Reply to: Common orthopaedic trauma may explain 31,000-year-old remains.
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SUBMITTER: Vlok M
PROVIDER: S-EPMC10017509 | biostudies-literature | 2023 Mar
REPOSITORIES: biostudies-literature
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Reply to: Common orthopaedic trauma may explain 31,000-year-old remains.
Vlok Melandri M Maloney Tim T Dilkes-Hall India Ella IE Oktaviana Adhi Agus AA Setiawan Pindi P Priyatno Andika Arief Drajat AAD Ririmasse Marlon M Geria I Made IM Effendy Muslimin A R MAR Istiawan Budy B Atmoko Falentinus Triwijaya FT Adhityatama Shinatria S Moffat Ian I Joannes-Boyau Renaud R Brumm Adam A Aubert Maxime M
Nature 20230301 7952
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| S-EPMC10017491 | biostudies-literature
Project description:Insects form an important source of food for many people around the world, but little is known of the deep-time history of insect harvesting from the archaeological record. In Australia, early settler writings from the 1830s to mid-1800s reported congregations of Aboriginal groups from multiple clans and language groups taking advantage of the annual migration of Bogong moths (Agrotis infusa) in and near the Australian Alps, the continent's highest mountain range. The moths were targeted as a food item for their large numbers and high fat contents. Within 30 years of initial colonial contact, however, the Bogong moth festivals had ceased until their recent revival. No reliable archaeological evidence of Bogong moth exploitation or processing has ever been discovered, signalling a major gap in the archaeological history of Aboriginal groups. Here we report on microscopic remains of ground and cooked Bogong moths on a recently excavated grindstone from Cloggs Cave, in the southern foothills of the Australian Alps. These findings represent the first conclusive archaeological evidence of insect foods in Australia, and, as far as we know, of their remains on stone artefacts in the world. They provide insights into the antiquity of important Aboriginal dietary practices that have until now remained archaeologically invisible.
| S-EPMC7747710 | biostudies-literature
Project description:BackgroundAs Short Interspersed Elements (SINEs), human-specific Alu elements can be used for population genetic studies. Very recent inserts are polymorphic within and between human populations. In a sample of 30 elements originating from three different Alu subfamilies, we investigated whether they are preserved in prehistorical skeletal human remains from the Bronze Age Lichtenstein cave in Lower Saxony, Germany. In the present study, we examined a prehistoric triad of father, mother and daughter.ResultsFor 26 of the 30 Alu loci investigated, definite results were obtained. We were able to demonstrate that presence/absence analyses of Alu elements can be conducted on individuals who lived 3,000 years ago. The preservation of the ancient DNA (aDNA) is good enough in two out of three ancient individuals to routinely allow the amplification of 500 bp fragments. The third individual revealed less well-preserved DNA, which results in allelic dropout or complete amplification failures. We here present an alternative molecular approach to deal with these degradation phenomena by using internal Alu subfamily specific primers producing short fragments of approximately 150 bp.ConclusionsOur data clearly show the possibility of presence/absence analyses of Alu elements in individuals from the Lichtenstein cave. Thus, we demonstrate that our method is reliably applicable for aDNA samples with good or moderate DNA preservation. This method will be very useful for further investigations with more Alu loci and larger datasets. Human population genetic studies and other large-scale investigations would provide insight into Alu SINE-based microevolutionary processes in humans during the last few thousand years and help us comprehend the evolutionary dynamics of our genome.
| S-EPMC4836192 | biostudies-literature
Project description:The disability adjusted life years (DALYs) associated with injuries have increased by 34% from 1990 to 2010, making it the 10th leading cause of disability worldwide, with most of the burden affecting low-income countries. Although disability from injuries is often preventable, limited access to essential surgical services contributes to these increasing DALY rates. Similar to many other low- and middle-income countries (LMIC), Uganda is plagued by a growing volume of traumatic injuries. The aim of this study is to explore the orthopaedic trauma patient's experience in accessing medical care in Uganda and what affects the injury might have on the socioeconomic status for the patient and their dependents. We also evaluate the factors that impact an individual's ability to access an appropriate treatment facility for their traumatic injury. Semi-structured interviews were conducted with patients 18 year of age or older admitted with a fractured tibia or femur at Mulago National Referral Hospital in Kampala, Uganda. As limited literature exists on the socioeconomic impacts of disability from trauma, we designed a descriptive qualitative case study, using thematic analysis, to extract unique information for which little has been previously been documented. This methodology is subject to less bias than other qualitative methods as it imposes fewer preconceptions. Data analysis of the patient interviews (n = 35) produced over one hundred codes, nine sub-themes and three overarching themes. The three overarching categories revealed by the data were: 1) the importance of social supports; 2) the impact of and on economic resources; and 3) navigating the healthcare system. Limited resources to fund the treatment of orthopaedic trauma patients in Uganda leads to reliance of patients on their friends, family, and hospital connections, and a tremendous economic burden that falls on the patient and their dependents.
| S-EPMC4215992 | biostudies-literature
Project description:Mastodon (Mammut americanum) remains unearthed during excavation of ancient sediments usually consist only of skeletal material, due to postmortem decomposition of soft tissues by microorganisms. Two recent excavations of skeletal remains in anoxic sediments in Ohio and Michigan, however, have uncovered organic masses which appear to be remnants of the small and large intestines, respectively. Macrobotanical examinations of the composition of these masses revealed assemblages of plant material radiocarbon dated to approximately 11,500 years before the present and thought to be incompletely digested food remains from this extinct mammal. We attempted to cultivate and identify bacteria from the intestinal contents, bone-associated sediments, and sediments not in proximity to the remains using a variety of general and selective media. In all, 295 isolates were cultivated, and 38 individual taxa were identified by fatty acid-methyl ester (FAME) profiles and biochemical characteristics (API-20E). The taxonomic positions of selected enteric and obligately anaerobic bacteria were confirmed by 16S ribosomal DNA (rDNA) sequencing. Results indicate that the intestinal and bone-associated samples contained the greatest diversity of bacterial taxa and that members of the family Enterobacteriaceae represented 41% of all isolates and were predominant in the intestinal masses and sediments in proximity to the skeleton but were uncommon in the background sediments. Enterobacter cloacae was the most commonly identified isolate, and partial rDNA sequencing revealed that Rahnella aquatilis was the correct identity of strains suggested by FAME profiles to be Yersinia enterocolitica. No Bacteroides spp. or expected intestinal anaerobes were recovered. The only obligate anaerobes recovered were clostridia, and these were not recovered from the small intestinal masses. Microbiological evidence from this study supports other, macrobotanical data indicating the intestinal origin of these masses. Whether these organisms are direct descendants of the original intestinal microbiota, however, cannot be established.
| S-EPMC106097 | biostudies-literature
Project description:ObjectiveThe COVID-19 pandemic has affected specialised healthcare training at all levels. Surgical learning has been severely affected, and the impact on orthopaedic surgery residency training has so far not been assessed.Material and methodsAn online survey of 17 questions was sent via web link to orthopaedic surgery residents throughout Spain between February 10, 2021 and February 28, 2021. The effects of the COVID-19 pandemic on the care and training activities of residents were analysed.ResultsA total of 307 orthopaedic surgery residents from all over Spain responded to the online survey. A total of 77.2% of the respondents had to suspend their rotations. Of these, 67.5% would like to resume the rotations they missed during the pandemic. A total of 69.7% of scheduled surgeries were suspended. Surgical activity was completely stopped for an average of 8 weeks. 66.8% of the residents consider that their surgical training has been affected and this will have repercussions on their future work. 49.5% considered the online training offered to be insufficient. Of the total number of respondents, 52.1% considered that the impact of the pandemic situation on their training situation was bad or very bad.ConclusionsThe data collection shows a negative impact on both theoretical and clinical training. This study highlights the need to continue offering quality training by maximising learning opportunities.
| S-EPMC9281451 | biostudies-literature
Project description:IntroductionThe Royal College of Surgeons of England (RCS) has issued guidance regarding the use of reoperation rates in the revalidation of UK-based orthopaedic surgeons. Currently, little has been published concerning acceptable rates of reoperation following primary surgical management of orthopaedic trauma, particularly with reference to revalidation.MethodsA retrospective review was conducted of patients undergoing clearly defined reoperations following primary surgical management of trauma between 1 January 2010 and 31 December 2011. A full case note review was undertaken to establish the demographics, clinical course and context of reoperation. A review of the imaging was performed to establish whether the procedure performed was in line with accepted trauma practice and whether the technical execution was acceptable.ResultsA total of 3,688 patients underwent primary procedures within the time period studied while 70 (1.90%, 99% CI: 1.39-2.55) required an unplanned reoperation. Thirty-nine (56%) of these patients were male. The mean age of patients was 56 years (range: 18-98 years) and there was a median time to reoperation of 50 days (IQR: 13-154 days). Potentially avoidable reoperations occurred in 41 patients (58.6%, 99% CI: 43.2-72.6). This was largely due to technical errors (40 patients, 57.1%, 99% CI: 41.8-71.3), representing 1.11% (99% CI: 0.73-1.64) of the total trauma workload. Within RCS guidelines, 28-day reoperation rates for hip, wrist and ankle fractures were 1.4% (99% CI: 0.5-3.3), 3.5% (99% CI: 0.8%-12.1) and 1.86% (99% CI: 0.4-6.6) respectively.ConclusionsWe present novel work that has established baseline reoperation rates for index procedures required for revalidation of orthopaedic surgeons.
| S-EPMC4473898 | biostudies-literature
Project description:Traumatic lesions on human skeletal remains are widely used for reconstructing past accidents or violent encounters and for comparing trauma prevalence across samples over time and space. However, uncertainties in trauma prevalence estimates increase proportionally with decreasing skeletal completeness, as once-present trauma might have gone missing. To account for this bias, samples are typically restricted to skeletal remains meeting a predefined minimum completeness threshold. However, the effect of this common practice on resulting estimates remains unexplored. Here, we test the performance of the conventional frequency approach, which considers only specimens with ≥ 75% completeness, against a recent alternative based on generalized linear models (GLMs), integrating specimen completeness as a covariate. Using a simulation framework grounded on empirical forensic, clinical, and archaeological data, we evaluated how closely frequency- and GLM-based estimates conform to the known trauma prevalence of once-complete cranial samples after introducing increasing levels of missing values. We show that GLM-based estimates were consistently more precise than frequencies across all levels of incompleteness and regardless of sample size. Unlike GLMs, frequencies increasingly produced incorrect relative patterns between samples and occasionally failed to produce estimates as incompleteness increased, particularly in smaller samples. Consequently, we generally recommend using GLMs and their extensions over frequencies, although neither approach is fully reliable when applied to largely incomplete samples.
| S-EPMC11557604 | biostudies-literature
Project description:PurposeTo determine the practice patterns and complication rates in medial ulnar collateral ligament (MUCL) repair versus reconstruction procedures performed by early-career orthopaedic surgeons each year between 2010 and 2020, stratified by fellowship training and concomitant procedures performed, during their 6-month American Board of Orthopaedic Surgery (ABOS) Case List collection period.MethodsThe ABOS database was queried for MUCL reconstruction and MUCL repair procedures reported by ABOS Part II Oral Examination examinees from 2010 to 2020. Surgeon fellowship training background, patient demographics, procedural diagnosis codes, complications, and concomitant procedures were recorded for each case. Differences between overall procedure rates and the associated complications reported were examined. Data regarding the specific injury pathology and other patient-specific characteristics for each case were not available.ResultsIn total, 187 primary procedures performed to address isolated MUCL injuries were reported. Of those, 83% (n = 155) were reconstructions and 17% (n = 32) were repairs. The annual percentage of MUCL repair increased from 10% (1/10) in 2010 to 38% (8/21) in 2020 (linear regression; R2 = 0.56, P < .05). The cumulative complication rate for MUCL reconstruction (11.6%) was significantly lower than for MUCL repair (25%) from 2010 to 2020 (P < .05). This remained true among subsets of cases from Orthopaedic Sports Medicine, Shoulder & Elbow, and or Hand Surgery fellowship-trained examinees, although only statistically significant in the Hand Surgery subset. Reported complication rates were not significantly different among cases in which concurrent ulnar nerve neuroplasty and/or transposition or concurrent elbow arthroscopy were performed.ConclusionsAmong cases reported by ABOS Part II Oral Examination examinees from 2010 to 2020, there was an increasing rate of MUCL repair whereas MUCL reconstruction remained more common overall. Interestingly, the overall complication rates were significantly lower for MUCL reconstruction than for MUCL repair both in isolation and when concurrent procedures were performed.Level of evidenceLevel III, retrospective cohort study.
| S-EPMC10300532 | biostudies-literature
Project description:BACKGROUND:The objective of this analysis is to evaluate the necessity of large clinical trials using FLOW trial data. METHODS:The FLOW pilot study and definitive trial were factorial trials evaluating the effect of different irrigation solutions and pressures on re-operation. To explore treatment effects over time, we analyzed data from the pilot and definitive trial in increments of 250 patients until the final sample size of 2447 patients was reached. At each increment we calculated the relative risk (RR) and associated 95% confidence interval (CI) for the treatment effect, and compared the results that would have been reported at the smaller enrolments with those seen in the final, adequately powered study. RESULTS:The pilot study analysis of 89 patients and initial incremental enrolments in the FLOW definitive trial favored low pressure compared to high pressure (RR: 1.50, 95% CI: 0.75-3.04; RR: 1.39, 95% CI: 0.60-3.23, respectively), which is in contradiction to the final enrolment, which found no difference between high and low pressure (RR: 1.04, 95% CI: 0.81-1.33). In the soap versus saline comparison, the FLOW pilot study suggested that re-operation rate was similar in both the soap and saline groups (RR: 0.98, 95% CI: 0.50-1.92), whereas the FLOW definitive trial found that the re-operation rate was higher in the soap treatment arm (RR: 1.28, 95% CI: 1.04-1.57). CONCLUSIONS:Our findings suggest that studies with smaller sample sizes would have led to erroneous conclusions in the management of open fracture wounds. TRIAL REGISTRATION:NCT01069315 (FLOW Pilot Study) Date of Registration: February 17, 2010, NCT00788398 (FLOW Definitive Trial) Date of Registration: November 10, 2008.
| S-EPMC5909275 | biostudies-literature