THE PATIENT-SPECIFIC INJURY SCORE: PRECISION MEDICINE IN TRAUMA PATIENTS PREDICTS ORGAN DYSFUNCTION AND OUTCOMES

poster abstractIntroduction: Current injury scoring systems in polytraumatized patients are limited at predicting patient outcomes. We present a novel method that quantifies mechanical tissue damage and cumulative hypoperfusion using a precision medicine approach. We hypothesized that a Patient-Specific Injury score formulated from individualized injury indices would stratify patient risk for developing organ dysfunction after injury. We compared correspondence between PSI and the Injury Severity Score with outcomes of organ dysfunction and MOF. Methods: Fifty Multiply-injured-patients (MIPs) were studied. Tissue Damage Volume scores were measured from admission pan-axial CT scans using purpose-designed post-processing software to quantify volumetric magnitude and distribution of injuries. Ischemic injury was quantified using Shock Volumes. SV is a time-magnitude integration of shock index. Values above 0.9 were measured in the 24-hours after injury. Metabolic response was quantified by subtracting the lowest first 24 hr pH from 7.40. PSI combines these indices into the formula: PSI=[0.2TDV+SV]*MR. Correspondence coefficients from regression modeling between PSI and organ dysfunction, measured by the Marshall Multiple Organ Dysfunction score averaged from days 2-5 post-injury, were compared to similar regression models of ISS vs. day 2-5 MOD-scores. We compared PSI and ISS in patients that did or did not develop MOF. Results: PSI demonstrated better correlation to organ dysfunction (r2=0.576) in comparison to ISS (r2=0.393) using the MOD-score on days 2-5. Mean PSI increased 3.4x(58.5vs.17.0;p<0.02) and ISS scores increased 1.4x(39.0vs.28.0;p=0.10) in patients that developed MOF versus those that did not. Conclusions: This study shows that a precision medicine approach that integrates patient-specific indices of mechanical tissue damage, ischemic tissue injury, and metabolic response better corresponds to phenotypic changes including organ dysfunction and MOF compared to ISS in MIPs. The PSI-score can be calculated within 24 hours of injury, making it useful for stratifying risk and predicting the magnitude of organ dysfunction to anticipate

Post-Prior discrepancies in CDW-EIS calculations for ion impact ionization fully differential cross sections

In this work we present fully differential cross sections (FDCSs) calculations using post and prior version of CDW--EIS theory for helium single ionization by 100 MeV C$^{6+}$ amu$^{-1}$ and 3.6 MeV amu$^{-1}$ Au$^{24+}$ and Au$^{53+}$ ions. We performed our calculations for different momentum transfer and ejected electron energies. The influence of internuclear potential on the ejected electron spectra is taken into account in all cases. We compare our calculations with absolute experimental measurements. It is shown that prior version calculations give better agreement with experiments in almost all studied cases.Comment: 9 pages, 7 figure

On Exchange of Orbital Angular Momentum Between Twisted Photons and Atomic Electrons

We obtain an expression for the matrix element for a twisted (Laguerre-Gaussian profile) photon scattering from a hydrogen atom. We consider photons incoming with an orbital angular momentum (OAM) of $\ell \hbar$, carried by a factor of $e^{i \ell \phi}$ not present in a plane-wave or pure Gaussian profile beam. The nature of the transfer of $+2\ell$ units of OAM from the photon to the azimuthal atomic quantum number of the atom is investigated. We obtain simple formulae for these OAM flip transitions for elastic forward scattering of twisted photons when the photon wavelength $\lambda$ is large compared with the atomic target size $a$, and small compared the Rayleigh range $z_R$, which characterizes the collimation length of the twisted photon beam.Comment: 16 page

The reality of authentic leadership: the rugby football league challenge

© 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis GroupPurpose/rationale: The aim of this paper is to increase the understanding in the area of authentic leadership (AL) within executive leader practice in a UK commercial sport national governing body (NGB). Design/methodology/approach: Ten interviews were conducted with members of the organisation’s management group. The interviews were utilised to gain new insights into the levels of executive leader AL within a commercial sport governance environment. Interviews were analysed using an interpretive approach, and a thematic structure relating to AL in the commercial NGB context. Findings: Authentic elements within the executive leadership team’s practice were dependent on the organisational context and the impact of external factors on individuals and the NGB. Full engagement with the AL construct is curtailed by organisational structure and objectives. Practical implications: The findings and related existing literature, notably the debate on the universal acceptance of the AL construct, are integrated into the paper to contribute to the discourse on the leadership construct in a sport governance environment. Research contribution: The study contributes to the growing body of sport leadership within NGB literature and provides insights into the paradoxical nature of leadership and the executive leader ability to fully engage with all elements of the AL construct.Unfunde

The climate sensitivity of Norway spruce [Picea abies (L.) Karst.] in the southeastern European Alps

Tree ring chronologies were developed from trees growing at two sites in Slovenia which differed in their ecological and climatological characteristics. Ring width, maximum latewood density, annual height increment and latewood cellulose carbon isotope composition were developed at both sites and time-series verified against instrumental climate data over the period (AD 1960–AD 2002). Ring width sensitivity to summer temperature is site-dependent, with contrasting responses at alpine and lowland sites. Maximum density responds to September temperatures, suggesting lignification after cell division has ended for the season. Stable carbon isotopes have great potential, responding to summer temperature at oth alpine and lowland stands. Height increment appears relatively insensitive to climate, and is likely to be dominated by local stand dynamics

Deep coverage whole genome sequences and plasma lipoprotein(a) in individuals of European and African ancestries.

Lipoprotein(a), Lp(a), is a modified low-density lipoprotein particle that contains apolipoprotein(a), encoded by LPA, and is a highly heritable, causal risk factor for cardiovascular diseases that varies in concentrations across ancestries. Here, we use deep-coverage whole genome sequencing in 8392 individuals of European and African ancestry to discover and interpret both single-nucleotide variants and copy number (CN) variation associated with Lp(a). We observe that genetic determinants between Europeans and Africans have several unique determinants. The common variant rs12740374 associated with Lp(a) cholesterol is an eQTL for SORT1 and independent of LDL cholesterol. Observed associations of aggregates of rare non-coding variants are largely explained by LPA structural variation, namely the LPA kringle IV 2 (KIV2)-CN. Finally, we find that LPA risk genotypes confer greater relative risk for incident atherosclerotic cardiovascular diseases compared to directly measured Lp(a), and are significantly associated with measures of subclinical atherosclerosis in African Americans

Haplotype differences for copy number variants in the 22q11.23 region among human populations: a pigmentation-based model for selective pressure.

Two gene clusters are tightly linked in a narrow region of chromosome 22q11.23: the macrophage migration inhibitory factor (MIF) gene family and the glutathione S-transferase theta class. Within 120 kb in this region, two 30-kb deletions reach high frequencies in human populations. This gives rise to four haplotypic arrangements, which modulate the number of genes in both families. The variable patterns of linkage disequilibrium (LD) between these copy number variants (CNVs) in diverse human populations remain poorly understood. We analyzed 2469 individuals belonging to 27 human populations with different ethnic origins. Then we correlated the genetic variability of 22q11.23 CNVs with environmental variables. We confirmed an increasing strength of LD from Africa to Asia and to Europe. Further, we highlighted strongly significant correlations between the frequency of one of the haplotypes and pigmentation-related variables: skin color (R2=0.675, P<0.001), distance from the equator (R2=0.454, P<0.001), UVA radiation (R2=0.439, P<0.001), and UVB radiation (R2=0.313, P=0.002). The fact that all MIF-related genes are retained on this haplotype and the evidences gleaned from experimental systems seem to agree with the role of MIF-related genes in melanogenesis. As such, we propose a model that explains the geographic and ethnic distribution of 22q11.23 CNVs among human populations, assuming that MIF-related gene dosage could be associated with adaptation to low UV radiatio

New age constraints for the limit of the British–Irish Ice Sheet on the Isles of Scilly

This is the final version of the article. Available from Wiley via the DOI in this record.The southernmost terrestrial extent of the Irish Sea Ice Stream (ISIS), which drained a large proportion of the last British–Irish Ice Sheet, impinged on to the Isles of Scilly during Marine Isotope Stage 2. However, the age of this ice limit has been contested and the interpretation that this occurred during the Last Glacial Maximum (LGM) remains controversial. This study reports new ages using optically stimulated luminescence (OSL) dating of outwash sediments at Battery, Tresco (25.5 ± 1.5 ka), and terrestrial cosmogenic nuclide exposure dating of boulders overlying till on Scilly Rock (25.9 ± 1.6 ka), which confirm that the ISIS reached the Isles of Scilly during the LGM. The ages demonstrate this ice advance on to the northern Isles of Scilly occurred at ∼26 ka around the time of increased ice-rafted debris in the adjacent marine record from the continental margin, which coincided with Heinrich Event 2 at ∼24 ka. OSL dating (19.6 ± 1.5 ka) of the post-glacial Hell Bay Gravel at Battery suggests there was then an ∼5-ka delay between primary deposition and aeolian reworking of the glacigenic sediment, during a time when the ISIS ice front was oscillating on and around the Llŷn Peninsula, ∼390 km to the north.This paper was supported by a Natural Environment Research Council consortium grant (BRITICE-CHRONO NE/J008672/1). H. Wynne is thanked for etching the quartz grains for OSL dating. A. Palmer and S. Carr are also acknowledged for preparing the thin sections and running the tomograph analyses, respectively. Thanks to the Tresco Estate for allowing us access to the Battery and Gunhill sites and facilitating sampling there, to Dave Mawer and Julie Love of the IOS Wildlife Trust for facilitating access to Shipman Head and Scilly Rock, and for supplying the photograph (Fig. 4b). We would like to thank Jeremy Phillips of the St Mary's Boatmen's Association for logistical support