RESUMEN
The first step in carbon (C) turnover, where senesced plant biomass is converted through various pathways into compounds that are released to the atmosphere or incorporated into the soil, is termed litter decomposition. This review is focused on recent advances of how solar radiation can affect this important process in terrestrial ecosystems. We explore the photochemical degradation of plant litter and its consequences for biotic decomposition and C cycling. The ubiquitous presence of lignin in plant tissues poses an important challenge for enzymatic litter decomposition due to its biological recalcitrance, creating a substantial bottleneck for decomposer organisms. The recognition that lignin is also photolabile and can be rapidly altered by natural doses of sunlight to increase access to cell wall carbohydrates and even bolster the activity of cell wall degrading enzymes highlights a novel role for lignin in modulating rates of litter decomposition. Lignin represents a key functional connector between photochemistry and biochemistry with important consequences for our understanding of how sunlight exposure may affect litter decomposition in a wide range of terrestrial ecosystems. A mechanistic understanding of how sunlight controls litter decomposition and C turnover can help inform management and other decisions related to mitigating human impact on the planet.
RESUMEN
OBJECTIVES: To describe mismatch repair (MMR) and microsatellite instability (MSI) testing practices in laboratories using the College of American Pathologists (CAP) MSI/MMR proficiency testing programs prior to the 2022 publication of the MSI/MMR practice guidelines copublished by CAP and the Association of Molecular Pathology (AMP). METHODS: Data from supplemental questionnaires provided with the 2020-B MSI/MMR programs to 542 laboratories across different practice settings were reviewed. Questionnaires contained 21 questions regarding the type of testing performed, specimen/tumor types used for testing, and clinical practices for checkpoint blockade therapy. RESULTS: Domestic laboratories test for MSI/MMR more often than international laboratories (P = .04) and academic hospitals/medical centers test more frequently than nonhospital sites/clinics (P = .03). The most commonly used testing modality is immunohistochemistry, followed by polymerase chain reaction, then next-generation sequencing. Most laboratories (72.6%; 347/478) reported awareness of the use of immune checkpoint inhibitor therapy for patients with high MSI or MMR-deficient results. CONCLUSIONS: The results demonstrate the state of MMR and MSI testing in laboratories prior to the publication of the CAP/AMP best practice guidelines, highlighting differences between various laboratory types. The findings indicate the importance of consensus guidelines and provide a baseline for comparison after their implementation.
RESUMEN
Interactions among organisms in natural ecosystems are the foundational underpinnings of nearly all ecological studies. It has never been more important to increase our awareness of how these interactions are altered by human activity, threatening biodiversity and disrupting ecosystem functioning. Much of the historic focus of species conservation has been the preservation of endangered and endemic species at risk from hunting, over-exploitation, and habitat destruction. However, there is increasing evidence that differences between plants and their attacking organisms in the speed and direction of physiological, demographic, and genetic (adaptation) responses to global change are having devastating consequences, resulting in large-scale losses of dominant or abundant plant species, particularly in forest ecosystems. From the elimination in the wild of the American chestnut to the extensive regional damage caused by insect outbreaks in temperate forest ecosystems, these losses of dominant species change the ecological landscape and functioning, and represent important threats to biodiversity at all scales. Introductions due to human activity, range shifts due to climate change, and their combination are the principal drivers behind these profound ecosystem changes. In this Review, we argue that there is an urgent need to increase our recognition and hone our predictive power for how these imbalances may occur. Moreover, we should seek to minimize the consequences of these imbalances in order to ensure the preservation of the structure, function and biodiversity of entire ecosystems, not just rare or highly endangered species.
Asunto(s)
Conservación de los Recursos Naturales , Ecosistema , Humanos , Biodiversidad , Bosques , Plantas , Cambio ClimáticoRESUMEN
Deadwood is a large global carbon store with its store size partially determined by biotic decay. Microbial wood decay rates are known to respond to changing temperature and precipitation. Termites are also important decomposers in the tropics but are less well studied. An understanding of their climate sensitivities is needed to estimate climate change effects on wood carbon pools. Using data from 133 sites spanning six continents, we found that termite wood discovery and consumption were highly sensitive to temperature (with decay increasing >6.8 times per 10°C increase in temperature)-even more so than microbes. Termite decay effects were greatest in tropical seasonal forests, tropical savannas, and subtropical deserts. With tropicalization (i.e., warming shifts to tropical climates), termite wood decay will likely increase as termites access more of Earth's surface.
Asunto(s)
Bosques , Calentamiento Global , Isópteros , Madera , Animales , Ciclo del Carbono , Temperatura , Clima Tropical , Madera/microbiologíaRESUMEN
Plant litter decomposition is a key process for carbon (C) turnover in terrestrial ecosystems. Sunlight has been shown to cause and accelerate C release in semiarid ecosystems, yet the dose-response relationships for these effects have not been evaluated. We conducted a two-phase experiment where plant litter of three species was subjected to a broad range of cumulative solar radiation (CSR) exposures under field conditions. We then evaluated the relationships between CSR exposure and abiotic mass loss, litter quality and the subsequent biotic decomposition and microbial activity in litter. Dose-response relationships demonstrated that CSR exposure was modestly correlated with abiotic mass loss but highly significantly correlated with lignin degradation, saccharification, microbial activity and biotic decay of plant litter across all species. Moreover, a comparison of these dose-response relationships suggested that small reductions in litter lignin due to exposure to sunlight may have large consequences for biotic decay. These results provide strong support for a model that postulates a critical role for lignin photodegradation in the mechanism of photofacilitation and demonstrate that, under natural field conditions, biotic degradation of plant litter is linearly related with the dose of solar radiation received by the material before coming into contact with decomposer microorganisms.
Asunto(s)
Ecosistema , Exposición a la Radiación , Lignina/metabolismo , Fotólisis , Hojas de la Planta/metabolismo , Plantas/metabolismoRESUMEN
Autoimmune hepatitis (AIH) is an inflammatory disorder of the liver with a wide spectrum of disease presentation, from asymptomatic elevations in liver-associated enzymes to acute liver failure. AIH is classically associated with elevated immunoglobulins and autoantibodies, although approximately 20% of patients with features of AIH lack circulating antibodies. Recently, tumour necrosis factor alpha inhibitors have been implicated in several cases of drug-induced AIH which impact treatment regimens for patients with inflammatory bowel disease (IBD). We present a case of infliximab-induced seronegative AIH responding to budesonide therapy with successful alteration of IBD treatment regimen to vedolizumab.
Asunto(s)
Enfermedad Hepática Inducida por Sustancias y Drogas , Hepatitis Autoinmune , Autoanticuerpos , Enfermedad Hepática Inducida por Sustancias y Drogas/diagnóstico , Enfermedad Hepática Inducida por Sustancias y Drogas/etiología , Hepatitis Autoinmune/diagnóstico , Hepatitis Autoinmune/tratamiento farmacológico , Hepatitis Autoinmune/etiología , Humanos , Infliximab/efectos adversosRESUMEN
Ehrlichiosis, caused by Gram-negative bacteria of the genus Ehrlichia, is considered an emerging infectious disease due to the increasing number of reported cases. Symptoms are non-specific and occur within 1 to 2 weeks following the bite of an infected tick. Confirmatory laboratory diagnostic methods vary in sensitivity and specimen requirements, which can lead to delayed diagnosis. PCR testing serves as an efficient approach to Ehrlichia confirmation in the acute stage of illness. Published assays have been effectively used to detect human ehrlichiosis at limit of detections ranging from 10 to 50 genomic copies (GC) of Ehrlichia DNA. With the discovery of new species capable of human infection, we wanted to develop assays that are sensitive and encompass a wide range of Ehrlichia. Here we developed and validated two sensitive and specific real-time PCR assays (PanE1 and PanE2) for the detection of Ehrlichia species, as well as two real-time PCR assays (ECh2 and ECh4) for the detection of Ehrlichia chaffeensis, specifically. The limit of detection was determined to be 10 GC per reaction with 100% confidence, and as little as 1 GC with lower efficiencies. Accuracy was assessed at 100% correlation. Specificity from exclusivity testing demonstrated that neither the Ehrlichia species assays (n = 60), nor the E. chaffeensis specific assays (n = 64) had cross reactivity with near neighbors or environmental bacteria. A positive predictive value of 100% and a negative predictive value of ≥93% was determined by evaluating banked clinical specimens from 62 patients with the assays. These real-time PCR assays are effective tools to detect human Ehrlichia species during the acute stage of illness. Early detection of Ehrlichia infection by these real-time PCR assays can facilitate diagnosis and treatment.
Asunto(s)
Ehrlichia chaffeensis/aislamiento & purificación , Ehrlichiosis/microbiología , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , ADN Bacteriano/genética , Ehrlichia chaffeensis/clasificación , Ehrlichia chaffeensis/genética , Ehrlichiosis/diagnóstico , Humanos , Sensibilidad y EspecificidadRESUMEN
Photodegradation of aboveground senescent plant material (plant litter) due to exposure to solar radiation has been identified as a dominant control on carbon (C) loss in semi-arid ecosystems [1], upturning traditional models of C cycling based only on available moisture and litter quality. In addition to the photochemical mineralization of organic matter [1, 2], sunlight alters the chemistry of cell walls in plant litter [3, 4], making them more susceptible to subsequent biotic degradation [5-7]. Nevertheless, the interactive effects of sunlight exposure, climate seasonality, and biotic decomposition on C turnover remain unresolved in terrestrial ecosystems. We show here that exposure to sunlight accelerated litter decomposition in a Patagonian woodland with a marked dry summer season. Controls on initial decomposition varied seasonally from direct photochemical mineralization in the dry summer to biotic degradation in the wet winter. By manipulating sunlight received by plant litter using spectral filters that attenuated ultraviolet and short-wave visible light, we demonstrate that direct photodegradation and its legacy, associated with increased microbial access to labile carbohydrates, are responsible for the acceleration of aboveground C turnover in this Mediterranean-type climate. Across plant species and over a 2-year period, litter exposed to the full solar spectrum decomposed twice as fast as litter that received attenuated sunlight. Changes in vegetation cover or biodiversity due to projected increased drought and dry season length [8] will likely exacerbate C losses from aboveground litter due to sunlight exposure, negatively impacting the C balance in ecosystems that are particularly vulnerable to global change [9].
Asunto(s)
Bacterias/metabolismo , Carbono/deficiencia , Ecosistema , Hojas de la Planta/metabolismo , Plantas/metabolismo , Estaciones del Año , Luz Solar , Bosques , Hojas de la Planta/microbiología , Hojas de la Planta/efectos de la radiación , Plantas/microbiología , Plantas/efectos de la radiaciónRESUMEN
Growth responses to competition1 and defence responses to the attack of consumer organisms2 are two classic examples of adaptive phenotypic plasticity in plants. However, the mechanistic and functional links between these responses are not well understood. Jasmonates, a family of lipid-derived signals, are potent growth inhibitors and central regulators of plant immunity to herbivores and pathogens3,4, with both roles being evolutionarily conserved from bryophytes5 to angiosperms6. When shade-intolerant plants perceive the proximity of competitors using the photoreceptor phytochrome B, they activate the shade-avoidance syndrome and downregulate jasmonate responses7. Despite the central implications of this light-mediated change in the growth/defence balance for plant adaptation and crop yield8,9, the mechanisms by which photoreceptors relay light cues to the jasmonate signalling pathway remain poorly understood10. Here, we identify a sulfotransferase (ST2a) that is strongly upregulated by plant proximity perceived by phytochrome B via the phytochrome B-phytochrome interacting factor signalling module. By catalysing the formation of a sulfated jasmonate derivative, ST2a acts to reduce the pool of precursors of active forms of jasmonates and represents a direct molecular link between photoreceptors and hormone signalling in plants. The metabolic step defined by this enzyme provides a molecular mechanism for prioritizing shade avoidance over defence under intense plant competition.
Asunto(s)
Arabidopsis/genética , Regulación de la Expresión Génica de las Plantas , Luz , Inmunidad de la Planta/genética , Transducción de Señal , Arabidopsis/enzimología , Arabidopsis/crecimiento & desarrollo , Arabidopsis/inmunología , Fitocromo B/metabolismo , Regulación hacia ArribaRESUMEN
Shifts in densities of apex predators may indirectly affect fundamental ecosystem processes, such as decomposition, by altering patterns of cascading effects propagating through lower trophic levels. These top-down effects may interact with anthropogenic impacts, such as climate change, in largely unknown ways. We investigated how changes in densities of large predatory arthropods in forest leaf-litter communities altered lower trophic levels and litter decomposition. We conducted our experiment in soil communities that had experienced different levels of long-term average precipitation. We hypothesized that altering abundances of apex predators would have stronger effects on soil communities inhabiting dry forests, due to lower secondary productivity and greater resource overexploitation by lower trophic levels compared to wet forests. We experimentally manipulated abundances of the largest arthropod predators (apex predators) in field mesocosms replicated in the leaf-litter community of Iberian beech forests that differed in long-term mean annual precipitation by 25% (three dry forests with MAP < 1,250 mm and four wet forests with MAP > 1,400 mm). After one year, we assessed abundances of soil fauna in lower trophic levels and indirect impacts on leaf-litter decomposition using litter of understorey hazel, Corylus avellana. Reducing densities of large predators had a consistently negative effect on final abundances of the different trophic groups and several taxa within each group. Moreover, large predatory arthropods strongly impacted litter decomposition, and their effect interacted with the long-term annual rainfall experienced by the soil community. In the dry forests, a 50% reduction in the densities of apex predators was associated with a 50% reduction in decomposition. In wet forests, the same reduction in densities of apex soil predators did not alter the rate of litter decomposition. Our results suggest that predators may facilitate lower trophic levels by indirectly reducing competition and resource overexploitation, cascading effects that may be more pronounced in drier forests where conditions have selected for greater competitive ability and more rapid resource utilization. These findings thus provide insights into the functioning of soil invertebrate communities and their role in decomposition, as well as potential consequences of soil community responses to climate change.
Asunto(s)
Artrópodos , Suelo , Animales , Ecosistema , Bosques , Hojas de la PlantaRESUMEN
Zika virus's (ZIKV) emergence as a pathogen of significant public health importance has accelerated efforts to develop a ZIKV vaccine. To date, the need for an effective ZIKV vaccine is unmet. In this study, we report inactivation of ZIKV using a hydrophobic photoactive compound: 1, 5 iodonaphthyl azide (INA). 50 and 100 µM of INA completely inactivated ZIKV (INA-ZIKV). Western blot and ELISA analysis show some loss of the binding capacity of INA-iZIKV to anti-ZIKV monoclonal antibodies; however, immunization of mice with INA-iZIKV demonstrated seroconversion and ZIKV-neutralizing antibody response. RNA isolated from INA-iZIKV did not induce productive infection in Vero cells, suggesting inactivation of ZIKV RNA. These results suggest that in the absence of an approved ZIKV vaccine, INA-iZIKV can be pursued as a viable ZIKV vaccine candidate.
RESUMEN
Nitrogen is a critical component of the economy, food security, and planetary health. Many of the world's sustainability targets hinge on global nitrogen solutions, which, in turn, contribute lasting benefits for: (i) world hunger; (ii) soil, air and water quality; (iii) climate change mitigation; and (iv) biodiversity conservation. Balancing the projected rise in agricultural nitrogen demands while achieving these 21st century ideals will require policies to coordinate solutions among technologies, consumer choice, and socioeconomic transformation.
RESUMEN
The growth-defense trade-off in plant biology has gained enormous traction in the last two decades, highlighting the importance of understanding how plants deal with two of the greatest challenges for their survival and reproduction. It has been well established that in response to competition signals perceived by informational photoreceptors, shade-intolerant plants typically activate the shade-avoidance syndrome (SAS). In turn, in response to signals of biotic attack, plants activate a suite of defense responses, many of which are directed to minimize the loss of plant tissue to the attacking agent (broadly defined, the defense syndrome, DS). We argue that components of the SAS, including increased elongation, apical dominance, reduced leaf mass per area (LMA), and allocation to roots, are in direct conflict with configurational changes that plants require to maximize defense. We hypothesize that these configurational trade-offs provide a functional explanation for the suppression of components of the DS in response to competition cues. Based on this premise, we discuss recent advances in the understanding of the mechanisms by which informational photoreceptors, by interacting with jasmonic acid (JA) signaling, help the plant to make intelligent allocation and developmental decisions that optimize its configuration in complex biotic contexts.
Asunto(s)
Proteínas de Arabidopsis/metabolismo , Proteínas Cromosómicas no Histona/metabolismo , Ciclopentanos/metabolismo , Oxilipinas/metabolismo , Fotorreceptores de Plantas/metabolismo , Fitocromo/metabolismo , Viridiplantae , Desarrollo de la Planta/fisiología , Enfermedades de las Plantas/inmunología , Inmunidad de la Planta/fisiología , Hojas de la Planta/metabolismo , Proteínas de Plantas/metabolismo , Raíces de Plantas/metabolismo , Transducción de Señal , Viridiplantae/crecimiento & desarrollo , Viridiplantae/inmunología , Viridiplantae/metabolismoRESUMEN
Culex pipiens serves as the endemic vector of West Nile virus (WNV) in eastern North America, where house sparrows (HOSP, Passer domesticus) serve as a reservoir host. We tested the hypotheses that: (1) Attraction of Cx. pipiens to HOSP is influenced by bird age and (2) that age-specific variation in chemical profiles of bird uropygial gland secretions informs this choice. We conducted mosquito choice trials in an olfactometer and found that Cx. pipiens were more often attracted to adult sparrows over nestlings, however, they demonstrated no preference for adults over fledglings. Using gas chromatography-mass spectrometry we observed age-specific differences in the semi-volatile chemical profiles of house sparrow uropygial gland secretions. Contrary to our hypothesis, we found no significant difference in mosquito feeding preference between the secretions of adults and those of either nestlings or fledglings. We suggest that other chemical cues influence the feeding preference of Cx. pipiens, either independently of uropygial gland secretions, or synergistically with them.
RESUMEN
Culex pipiens, the endemic mosquito vector of West Nile virus in eastern North America, is responsible for maintenance of the virus in avian reservoir hosts, the most important of which appears to be the American robin. One reason for the greater involvement of robins is believed to be the feeding preference of Cx. pipiens, however, the basis of this preference is not understood. We tested the hypothesis that the species-specific chemical profile of avian uropygial gland secretions are used by Cx. pipiens as cues to locate birds and, therefore, may contribute to the observed feeding preferences. We used gas chromatography-mass spectrometry to identify the semi-volatile components of the uropygial gland secretions of American robins and two other common reservoir host species, the house sparrow and European starling. We found that the chemical composition of the robin secretions was different from those of the sparrows and starlings. Through behavioral choice trials conducted in a dual-port olfactometer, we also found that Cx. pipiens did not prefer the secretions of robins over the other two species. Surprisingly, however, we found that Cx pipiens were more often attracted to live starlings over robins and to the secretions of starlings over those of robins.
Asunto(s)
Culex/patogenicidad , Culex/virología , Glándulas Sebáceas/parasitología , Pájaros Cantores/parasitología , Animales , Conducta Alimentaria/fisiología , Especificidad del Huésped , Mosquitos Vectores/patogenicidad , Mosquitos Vectores/virología , Especificidad de la Especie , Fiebre del Nilo Occidental/transmisión , Fiebre del Nilo Occidental/virología , Virus del Nilo Occidental/patogenicidadRESUMEN
Plant-microbial interactions in the litter layer represent one of the most relevant interactions for biogeochemical cycling as litter decomposition is a key first step in carbon and nitrogen turnover. However, our understanding of these interactions in the litter layer remains elusive. In an old-growth mixed Nothofagus forest in Patagonia, we studied the effects of single tree species identity and the mixture of three tree species on the fungal and bacterial composition in the litter layer. We also evaluated the effects of nitrogen (N) addition on these plant-microbial interactions. In addition, we compared the magnitude of stimulation of litter decomposition due to home field advantage (HFA, decomposition occurs more rapidly when litter is placed beneath the plant species from which it had been derived than beneath a different plant species) and N addition that we previously demonstrated in this same forest, and used microbial information to interpret these results. Tree species identity had a strong and significant effect on the composition of fungal communities but not on the bacterial community of the litter layer. The microbial composition of the litter layer under the tree species mixture show an averaged contribution of each single tree species. N addition did not erase the plant species footprint on the fungal community, and neither altered the bacterial community. N addition stimulated litter decomposition as much as HFA for certain tree species, but the mechanisms behind N and HFA stimulation may have differed. Our results suggest that stimulation of decomposition from N addition might have occurred due to increased microbial activity without large changes in microbial community composition, while HFA may have resulted principally from plant species' effects on the litter fungal community. Together, our results suggest that plant-microbial interactions can be an unconsidered driver of litter decomposition in temperate forests.
RESUMEN
OBJECTIVES: Little is known regarding the effect that caring for an individual with Mild Cognitive Impairment (MCI) has on health-related quality of life (HRQOL). We sought to identify the most important aspects of HRQOL related to caring for an individual with MCI. METHODS: Six focus groups were conducted with caregivers of individuals with MCI (n = 32). Qualitative frequency analysis was used to analyze the data. RESULTS: Findings indicated that caregivers most frequently discussed social health, including changes in social roles and an increased need for social support (51.2% of the total discussion). This was followed by mental health concerns (37.9%) centering on anger/frustration, and a need for patience in the caregiving role, as well as caregiver-specific anxiety. Other topics included physical health (10.0%; including the impact that stress and burden have on medical heath), and caregivers' cognitive health (0.9%; including memory problems in relation to caregiver strain, sleep disruption, and cognitive fatigue). CONCLUSIONS: Findings illustrate the multiple domains of HRQOL that are affected in individuals providing care for someone with MCI. Moreover, the findings highlight the need for extending support services to MCI caregivers, a group that is typically not offered support services due to the 'less severe' nature of an MCI diagnosis.
Asunto(s)
Ansiedad/psicología , Cuidadores/psicología , Disfunción Cognitiva/enfermería , Costo de Enfermedad , Calidad de Vida , Apoyo Social , Estrés Psicológico/psicología , Adulto , Anciano , Anciano de 80 o más Años , Ira/fisiología , Femenino , Grupos Focales , Frustación , Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Investigación CualitativaRESUMEN
A search was undertaken at Forensic Science South Australia (FSSA) for all cases of suicide registered in South Australia, Australia, over a 10-year period from January 2003 to December 2012. More recent data was not accessioned as not all contemporary cases may have been completed or formally registered. The data were compared to corresponding numbers on two national registers: the National Coronial Information System (NCIS) and the Australian Bureau of Statistics (ABS). A total of 2105 cases of suicide were registered at FSSA, with a death rate of 13.3/100,000 population. NCIS data were available from 2003 to 2010, with 1542 suicides recorded (12.3/100,000 population). ABS data were available from 2003 to 2011, with 1366 deaths coded as suicides (12.4/100,000 population). Significant differences were found between local data on suicides and related data accrued nationally from the same population, with only 67.8% of local drug overdoses recorded on the NCIS. Although this represents an Australian-based study the conclusions have global applications. Thus, given the likely accuracy of local data, reliance on smaller, community-specific datasets in any country/jurisdiction may be of far greater use in analyzing and monitoring such complex cases.
Asunto(s)
Sistema de Registros , Suicidio/estadística & datos numéricos , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Australia/epidemiología , Niño , Femenino , Humanos , Masculino , Métodos , Persona de Mediana Edad , Distribución por Sexo , Adulto JovenRESUMEN
BACKGROUND: Currently, no published, validated patient-reported outcome (PRO) measures of health-related quality of life (HRQOL) exist for use with neonatal brachial plexus palsy (NBPP). NBPP is a debilitating condition that occurs during the perinatal period, resulting in paralysis/paresis and loss of sensation in the affected arm. Commonly used NBPP measures are not comprehensive and do not fully account for clinically meaningful changes in function or progression of the disorder. OBJECTIVE: To evaluate important components of HRQOL for children with NBPP and identify where new PRO measures are needed. DESIGN: Eleven focus groups comprising children with NBPP (4), family members (6), and professional providers (1) to assess HRQOL. SETTING: Brachial plexus clinic. PARTICIPANTS: Children with NBPP, their parents, and professional providers. INCLUSION CRITERIA: Children 7-17 years old with NBPP; parents/caregivers at least 18 years of age; professionals with ≥2 years' experience providing NBPP clinical care; ability to read and speak English fluently. METHODS: Focus group sessions were recorded, transcribed verbatim, and deidentified. Qualitative frequency analysis identified different aspects of HRQOL relevant to NBPP. This analysis expands on the grounded-theory approach to qualitative analysis, including development of a domain framework, open and axial coding, selective coding, and descriptive analysis. The resulting HRQOL domain framework (and frequency analysis) was then compared to the domain framework for existing PRO measures (PROMIS and Neuro-QoL) to identify components of HRQOL where new PRO measures are needed for NBPP. MAIN OUTCOME MEASURES: Not applicable. RESULTS: Although many physical, social, and emotional health domains were captured by existing PRO measures, some significant NBPP-specific topics emerged from qualitative analysis-functionality, sensory, physical appearance, arm/hand compensation and preference, explaining functionality/appearance to others, and self-esteem and body image concerns. CONCLUSIONS: Development of sensitive and specific measures capturing arm/hand function and body image would improve the clinical care of patients with NBPP. LEVEL OF EVIDENCE: Not applicable.