Abdominal shotgun trauma: A case report

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SWI/SNF-like chromatin remodeling factor Fun30 supports point centromere function in S. cerevisiae

Budding yeast centromeres are sequence-defined point centromeres and are, unlike in many other organisms, not embedded in heterochromatin. Here we show that Fun30, a poorly understood SWI/SNF-like chromatin remodeling factor conserved in humans, promotes point centromere function through the formation of correct chromatin architecture at centromeres. Our determination of the genome-wide binding and nucleosome positioning properties of Fun30 shows that this enzyme is consistently enriched over centromeres and that a majority of CENs show Fun30-dependent changes in flanking nucleosome position and/or CEN core micrococcal nuclease accessibility. Fun30 deletion leads to defects in histone variant Htz1 occupancy genome-wide, including at and around most centromeres. FUN30 genetically interacts with CSE4, coding for the centromere-specific variant of histone H3, and counteracts the detrimental effect of transcription through centromeres on chromosome segregation and suppresses transcriptional noise over centromere CEN3. Previous work has shown a requirement for fission yeast and mammalian homologs of Fun30 in heterochromatin assembly. As centromeres in budding yeast are not embedded in heterochromatin, our findings indicate a direct role of Fun30 in centromere chromatin by promoting correct chromatin architecture

RAN-related neural-congruency: a machine learning approach toward the study of the neural underpinnings of naming speed

ObjectiveNaming speed, behaviorally measured via the serial Rapid automatized naming (RAN) test, is one of the most examined underlying cognitive factors of reading development and reading difficulties (RD). However, the unconstrained-reading format of serial RAN has made it challenging for traditional EEG analysis methods to extract neural components for studying the neural underpinnings of naming speed. The present study aims to explore a novel approach to isolate neural components during the serial RAN task that are (a) informative of group differences between children with dyslexia (DYS) and chronological age controls (CAC), (b) improve the power of analysis, and (c) are suitable for deciphering the neural underpinnings of naming speed.MethodsWe propose a novel machine-learning-based algorithm that extracts spatiotemporal neural components during serial RAN, termed RAN-related neural-congruency components. We demonstrate our approach on EEG and eye-tracking recordings from 60 children (30 DYS and 30 CAC), under phonologically or visually similar, and dissimilar control tasks.ResultsResults reveal significant differences in the RAN-related neural-congruency components between DYS and CAC groups in all four conditions.ConclusionRapid automatized naming-related neural-congruency components capture the neural activity of cognitive processes associated with naming speed and are informative of group differences between children with dyslexia and typically developing children.SignificanceWe propose the resulting RAN-related neural-components as a methodological framework to facilitate studying the neural underpinnings of naming speed and their association with reading performance and related difficulties

Infections in a surgical intensive care unit of a university hospital in Greece

SummaryObjectivesWe aimed to evaluate the clinical and microbiological characteristics of the patients who developed an infection in our surgical intensive care unit (SICU).MethodsThis was a prospective study of all patients who sustained an ICU-acquired infection from 2002 to 2004.ResultsAmong 683 consecutive SICU patients, 123 (18.0%) developed 241 infections (48.3 infections per 1000 patient-days). The mean age of patients was 66.7±3.8 years, the mean APACHE II score (acute physiology and chronic health evaluation) on SICU admission was 18.2±2.4, and the mean SOFA score (sepsis-related organ failure assessment) at the onset of infection was 8.8±2. Of the study patients, 51.2% were women. Infections were: bloodstream (36.1%), ventilator-associated pneumonia (VAP; 25.3%, 20.3/1000 ventilator-days), surgical site (18.7%), central venous catheter (10.4%, 7.1/1000 central venous catheter-days), and urinary tract infection (9.5%, 4.6/1000 urinary catheter-days). The most frequent microorganisms found were: Acinetobacter baumannii (20.3%), Pseudomonas aeruginosa (15.7%), Candida albicans (13.2%), Enterococcus faecalis (10.4%), Klebsiella pneumoniae (9.2%), Enterococcus faecium (7.9%), and Staphylococcus aureus (6.7%). High resistance to the majority of antibiotics was identified. The complication and mortality rates were 58.5% and 39.0%, respectively. Multivariate analysis identified APACHE II score on admission (odds ratio (OR) 4.63, 95% confidence interval (CI) 2.69–5.26, p=0.01), peritonitis (OR 1.85, 95% CI 1.03–3.25, p=0.03), acute pancreatitis (OR 2.27, 95% CI 1.05–3.75, p=0.02), previous aminoglycoside use (OR 2.84, 95% CI 1.06–5.14, p=0.03), and mechanical ventilation (OR 3.26, 95% CI: 2.43–6.15, p=0.01) as risk factors for infection development. Age (OR 1.16, 95% CI 1.01–1.33, p=0.03), APACHE II score on admission (OR 2.53, 95% CI 1.77–3.41, p=0.02), SOFA score at the onset of infection (OR 2.88, 95% CI 1.85–4.02, p=0.02), and VAP (OR 1.32, 95% CI 1.04–1.85, p=0.03) were associated with mortality.ConclusionsInfections are an important problem in SICUs due to high incidence, multi-drug resistance, complications, and mortality rate. In our study, APACHE II score on admission, peritonitis, acute pancreatitis, previous aminoglycoside use, and mechanical ventilation were identified as risk factors for infection development, whereas age, APACHE II score on admission, SOFA score at the onset of infection, and VAP were associated with mortality

Ocular myasthenia gravis saccades as a measure of extraocular muscle function

BACKGROUND: It is important to understand the pathophysiology of ocular myasthenia gravis (OMG) to improve treatment. AIM: To use modern video-oculography to characterise saccadic eye movements in patients with OMG, including anti-AChR, anti-MuSK, anti-LRP4, and seronegative OMG. METHODS: In total, 21 patients with OMG and five age-matched healthy control subjects underwent video-oculography. Participants performed a sequence of horizontal saccades (3 minutes each) at ±5°, ± 10°, and ±20°, followed by 3 minutes of saccades directed at randomly presented targets at ±5°, ± 10°, and ±15°. We recorded the direction, amplitude, duration, peak, and average velocity of each saccade for each task for each participant. RESULTS: Saccadic amplitude, duration, and average velocity were all lower in OMG patients than in control subjects (p < 0.021). Saccadic amplitude and velocity decreased over time, but this decrease was similar in OMG patients and control subjects. Fixation drift and ocular disparity tended to be greater in OMG patients than in control subjects. Saccadic intrusions occurred more frequently in OMG patients than in control subjects (p < 0.001). No significant effects of time or group by time on fixation drift or ocular disparity were found. DISCUSSION: Saccadic velocities in OMG patients differed from those in normal control subjects, which suggests that OMG affects fast-twitch fibres, although fast-twitch fibres were still able to generate “twitch” or “quiver” movements in the presence of even severe ophthalmoplegia. Slow-twitch muscle fibres involved in gaze holding were also affected, accounting for increased fixation drift following saccades. Our objective finding of increased fixation drift and a larger number of saccadic intrusions mirror our anecdotal experience of patients with OMG who report significant diplopia despite minimal ophthalmoplegia on examination. Such microsaccades may be a surrogate for compensation of a gaze-holding deficit in MG

APPROACH SPEED, LAST STEP CHARACTERISTICS AND TAKE-OFF ACCURACY OF T36 CLASS PARALYMPIC LONG JUMPERS

The purpose of this study was to examine the approach speed (VAPP), the characteristics of the last three steps and the accuracy of foot placement at the take-off board (TTB) in T36 Paralympic long jumpers. Nine male finalists in the T36 Class long jump event who competed at the 2012 London Paralympics were analyzed using high speed video cameras and a speed radar gun. Results revealed that VAPP (8.0 ± 0.4 m/s) peaked at a distance of 6.40 ± 3.25 m from the take-off board. Both parameters were significantly correlated with the effective distance of the jump. TTB was 0.14 ± 0.10 m. There was no indication that the last steps were performed using the adequate step length for the proper execution of the “larger penultimate – shorter last step” technique. The adoption of this technique when approaching the take-off board may improve the effectiveness of the approach and aid in achieving a better take-off

Interfacility transfers in a non-trauma system setting: an assessment of the Greek reality

<p>Abstract</p> <p>Background</p> <p>Quality assessment of any trauma system involves the evaluation of the transferring patterns. This study aims to assess interfacility transfers in the absence of a formal trauma system setting and to estimate the benefits from implementing a more organized structure.</p> <p>Methods</p> <p>The 'Report of the Epidemiology and Management of Trauma in Greece' is a one year project of trauma patient reporting throughout the country. It provided data concerning the patterns of interfacility transfers. We compared the transferred patient group to the non transferred patient group. Information reviewed included patient and injury characteristics, need for an operation, Intensive Care Unit (ICU) admittance and mortality. Analysis employed descriptive statistics and Chi-square test. Interfacility transfers were then assessed according to each health care facility's availability of five requirements; Computed Tomography scanner, ICU, neurosurgeon, orthopedic and vascular surgeon.</p> <p>Results</p> <p>Data on 8,524 patients were analyzed; 86.3% were treated at the same facility, whereas 13.7% were transferred. Transferred patients tended to be younger, male, and more severely injured than non transferred patients. Moreover, they were admitted to ICU more often, had a higher mortality rate but were less operated on compared to non transferred patients. The 34.3% of transfers was from facilities with none of the five requirements, whereas the 12.4% was from those with one requirement. Low level facilities, with up to three requirements transferred 43.2% of their transfer volume to units of equal resources.</p> <p>Conclusion</p> <p>Trauma management in Greece results in a high number of transfers. Patients are frequently transferred between low level facilities. Better coordination could lead to improved outcomes and less cost.</p

Enhancement of endogenous midbrain neurogenesis by microneurotrophin BNN-20 after neural progenitor grafting in a mouse model of nigral degeneration

We have previously shown the neuroprotective and pro-neurogenic activity of microneurotrophin BNN-20 in the substantia nigra of the “weaver” mouse, a model of progressive nigrostriatal degeneration. Here, we extended our investigation in two clinically-relevant ways. First, we assessed the effects of BNN-20 on human induced pluripotent stem cell-derived neural progenitor cells and neurons derived from healthy and parkinsonian donors. Second, we assessed if BNN-20 can boost the outcome of mouse neural progenitor cell intranigral transplantations in weaver mice, at late stages of degeneration. We found that BNN-20 has limited direct effects on cultured human induced pluripotent stem cell-derived neural progenitor cells, marginally enhancing their differentiation towards neurons and partially reversing the pathological phenotype of dopaminergic neurons generated from parkinsonian donors. In agreement, we found no effects of BNN-20 on the mouse neural progenitor cells grafted in the substantia nigra of weaver mice. However, the graft strongly induced an endogenous neurogenic response throughout the midbrain, which was significantly enhanced by the administration of microneurotrophin BNN-20. Our results provide straightforward evidence of the existence of an endogenous midbrain neurogenic system that can be specifically strengthened by BNN-20. Interestingly, the lack of major similar activity on cultured human induced pluripotent stem cell-derived neural progenitors and their progeny reveals the in vivo specificity of the aforementioned pro-neurogenic effect