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Volumetric muscle injury (VML) causes an irrecoverable loss of muscle fibers, persistent strength deficits, and chronic disability. A crucial challenge to VML injury and possible regeneration is the removal of all of the in situ native elements necessary for skeletal muscle regeneration. Our first goal was to establish a reliable VML model in the mouse tibialis anterior (TA) muscle. In adult male wild‐type and nude mice, a non‐repaired ≈20% VML injury to the TA muscle resulted in an ≈59% loss in nerve evoked muscle strength, ≈33% loss in muscle mass, and ≈29% loss of muscle fibers at 28 day post‐injury. Our second goal was to investigate if minced muscle grafts (≈1 mm3 tissue fragments) promote recovery of muscle fibers after VML injury and to understand if the graft‐derived progenitor cells directly contribute to fiber regeneration. To assess donor cell contribution, donor muscle tissue was derived from UBC‐GFP mice in a subset of experiments. Minced grafts restored ≈34% of the lost fibers 28 days post‐injury. The number of GFP + fibers and the estimated number of regenerated fibers were similar, regardless of host mouse strain. The muscle tissue regeneration promoted by minced grafts did not improve TA muscle strength at this time post‐injury. These findings demonstrate the direct contribution of minced muscle graft‐derived myogenic stem/progenitor cells to recovery of muscle fibers after VML injury and signify the utility of autologous myogenic stem cell therapies for this indication.

Open fracture is a common occurrence in civilian and military populations. Though great strides have been made in limb salvage efforts, persistent muscle strength deficits can contribute to a diminished limb function after the bone has healed. Over the past decade, a growing effort to establish therapies directed at de novo muscle regeneration has produced several therapeutic approaches. As this effort progresses and as therapies reach clinical testing, many questions remain regarding the pathophysiology of the volumetric loss of skeletal muscle. The current study demonstrates, in a rat "open fracture" model, that the volumetric loss of skeletal muscle results in persistent functional deficits that are dependent on muscle length and joint angle. Moreover, the injured muscle has an increased stiffness during passive stretch and a reduced functional excursion. A case study of a patient with an open type III tibia fracture resulting in volumetric muscle loss in the anterior and posterior compartment is also presented. Eighteen months after injury and tibia healing, persistent functional deficits are apparent with many of the same qualities demonstrated in the animal model. Muscle architectural adaptations likely underlie the altered intrinsic functional characteristics of the remaining musculature.

FUsed in Sarcoma/Translocated in LipoSarcoma (FUS/TLS or FUS) has been linked to several biological processes involving DNA and RNA processing, and has been associated with multiple diseases, including myxoid liposarcoma and amyotrophic lateral sclerosis (ALS). ALS-associated mutations cause FUS to associate with stalled translational complexes called stress granules under conditions of stress. However, little is known regarding the normal role of endogenous (non-disease linked) FUS in cellular stress response. Here, we demonstrate that endogenous FUS exerts a robust response to hyperosmolar stress induced by sorbitol. Hyperosmolar stress causes an immediate re-distribution of nuclear FUS to the cytoplasm, where it incorporates into stress granules. The redistribution of FUS to the cytoplasm is modulated by methyltransferase activity, whereas the inhibition of methyltransferase activity does not affect the incorporation of FUS into stress granules. The response to hyperosmolar stress is specific, since endogenous FUS does not redistribute to the cytoplasm in response to sodium arsenite, hydrogen peroxide, thapsigargin, or heat shock, all of which induce stress granule assembly. Intriguingly, cells with reduced expression of FUS exhibit a loss of cell viability in response to sorbitol, indicating a prosurvival role for endogenous FUS in the cellular response to hyperosmolar stress.

Despite the fact that natural disasters occur more commonly in low and middle income countries than in wealthier countries, we know relatively little about how these disasters are experienced in such contexts. South Africa presents an especially telling example in which it is clear that natural events are affected profoundly by sociopolitical factors, including the spatial design of the apartheid city. We report here on interviews with twenty survivors of the biggest shanty town fire in the history of Cape Town, South Africa. The narratives of participants demonstrate that in order to understand the human cost of such disasters it is as important to understand the politics of the precursors of the disaster as well as what occurred subsequent to the disaster. The South African case, like that of Hurricane Katrina, underscores the fact that disaster, far from being an acute event which happens to individuals, is better understood as part of a far longer sociopolitical process affecting individuals, groups, and, indeed, societies.

Summary Objective To investigate the prevalence and correlates of missed opportunities for addressing reproductive and mental health needs during patients’ visits to primary healthcare facilities. Methods We selected a random sample of participants from 14 of the 49 clinics in Cape Town’s public health sector using stratified, cluster random sampling (n = 2618). Participants were screened to identify those at risk for unsafe sexual behaviour and a mental disorder (specifically substance use, depression, anxiety, and suicide). Information pertaining to whether or not respondents were asked about these issues during clinic visits during the previous year was elicited. The rates and correlates of missed opportunities for providing reproductive and mental health interventions were calculated. Results The criteria of a strict definition of a missed opportunity for reproductive or mental health care information were fulfilled by 25% of the sample, while 46% met criteria for a looser definition. After adjusting for the effects of other variables in the model, men and Coloured respondents were more likely to have satisfied the definition of a missed opportunity for an intervention, while having completed high school and having children increased the likelihood of receiving an intervention. Conclusion Consultations with primary healthcare providers in which these issues are not discussed may represent missed opportunities. Persons presenting for routine care can be counselled, screened and, if required, treated. Interventions are needed at the patient, provider, and community levels to increase the opportunities to provide reproductive and mental health care to patients during routine visits. Le moment est maintenant: les occasions manquees pour repondre aux besoins des patients dans les cliniques communautaires a Cape Town, Afrique du Sud Objectif: Investiguer la prevalence et les correlats des occasions manquees pour repondre aux besoins de la sante mentale et de reproduction lors des visites des patients dans les services de sante primaire. Methodes: Nous avons selectionne un echantillon aleatoire de participants dans 14 des 49 cliniques du secteur publique de sante de Cape Town en utilisant l’echantillonnage stratifie, aleatoire en grappes (n = 2618). Les participants ont eteevalues pour determiner ceux a risque de comportements sexuels a risque et de troubles mentaux (en particulier l’usage de substances, la depression, l’anxiete et le suicide). Des informations relatives a l’opportunite ou non pour les repondants d’avoir ete interroges sur ces questions lors des visites a la clinique au cours de l’annee precedente ont eteelucidees. Les taux et correlats des occasions manquees de fournir des interventions de sante reproductive et mentale ont ete calcules. Resultats: Les criteres pour une definition stricte d’une occasion manquee pour des informations sur les soins de sante mentale ou de reproduction etaient remplis par 25% de l’echantillon, tandis que 46% repondaient aux criteres d’une definition plus souple. Apres ajustement pour les effets d’autres variables du modele, les hommes et les repondants de couleur etaient plus susceptibles de satisfaire a la definition d’une occasion manquee pour une intervention, alors que le fait d’avoir termine les etudes secondaires et avoir des enfants augmentaient la probabilite de recevoir une intervention. Conclusion: Des consultations avec les prestataires des soins de sante primaire au cours desquelles ces questions ne sont pas abordees peuvent representer des occasions manquees. Les personnes se presentant pour des soins de routine peuvent etre conseillees, evaluees et, si necessaire, traitees. Des interventions sont necessaires a l’echelle du patient, du prestataire et de la communaute pour augmenter les possibilites de fournir des soins de sante mentale et reproductive aux patients lors des visites de routine. El momento es ahora: oportunidades perdidas para ocuparse de las necesidades del paciente en clinicas comunitarias de Ciudad del Cabo, Sudafrica Objetivo: Investigar la prevalencia y la correlacion entre las oportunidades perdidas para ocuparse de las necesidades en salud reproductiva y mental de los pacientes que se visitan en centros de atencion primaria Metodos: Hemos seleccionado una muestra aleatoria de participantes de 14 de las 49 clinicas del sector sanitario publico de Ciudad del Cabo, utilizando un muestreo estratificado, aleatorio y en conglomerados (n = 2,618). Los participantes fueron tamizados para identificar aquellos en riesgo por comportamientos sexuales de riesgo y desordenes mentales (especificamente uso de sustancias, depresion, ansiedad y suicidio). Se obtuvo informacion sobre si a los participantes se les habian preguntado acerca de estos temas durante el ano anterior. Se calcularon las tasas y correlaciones de las oportunidades perdidas para proveer intervenciones de salud reproductiva y mental. Resultados: Los criterios de una definicion estricta de oportunidad perdida para informar sobre cuidados reproductivos o mentales fueron alcanzados por un 25% de la muestra, mientras que un 46% cumplia criterios para una definicion mas laxa. Tras ajustar para los efectos de otras variables en el modelo, los hombres y participantes de color tenian una mayor probabilidad de haber satisfecho la definicion de una oportunidad perdida para una intervencion, mientras que el haber completado el bachillerato y tener ninos aumentaba la probabilidad de recibir una intervencion. Conclusion: Las consultas con proveedores del sector sanitario primario, en los que no se discuten los temas en cuestion, pueden representar oportunidades perdidas. Las personas que acuden a cuidados rutinarios pueden ser aconsejadas, tamizadas, y en caso de requerirlo, tratadas. Se requieren intervenciones a nivel del paciente, del proveedor y de la comunidad para aumentar las oportunidades de proveer cuidados reproductivos y mentales a los pacientes durantes las visitas de rutina.

Gangs have a long history in Cape Town and children tend to begin involvement around age 12. Children’s views on causes of children’s involvement in gangs and appropriate interventions, were sought for inclusion in policy recommendations. Thirty focus group discussions were held with in- and out-of-school youth in different communities. Participants identified failing social structures as the causes of gangsterism. They recommended interventions to enable social structures to provide a wide range of opportunities for positive youth development, rather than programmes narrowly focused on gangs.

This preliminary study investigated an intervention to mitigate mental health effects of forensic mortuary work. Fourteen peer-nominated opinion leaders at two mortuaries were trained in traumatic stress management methods. Effect was examined on variables assessing stress management and effects of traumatic stress. Sixty-two staff members participated. At baseline, opinion leaders did not differ from their colleagues on any variable. After intervention, opinion leaders had significantly better scores in comparison to coworkers in leisure repertoire, problem solving, and positive states of mind, but no difference in use of avoidance or social support, or in interpersonal relationships. Qualitative data suggests that opinion leaders had increased self-awareness, improved ability to tolerate unchangeable stressors, and increased belief in their ability to make changes.