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BackgroundDipeptidyl peptidase-3 (DPP3) is a metallopeptidase which cleaves bioactive peptides, notably angiotensin II, and is involved in inflammation regulation. DPP3 has been proposed to be a myocardial depressant factor and to be involved in circulatory failure in acute illnesses, possibly due to angiotensin II cleavage. In this study, we evaluated the association between plasmatic DPP3 level and outcome (mortality and hemodynamic failure) in severely ill burn patients.MethodsIn this biomarker analysis of a prospective cohort study, we included severely ill adult burn patients in two tertiary burn intensive care units. DPP3 was measured at admission (DPP3admin) and 3 days after. The primary endpoint was 90-day mortality. Secondary endpoints were hemodynamic failure and acute kidney injury (AKI).ResultsOne hundred and eleven consecutive patients were enrolled. The median age was 48 (32.5-63) years, with a median total body surface area burned of 35% (25-53.5) and Abbreviated Burn Severity Index (ABSI) of 8 (7-11). Ninety-day mortality was 32%. The median DPP3admin was significantly higher in non-survivors versus survivors (53.3 ng/mL [IQR 28.8-103.5] versus 27.1 ng/mL [IQR 19.4-38.9]; p

Abstract Background There is wide variability between intensivists in the decisions to forgo life-sustaining treatment (DFLST). Advance directives (ADs) allow patients to communicate their end-of-life wishes to physicians. We assessed whether ADs reduced variability in DFLSTs between intensivists. Methods We conducted a multicenter, prospective, simulation study. Eight patients expressed their wishes in ADs after being informed about DFLSTs by an intensivist-investigator. The participating intensivists answered ten questions about the DFLSTs of each patient in two scenarios, referring to patients’ characteristics without ADs (round 1) and then with (round 2). DFLST score ranged from 0 (no-DFLST) to 10 (DFLST for all questions). The main outcome was variability in DFLSTs between intensivists, expressed as relative standard deviation (RSD). Results A total of 19,680 decisions made by 123 intensivists from 27 ICUs were analyzed. The DFLST score was higher with ADs than without (6.02 95% CI [5.85; 6.19] vs 4.92 95% CI [4.75; 5.10], p

Abstract Background Dipeptidyl peptidase-3 (DPP3) is a metallopeptidase which cleaves bioactive peptides, notably angiotensin II, and is involved in inflammation regulation. DPP3 has been proposed to be a myocardial depressant factor and to be involved in circulatory failure in acute illnesses, possibly due to angiotensin II cleavage. In this study, we evaluated the association between plasmatic DPP3 level and outcome (mortality and hemodynamic failure) in severely ill burn patients. Methods In this biomarker analysis of a prospective cohort study, we included severely ill adult burn patients in two tertiary burn intensive care units. DPP3 was measured at admission (DPP3admin) and 3 days after. The primary endpoint was 90-day mortality. Secondary endpoints were hemodynamic failure and acute kidney injury (AKI). Results One hundred and eleven consecutive patients were enrolled. The median age was 48 (32.5–63) years, with a median total body surface area burned of 35% (25–53.5) and Abbreviated Burn Severity Index (ABSI) of 8 (7–11). Ninety-day mortality was 32%. The median DPP3admin was significantly higher in non-survivors versus survivors (53.3 ng/mL [IQR 28.8–103.5] versus 27.1 ng/mL [IQR 19.4–38.9]; p

Sesamoid identity has long been the focus of debate, and how they are linked to other elements of the skeleton has often been considered relevant to their definition. A driving hypothesis of our work was that sesamoids’ nature relies deeply on their connections, and thus we propose an explicit network framework to investigate this subject in Leptodactylus latinasus (Anura: Leptodactylidae). Through the dissection of L. latinasus’ skeleton, we modeled its anatomical network where skeletal elements were considered nodes while joints, muscles, tendons, and aponeurosis were considered links. The skeletal elements were categorized into canonical skeletal pieces, embedded sesamoids, and glide sesamoids. We inquired about the general network characterization and we have explored further into sesamoid connectivity behavior. We found that the network is structured in a modular hierarchical organization, with five modules on the first level and two modules on the second one. The modules reflect a functional, rather than a topological proximity clustering of the skeleton. The 25 sesamoid pieces are members of four of the first-level modules. Node parameters (centrality indicators) showed that: (i) sesamoids are, in general terms, peripheral elements of the skeleton, loosely connected to the canonical bone structures; (ii) embedded sesamoids are not significantly distinguishable from canonical skeletal elements; and (iii) glide sesamoids exhibit the lowest centrality values and strongly differ from both canonical skeletal elements and embedded sesamoids. The loose connectivity pattern of sesamoids, especially glides, could be related to their evolvability, which in turn seems to be reflected in their morphological variation and facultative expression. Based on the connectivity differences among skeletal categories found in our study, an open question remains: can embedded and glide sesamoids be defined under the same criteria? This study presents a new approach to the study of sesamoid identity and to the knowledge of their morphological evolution.

Many species of anurans display special mechanical abilities, such as excavation and climbing. The aim of this study is to investigate the development of traits that are associated with these special mechanical abilities, under the hypothesis that these structures attain their configuration during the juvenile stages of development. We examined specimens from four different species of Leptodactylidae and six species of Hylidae. For the digging behavior, we evaluated the progress of calcification in the anterior region of the skulls, as well as the development of the snout-ridge. To assess climbing ability, we examined the ossification rate, the variation in the shape of the phalanx, the progress of the offset angle, and the distance between the terminal phalanx and the penultimate phalange of finger IV. The ossification of the skull and phalanges, along with the development of the snout-ridge, progresses and reaches completion during the juvenile phase of ontogeny, suggesting that at the time of metamorphosis, individuals are not yet full-scale replicas of the adults. The shape and the mechanical characteristics of terminal phalanges are already established by the conclusion of metamorphosis, revealing intriguing distinctions among arboreal species with walking and jumping locomotion. [ABSTRACT FROM AUTHOR]

Network analyses have been increasingly used in the context of comparative vertebrate morphology. The structural units of the vertebrate body are treated as discrete elements (nodes) of a network, whose interactions at their physical contacts (links) determine the phenotypic modules. Here, we use the network approach to study the organization of the locomotor system underlying the hindlimb of frogs. Nodes correspond to fibrous knots, skeletal and muscular units. Edges encode the ligamentous and monoaxial tendinous connections in addition to joints. Our main hypotheses are that: (1) the higher centrality scores (measured as betweenness) are recorded for fibrous elements belonging to the connective system, (2) the organization of the musculoskeletal network belongs to a non-trivial modular architecture and (3) the modules in the hindlimb reflect functional and/or developmental constraints. We confirm all our hypotheses except for the first one, since bones overpass the fibrous knots in terms of centrality. Functionally, there is a correlation between the proximal-to-distal succession of modules and the progressive recruitment of elements involved with the motion of joints during jumping. From a developmental perspective, there is a correspondence between the order of the betweenness scores and the ontogenetic chronology of hindlimbs in tetrapods. Modular architecture seems to be a successful organization, providing of the building blocks on which evolution forges the many different functional specializations that organisms exploit.