Consensus on the management of traumatic brain injury in older adults: Results from a Delphi study

Introduction As the world population is rapidly becoming older, the incidence of traumatic brain injury (TBI) is increasing among older adults with vast implications for brain health of older adults in Europe. Due to differences from younger patients, there are areas of uncertainty in the assessment, diagnosis and management of TBI in older adults. Research question To reach a consensus among experts on statements regarding the definition of old age, assessment, diagnosis and management of traumatic brain injury in older adults. Materials and methods A modified Delphi method consisting of two online rounds was organised, followed by an in-person meeting. Consensus was defined as >75 % agreement. In the second online round the experts were able to view their first assessment and the average of the group. Some statements were rephrased and presented again in the in-person meeting. Questions with numerical data could not be assessed by consensus and descriptive and non-parametric statistics were used to analyze them. Results Experts (n = 72), from different nationalities (Europe, United States, Latin America, Africa and Asia) and specialities (Neurosurgery, Emergency Medicine, Intensive care medicine) responded on 62 statements. Consensus was finally reached on 44 statements regarding the definition of older adulthood, as well as the assessment, surgical and intensive care management, discharge, and rehabilitation of patients. Discussion and conclusions This consensus reinforces the importance of this area for physicians and researchers interested in traumatic brain injury. It signals important areas of agreement as well as future topics for research and specific knowledge gaps

SalMotifDB:a tool for analyzing putative transcription factor binding sites in salmonid genomes

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Rapid sex-specific evolution of age at maturity is shaped by genetic architecture in Atlantic salmon

AbstractUnderstanding the mechanisms by which populations adapt to their environments is a fundamental aim in biology. However, it remains challenging to identify the genetic basis of traits, provide evidence of genetic changes and quantify phenotypic responses. Age at maturity in Atlantic salmon represents an ideal trait to study contemporary adaptive evolution as it has been associated with a single locus in thevgll3region, and has also strongly changed in recent decades. Here, we provide an empirical example of contemporary adaptive evolution of a large effect locus driving contrasting sex-specific evolutionary responses at the phenotypic level. We identified an 18% decrease in thevgll3allele associated with late maturity (L) in a large and diverse salmon population over 36 years, induced by sex-specific selection during the sea migration. Those genetic changes resulted in a significant evolutionary response in males only, due to sex-specific dominance patterns andvgll3allelic effects. Thevgll3allelic and dominance effects differed greatly in a second population and were likely to generate different selection and evolutionary patterns. Our study highlights the importance of knowledge of genetic architecture to better understand fitness trait evolution and phenotypic diversity. It also emphasizes the potential role of adaptive evolution in the trend toward earlier maturation observed in numerous Atlantic salmon populations worldwide.</jats:p