Clinical DRUJ instability does not influence the long-term functional outcome of conservatively treated distal radius fractures

Trauma Surger

Megacrystals track magma convection between reservoir and surface

Active volcanoes are typically fed by magmatic reservoirs situated within the upper crust. The development of thermal and/or compositional gradients in such magma chambers may lead to vigorous convection as inferred from theoretical models and evidence for magma mixing recorded in volcanic rocks. Bi-directional flow is also inferred to prevail in the conduits of numerous persistently-active volcanoes based on observed gas and thermal emissions at the surface, as well as experiments with analogue models. However, more direct evidence for such exchange flows has hitherto been lacking. Here, we analyse the remarkable oscillatory zoning of anorthoclase feldspar megacrystals erupted from the lava lake of Erebus volcano, Antarctica. A comprehensive approach, combining phase equilibria, solubility experiments and melt inclusion and textural analyses shows that the chemical profiles are best explained as a result of multiple episodes of magma transport between a deeper reservoir and the lava lake at the surface. Individual crystals have repeatedly travelled up-and-down the plumbing system, over distances of up to several kilometers, presumably as a consequence of entrainment in the bulk magma flow. Our findings thus corroborate the model of bi-directional flow in magmatic conduits. They also imply contrasting flow regimes in reservoir and conduit, with vigorous convection in the former (regular convective cycles of ∼150 days at a speed of ∼0.5 mm s−1) and more complex cycles of exchange flow and re-entrainment in the latter. We estimate that typical, 1-cm-wide crystals should be at least 14 years old, and can record several (from 1 to 3) complete cycles between the reservoir and the lava lake via the conduit. This persistent recycling of phonolitic magma is likely sustained by CO2 fluxing, suggesting that accumulation of mafic magma in the lower crust is volumetrically more significant than that of evolved magma within the edifice.The work reported here has been partially supported by the National Science Foundation (Division of Polar Programs) under grant ANT1142083. The authors thank the Natural Environment Research Council (NERC) for access to the NERC Ion Microprobe Facility (Grant IMF453/1011) and Richard Hinton for invaluable help with SIMS analyses. Y.M. acknowledges support from the Cambridge Philosophical Society, the University of Cambridge Home and EU Scholarship Scheme, and the Philip Lake and William Vaughan Lewis funds from the Department of Geography, University of Cambridge. Y.M. also acknowledges support from ERC grant #279790.This is the final published version. It first appeared at http://www.sciencedirect.com/science/article/pii/S0012821X14007833#

Implant removal associated complications in children with limb fractures due to trauma

Surger

Routine follow-up radiographs for distal radius fractures are seldom clinically substantiated

Introduction: The value of routine radiographs during follow-up after distal radius fractures is unclear. The aim of this study was to evaluate whether routine radiographs performed during the follow-up period in patients with a distal radius fracture influenced clinical decision making. Methods: This retrospective cohort study included patients aged ≥18 years who were treated for a distal radius fracture at four hospitals in The Netherlands in 2012. Demographic and clinical and radiographic characteristics were collected from medical records. Results: 1042 patients were included. In 121 (14%) of the 841 radiographs, a clinical indication was reported. Treatment was affected by 22 (2.6%) radiographs, including 11 (1.5%) radiographs that were categorized as routine, 9 (1.2%) of which led to prolonged cast immobilization and 2 (0.2%) to surgery for conservatively treated patients. Conclusion: Although it is common practice to take radiographs after distal radius fractures, the study results indicate that routine radiographs seldom affect treatment. This finding should be weighed against the high health care costs associated with these fractures. We hope that the results of our study will trigger the awareness among surgeons that in the current practice, many radiographs are taken on routine without influencing clinical decision making and can probably be omitted. Level of evidence: Level III

SARS-CoV-2 ORF8 accessory protein is a virulence factor

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) encodes six accessory proteins (3a, 6, 7a, 7b, 8, and 9b) for which limited information is available on their role in pathogenesis. We showed that the deletion of open reading frames (ORFs) 6, 7a, or 7b individually did not significantly impact viral pathogenicity in humanized K18-hACE2 transgenic mice. In contrast, the deletion of ORF8 partially attenuated SARS-CoV-2, resulting in reduced lung pathology and 40% less mortality, indicating that ORF8 is a critical determinant of SARS-CoV-2 pathogenesis. Attenuation of SARS-CoV-2-∆8 was not associated with a significant decrease in replication either in the lungs of mice or in organoid-derived human airway cells. An increase in the interferon signaling at early times post-infection (1 dpi) in the lungs of mice and a decrease in the pro-inflammatory and interferon response at late times post-infection, both in the lungs of mice (6 dpi) and in organoid-derived human airway cells [72 hours post-infection (hpi)], were observed. The early, but not prolonged, interferon response along with the lower inflammatory response could explain the partial attenuation of SARS-CoV-∆8. The presence of ORF8 in SARS-CoV-2 was associated with an increase in the number of macrophages in the lungs of mice. In addition, the supernatant of SARS-CoV-2-WT (wild-type)-infected organoid-derived cells enhanced the activation of macrophages as compared to SARS-CoV-2-∆8-infected cells. These results show that ORF8 is a virulence factor involved in inflammation that could be targeted in COVID-19 therapies. IMPORTANCE The relevance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ORF8 in the pathogenesis of COVID-19 is unclear. Virus natural isolates with deletions in ORF8 were associated with wild milder disease, suggesting that ORF8 might contribute to SARS-CoV-2 virulence. This manuscript shows that ORF8 is involved in inflammation and in the activation of macrophages in two experimental systems: humanized K18-hACE2 transgenic mice and organoid-derived human airway cells. These results identify ORF8 protein as a potential target for COVID-19 therapies.</p

SARS-CoV-2 ORF8 accessory protein is a virulence factor

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) encodes six accessory proteins (3a, 6, 7a, 7b, 8, and 9b) for which limited information is available on their role in pathogenesis. We showed that the deletion of open reading frames (ORFs) 6, 7a, or 7b individually did not significantly impact viral pathogenicity in humanized K18-hACE2 transgenic mice. In contrast, the deletion of ORF8 partially attenuated SARS-CoV-2, resulting in reduced lung pathology and 40% less mortality, indicating that ORF8 is a critical determinant of SARS-CoV-2 pathogenesis. Attenuation of SARS-CoV-2-∆8 was not associated with a significant decrease in replication either in the lungs of mice or in organoid-derived human airway cells. An increase in the interferon signaling at early times post-infection (1 dpi) in the lungs of mice and a decrease in the pro-inflammatory and interferon response at late times post-infection, both in the lungs of mice (6 dpi) and in organoid-derived human airway cells [72 hours post-infection (hpi)], were observed. The early, but not prolonged, interferon response along with the lower inflammatory response could explain the partial attenuation of SARS-CoV-∆8. The presence of ORF8 in SARS-CoV-2 was associated with an increase in the number of macrophages in the lungs of mice. In addition, the supernatant of SARS-CoV-2-WT (wild-type)-infected organoid-derived cells enhanced the activation of macrophages as compared to SARS-CoV-2-∆8-infected cells. These results show that ORF8 is a virulence factor involved in inflammation that could be targeted in COVID-19 therapies. IMPORTANCE The relevance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ORF8 in the pathogenesis of COVID-19 is unclear. Virus natural isolates with deletions in ORF8 were associated with wild milder disease, suggesting that ORF8 might contribute to SARS-CoV-2 virulence. This manuscript shows that ORF8 is involved in inflammation and in the activation of macrophages in two experimental systems: humanized K18-hACE2 transgenic mice and organoid-derived human airway cells. These results identify ORF8 protein as a potential target for COVID-19 therapies.</p

Temporal Variability in Gas Emissions at Bagana Volcano Revealed by Aerial, Ground, and Satellite Observations

Abstract Bagana is a remote, highly active volcano, located on Bougainville Island in southeastern Papua New Guinea. The volcano has exhibited sustained and prodigious sulfur dioxide gas emissions in recent decades, accompanied by frequent episodes of lava extrusion. The remote location of Bagana and its persistent activity have made it a valuable case study for satellite observations of active volcanism. This remoteness has also left many features of Bagana relatively unexplored. Here, we present the first measurements of volcanic gas composition, achieved by unoccupied aerial system (UAS) flights through the volcano's summit plume, and a payload comprising a miniaturized MultiGAS. We combine our measurements of the molar CO2/SO2ratio in the plume with coincident remote sensing measurements (ground‐ and satellite‐based) of SO2emission rate to compute the first estimate of CO2flux at Bagana. We report low SO2and CO2fluxes at Bagana from our fieldwork in September 2019, ∼320 ± 76 td−1and ∼320 ± 84 td−1, respectively, which we attribute to the volcano's low level of activity at the time of our visit. We use satellite observations to demonstrate that Bagana's activity and emissions behavior are highly variable and advance the argument that such variability is likely an inherent feature of many volcanoes worldwide and yet is inadequately captured by our extant volcanic gas inventories, which are often biased to sporadic measurements. We argue that there is great value in the use of UAS combined with MultiGAS‐type instruments for remote monitoring of gas emissions from other inaccessible volcanoes

A reappraisal of explosive–effusive silicic eruption dynamics: syn-eruptive assembly of lava from the products of cryptic fragmentation

Silicic volcanic eruptions range in style from gently effusive to highly explosive, and may switch style unpredictably during a single eruption. Direct observations of subaerial rhyolitic eruptions (Chaiten 2008, Cordón Caulle 2011–2012, Chile) challenged long-standing paradigms of explosive and effusive eruptive styles and led to the formulation of new models of hybrid activity. However, the processes that govern such hybrid explosive–effusive activity remain poorly understood. Here, we bring together observations of the well-studied 2011–2012 Cordón Caulle eruption with new textural and petrologic data on erupted products, and video and still imagery of the eruption. We infer that all of the activity – explosive, effusive, and hybrid – was fed by explosive fragmentation at depth, and that effusive behaviour arose from sticking and sintering, in the shallow vent region, of the clastic products of deeper, cryptic fragmentation. We use a scaling approach to determine that there is sufficient time available, during emplacement, for diffusive pyroclast degassing and sintering to produce a degassed plug that occludes the shallow conduit, feeding clastogenic, apparently effusive, lava-like deposits. Based on evidence from Cordón Caulle, and from other similar eruptions, we further argue that hybrid explosive–effusive activity is driven by episodic gas-fracking of the occluding lava plug, fed by the underlying pressurized ash- and pyroclast-laden region. The presence of a pressurized pocket of ash-laden gas within the conduit provides a mechanism for generation of harmonic tremor, and for syn-eruptive laccolith intrusion, both of which were features of the Cordón Caulle eruption. We conclude that the cryptic fragmentation models is more consistent with available evidence than the prevailing model for effusion of silicic lava that assume coherent non-fragmental rise of magma from depth to the surface without wholesale explosive fragmentation

Particulate multivalent presentation of the receptor binding domain induces protective immune responses against MERS-CoV

Middle East respiratory syndrome coronavirus (MERS-CoV) is a WHO priority pathogen for which vaccines are urgently needed. Using an immune-focusing approach, we created self-assembling particles multivalently displaying critical regions of the MERS-CoV spike protein ─fusion peptide, heptad repeat 2, and receptor binding domain (RBD) ─ and tested their immunogenicity and protective capacity in rabbits. Using a "plug-and-display" SpyTag/SpyCatcher system, we coupled RBD to lumazine synthase (LS) particles producing multimeric RBD-presenting particles (RBD-LS). RBD-LS vaccination induced antibody responses of high magnitude and quality (avidity, MERS-CoV neutralizing capacity, and mucosal immunity) with cross-clade neutralization. The antibody responses were associated with blocking viral replication and upper and lower respiratory tract protection against MERS-CoV infection in rabbits. This arrayed multivalent presentation of the viral RBD using the antigen-SpyTag/LS-SpyCatcher is a promising MERS-CoV vaccine candidate and this platform may be applied for the rapid development of vaccines against other emerging vi