Graphical Abstract Highlights d First study of MICOS outside opisthokonts verifies a conserved role in shaping cristae d Trypanosome MICOS novelties include two distinct Mic10s and an atypical Mic60 d TbMICOS features a novel thioredoxin-like subunit called TbMic20 d TbMic20 appears to be a catalyst for intermembrane space protein import

ObjectivesSuccessful management of rheumatic conditions involves increasing complexity of care. Delivering this in a holistic way is a growing challenge. The aim of this study was to develop a Patient Concerns Inventory (PCI) and assess it in the Rheumatology clinic setting. MethodsThis observational exploratory study occurred with two phases. Phase 1: the PCI was developed after systematic literature search, expert opinion and three patient focus group discussions. Phase 2: the PCI was piloted in a general Rheumatology clinic. ResultsFifty-four patients were assessed in the pre-PCI group and 51 in the post-PCI group. Median (IQR) duration of consultation was 8 (5-14) minutes without PCI and 15 (10-20) minutes with PCI. The pre-PCI group raised 335 concerns from 50 patients, median (IQR) of 5 (3-10) per patient, rising post-PCI to 521 concerns, median (IQR) of 9 (5-16) from 51 patients, p=0.002. Additional concerns predominantly arising from 'Physical and functional well-being' and 'Social care and wellbeing' domains. Most patients rated their experience with their doctor in the consultation as excellent or outstanding across all 11 questions in the questionnaire, both before and after the introduction of the PCI to the clinic setting. ConclusionThe PCI is a useful holistic needs assessment tool for Rheumatology clinics. Although its use may initially prolong the consultation slightly, patients can raise a significantly higher number of concerns that do not occur at the expense of patient satisfaction. This may help in identifying areas of 'unmet need', which previously went unnoticed. Key messages1) Patient concerns inventory (PCI) is a useful holistic needs assessment tool in Rheumatology clinics.2) The PCI is able to highlight important areas of unmet needs in Rheumatology clinics.3) The use of PCI enables patients to ask more questions which may lead to greater patient satisfaction.2

ImportanceParkinsonism and Parkinson disease (PD) are known to result from repetitive head impacts from boxing. Repetitive head impacts from American football may also be associated with increased risk of neurodegenerative pathologies that cause parkinsonism, yet in vivo research on the association between football play and PD is scarce and limited by small samples and equivocal findings.ObjectiveTo evaluate the association between football participation and self-reported parkinsonism or PD diagnosis.Design, Setting, and ParticipantsThis cross-sectional study leveraged data from the online Fox Insight study. Participants completed online questionnaires and self-reported whether they currently had a diagnosis of Parkinson disease or parkinsonism by a physician or other health care professional. In November 2020, the Boston University Head Impact Exposure Assessment was launched for data collection on repetitive head impacts. Data used for this manuscript were obtained from the Fox Insight database on June 9, 2022. A total of 1875 men who endorsed playing any organized sport were included. Former athletes were divided into those who participated in football (n = 729 [38.9%]) and those who participated in other sports (reference group).ExposuresSelf-reported participation in football, duration and level of football play, age at first exposure.Main Outcomes and MeasuresLogistic regression tested associations between PD status and history of football play, duration of football play, highest level played, and age at first exposure, controlling for age, education, history of diabetes or heart disease, body mass index, history of traumatic brain injury with loss of consciousness, and family history of PD.ResultsIn this sample of 1875 men (mean [SD] age, 67.69 [9.84] years) enriched for parkinsonism or PD (n = 1602 [85.4%]), 729 (38.9%) played football (mean [SD] duration, 4.35 [2.91] years). History of playing football was associated with higher odds of having a parkinsonism or PD diagnosis (odds ratio [OR], 1.61; 95% CI, 1.19-2.17). Among the entire sample, longer duration of play was associated with higher odds of having a parkinsonism or PD diagnosis (OR, 1.12; 95% CI, 1.06-1.19). Among football players, longer duration of football play (OR, 1.12; 95% CI, 1.02-1.23) and higher level of play (OR, 2.93; 95% CI, 1.28-6.73) were associated with higher odds of having parkinsonism or PD.Conclusions and RelevanceIn this cross-sectional study of participants enriched for PD, participation in football was associated with higher odds of having a reported parkinsonism or PD diagnosis.

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