Penetrating trauma: Relationships to recreational drug and alcohol use.

INTRODUCTION: The incidence of alcohol and recreational drug use is increasing. The impact on penetrating trauma is unknown. This study was undertaken to identify the incidence of alcohol and recreational drug use prior to penetrating trauma, and to identify ISS and outcomes among patients with penetrating trauma. METHODS: In this retrospective study, eligible subjects included trauma patients age 18 and older, with major trauma (admitted or evaluated by the Trauma Team) from 2017 to 2021. A chart review was conducted to identify data including mechanism of injury, ISS, alcohol level, toxicologic testing, length of stay, and final disposition. RESULTS: Among 1270 adult subjects with penetrating trauma during 2017 through 2020, the majority were male (N = 1071; 84%), and African American (N = 679; 54.3%) or White (N = 537; 42.9%). Mechanisms of injury included gunshot wound (GSW) (N = 973; 76.6%) or stab wound (N = 297; 23.4%). Injury severity score (ISS) ranged from 1 to 75. Among 426 subjects (33.5%) tested for recreational drugs, 395 (93%) were positive for at least one substance. The most common recreational drugs identified included marijuana (N = 280; 65.7%), benzodiazepine ((N = 131;30.8%), alcohol ((N = 248; 25.3%), opiate ((N = 116; 27.2%), cocaine (N = 87; 20.4%), and amphetamine ((N = 84; 19.7%). Subjects with an ISS of 9 to 15 had higher odds of testing positive for opiates compared to subjects with an ISS of 1 to 3 (OR 2.3). Most patients were ultimately discharged home ((N = 912;71.8%) and a minority expired (N = 142; 11.2%). CONCLUSIONS: Positive screens for alcohol and recreational drugs were common among penetrating trauma patients in this setting. The most common identified recreational drugs included marijuana, benzodiazepine, opiates, alcohol, cocaine, and amphetamine.

Predicting Discharge Disposition in Trauma Patients: Development, Validation, and Generalization of a Model Using the National Trauma Data Bank.

BACKGROUND: Limited work has been done in predicting discharge disposition in trauma patients; most studies use single institutional data and have limited generalizability. This study develops and validates a model to predict, at admission, trauma patients' discharge disposition using NTDB, transforms the model into an easy-to-use score, and subsequently evaluates its generalizability on institutional data. METHODS: NTDB data were used to build and validate a binary logistic regression model using derivation-validation (ie, train-test) approach to predict patient disposition location (home vs non-home) upon admission. The model was then converted into a trauma disposition score (TDS) using an optimization-based approach. The generalizability of TDS was evaluated on institutional data from a single Level I trauma center in the U.S. RESULTS: A total of 614 625 patients in the NTDB were included in the study; 212 684 (34.6%) went to a non-home location. Patients with a non-home disposition compared to home had significantly higher age (69 ± 19.7 vs 48.3 ± 20.3) and ISS (11.2 ± 8.2 vs 8.2 ± 6.3); P < .001. Older age, female sex, higher ISS, comorbidities (cancer, cardiovascular, coagulopathy, diabetes, hepatic, neurological, psychiatric, renal, substance abuse), and Medicare insurance were independent predictors of non-home discharge. The logistic regression model's AUC was 0.8; TDS achieved a correlation of 0.99 and performed similarly well on institutional data (n = 3161); AUC = 0.8. CONCLUSION: We developed a score based on a large national trauma database that has acceptable performance on local institutions to predict patient discharge disposition at the time of admission. TDS can aid in early discharge preparation for likely-to-be non-home patients and may improve hospital efficiency.

JNSViewer-A JavaScript-based Nucleotide Sequence Viewer for DNA/RNA secondary structures.

Many tools are available for visualizing RNA or DNA secondary structures, but there is scarce implementation in JavaScript that provides seamless integration with the increasingly popular web computational platforms. We have developed JNSViewer, a highly interactive web service, which is bundled with several popular tools for DNA/RNA secondary structure prediction and can provide precise and interactive correspondence among nucleotides, dot-bracket data, secondary structure graphs, and genic annotations. In JNSViewer, users can perform RNA secondary structure predictions with different programs and settings, add customized genic annotations in GFF format to structure graphs, search for specific linear motifs, and extract relevant structure graphs of sub-sequences. JNSViewer also allows users to choose a transcript or specific segment of Arabidopsis thaliana genome sequences and predict the corresponding secondary structure. Popular genome browsers (i.e., JBrowse and BrowserGenome) were integrated into JNSViewer to provide powerful visualizations of chromosomal locations, genic annotations, and secondary structures. In addition, we used StructureFold with default settings to predict some RNA structures for Arabidopsis by incorporating in vivo high-throughput RNA structure profiling data and stored the results in our web server, which might be a useful resource for RNA secondary structure studies in plants. JNSViewer is available at http://bioinfolab.miamioh.edu/jnsviewer/index.html.

CT-Finder: A Web Service for CRISPR Optimal Target Prediction and Visualization.

The CRISPR system holds much promise for successful genome engineering, but therapeutic, industrial, and research applications will place high demand on improving the specificity and efficiency of this tool. CT-Finder (http://bioinfolab.miamioh.edu/ct-finder) is a web service to help users design guide RNAs (gRNAs) optimized for specificity. CT-Finder accommodates the original single-gRNA Cas9 system and two specificity-enhancing paired-gRNA systems: Cas9 D10A nickases (Cas9n) and dimeric RNA-guided FokI nucleases (RFNs). Optimal target candidates can be chosen based on the minimization of predicted off-target effects. Graphical visualization of on-target and off-target sites in the genome is provided for target validation. Major model organisms are covered by this web service.

Motor unit firing rates of the gastrocnemii during maximal brief steady-state contractions in humans.

The human triceps surae (soleus, medial (MG) and lateral (LG) gastrocnemii) is complex and important for posture and gait. The soleus exhibits markedly lower motor unit firing rates (MUFRs; ∼16Hz) during maximal voluntary isometric contraction (MVC) than other limb muscles, but this information is unknown for the MG and LG. During multiple visits, subjects performed a series of 5-7, ∼7-s plantar flexor MVCs with tungsten microelectrodes inserted into the MG and LG. During a separate testing session, another group of subjects performed submaximal isometric contractions at 25%, 50%, and 75% MVC with inserted fine-wires in the MG, LG and soleus. Maximum steady-state MUFRs for MG and LG (∼23Hz) were not different, but faster than prior reports for the soleus. No differences between the three triceps surae components were detected for 25% or 50% MVC, but at 75% MVC, the MG MUFRs were 31% greater than soleus. The triceps surae exhibit similar torque modulation strategies at <75% MVC, but to achieve higher contraction intensities (>75% MVC) the gastrocnemii rely on faster rates to generate maximal torque than the soleus. Therefore, the MG and LG exhibit a larger range of MUFR capacities.

Effect of creatine supplementation on muscle damage and repair following eccentrically-induced damage to the elbow flexor muscles.

We investigated effects of creatine (Cr) supplementation (CrS) on exercise-induced muscle damage. Untrained males and females (N = 27) ages 18-25, with no CrS history in the past 4 months, were randomly assigned to CrS (creatine and carbohydrate) (n = 9), placebo (P) (carbohydrate only) (n = 9), or control (C) (no supplements) groups (n = 9). Participants followed a 5-day Cr loading protocol of 40 g·day(-1), divided for 5 days prior to exercise, reduced to 10 g g·day(-1) for 5 days following exercise. Testing consisted of 5 maximal isometric contractions at 90 arm flexion with the preferred arm on a CYBEX NORM dynamometer, assessed prior to, immediately following, and 24, 48, 72, and 96 hours post muscle-damaging procedures. Damage was induced to the elbow flexor muscles using 6 sets of 10 eccentric contractions at 75 °/sec, 90 °/sec and 120 °/sec. Participants were asked to rate their muscle soreness on a scale of 1-10. Data was analyzed using repeated-measures ANOVA, with an alpha of 0.05. No significant differences were found between muscle force loss and rate of recovery or muscle soreness between groups over the 96 hr recovery period (p > 0.05). Across all 3 experimental groups an initial decrease in force was observed, followed by a gradual recovery. Significant differences were found between baseline and all others times (p = 0.031,0 .022, 0.012, 0.001 respectively), and between the 48 hour and 96 hour time periods (p = 0.034). A weak negative correlation between subjectively rated muscle soreness and mean peak isometric force loss (R(2) = 0.0374 at 96 hours), suggested that muscle soreness and muscle force loss may not be directly related. In conclusion, 5 days of Cr loading, followed by a Cr maintenance protocol did not reduce indices of muscle damage or speed recovery of upper body muscles following eccentrically induced muscle damage.