gear footprint of ∼1.6 km2 h−1 of which 0.08 km2 has an impact at the subsurface level (sediment penetration ≥ 2 cm). Beam trawling for flatfish ranks low when comparing overall footprint size/hour but ranks substantially higher when comparing only impact at the subsurface level (0.19 km2h−1). These results have substantial implications for the definition, estimation, and monitoring of fishing pressure indicators, which are discussed in the context of an ecosystem approach to fisheries managemen

Cryopreserved platelets in bleeding management in remote hospitals: A clinical feasibility study in Sweden

BackgroundBalanced transfusions, including platelets, are critical for bleeding patients to maintain hemostasis. Many rural hospitals have no or limited platelet inventory, with several hours of transport time from larger hospitals. This study aimed to evaluate the feasibility of using cryopreserved platelets that can be stored for years, in remote hospitals with no or limited platelet inventory.Material and methodsThree remote hospitals participated in a prospective study including adult bleeding patients where platelet transfusions were indicated. Cryopreserved platelets were prepared in a university hospital, concentrated in 10 ml, transported on dry ice, and stored at −80°C at the receiving hospital. At request, the concentrated platelet units were thawed and diluted in fresh frozen plasma. The indications, blood transfusion needs, and laboratory parameters pre- and post-transfusion, as well as logistics, such as time from request to transfusion and work efforts in preparing cryopreserved platelets, were evaluated.ResultsTwenty-three bleeding patients were included. Nine patients (39%) were treated for gastrointestinal bleeding, five (22%) for perioperative bleeding, and four (17%) for trauma bleeding. The transfusion needs were 4.9 ± 3.3 red blood cell units, 3.2 ± 2.3 plasma units, and 1.9 ± 2.2 platelet units, whereof cryopreserved were 1.5 ± 1.1 (mean ± SD). One patient had a mild allergic reaction. We could not show the difference in laboratory results between pre- and post-transfusion of the cryopreserved units in the bleeding patients. The mean time from the order of cryopreserved platelets to transfusion was 64 min, with a range from 25 to 180 min.ConclusionCryopreserved platelets in remote hospitals are logistically feasible in the treatment of bleeding. The ability to have platelets in stock reduces the time to platelet transfusion in bleeding patients where the alternative often is many hours delay. Clinical effectiveness and safety previously shown in other studies are supported in this small feasibility study

Relationship between the Clinical Frailty Scale and short-term mortality in patients ≥ 80 years old acutely admitted to the ICU: a prospective cohort study.

BACKGROUND: The Clinical Frailty Scale (CFS) is frequently used to measure frailty in critically ill adults. There is wide variation in the approach to analysing the relationship between the CFS score and mortality after admission to the ICU. This study aimed to evaluate the influence of modelling approach on the association between the CFS score and short-term mortality and quantify the prognostic value of frailty in this context. METHODS: We analysed data from two multicentre prospective cohort studies which enrolled intensive care unit patients ≥ 80 years old in 26 countries. The primary outcome was mortality within 30-days from admission to the ICU. Logistic regression models for both ICU and 30-day mortality included the CFS score as either a categorical, continuous or dichotomous variable and were adjusted for patient's age, sex, reason for admission to the ICU, and admission Sequential Organ Failure Assessment score. RESULTS: The median age in the sample of 7487 consecutive patients was 84 years (IQR 81-87). The highest fraction of new prognostic information from frailty in the context of 30-day mortality was observed when the CFS score was treated as either a categorical variable using all original levels of frailty or a nonlinear continuous variable and was equal to 9% using these modelling approaches (p < 0.001). The relationship between the CFS score and mortality was nonlinear (p < 0.01). CONCLUSION: Knowledge about a patient's frailty status adds a substantial amount of new prognostic information at the moment of admission to the ICU. Arbitrary simplification of the CFS score into fewer groups than originally intended leads to a loss of information and should be avoided. Trial registration NCT03134807 (VIP1), NCT03370692 (VIP2)