Corrigendum: Retrospective cohort study to determine the effect of preinjury antiplatelet or anticoagulant therapy on mortality in patients with major trauma

OBJECTIVE: This study aimed to compare outcomes among patients who sustained major trauma from injury with and without receiving antiplatelet therapy (APT) or anticoagulant therapy (ACT) to test the hypothesis that APT does not increase the risk of mortality. However, ACT increases the mortality risk in the acute phase of trauma. METHODS: Patients registered in the Japanese Observational body for Coagulation and Thrombolysis in Early Trauma 2 between April 2017 and March 2018 who had sustained a severe injury in any anatomic region of the body, as determined using an injury severity score (ISS) ≥ 16 were included in this retrospective cohort study. We analyzed the mortality within 24 h from the arrival using a multivariable linear regression analysis adjusted for several confounding variables. RESULTS: We identified 1,186 eligible participants who met the inclusion criteria for this study: 105 in the APT (cases), 1,081 in the non-antiplatelet therapy (nAPT) group (controls), 65 in the ACT (cases), and 1,121 in the non-anticoagulant therapy (nACT) group (controls). The mortality within 24 h in the ACT group was significantly higher than in the nACT group (odds ratio 4.5; 95%CI: 1.2–16.79; p = 0.025); however, there was no significant difference between the two groups with or without the antiplatelet drug (odds ratio 0.32; 95%CI: 0.04–2.79; p = 0.3) administration. Other outcomes, like the 28-day mortality, mortality at discharge, and surgery for hemostasis, were not significantly different between regular users and non-users of either antiplatelet or anticoagulant drugs. CONCLUSION: Regular antiplatelet medications did not increase mortality within 24 h, 28 days, or at discharge in patients with major trauma, suggesting that standard treatment, including surgery, is sufficient

Ternary Complex of Plasmid DNA Electrostatically Assembled with Polyamidoamine Dendrimer and Chondroitin Sulfate for Effective and Secure Gene Delivery

The purpose of this study was to develop a ternary complex of plasmid DNA (pDNA) electrostatically assembled with polyamidoamine (PAMAM) dendrimer and chondroitin sulfate (CS) for effective and secure gene delivery. PAMAM dendrimers are new cationic polymers that are expected to be used as gene delivery vectors. However, cationic non-viral gene vectors showed cytotoxicity by binding to negative cellular membranes. We therefore prepared a ternary complex by adding CS, an anionic polymer, and examined its usefulness. The pDNA/PAMAM dendrimer complex (PAMAM dendriplex) and the PAMAM dendriplex coated by CS (CS complex) showed nanoparticles with positive ζ- potential and negative ζ-potential, respectively. The CS complex had no cytotoxicity against B16-F10 cells and no agglutination activity, although severe cytotoxicity and high agglutination were observed in the PAMAM dendriplex. As a result of an in vitro gene expression study of B16-F10 cells, not only the PAMAM dendriplex but also the CS complex showed high transfection efficiency. The transfection efficiency of the CS complex was significantly inhibited by clathrinmediated endocytosis inhibitor (chlorpromazine), caveolae-mediated endocytosis inhibitor (genistein), and hypothermia. Tail-vein injection of the CS complex into mice led to significantly higher gene expression in the spleen than the PAMAM dendriplex. Thus, the ternary complex of pDNA electrostatically assembled with PAMAM denriplex and CS showed safe high gene expression in the spleen. This vector is expected to be useful for useful gene delivery

Ternary Complex of Plasmid DNA with Protamine and γ-Polyglutamic Acid for Biocompatible Gene Delivery System

The purpose of the present study was to investigate the usefulness of the ternary complex with protamine and γ-polyglutamic acid (γ-PGA), which are biodegradable materials for foods and medical products, as a safe gene delivery vector. We formed cationic binary complexes (plasmid DNA (pDNA)/protamine complexes) with high transfection efficiency. The binary complex showed slight toxicity probably related to its total cationic charge. Then, we formed ternary complexes (pDNA/protamine/γ-PGA complexes) by addition of anionic polymer, γ-PGA, and they showed no cytotoxicity. The transfection efficiency of the pDNA/protamine/γ-PGA complexes was as high as that of the pDNA/protamine complexes, although their zeta potentials were different. Inhibition study of the gene expressions in B16-F10 cells suggested that pDNA/protamine complexes were taken up by caveolae-mediated endocytosis and macropinocytosis. On the other hand, pDNA/protamine/ γ-PGA complexes were taken up by clathrin-mediated endocytosis and macropinocytosis. Thus, we succeeded in developing the ternary complex as a safe gene delivery vector with biocompatible materials

Table_1_A short decision time for transcatheter embolization can better associate mortality in patients with pelvic fracture: a retrospective study.docx

BackgroundEarly use of hemostasis strategies, transcatheter arterial embolization (TAE) is critical in cases of pelvic injury because of the risk of hemorrhagic shock and other fatal injuries. We investigated the influence of delays in TAE administration on mortality.MethodsPatients admitted to the Advanced Critical Care Center at Gifu University with pelvic injury between January 2008 and December 2019, and who underwent acute TAE, were retrospectively enrolled. The time from when the doctor decided to administer TAE to the start of TAE (needling time) was defined as “decision-TAE time.”ResultsWe included 158 patients, of whom 23 patients died. The median decision-TAE time was 59.5 min. Kaplan–Meier curves for overall survival were compared between patients with decision-TAE time above and below the median cutoff value; survival was significantly better for patients with values below the median cutoff value (p = 0.020). Multivariable Cox proportional hazards regression analysis revealed that the longer the decision-TAE time, the higher the risk of mortality (p = 0.031). TAE duration modified the association between decision-TAE time and overall survival (p = 0.109), as shorter TAE duration (procedure time) was associated with the best survival rate (p for interaction = 0.109).ConclusionDecision-TAE time may play a key role in establishing resuscitation procedures in patients with pelvic fracture, and efforts to shorten this time should be pursued.</p

Experimental setup for absorbance spectral imaging of single cells.

<p>Experimental setup for absorbance spectral imaging of single cells.</p

Absorbance spectra of 0.16 <i>μ</i>m × 0.6 <i>μ</i>m area (division unit) on the eyespot within two single live cells obtained by the 2D-1D conversion method.

<p>The estimated absorbance spectra (red lines) of the eyespot are calculated by subtracting the average spectra (thick black lines) from the raw spectra (thin black lines). The average spectra within the cells are calculated by the method in Appendix 2[B]. Insets: The color photographs of the live cells, where the eyespot is located on the edge of the cell within the circle.</p

The 715-nm absorption peak localized within a single cell, measured by the 2D-1D conversion method.

<p>(a) Absorption spectrum of a cell suspension after under hydrogen generation conditions. (b) Position-dependent variation of absorbance spectra of 0.16 <i>μ</i>m × 0.6 <i>μ</i>m area (division unit) within a single cell obtained by the 2D-1D conversion method. (c) Right: The image of the cell for single-cell absorbance measurement in (b) picked up from the cell suspension with a 715 nm absorption peak. Left: A(x,y,<i>λ</i> = 715 nm) for the area enclosed by the red square within the cell. The local spectra at the positions A, B, and C are displayed in (b).</p

Model for relating the single cell absorbance to the cell suspension absorbance.

<p><i>T</i>_sphere:transmittance of the chloroplast sphere as shown in the left. <i>α</i>:absorption coefficient within the chloroplast. <i>d</i>:diameter of the chloroplast sphere. <i>n</i>_<i>c</i>: cell number density in the cell suspension. <i>x</i>:chloroplast coverage ratio in the layer of the thickness <i>d</i><i>T</i>_<i>d</i>:transmittance of the layer of thickness <i>d</i> in the cell suspension <i>A</i>_s:absorbance of the cell suspension <i>L</i>:thickness of the cell suspension <i>A</i>_m:maximum local absorbance of a single cell for the light transmitted through the center of the cell</p

Comparison between single cell absorbance calculated from cell suspension absorbance and that averaged over 100 single-cell measurements.

<p>(a) Black: absorbance of a cell suspension of 5-mm path length measured with an integrating sphere. Red: maximum local absorbance calculated from the absorbance of the 5-mm cell suspension. (b) The maximum local absorbance of a single living cell, (black line) averaged over 100 single live cells measurement assuming a chloroplast of average diameter 7.42 <i>μ</i>m, and (red line) calculated from the absorbance of the cell suspension.</p