Predictive Validity of Pressure Ulcer Risk Assessment Scales among Patients in a Trauma Intensive Care Unit / 중환자간호학회지

PURPOSE: The aims of this study were to identify the incidence of pressure ulcers and to compare the predictive validities of pressure ulcer risk assessment scales among trauma patients.METHODS: This was a prospective observational study. A total of 155 patients admitted to a trauma intensive care unit in a university hospital were enrolled. The predictive validity of the Braden, Cubbin & Jackson, and Waterlow scales were assessed based on the sensitivity, specificity, positive and negative predictive values, and area under the receiver operating characteristic curve (AUC).RESULTS: Of the patients, 14 (9.0%) subsequently developed pressure ulcers. The sensitivity, specificity, positive predictive values, and negative predictive values were 78.6%, 75.9%, 24.4%, and 97.3%, respectively, for the Braden scale (cut-off point of 12); 85.7%, 68.8%, 21.4%, and 98.0%, respectively, for the Cubbin & Jackson scale (cut-off point of 26); and 71.4%, 87.2%, 35.7%, and 96.9%, respectively, for the Waterlow scale (cut-off point of 18). The AUCs were 0.88 (Waterlow), 0.86 (Braden), and 0.85 (Cubbin & Jackson).CONCLUSION: The findings indicate that the predictive validity values of the Waterlow, Braden, and Cubbin & Jackson scales were similarly high. However, further studies need to also consider clinical usefulness of the scales.

Spatial Learning and Motor Deficits in Vacuolar Protein Sorting-associated Protein 13b (Vps13b) Mutant Mouse

Vacuolar protein sorting-associated protein 13B (VPS13B), also known as COH1, is one of the VPS13 family members which is involved in transmembrane transport, Golgi integrity, and neuritogenesis. Mutations in the VPS13B gene are associated with Cohen syndrome and other cognitive disorders such as intellectual disabilities and autism spectrum disorder (ASD). However, the patho-physiology of VPS13B-associated cognitive deficits is unclear, in part, due to the lack of animal models. Here, we generated a Vps13b exon 2 deletion mutant mouse and analyzed the behavioral phenotypes. We found that Vps13b mutant mice showed reduced activity in open field test and significantly shorter latency to fall in the rotarod test, suggesting that the mutants have motor deficits. In addition, we found that Vps13b mutant mice showed deficits in spatial learning in the hidden platform version of the Morris water maze. The Vps13b mutant mice were normal in other behaviors such as anxiety-like behaviors, working memory and social behaviors. Our results suggest that Vps13b mutant mice may recapitulate key clinical symptoms in Cohen syndrome such as intellectual disability and hypotonia. Vps13b mutant mice may serve as a useful model to investigate the pathophysiology of VPS13B-associated disorders.

Circadian Regulation by REV-ERBα Mediates Hippocampal E-LTP in a Time-dependent Manner

Circadian rhythms are driven by circadian oscillators, and these rhythms result in the biological phenomenon of 24-h oscillations. Previous studies suggest that learning and memory are affected by circadian rhythms. One of the genes responsible for generating the circadian rhythm is Rev-erbα. The REV-ERBα protein is a nuclear receptor that acts as a transcriptional repressor, and is a core component of the circadian clock. However, the role of REV-ERBα in neurophysiological processes in the hippocampus has not been characterized yet. In this study, we examined the time-dependent role of REV-ERBα in hippocampal synaptic plasticity using Rev-erbα KO mice. The KO mice lacking REV-ERBα displayed abnormal NMDAR-dependent synaptic potentiation (E-LTP) at CT12~CT14 (subjective night) when compared to their wild-type littermates. However, Rev-erbα KO mice exhibited normal E-LTP at CT0~CT2 (subjective day). We also found that the Rev-erbα KO mice had intact late LTP (L-LTP) at both subjective day and night. Taken together, these results provide evidence that REV-ERBα is critical for hippocampal E-LTP during the dark period.