Cerebellar interaction with the acoustic reflex.

Science.gov (United States)

Jastreboff, P J

1981-01-01

The involvement of the cerebellar vermis in the acoustic reflex was analyzed in 12 cats, decerebrated or in pentobarbital anesthesia. Anatomical data suggested the existence of a connection of lobules VIII with the ventral cochlear nucleus. Single cell recording and evoked potential techniques demonstrated the existence of the acoustic projection to lobulus VIII. Electrical stimulation of this area changed the tension of the middle ear muscle and caused evoked potential responses in the caudal part of the ventral cochlear nucleus. Electrical stimulation of the motor nucleus of the facial nerve evoked a slow wave in the recording taken from the surrounding of the cochlear round window. A hypothesis is proposed which postulates the involvement of the acoustic reflex in space localization of acoustic stimuli and the action of cerebellar vermis in order to assure the stability and plasticity of the acoustic reflex arc.

History of chronic stress modifies acute stress-evoked fear memory and acoustic startle in male rats.

Science.gov (United States)

Schmeltzer, Sarah N; Vollmer, Lauren L; Rush, Jennifer E; Weinert, Mychal; Dolgas, Charles M; Sah, Renu

2015-01-01

Chronicity of trauma exposure plays an important role in the pathophysiology of posttraumatic stress disorder (PTSD). Thus, exposure to multiple traumas on a chronic scale leads to worse outcomes than acute events. The rationale for the current study was to investigate the effects of a single adverse event versus the same event on a background of chronic stress. We hypothesized that a history of chronic stress would lead to worse behavioral outcomes than a single event alone. Male rats (n = 14/group) were exposed to either a single traumatic event in the form of electric foot shocks (acute shock, AS), or to footshocks on a background of chronic stress (chronic variable stress-shock, CVS-S). PTSD-relevant behaviors (fear memory and acoustic startle responses) were measured following 7 d recovery. In line with our hypothesis, CVS-S elicited significant increases in fear acquisition and conditioning versus the AS group. Unexpectedly, CVS-S elicited reduced startle reactivity to an acoustic stimulus in comparison with the AS group. Significant increase in FosB/ΔFosB-like immunostaining was observed in the dentate gyrus, basolateral amygdala and medial prefrontal cortex of CVS-S rats. Assessments of neuropeptide Y (NPY), a stress-regulatory transmitter associated with chronic PTSD, revealed selective reduction in the hippocampus of CVS-S rats. Collectively, our data show that cumulative stress potentiates delayed fear memory and impacts defensive responding. Altered neuronal activation in forebrain limbic regions and reduced NPY may contribute to these phenomena. Our preclinical studies support clinical findings reporting worse PTSD outcomes stemming from cumulative traumatization in contrast to acute trauma.

Intermediate Latency-Evoked Potentials of Multimodal Cortical Vestibular Areas: Galvanic Stimulation

Directory of Open Access Journals (Sweden)

Stefan Kammermeier

2017-11-01

Full Text Available IntroductionHuman multimodal vestibular cortical regions are bilaterally anterior insulae and posterior opercula, where characteristic vestibular-related cortical potentials were previously reported under acoustic otolith stimulation. Galvanic vestibular stimulation likely influences semicircular canals preferentially. Galvanic stimulation was compared to previously established data under acoustic stimulation.Methods14 healthy right-handed subjects, who were also included in the previous acoustic potential study, showed normal acoustic and galvanic vestibular-evoked myogenic potentials. They received 2,000 galvanic binaural bipolar stimuli for each side during EEG recording.ResultsVestibular cortical potentials were found in all 14 subjects and in the pooled data of all subjects (“grand average” bilaterally. Anterior insula and posterior operculum were activated exclusively under galvanic stimulation at 25, 35, 50, and 80 ms; frontal regions at 30 and 45 ms. Potentials at 70 ms in frontal regions and at 110 ms at all of the involved regions could also be recorded; these events were also found using acoustic stimulation in our previous study.ConclusionGalvanic semicircular canal stimulation evokes specific potentials in addition to those also found with acoustic otolith stimulation in identically located regions of the vestibular cortex. Vestibular cortical regions activate differently by galvanic and acoustic input at the peripheral sensory level.SignificanceDifferential effects in vestibular cortical-evoked potentials may see clinical use in specific vertigo disorders.

A Study of Relationship between the Acoustic Sensitivity of Vestibular System and the Ability to Trigger Sound-Evoked Muscle Reflex of the Middle Ear in Adults with Normal Hearing

Directory of Open Access Journals (Sweden)

S.F. Emami

2014-07-01

Full Text Available Introduction & Objective: The vestibular system is sound sensitive and the sensitivity is related to the saccule. The vestibular afferents are projected to the middle ear muscles (such as the stapedius. The goal of this research was studying the relationship between the vestibular hearing and the sound-evoked muscle reflex of the middle ear to 500 HZ. Materials & Methods: This study was a cross sectional-comparison done in audiology department of Sheikholreis C‍‍linic (Hamadan, Iran. The study groups consisted of thirty healthy people and thirty patients with benign paroxysmal positional vertigo. Inclusion criteria of the present study were to have normal hearing on pure tone audiometry, acoustic reflex, and speech discrimination scores. Based on ipsilateral acoustic reflex test at 500HZ, they were divided to normal and abnormal groups. Then they were evaluated by cervical vestibular evoked myogenic potentials (cVEMPs and finally classified in three groups (N Normal ear , (CVUA Contra lateral vertiginous ear with unaffected saccular sensitivity to sound,(IVA Ipsilateral vertiginous ear with affected saccular sensitivity to sound. Results: Thirty affected ears (IVA with decreased vestibular excitability as detected by ab-normal cVEMPs, revealed abnormal findings of acoustic reflex at 500HZ. Whereas, both un-affected (CVUA and normal ears (N had normal results. Multiple comparisons of mean values of cVEMPs (p13,n23 and acoustic reflex at500HZ among the three groups were sig-nificant. The correlation between acoustic reflex at 500HZ and p13 latencies was significant. The n23 latencies showed significant correlation with acoustic reflex at 500HZ. Conclusion: The vestibular sensitivity to sound retains the ability to trigger sound-evoked re-flex of the middle ear at 500 HZ. (Sci J Hamadan Univ Med Sci 2014; 21 (2:99-104

[Clinical development of acute noise-induced acoustic trauma. An evaluation of a study of 250 cases].

Science.gov (United States)

Suc, B; Poulet, M; Asperge, A; Vix, J; Barberot, J P; Doucet, F

1994-01-01

Traumatic damage on Cochlea (250 cases) induced by assault gun (F.A.M.A.S.) consists in tinitus and hearing impairement on 6000 Hz. Noise's effects are specific to one Cochlea. Dissociated developments of both tinitus and hearing loss show that their anatomical sites are different. Acoustic injury entails definitive haire cells lesions, cellular biochemical and vascular changes. The treatment that reestablishes or raises cochlear blood flow entails recovery in 80% of cases provided that it is given within 48 hours after the trauma.

4-aminopyridine in scala media reversibly alters the cochlear potentials and suppresses electrically evoked oto-acoustic emissions.

Science.gov (United States)

Kirk, D L; Yates, G K

1998-01-01

Iontophoresis of 4-aminopyridine into scala media of the guinea pig cochlea caused elevation of the thresholds of the compound action potential of the auditory nerve, loss of amplitude of the extracellular cochlear microphonic response (CM), increase in the endocochlear potential (EP) and reduction in the amplitude of electrically evoked oto-acoustic emissions (EEOAEs). These changes were reversible over 10-20 min. The reciprocity of the changes in the CM and the EP was consistent with an interruption of both DC and AC currents through outer hair cells (OHCs), probably by blockade of mechano-electrical transduction (MET) channels in OHCs. Reductions in EEOAEs were consistent with the extrinsically applied generating current entering the OHC via the MET channels. Implications for the activation of OHC electromotility in vivo are discussed.

Predicting Natural Neuroprotection in Marine Mammals: Environmental and Biological Factors Affecting the Vulnerability to Acoustically Mediated Tissue Trauma in Marine Species

Science.gov (United States)

2013-09-30

comparing both globin deposition profiles from carcasses ranging in age from neonates to adults, as well as the change in mass-specific metabolic demands...to acoustically mediated trauma, 1) molecular and biochemical evaluation of neuroprotection at the tissue level, and 2) whole animal /physiological...Noren, UCSC.) The second component of this study examined the susceptibility of marine mammals to decompression illness at the whole animal

Changes in oto-acoustic emissions after exposure to live music

DEFF Research Database (Denmark)

Ordoñez, Rodrigo Pizarro; Hammershøi, Dorte; Voetmann, Jan

2012-01-01

Distortion Product Oto-acoustic Emissions (DPOAE) and Transient Evoked Oto-acoustic Emissions (TEOAE) were measured in subjects before and after attendance to live music. The changes measured were compared to the exposure levels measured at the position of the subject. The main objectives...

Intraoperative facial motor evoked potentials monitoring with transcranial electrical stimulation for preservation of facial nerve function in patients with large acoustic neuroma

Institute of Scientific and Technical Information of China (English)

LIU Bai-yun; TIAN Yong-ji; LIU Wen; LIU Shu-ling; QIAO Hui; ZHANG Jun-ting; JIA Gui-jun

2007-01-01

Background Although various monitoring techniques have been used routinely in the treatment of the lesions in the skull base, iatrogenic facial paresis or paralysis remains a significant clinical problem. The aim of this study was to investigate the effect of intraoperative facial motor evoked potentials monitoring with transcranial electrical stimulation on preservation of facial nerve function.Method From January to November 2005, 19 patients with large acoustic neuroma were treated using intraoperative facial motor evoked potentials monitoring with transcranial electrical stimulation (TCEMEP) for preservation of facial nerve function. The relationship between the decrease of MEP amplitude after tumor removal and the postoperative function of the facial nerve was analyzed.Results MEP amplitude decreased more than 75% in 11 patients, of which 6 presented significant facial paralysis (H-B grade 3), and 5 had mild facial paralysis (H-B grade 2). In the other 8 patients, whose MEP amplitude decreased less than 75%, 1 experienced significant facial paralysis, 5 had mild facial paralysis, and 2 were normal.Conclusions Intraoperative TCEMEP can be used to predict postoperative function of the facial nerve. The decreased MEP amplitude above 75 % is an alarm point for possible severe facial paralysis.

DESCRIPTION OF BRAINSTEM AUDITORY EVOKED RESPONSES (AIR AND BONE CONDUCTION IN CHILDREN WITH NORMAL HEARING

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A. V. Pashkov

2014-01-01

Full Text Available Diagnosis of hearing level in small children with conductive hearing loss associated with congenital craniofacial abnormalities, particularly with agenesis of external ear and external auditory meatus is a pressing issue. Conventional methods of assessing hearing in the first years of life, i. e. registration of brainstem auditory evoked responses to acoustic stimuli in the event of air conduction, does not give an indication of the auditory analyzer’s condition due to potential conductive hearing loss in these patients. This study was aimed at assessing potential of diagnosing the auditory analyzer’s function with registering brainstem auditory evoked responses (BAERs to acoustic stimuli transmitted by means of a bone vibrator. The study involved 17 children aged 3–10 years with normal hearing. We compared parameters of registering brainstem auditory evoked responses (peak V depending on the type of stimulus transmission (air/bone in children with normal hearing. The data on thresholds of the BAERs registered to acoustic stimuli in the event of air and bone conduction obtained in this study are comparable; hearing thresholds in the event of acoustic stimulation by means of a bone vibrator correlates with the results of the BAERs registered to the stimuli transmitted by means of air conduction earphones (r = 0.9. High correlation of thresholds of BAERs to the stimuli transmitted by means of a bone vibrator with thresholds of BAERs registered when air conduction earphones were used helps to assess auditory analyzer’s condition in patients with any form of conductive hearing loss.  

Challenges in treating post-traumatic stress disorder and attachment trauma.

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Allen, Jon G

2003-06-01

Treating women suffering from trauma poses significant challenges. The diagnostic prototype of post-traumatic stress disorder (PTSD) is based on single-event trauma, such as sexual assault in adulthood. Several effective cognitive- behavioral treatments for such traumas have been developed, although many treated patients continue to experience residual symptoms. Even more problematic is the complex developmental psychopathology stemming from a lifetime history of multiple traumas, often beginning with maltreatment in early attachment relationships. A history of attachment trauma undermines the development of capacities to regulate emotional distress and thereby complicates the treatment of acute trauma in adulthood. Such complex trauma requires a multifaceted treatment approach that must balance processing of traumatic memories with strategies to contain the intense emotions this processing evokes. Moreover, conducting such treatment places therapists at risk for secondary trauma such that trauma therapists also must process this stressful experience and implement strategies to regulate their own distress.

Otolith function in patients with head trauma.

Science.gov (United States)

Lee, Jong Dae; Park, Moo Kyun; Lee, Byung Don; Park, Ji Yun; Lee, Tae Kyung; Sung, Ki-Bum

2011-10-01

This study evaluates the otolith function of patients with head trauma, postulating that otolith dysfunction is a cause of nonspecific dizziness after head trauma. We prospectively enrolled 28 patients referred within 3 months after head trauma between March 2007 and December 2009. Pure tone audiometry, caloric testing and otolith function tests, including cervical vestibular evoked myogenic potential (cVEMP) and subjective visual vertical (SVV) tests, were performed on all patients. The relationship between otolith function and otologic symptoms was analyzed. Of the 28 patients with head trauma, 18 complained of dizziness and 12 experienced hearing loss, including 6 patients who complained of both. On defining otolith dysfunction as an abnormal cVEMP or abnormal SVV, a significant difference in otolith dysfunction existed between the groups with and without dizziness [72 (13/18) vs. 20% (2/10)]. In contrast, no significant difference in otolith dysfunction was detected between the abnormal and normal hearing groups. A significant number of the patients who complained of nonspecific dizziness after trauma had abnormal otolith function. After trauma, when patients complain of dizziness, vestibular function tests, including otolith function tests, should be considered.

Marine bioacoustics and technology: The new world of marine acoustic ecology

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Hastings, Mardi C.; Au, Whitlow W. L.

2012-11-01

Marine animals use sound for communication, navigation, predator avoidance, and prey detection. Thus the rise in acoustic energy associated with increasing human activity in the ocean has potential to impact the lives of marine animals. Thirty years ago marine bioacoustics primarily focused on evaluating effects of human-generated sound on hearing and behavior by testing captive animals and visually observing wild animals. Since that time rapidly changing electronic and computing technologies have yielded three tools that revolutionized how bioacousticians study marine animals. These tools are (1) portable systems for measuring electrophysiological auditory evoked potentials, (2) miniaturized tags equipped with positioning sensors and acoustic recording devices for continuous short-term acoustical observation rather than intermittent visual observation, and (3) passive acoustic monitoring (PAM) systems for remote long-term acoustic observations at specific locations. The beauty of these breakthroughs is their direct applicability to wild animals in natural habitats rather than only to animals held in captivity. Hearing capabilities of many wild species including polar bears, beaked whales, and reef fishes have now been assessed by measuring their auditory evoked potentials. Miniaturized acoustic tags temporarily attached to an animal to record its movements and acoustic environment have revealed the acoustic foraging behavior of sperm and beaked whales. Now tags are being adapted to fishes in effort to understand their behavior in the presence of noise. Moving and static PAM systems automatically detect and characterize biological and physical features of an ocean area without adding any acoustic energy to the environment. PAM is becoming a powerful technique for understanding and managing marine habitats. This paper will review the influence of these transformative tools on the knowledge base of marine bioacoustics and elucidation of relationships between marine

The Role of Auditory Evoked Potentials in the Context of Cochlear Implant Provision.

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Hoth, Sebastian; Dziemba, Oliver Christian

2017-12-01

: Auditory evoked potentials (AEP) are highly demanded during the whole process of equipping patients with cochlear implants (CI). They play an essential role in preoperative diagnostics, intraoperative testing, and postoperative monitoring of auditory performance and success. The versatility of AEP's is essentially enhanced by their property to be evokable by acoustic as well as electric stimuli. Thus, the electric responses of the auditory system following acoustic stimulation and recorded by the conventional surface technique as well as by transtympanic derivation from the promontory (Electrocochleography [ECochG]) are used for the quantitative determination of hearing loss and, additionally, electrically evoked compound actions potentials (ECAP) can be recorded with the intracochlear electrodes of the implant just adjacent to the stimulation electrode to check the functional integrity of the device and its coupling to the auditory system. The profile of ECAP thresholds is used as basis for speech processor fitting, the spread of excitation (SOE) allows the identification of electrode mislocations such as array foldover, and recovery functions may serve to optimize stimulus pulse rate. These techniques as well as those relying on scalp surface activity originating in the brainstem or the auditory cortex accompany the CI recipient during its whole life span and they offer valuable insights into functioning and possible adverse effects of the CI for clinical and scientific purposes.

Amplitude and phase dynamics associated with acoustically paced finger tapping

NARCIS (Netherlands)

Boonstra, T.W.; Daffertshofer, A.; Peper, C.E.; Beek, P.J.

2006-01-01

To gain insight into the brain activity associated with the performance of an acoustically paced synchronization task, we analyzed the amplitude and phase dynamics inherent in magnetoencephalographic (MEG) signals across frequency bands in order to discriminate between evoked and induced responses.

Evoked acoustic emissions from the human ear. III. Findings in neonates

DEFF Research Database (Denmark)

Johnsen, N J; Bagi, P; Elberling, C

1983-01-01

Stimulated acoustic emissions were recorded in a consecutive series of 20 full-term and otherwise normal neonates with the equipment and method previously used in adults. One ear randomly chosen was tested in each baby, and otoscopy and tympanometry were normal in all ears. A 2 kHz click stimulus...

Absence of both auditory evoked potentials and auditory percepts dependent on timing cues.

Science.gov (United States)

Starr, A; McPherson, D; Patterson, J; Don, M; Luxford, W; Shannon, R; Sininger, Y; Tonakawa, L; Waring, M

1991-06-01

An 11-yr-old girl had an absence of sensory components of auditory evoked potentials (brainstem, middle and long-latency) to click and tone burst stimuli that she could clearly hear. Psychoacoustic tests revealed a marked impairment of those auditory perceptions dependent on temporal cues, that is, lateralization of binaural clicks, change of binaural masked threshold with changes in signal phase, binaural beats, detection of paired monaural clicks, monaural detection of a silent gap in a sound, and monaural threshold elevation for short duration tones. In contrast, auditory functions reflecting intensity or frequency discriminations (difference limens) were only minimally impaired. Pure tone audiometry showed a moderate (50 dB) bilateral hearing loss with a disproportionate severe loss of word intelligibility. Those auditory evoked potentials that were preserved included (1) cochlear microphonics reflecting hair cell activity; (2) cortical sustained potentials reflecting processing of slowly changing signals; and (3) long-latency cognitive components (P300, processing negativity) reflecting endogenous auditory cognitive processes. Both the evoked potential and perceptual deficits are attributed to changes in temporal encoding of acoustic signals perhaps occurring at the synapse between hair cell and eighth nerve dendrites. The results from this patient are discussed in relation to previously published cases with absent auditory evoked potentials and preserved hearing.

Percepts, not acoustic properties, are the units of auditory short-term memory.

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Mathias, Samuel R; von Kriegstein, Katharina

2014-04-01

For decades, researchers have sought to understand the organizing principles of auditory and visual short-term memory (STM). Previous work in audition has suggested that there are independent memory stores for different sound features, but the nature of the representations retained within these stores is currently unclear. Do they retain perceptual features, or do they instead retain representations of the sound's specific acoustic properties? In the present study we addressed this question by measuring listeners' abilities to keep one of three acoustic properties (interaural time difference [ITD], interaural level difference [ILD], or frequency) in memory when the target sound was followed by interfering sounds that varied randomly in one of the same properties. Critically, ITD and ILD evoked the same percept (spatial location), despite being acoustically different and having different physiological correlates, whereas frequency evoked a different percept (pitch). The results showed that listeners found it difficult to remember the percept of spatial location when the interfering tones varied either in ITD or ILD, but not when they varied in frequency. The study demonstrates that percepts are the units of auditory STM, and provides testable predictions for future neuroscientific work on both auditory and visual STM.

A measure of acoustic noise generated from transcranial magnetic stimulation coils.

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Dhamne, Sameer C; Kothare, Raveena S; Yu, Camilla; Hsieh, Tsung-Hsun; Anastasio, Elana M; Oberman, Lindsay; Pascual-Leone, Alvaro; Rotenberg, Alexander

2014-01-01

The intensity of sound emanating from the discharge of magnetic coils used in repetitive transcranial magnetic stimulation (rTMS) can potentially cause acoustic trauma. Per Occupational Safety and Health Administration (OSHA) standards for safety of noise exposure, hearing protection is recommended beyond restricted levels of noise and time limits. We measured the sound pressure levels (SPLs) from four rTMS coils with the goal of assessing if the acoustic artifact levels are of sufficient amplitude to warrant protection from acoustic trauma per OSHA standards. We studied the SPLs at two frequencies (5 and 10 Hz), three machine outputs (MO) (60, 80 and 100%), and two distances from the coil (5 and 10 cm). We found that the SPLs were louder at closer proximity from the coil and directly dependent on the MO. We also found that in all studied conditions, SPLs were lower than the OSHA permissible thresholds for short (8 h) exposure. Copyright © 2014 Elsevier Inc. All rights reserved.

Scent-evoked nostalgia.

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Reid, Chelsea A; Green, Jeffrey D; Wildschut, Tim; Sedikides, Constantine

2015-01-01

Can scents evoke nostalgia; what might be the psychological implications of such an evocation? Participants sampled 12 scents and rated the extent to which each scent was familiar, arousing and autobiographically relevant, as well as the extent to which each scent elicited nostalgia. Participants who were high (compared to low) in nostalgia proneness reported more scent-evoked nostalgia, and scents elicited greater nostalgia to the extent that they were arousing, familiar and autobiographically relevant. Scent-evoked nostalgia predicted higher levels of positive affect, self-esteem, self-continuity, optimism, social connectedness and meaning in life. In addition, scent-evoked nostalgia was characterised by more positive emotions than either non-nostalgic autobiographical memories or non-nostalgic non-autobiographical memories. Finally, scent-evoked nostalgia predicted in-the-moment feelings of personal (general or object-specific) nostalgia. The findings represent a foray into understanding the triggers and affective signature of scent-evoked nostalgia.

The systemic immune response to trauma: an overview of pathophysiology and treatment.

Science.gov (United States)

Lord, Janet M; Midwinter, Mark J; Chen, Yen-Fu; Belli, Antonio; Brohi, Karim; Kovacs, Elizabeth J; Koenderman, Leo; Kubes, Paul; Lilford, Richard J

2014-10-18

Improvements in the control of haemorrhage after trauma have resulted in the survival of many people who would otherwise have died from the initial loss of blood. However, the danger is not over once bleeding has been arrested and blood pressure restored. Two-thirds of patients who die following major trauma now do so as a result of causes other than exsanguination. Trauma evokes a systemic reaction that includes an acute, non-specific, immune response associated, paradoxically, with reduced resistance to infection. The result is damage to multiple organs caused by the initial cascade of inflammation aggravated by subsequent sepsis to which the body has become susceptible. This Series examines the biological mechanisms and clinical implications of the cascade of events caused by large-scale trauma that leads to multiorgan failure and death, despite the stemming of blood loss. Furthermore, the stark and robust epidemiological finding--namely, that age has a profound influence on the chances of surviving trauma irrespective of the nature and severity of the injury--will be explored. Advances in our understanding of the inflammatory response to trauma, the impact of ageing on this response, and how this information has led to new and emerging treatments aimed at combating immune dysregulation and reduced immunity after injury will also be discussed.

Lifelong susceptibility to acoustic trauma: Changing patterns of chochlear damage over the life span of the mouse

Energy Technology Data Exchange (ETDEWEB)

Henry, K.R.

1983-01-01

Age-related differences in susceptibility to noise-induced threshold shift (NITS) were examined over the entire life span of the CBA/J mouse. Mice of varying ages were given a single 5-min exposure to a 124-dB octave-band (12-24 kHz) noise. Susceptibility began at 15-16 days postpartum and increased rapidly until approximately 20 days of age. During this phase, NITS (as measured by increased action potential threshold) was greatest at 16 kHz. Overall susceptibility was consistently high from 20 to 90 days. During this phase, NITS became most severe at 32 kHz. From 120 days until beyond the end of its acturarial life span (527 days), NITS no longer occured at 2-16 kHz, but the 64-kHz response retained its susceptibility to acoustic trauma. Mice at 20 and 60 days of age showed the same pattern of decreasing susceptibility as the intensity of the noise exposure was reduced to 114 and 104 dB, indicating that the absence of a tightly restricted critical period is not peculiar to a particular sound pressure level.

Application of a TNF-alpha-inhibitor into the scala tympany after cochlear electrode insertion trauma in guinea pigs: preliminary audiologic results.

Science.gov (United States)

Ihler, Friedrich; Pelz, Sabrina; Coors, Melanie; Matthias, Christoph; Canis, Martin

2014-11-01

Cochlear implantation trauma causes both macroscopic and inflammatory trauma. The aim of the present study was to evaluate the effectiveness of the TNF-alpha inhibitor etanercept applied after cochlear implantation trauma on the preservation of acoustic hearing. Guinea pigs were randomly assigned to three groups receiving cochlear implantation trauma by cochleostomy. In one group, the site was sealed by bone cement with no further treatment. A second group was additionally implanted with an osmotic minipump delivering artificial perilymph into the scala tympani for seven days. In the third group, etanercept 1 mg/ml was added to artificial perilymph. Hearing was assessed by auditory brainstem responses at 2, 4, 6, and 8 kHz prior to and after surgery and on days 3, 5, 7, 14, 28. Fifteen healthy guinea pigs. The trauma led to threshold shifts from 50.3 dB ± 16.3 dB to 68.0 dB ± 19.3 dB. Hearing thresholds were significantly lower in etanercept-treated animals compared to controls on day 28 at 8 kHz and from day 3 onwards at 4 and 2 kHz (p < 0.01; two-way RM ANOVA / Bonferroni t-test). The application of etanercept led to preservation of acoustic hearing after cochlear implantation trauma.

Noise Trauma-Induced Behavioral Gap Detection Deficits Correlate with Reorganization of Excitatory and Inhibitory Local Circuits in the Inferior Colliculus and Are Prevented by Acoustic Enrichment.

Science.gov (United States)

Sturm, Joshua J; Zhang-Hooks, Ying-Xin; Roos, Hannah; Nguyen, Tuan; Kandler, Karl

2017-06-28

Hearing loss leads to a host of cellular and synaptic changes in auditory brain areas that are thought to give rise to auditory perception deficits such as temporal processing impairments, hyperacusis, and tinnitus. However, little is known about possible changes in synaptic circuit connectivity that may underlie these hearing deficits. Here, we show that mild hearing loss as a result of brief noise exposure leads to a pronounced reorganization of local excitatory and inhibitory circuits in the mouse inferior colliculus. The exact nature of these reorganizations correlated with the presence or absence of the animals' impairments in detecting brief sound gaps, a commonly used behavioral sign for tinnitus in animal models. Mice with gap detection deficits (GDDs) showed a shift in the balance of synaptic excitation and inhibition that was present in both glutamatergic and GABAergic neurons, whereas mice without GDDs showed stable excitation-inhibition balances. Acoustic enrichment (AE) with moderate intensity, pulsed white noise immediately after noise trauma prevented both circuit reorganization and GDDs, raising the possibility of using AE immediately after cochlear damage to prevent or alleviate the emergence of central auditory processing deficits. SIGNIFICANCE STATEMENT Noise overexposure is a major cause of central auditory processing disorders, including tinnitus, yet the changes in synaptic connectivity underlying these disorders remain poorly understood. Here, we find that brief noise overexposure leads to distinct reorganizations of excitatory and inhibitory synaptic inputs onto glutamatergic and GABAergic neurons and that the nature of these reorganizations correlates with animals' impairments in detecting brief sound gaps, which is often considered a sign of tinnitus. Acoustic enrichment immediately after noise trauma prevents circuit reorganizations and gap detection deficits, highlighting the potential for using sound therapy soon after cochlear damage

Adverse Weather Evokes Nostalgia.

Science.gov (United States)

van Tilburg, Wijnand A P; Sedikides, Constantine; Wildschut, Tim

2018-03-01

Four studies examined the link between adverse weather and the palliative role of nostalgia. We proposed and tested that (a) adverse weather evokes nostalgia (Hypothesis 1); (b) adverse weather causes distress, which predicts elevated nostalgia (Hypothesis 2); (c) preventing nostalgia exacerbates weather-induced distress (Hypothesis 3); and (d) weather-evoked nostalgia confers psychological benefits (Hypothesis 4). In Study 1, participants listened to recordings of wind, thunder, rain, and neutral sounds. Adverse weather evoked nostalgia. In Study 2, participants kept a 10-day diary recording weather conditions, distress, and nostalgia. We also obtained meteorological data. Adverse weather perceptions were positively correlated with distress, which predicted higher nostalgia. Also, adverse natural weather was associated with corresponding weather perceptions, which predicted elevated nostalgia. (Results were mixed for rain.) In Study 3, preventing nostalgia (via cognitive load) increased weather-evoked distress. In Study 4, weather-evoked nostalgia was positively associated with psychological benefits. The findings pioneer the relevance of nostalgia as source of comfort in adverse weather.

Development of the acoustic startle response in rats and its change after early acoustic trauma

Czech Academy of Sciences Publication Activity Database

Rybalko, Natalia; Chumak, Tetyana; Bureš, Zbyněk; Popelář, Jiří; Šuta, Daniel; Syka, Josef

2015-01-01

Roč. 286, jul 1 (2015), s. 212-221 ISSN 0166-4328 R&D Projects: GA ČR(CZ) GAP303/12/1347; GA ČR(CZ) GBP304/12/G069; GA MŠk(CZ) ED1.1.00/02.0109 Institutional support: RVO:68378041 Keywords : auditory system * rat * acoustic startle reflex * development * critical period * noise exposure Subject RIV: FH - Neurology Impact factor: 3.002, year: 2015

Music evokes vivid autobiographical memories.

Science.gov (United States)

Belfi, Amy M; Karlan, Brett; Tranel, Daniel

2016-08-01

Music is strongly intertwined with memories-for example, hearing a song from the past can transport you back in time, triggering the sights, sounds, and feelings of a specific event. This association between music and vivid autobiographical memory is intuitively apparent, but the idea that music is intimately tied with memories, seemingly more so than other potent memory cues (e.g., familiar faces), has not been empirically tested. Here, we compared memories evoked by music to those evoked by famous faces, predicting that music-evoked autobiographical memories (MEAMs) would be more vivid. Participants listened to 30 songs, viewed 30 faces, and reported on memories that were evoked. Memories were transcribed and coded for vividness as in Levine, B., Svoboda, E., Hay, J. F., Winocur, G., & Moscovitch, M. [2002. Aging and autobiographical memory: Dissociating episodic from semantic retrieval. Psychology and Aging, 17, 677-689]. In support of our hypothesis, MEAMs were more vivid than autobiographical memories evoked by faces. MEAMs contained a greater proportion of internal details and a greater number of perceptual details, while face-evoked memories contained a greater number of external details. Additionally, we identified sex differences in memory vividness: for both stimulus categories, women retrieved more vivid memories than men. The results show that music not only effectively evokes autobiographical memories, but that these memories are more vivid than those evoked by famous faces.

Data driven linear algebraic methods for analysis of molecular pathways: application to disease progression in shock/trauma.

Science.gov (United States)

McGuire, Mary F; Sriram Iyengar, M; Mercer, David W

2012-04-01

Although trauma is the leading cause of death for those below 45years of age, there is a dearth of information about the temporal behavior of the underlying biological mechanisms in those who survive the initial trauma only to later suffer from syndromes such as multiple organ failure. Levels of serum cytokines potentially affect the clinical outcomes of trauma; understanding how cytokine levels modulate intra-cellular signaling pathways can yield insights into molecular mechanisms of disease progression and help to identify targeted therapies. However, developing such analyses is challenging since it necessitates the integration and interpretation of large amounts of heterogeneous, quantitative and qualitative data. Here we present the Pathway Semantics Algorithm (PSA), an algebraic process of node and edge analyses of evoked biological pathways over time for in silico discovery of biomedical hypotheses, using data from a prospective controlled clinical study of the role of cytokines in multiple organ failure (MOF) at a major US trauma center. A matrix algebra approach was used in both the PSA node and PSA edge analyses with different matrix configurations and computations based on the biomedical questions to be examined. In the edge analysis, a percentage measure of crosstalk called XTALK was also developed to assess cross-pathway interference. In the node/molecular analysis of the first 24h from trauma, PSA uncovered seven molecules evoked computationally that differentiated outcomes of MOF or non-MOF (NMOF), of which three molecules had not been previously associated with any shock/trauma syndrome. In the edge/molecular interaction analysis, PSA examined four categories of functional molecular interaction relationships--activation, expression, inhibition, and transcription--and found that the interaction patterns and crosstalk changed over time and outcome. The PSA edge analysis suggests that a diagnosis, prognosis or therapy based on molecular interaction

Low-intensity focused ultrasound alters the latency and spatial patterns of sensory-evoked cortical responses in vivo

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Fisher, Jonathan A. N.; Gumenchuk, Iryna

2018-06-01

Objective. The use of transcranial, low intensity focused ultrasound (FUS) is an emerging neuromodulation technology that shows promise for both therapeutic and research applications. Among many, one of the most exciting applications is the use of FUS to rehabilitate or augment human sensory capabilities. While there is compelling empirical evidence demonstrating this capability, basic questions regarding the spatiotemporal extent of the modulatory effects remain. Our objective was to assess the basic, yet often overlooked hypothesis that FUS in fact alters sensory-evoked neural activity within the region of the cerebral cortex at the beam’s focus. Approach. To address this knowledge gap, we developed an approach to optically interrogate patterns of neural activity in the cortex directly at the acoustic focus, in vivo. Implementing simultaneous wide-field optical imaging and FUS stimulation in mice, our experiments probed somatosensory-evoked electrical activity through the use of voltage sensitive dyes (VSDs) and, in transgenic mice expressing GCaMP6f, monitored associated Ca2+ responses. Main results. Our results demonstrate that low-intensity FUS alters both the kinetics and spatial patterns of neural activity in primary somatosensory cortex at the acoustic focus. When preceded by 1 s of pulsed ultrasound at intensities below 1 W cm‑2 (I sppa), the onset of sensory-evoked cortical responses occurred 3.0  ±  0.7 ms earlier and altered the surface spatial morphology of Ca2+ responses. Significance. These findings support the heretofore unconfirmed assumption that FUS-induced sensory modulation reflects, at least in part, altered reactivity in primary sensory cortex at the site of sonication. The findings are significant given the interest in using FUS to target and alter spatial aspects of sensory receptive fields on the cerebral cortex.

Low-intensity focused ultrasound alters the latency and spatial patterns of sensory-evoked cortical responses in vivo.

Science.gov (United States)

Fisher, Jonathan A N; Gumenchuk, Iryna

2018-02-13

The use of transcranial, low intensity focused ultrasound (FUS) is an emerging neuromodulation technology that shows promise for both therapeutic and research applications. Among many, one of the most exciting applications is the use of FUS to rehabilitate or augment human sensory capabilities. While there is compelling empirical evidence demonstrating this capability, basic questions regarding the spatiotemporal extent of the modulatory effects remain. Our objective was to assess the basic, yet often overlooked hypothesis that FUS in fact alters sensory-evoked neural activity within the region of the cerebral cortex at the beam's focus. To address this knowledge gap, we developed an approach to optically interrogate patterns of neural activity in the cortex directly at the acoustic focus, in vivo. Implementing simultaneous wide-field optical imaging and FUS stimulation in mice, our experiments probed somatosensory-evoked electrical activity through the use of voltage sensitive dyes (VSDs) and, in transgenic mice expressing GCaMP6f, monitored associated Ca 2+ responses. Our results demonstrate that low-intensity FUS alters both the kinetics and spatial patterns of neural activity in primary somatosensory cortex at the acoustic focus. When preceded by 1 s of pulsed ultrasound at intensities below 1 W cm -2 (I sppa ), the onset of sensory-evoked cortical responses occurred 3.0  ±  0.7 ms earlier and altered the surface spatial morphology of Ca 2+ responses. These findings support the heretofore unconfirmed assumption that FUS-induced sensory modulation reflects, at least in part, altered reactivity in primary sensory cortex at the site of sonication. The findings are significant given the interest in using FUS to target and alter spatial aspects of sensory receptive fields on the cerebral cortex.

A paediatric case of bilateral mandibular condyle fracture presenting with bloody otorrhoea following trauma.

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Chan, Yat Chun; Au-Yeung, Kwan Leong

2017-04-22

A 7-year-old boy presented to the emergency department with bilateral bloody otorrhoea after falling from his scooter. Skull base fracture was suspected. CT showed no evidence of skull base fracture but bilateral mandibular condyle and external acoustic canals fractures. We report this case to illustrate a rare possibility of bilateral external acoustic canal fracture associated with condylar fracture in trauma patients presented with bloody otorrhoea. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Acoustic pollution in hospital environments

International Nuclear Information System (INIS)

Olivera, J M; Rocha, L A; Rotger, V I; Herrera, M C

2011-01-01

There are many different services within a hospital. This means different types of noise which can be considered as acoustic pollution. Knowing that preterm infants exposed to high amounts of noise in the NICU are at a much higher risk because of their neurologic immaturity and physiologic instability, that excessive levels of noise also affect the persons and it can also impede some studies on patients, it was proposed to evaluate the Sound Pressure Level in some services of the Instituto de Maternidad, Tucumán, Argentina. There were evaluated the Level III NICU, the laundry service, a physical space destined for a service of evoked potential and a neonatal incubator under working conditions. The measurements were performed with a type II sonometer (CENTER 322) and it was also used an incubator analyzer (FLUKE INCU) for the incubator. The average values obtained were of 63.6 dBA for the NICU, 82.5dBA for the laundry room, 52.7 dBA for the evoked potential room and 62.8 dBA in the inside of the incubator under 64 dBA in the outside. The reports were documented in compliance with the appropriate standards.

Proprioceptive evoked gamma oscillations

DEFF Research Database (Denmark)

Arnfred, S.M.; Hansen, Lars Kai; Parnas, J.

2007-01-01

A proprioceptive stimulus consisting of a weight change of a handheld load has recently been shown to elicit an evoked potential. Previously, somatosensory gamma oscillations have only been evoked by electrical stimuli. We conjectured that a natural proprioceptive stimulus also would be able...... to evoke gamma oscillations. EEG was recorded using 64 channels in 14 healthy subjects. In each of three runs a stimulus of 100 g load increment in each hand was presented in 120 trials. Data were wavelet transformed and runs collapsed. Inter-trial phase coherence (ITPC) was computed as the best measure...

Analysis of the acoustic sound in MRI

Energy Technology Data Exchange (ETDEWEB)

Wada, Tetsuro; Hara, Akira; Kusakari, Jun; Yoshioka, Hiroshi; Niitsu, Mamoru; Itai, Yuji [Tsukuba Univ., Ibaraki (Japan). Inst. of Clinical Medicine; Ase, Yuji

1999-04-01

The noise level and power spectra of the acoustic sound exposed during the examination of Magnetic Resonance Imaging (MRI) using a MRI scanner (Philips Gyroscan 1.5 T) were measured at the position of the human auricle. The overall noise levels on T1-weighted images and T2-weighted images with Spin Echo were 105 dB and 98 dB, respectively. The overall noise level on T2-weighted images with Turbo Spin Echo was 110 dB. Fourier analysis revealed energy peaks ranging from 225 to 325 Hz and a steep high frequency cutoff for each pulse sequence. The MRI noise was not likely to cause permanent threshold shift. However, because of the inter-subject variation in susceptibility to acoustic trauma and to exclude the anxiety in patients, ear protectors were recommended for all patients during MRI testing. (author)

Mismatch negativity evoked by the McGurk-MacDonald effect: a phonetic representation within short-term memory.

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Colin, C; Radeau, M; Soquet, A; Demolin, D; Colin, F; Deltenre, P

2002-04-01

The McGurk-MacDonald illusory percept is obtained by dubbing an incongruent articulatory movement on an auditory phoneme. This type of audiovisual speech perception contributes to the assessment of theories of speech perception. The mismatch negativity (MMN) reflects the detection of a deviant stimulus within the auditory short-term memory and besides an acoustic component, possesses, under certain conditions, a phonetic one. The present study assessed the existence of an MMN evoked by McGurk-MacDonald percepts elicited by audiovisual stimuli with constant auditory components. Cortical evoked potentials were recorded using the oddball paradigm on 8 adults in 3 experimental conditions: auditory alone, visual alone and audiovisual stimulation. Obtaining illusory percepts was confirmed in an additional psychophysical condition. The auditory deviant syllables and the audiovisual incongruent syllables elicited a significant MMN at Fz. In the visual condition, no negativity was observed either at Fz, or at O(z). An MMN can be evoked by visual articulatory deviants, provided they are presented in a suitable auditory context leading to a phonetically significant interaction. The recording of an MMN elicited by illusory McGurk percepts suggests that audiovisual integration mechanisms in speech take place rather early during the perceptual processes.

Evoked emotions predict food choice.

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Dalenberg, Jelle R; Gutjar, Swetlana; Ter Horst, Gert J; de Graaf, Kees; Renken, Remco J; Jager, Gerry

2014-01-01

In the current study we show that non-verbal food-evoked emotion scores significantly improve food choice prediction over merely liking scores. Previous research has shown that liking measures correlate with choice. However, liking is no strong predictor for food choice in real life environments. Therefore, the focus within recent studies shifted towards using emotion-profiling methods that successfully can discriminate between products that are equally liked. However, it is unclear how well scores from emotion-profiling methods predict actual food choice and/or consumption. To test this, we proposed to decompose emotion scores into valence and arousal scores using Principal Component Analysis (PCA) and apply Multinomial Logit Models (MLM) to estimate food choice using liking, valence, and arousal as possible predictors. For this analysis, we used an existing data set comprised of liking and food-evoked emotions scores from 123 participants, who rated 7 unlabeled breakfast drinks. Liking scores were measured using a 100-mm visual analogue scale, while food-evoked emotions were measured using 2 existing emotion-profiling methods: a verbal and a non-verbal method (EsSense Profile and PrEmo, respectively). After 7 days, participants were asked to choose 1 breakfast drink from the experiment to consume during breakfast in a simulated restaurant environment. Cross validation showed that we were able to correctly predict individualized food choice (1 out of 7 products) for over 50% of the participants. This number increased to nearly 80% when looking at the top 2 candidates. Model comparisons showed that evoked emotions better predict food choice than perceived liking alone. However, the strongest predictive strength was achieved by the combination of evoked emotions and liking. Furthermore we showed that non-verbal food-evoked emotion scores more accurately predict food choice than verbal food-evoked emotions scores.

Characterization of music-evoked autobiographical memories.

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Janata, Petr; Tomic, Stefan T; Rakowski, Sonja K

2007-11-01

Despite music's prominence in Western society and its importance to individuals in their daily lives, very little is known about the memories and emotions that are often evoked when hearing a piece of music from one's past. We examined the content of music-evoked autobiographical memories (MEAMs) using a novel approach for selecting stimuli from a large corpus of popular music, in both laboratory and online settings. A set of questionnaires probed the cognitive and affective properties of the evoked memories. On average, 30% of the song presentations evoked autobiographical memories, and the majority of songs also evoked various emotions, primarily positive, that were felt strongly. The third most common emotion was nostalgia. Analyses of written memory reports found both general and specific levels of autobiographical knowledge to be represented, and several social and situational contexts for memory formation were common across many memories. The findings indicate that excerpts of popular music serve as potent stimuli for studying the structure of autobiographical memories.

Language related differences of the sustained response evoked by natural speech sounds.

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Christina Siu-Dschu Fan

Full Text Available In tonal languages, such as Mandarin Chinese, the pitch contour of vowels discriminates lexical meaning, which is not the case in non-tonal languages such as German. Recent data provide evidence that pitch processing is influenced by language experience. However, there are still many open questions concerning the representation of such phonological and language-related differences at the level of the auditory cortex (AC. Using magnetoencephalography (MEG, we recorded transient and sustained auditory evoked fields (AEF in native Chinese and German speakers to investigate language related phonological and semantic aspects in the processing of acoustic stimuli. AEF were elicited by spoken meaningful and meaningless syllables, by vowels, and by a French horn tone. Speech sounds were recorded from a native speaker and showed frequency-modulations according to the pitch-contours of Mandarin. The sustained field (SF evoked by natural speech signals was significantly larger for Chinese than for German listeners. In contrast, the SF elicited by a horn tone was not significantly different between groups. Furthermore, the SF of Chinese subjects was larger when evoked by meaningful syllables compared to meaningless ones, but there was no significant difference regarding whether vowels were part of the Chinese phonological system or not. Moreover, the N100m gave subtle but clear evidence that for Chinese listeners other factors than purely physical properties play a role in processing meaningful signals. These findings show that the N100 and the SF generated in Heschl's gyrus are influenced by language experience, which suggests that AC activity related to specific pitch contours of vowels is influenced in a top-down fashion by higher, language related areas. Such interactions are in line with anatomical findings and neuroimaging data, as well as with the dual-stream model of language of Hickok and Poeppel that highlights the close and reciprocal interaction

Language related differences of the sustained response evoked by natural speech sounds.

Science.gov (United States)

Fan, Christina Siu-Dschu; Zhu, Xingyu; Dosch, Hans Günter; von Stutterheim, Christiane; Rupp, André

2017-01-01

In tonal languages, such as Mandarin Chinese, the pitch contour of vowels discriminates lexical meaning, which is not the case in non-tonal languages such as German. Recent data provide evidence that pitch processing is influenced by language experience. However, there are still many open questions concerning the representation of such phonological and language-related differences at the level of the auditory cortex (AC). Using magnetoencephalography (MEG), we recorded transient and sustained auditory evoked fields (AEF) in native Chinese and German speakers to investigate language related phonological and semantic aspects in the processing of acoustic stimuli. AEF were elicited by spoken meaningful and meaningless syllables, by vowels, and by a French horn tone. Speech sounds were recorded from a native speaker and showed frequency-modulations according to the pitch-contours of Mandarin. The sustained field (SF) evoked by natural speech signals was significantly larger for Chinese than for German listeners. In contrast, the SF elicited by a horn tone was not significantly different between groups. Furthermore, the SF of Chinese subjects was larger when evoked by meaningful syllables compared to meaningless ones, but there was no significant difference regarding whether vowels were part of the Chinese phonological system or not. Moreover, the N100m gave subtle but clear evidence that for Chinese listeners other factors than purely physical properties play a role in processing meaningful signals. These findings show that the N100 and the SF generated in Heschl's gyrus are influenced by language experience, which suggests that AC activity related to specific pitch contours of vowels is influenced in a top-down fashion by higher, language related areas. Such interactions are in line with anatomical findings and neuroimaging data, as well as with the dual-stream model of language of Hickok and Poeppel that highlights the close and reciprocal interaction between

Childhood trauma and dissociation among women with genito-pelvic pain/penetration disorder.

Science.gov (United States)

Özen, Beliz; Özdemir, Y Özay; Beştepe, E Emrem

2018-01-01

Causes such as childhood trauma, negative attitude about sexuality, inadequate sexual knowledge and education, relationship problems, and unconscious motivation are reported about psychosexual development in the etiology of genito-pelvic pain/penetration disorder (GPP/PD). There are few studies that focus directly on research etiology of GPP/PD and use structured scales. The aim of this study was to research childhood trauma and dissociation forms among women with GPP/PD. Fifty-five women with GPP/PD according to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and 61 healthy women with no complaints of sexual function as a control group, in the age range of 18-60 years, were included in this study. Sociodemographic data form, Childhood Trauma Questionnaire (CTQ-28), Dissociative Experiences Scale (DES), and Somatoform Dissociation Questionnaire (SDQ-20) were administered to all participants. Sexual abuse, emotional abuse, and emotional neglect scores, which comprise the subgroups of CTQ, were found high among women with GPP/PD compared with the control group ( p =0.003, p =0.006, p =0.001). While a significant difference between the two groups' SDQ scores was obtained ( p =0.000), no significant difference was detected between the two groups' DES scores ( p =0.392). The results evoke the question are genitopelvic pain conditions, vaginismus and dyspareunia, that cannot be explained with a medical cause and that cause penetration disorder, a kind of dissociative symptom prone to develop in some women with childhood psychogenic trauma.

Task-specific modulation of human auditory evoked responses in a delayed-match-to-sample task

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Feng eRong

2011-05-01

Full Text Available In this study, we focus our investigation on task-specific cognitive modulation of early cortical auditory processing in human cerebral cortex. During the experiments, we acquired whole-head magnetoencephalography (MEG data while participants were performing an auditory delayed-match-to-sample (DMS task and associated control tasks. Using a spatial filtering beamformer technique to simultaneously estimate multiple source activities inside the human brain, we observed a significant DMS-specific suppression of the auditory evoked response to the second stimulus in a sound pair, with the center of the effect being located in the vicinity of the left auditory cortex. For the right auditory cortex, a non-invariant suppression effect was observed in both DMS and control tasks. Furthermore, analysis of coherence revealed a beta band (12 ~ 20 Hz DMS-specific enhanced functional interaction between the sources in left auditory cortex and those in left inferior frontal gyrus, which has been shown to involve in short-term memory processing during the delay period of DMS task. Our findings support the view that early evoked cortical responses to incoming acoustic stimuli can be modulated by task-specific cognitive functions by means of frontal-temporal functional interactions.

Trauma team activation: Not just for trauma patients

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Phoenix Vuong

2017-01-01

Full Text Available Specialized trauma teams have been shown to improve outcomes in critically injured patients. At our institution, an the American College of Surgeons Committee on trauma level I Trauma center, the trauma team activation (TTA criteria includes both physiologic and anatomic criteria, but any attending physician can activate the trauma team at their discretion outside criteria. As a result, the trauma team has been activated for noninjured patients meeting physiologic criteria secondary to nontraumatic hemorrhage. We present two cases in which the trauma team was activated for noninjured patients in hemorrhagic shock. The utilization of the TTA protocol and subsequent management by the trauma team are reviewed as we believe these were critical factors in the successful recovery of both patients. Beyond the primary improved survival outcomes of severely injured patients, trauma center designation has a “halo effect” that encompasses patients with nontraumatic hemorrhage.

Trauma Tactics: Rethinking Trauma Education for Professional Nurses.

Science.gov (United States)

Garvey, Paula; Liddil, Jessica; Eley, Scott; Winfield, Scott

2016-01-01

According to the National Trauma Institute (2015), trauma accounts for more than 180,000 deaths each year in the United States. Nurses play a significant role in the care of trauma patients and therefore need appropriate education and training (L. ). Although several courses exist for trauma education, many nurses have not received adequate education in trauma management (B. ; L. ). Trauma Tactics, a 2-day course that focuses on high-fidelity human patient simulation, was created to meet this educational need. This descriptive study was conducted retrospectively to assess the effectiveness of the Trauma Tactics course. Pre- and postsurveys, tests, and simulation performance were used to evaluate professional nurses who participated in Trauma Tactics over a 10-month period. Fifty-five nurses were included in the study. Pre- and postsurveys revealed an increase in overall confidence, test scores increased by an average of 2.5 points, and simulation performance scores increased by an average of 16 points. Trauma Tactics is a high-quality course that provides a valuable and impactful educational experience for nurses. Further research is needed to evaluate the long-term effects of Trauma Tactics and its impacts on quality of care and patient outcomes.

Objective assessment of spectral ripple discrimination in cochlear implant listeners using cortical evoked responses to an oddball paradigm.

Science.gov (United States)

Lopez Valdes, Alejandro; Mc Laughlin, Myles; Viani, Laura; Walshe, Peter; Smith, Jaclyn; Zeng, Fan-Gang; Reilly, Richard B

2014-01-01

Cochlear implants (CIs) can partially restore functional hearing in deaf individuals. However, multiple factors affect CI listener's speech perception, resulting in large performance differences. Non-speech based tests, such as spectral ripple discrimination, measure acoustic processing capabilities that are highly correlated with speech perception. Currently spectral ripple discrimination is measured using standard psychoacoustic methods, which require attentive listening and active response that can be difficult or even impossible in special patient populations. Here, a completely objective cortical evoked potential based method is developed and validated to assess spectral ripple discrimination in CI listeners. In 19 CI listeners, using an oddball paradigm, cortical evoked potential responses to standard and inverted spectrally rippled stimuli were measured. In the same subjects, psychoacoustic spectral ripple discrimination thresholds were also measured. A neural discrimination threshold was determined by systematically increasing the number of ripples per octave and determining the point at which there was no longer a significant difference between the evoked potential response to the standard and inverted stimuli. A correlation was found between the neural and the psychoacoustic discrimination thresholds (R2=0.60, p<0.01). This method can objectively assess CI spectral resolution performance, providing a potential tool for the evaluation and follow-up of CI listeners who have difficulty performing psychoacoustic tests, such as pediatric or new users.

Assessment of visual disability using visual evoked potentials.

Science.gov (United States)

Jeon, Jihoon; Oh, Seiyul; Kyung, Sungeun

2012-08-06

disability in a range >5.77 μV. The results could be useful, especially in cases of no obvious pale disc with trauma. Visual acuity quantification using absolute value of amplitude in pattern visual evoked potentials was useful in confirming subjective visual acuity for cutoff values >5.77 μV in disability evaluation to discriminate the malingering from real disability.

Sex differences in the refractory period of the 100 ms auditory evoked magnetic field.

Science.gov (United States)

Rojas, D C; Teale, P; Sheeder, J; Reite, M

1999-11-08

The 100 ms latency auditory evoked magnetic response (M100) has been implicated in the earliest stage of acoustic memory encoding in the brain. Sex differences in this response have been found in its location within the brain and its functional properties. We recorded the M100 in 25 adults in response to changes in interstimulus interval of an auditory stimulus. Response amplitudes of the M100 were used to compute a measure of the M100 refractory period, which has been proposed to index the decay time constant of echoic memory. This time constant was significantly longer in both hemispheres of the female participants when compared to the male participants. Possible implications of this for behavioral sex differences in human memory performance are discussed.

Acoustic cloaking and transformation acoustics

International Nuclear Information System (INIS)

Chen Huanyang; Chan, C T

2010-01-01

In this review, we give a brief introduction to the application of the new technique of transformation acoustics, which draws on a correspondence between coordinate transformation and material properties. The technique is formulated for both acoustic waves and linear liquid surface waves. Some interesting conceptual devices can be designed for manipulating acoustic waves. For example, we can design acoustic cloaks that make an object invisible to acoustic waves, and the cloak can either encompass or lie outside the object to be concealed. Transformation acoustics, as an analog of transformation optics, can go beyond invisibility cloaking. As an illustration for manipulating linear liquid surface waves, we show that a liquid wave rotator can be designed and fabricated to rotate the wave front. The acoustic transformation media require acoustic materials which are anisotropic and inhomogeneous. Such materials are difficult to find in nature. However, composite materials with embedded sub-wavelength resonators can in principle be made and such 'acoustic metamaterials' can exhibit nearly arbitrary values of effective density and modulus tensors to satisfy the demanding material requirements in transformation acoustics. We introduce resonant sonic materials and Helmholtz resonators as examples of acoustic metamaterials that exhibit resonant behaviour in effective density and effective modulus. (topical review)

Current trauma care system and trauma care training in China

Directory of Open Access Journals (Sweden)

Lian-Yang Zhang

2018-04-01

Full Text Available Trauma is a life-threatening “modern disease”. The outcomes could only be optimized by cost-efficient and prompt trauma care, which embarks on the improvement of essential capacities and conceptual revolution in addition to the disruptive innovation of the trauma care system. According to experiences from the developed countries, systematic trauma care training is the cornerstone of the generalization and the improvement on the trauma care, such as the Advance Trauma Life Support (ATLS. Currently, the pre-hospital emergency medical services (EMS has been one of the essential elements of infrastructure of health services in China, which is also fundamental to the trauma care system. Hereby, the China Trauma Care Training (CTCT with independent intellectual property rights has been initiated and launched by the Chinese Trauma Surgeon Association to extend the up-to-date concepts and techniques in the field of trauma care as well to reinforce the generally well-accepted standardized protocols in the practices. This article reviews the current status of the trauma care system as well as the trauma care training. Keywords: Trauma care system, Trauma care training, China

Beyond the evoked/intrinsic neural process dichotomy

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Taylor Bolt

2018-03-01

Full Text Available Contemporary functional neuroimaging research has increasingly focused on characterization of intrinsic or “spontaneous” brain activity. Analysis of intrinsic activity is often contrasted with analysis of task-evoked activity that has traditionally been the focus of cognitive neuroscience. But does this evoked/intrinsic dichotomy adequately characterize human brain function? Based on empirical data demonstrating a close functional interdependence between intrinsic and task-evoked activity, we argue that the dichotomy between intrinsic and task-evoked activity as unobserved contributions to brain activity is artificial. We present an alternative picture of brain function in which the brain’s spatiotemporal dynamics do not consist of separable intrinsic and task-evoked components, but reflect the enaction of a system of mutual constraints to move the brain into and out of task-appropriate functional configurations. According to this alternative picture, cognitive neuroscientists are tasked with describing both the temporal trajectory of brain activity patterns across time, and the modulation of this trajectory by task states, without separating this process into intrinsic and task-evoked components. We argue that this alternative picture of brain function is best captured in a novel explanatory framework called enabling constraint. Overall, these insights call for a reconceptualization of functional brain activity, and should drive future methodological and empirical efforts.

Childhood trauma and dissociation among women with genito-pelvic pain/penetration disorder

Science.gov (United States)

Özen, Beliz; Özdemir, Y Özay; Beştepe, E Emrem

2018-01-01

Objective Causes such as childhood trauma, negative attitude about sexuality, inadequate sexual knowledge and education, relationship problems, and unconscious motivation are reported about psychosexual development in the etiology of genito-pelvic pain/penetration disorder (GPP/PD). There are few studies that focus directly on research etiology of GPP/PD and use structured scales. The aim of this study was to research childhood trauma and dissociation forms among women with GPP/PD. Patients and methods Fifty-five women with GPP/PD according to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and 61 healthy women with no complaints of sexual function as a control group, in the age range of 18–60 years, were included in this study. Sociodemographic data form, Childhood Trauma Questionnaire (CTQ-28), Dissociative Experiences Scale (DES), and Somatoform Dissociation Questionnaire (SDQ-20) were administered to all participants. Results Sexual abuse, emotional abuse, and emotional neglect scores, which comprise the subgroups of CTQ, were found high among women with GPP/PD compared with the control group (p=0.003, p=0.006, p=0.001). While a significant difference between the two groups’ SDQ scores was obtained (p=0.000), no significant difference was detected between the two groups’ DES scores (p=0.392). Discussion The results evoke the question are genitopelvic pain conditions, vaginismus and dyspareunia, that cannot be explained with a medical cause and that cause penetration disorder, a kind of dissociative symptom prone to develop in some women with childhood psychogenic trauma. PMID:29503548

Aspectos epidemiológicos del trauma acústico en personal expuesto a ruido intenso Epidemiological aspects of acoustic trauma found in the staff exposed to intensive noise

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Yazmila Rodríguez Fernández

2012-06-01

Full Text Available Introducción: el trauma acústico, ligado a las enfermedades profesionales, comenzó a estudiarse con profundidad a raíz de la segunda guerra mundial, y por los alarmantes resultados se implantaron una serie de medidas de prevención para evitar esta agresión. No obstante, estas no fueron eficaces debido a la falta de educación y de concientización del personal al cual iban dirigidas. Objetivos: determinar las manifestaciones auditivas en pacientes expuestos a ruidos intensos, teniendo en cuenta la edad, el sexo y el tiempo de exposición, y tomando como base los resultados audiométricos. Métodos: se realizó una encuesta epidemiológica a un grupo de 50 casos expuestos a ruidos intensos, en el período comprendido de enero de 2007 a enero de 2008. La muestra estuvo compuesta por pacientes entre los 20 y 55 años, en los cuales la manifestación auditiva más frecuente fue la hipoacusia. Resultados: en los resultados audiométricos se observó que la gran mayoría de los casos presentó una hipoacusia de tipo neurosensorial, con predominio del sexo masculino. Conclusiones: el sexo masculino fue el más afectado y la edad de 41 a 55 años, además, la intensidad de la hipoacusia fue mayor en correspondencia con el tiempo de exposición más prolongado.Introduction: acoustic trauma is linked to professional diseases and began to be studied in depth after the Second World War. Due to the alarming results obtained, a number of preventive measures to avoid this aggression were implemented; however, they were not effective because of the lack of education and awareness of the staff to which they were directed. Objectives: to find out the auditory manifestations in patients exposed to intensive noise, taking age, sex, time of exposure and the audiometric results into consideration. Methods: an epidemiological survey was carried out in a group of 50 cases exposed to intensive noises from January 2007 to January, 2008. The sample was made up of 20

Recording visual evoked potentials and auditory evoked P300 at 9.4T static magnetic field.

Science.gov (United States)

Arrubla, Jorge; Neuner, Irene; Hahn, David; Boers, Frank; Shah, N Jon

2013-01-01

Simultaneous recording of electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) has shown a number of advantages that make this multimodal technique superior to fMRI alone. The feasibility of recording EEG at ultra-high static magnetic field up to 9.4 T was recently demonstrated and promises to be implemented soon in fMRI studies at ultra high magnetic fields. Recording visual evoked potentials are expected to be amongst the most simple for simultaneous EEG/fMRI at ultra-high magnetic field due to the easy assessment of the visual cortex. Auditory evoked P300 measurements are of interest since it is believed that they represent the earliest stage of cognitive processing. In this study, we investigate the feasibility of recording visual evoked potentials and auditory evoked P300 in a 9.4 T static magnetic field. For this purpose, EEG data were recorded from 26 healthy volunteers inside a 9.4 T MR scanner using a 32-channel MR compatible EEG system. Visual stimulation and auditory oddball paradigm were presented in order to elicit evoked related potentials (ERP). Recordings made outside the scanner were performed using the same stimuli and EEG system for comparison purposes. We were able to retrieve visual P100 and auditory P300 evoked potentials at 9.4 T static magnetic field after correction of the ballistocardiogram artefact using independent component analysis. The latencies of the ERPs recorded at 9.4 T were not different from those recorded at 0 T. The amplitudes of ERPs were higher at 9.4 T when compared to recordings at 0 T. Nevertheless, it seems that the increased amplitudes of the ERPs are due to the effect of the ultra-high field on the EEG recording system rather than alteration in the intrinsic processes that generate the electrophysiological responses.

The Use of Drugs to Reduce Hearing Loss Following Acute Acoustic Trauma

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2013-10-15

compare, in the rescue mode of treatment, the effectiveness of (1) L-N-acetylcysteine (L- NAC); (2) D-Methionine (D-MET); (3) Ebselen SPI-1005; (4) Acetyl...trauma: (1) L-N-acetylcysteine (L-NAC); (2) D-Methionine (D-MET); (3) Ebselen SPI-1005; (4) Acetyl-L-carnitine (ALCAR) and (5) Src-PTK inhibitor, KX1...octave band of noise at 108 dB SPL and treated in the rescue mode with (i) L-NAC, (ii) D-MET, (iii) Ebselen SPI-1005, (iv) ALCAR, or (v) Src-PTK

Normalization of auditory evoked potential and visual evoked potential in patients with idiot savant.

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Chen, X; Zhang, M; Wang, J; Lou, F; Liang, J

1999-03-01

To investigate the variations of auditory evoked potentials (AEP) and visual evoked potentials (VEP) of patients with idiot savant (IS) syndrome. Both AEP and VEP were recorded from 7 patients with IS syndrome, 21 mentally retarded (MR) children without the syndrome and 21 normally age-matched controls, using a Dantec concerto SEEG-16 BEAM instrument. Both AEP and VEP of MR group showed significantly longer latencies (P1 and P2 latencies of AEP, P savant syndrome presented normalized AEP and VEP.

Visually Evoked Spiking Evolves While Spontaneous Ongoing Dynamics Persist

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Huys, Raoul; Jirsa, Viktor K.; Darokhan, Ziauddin; Valentiniene, Sonata; Roland, Per E.

2016-01-01

Neurons in the primary visual cortex spontaneously spike even when there are no visual stimuli. It is unknown whether the spiking evoked by visual stimuli is just a modification of the spontaneous ongoing cortical spiking dynamics or whether the spontaneous spiking state disappears and is replaced by evoked spiking. This study of laminar recordings of spontaneous spiking and visually evoked spiking of neurons in the ferret primary visual cortex shows that the spiking dynamics does not change: the spontaneous spiking as well as evoked spiking is controlled by a stable and persisting fixed point attractor. Its existence guarantees that evoked spiking return to the spontaneous state. However, the spontaneous ongoing spiking state and the visual evoked spiking states are qualitatively different and are separated by a threshold (separatrix). The functional advantage of this organization is that it avoids the need for a system reorganization following visual stimulation, and impedes the transition of spontaneous spiking to evoked spiking and the propagation of spontaneous spiking from layer 4 to layers 2–3. PMID:26778982

Blocking proteinase-activated receptor 2 alleviated neuropathic pain evoked by spinal cord injury.

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Wei, H; Wei, Y; Tian, F; Niu, T; Yi, G

2016-01-01

Spinal cord injury (SCI) is an extremely serious type of physical trauma observed in clinics. Especially, neuropathic pain resulting from SCI has a lasting and significant impact on most aspects of daily life. Thus, a better understanding of the molecular pathways responsible for the cause of neuropathic pain observed in SCI is important to develop effectively therapeutic agents and treatment strategies. Proteinase-activated receptors (PARs) are a family member of G-protein-coupled receptors and are activated by a proteolytic mechanism. One of its subtypes PAR2 has been reported to be engaged in mechanical and thermal hyperalgesia. Thus, in this study we specifically examined the underlying mechanisms responsible for SCI evoked-neuropathic pain in a rat model. Overall, we demonstrated that SCI increases PAR2 and its downstream pathways TRPV1 and TRPA1 expression in the superficial dorsal horn of the spinal cord. Also, we showed that blocking spinal PAR2 by intrathecal injection of FSLLRY-NH2 significantly inhibits neuropathic pain responses induced by mechanical and thermal stimulation whereas FSLLRY-NH2 decreases the protein expression of TRPV1 and TRPA1 as well as the levels of substance P and calcitonin gene-related peptide. Results of this study have important implications, i.e. targeting one or more of these signaling molecules involved in activation of PAR2 and TRPV1/TRPA1 evoked by SCI may present new opportunities for treatment and management of neuropathic pain often observed in patients with SCI.

Brain-immune interaction accompanying odor-evoked autobiographic memory.

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Matsunaga, Masahiro; Bai, Yu; Yamakawa, Kaori; Toyama, Asako; Kashiwagi, Mitsuyoshi; Fukuda, Kazuyuki; Oshida, Akiko; Sanada, Kazue; Fukuyama, Seisuke; Shinoda, Jun; Yamada, Jitsuhiro; Sadato, Norihiro; Ohira, Hideki

2013-01-01

The phenomenon in which a certain smell evokes a specific memory is known as the Proust phenomenon. Odor-evoked autobiographic memories are more emotional than those elicited by other sensory stimuli. The results of our previous study indicated that odor-evoked autobiographic memory accompanied by positive emotions has remarkable effects on various psychological and physiological activities, including the secretion of cytokines, which are immune-signaling molecules that modulate systemic inflammation. In this study, we aimed to clarify the neural substrates associated with the interaction between odor-evoked autobiographic memory and peripheral circulating cytokines. We recruited healthy male and female volunteers and investigated the association between brain responses and the concentration of several cytokines in the plasma by using positron emission tomography (PET) recordings when an autographic memory was evoked in participants by asking them to smell an odor that was nostalgic to them. Participants experienced positive emotions and autobiographic memories when nostalgic odors were presented to them. The levels of peripheral proinflammatory cytokines, such as the tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ), were significantly reduced after experiencing odor-evoked autobiographic memory. Subtraction analysis of PET images indicated that the medial orbitofrontal cortex (mOFC) and precuneus/posterior cingulate cortex (PCC) were significantly activated during experiences of odor-evoked autobiographic memory. Furthermore, a correlation analysis indicated that activities of the mOFC and precuneus/PCC were negatively correlated with IFN-γ concentration. These results indicate that the neural networks including the precuneus/PCC and mOFC might regulate the secretion of peripheral proinflammatory cytokines during the experience of odor-evoked autobiographic memories accompanied with positive emotions.

Brain–Immune Interaction Accompanying Odor-Evoked Autobiographic Memory

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Matsunaga, Masahiro; Bai, Yu; Yamakawa, Kaori; Toyama, Asako; Kashiwagi, Mitsuyoshi; Fukuda, Kazuyuki; Oshida, Akiko; Sanada, Kazue; Fukuyama, Seisuke; Shinoda, Jun; Yamada, Jitsuhiro; Sadato, Norihiro; Ohira, Hideki

2013-01-01

The phenomenon in which a certain smell evokes a specific memory is known as the Proust phenomenon. Odor-evoked autobiographic memories are more emotional than those elicited by other sensory stimuli. The results of our previous study indicated that odor-evoked autobiographic memory accompanied by positive emotions has remarkable effects on various psychological and physiological activities, including the secretion of cytokines, which are immune-signaling molecules that modulate systemic inflammation. In this study, we aimed to clarify the neural substrates associated with the interaction between odor-evoked autobiographic memory and peripheral circulating cytokines. We recruited healthy male and female volunteers and investigated the association between brain responses and the concentration of several cytokines in the plasma by using positron emission tomography (PET) recordings when an autographic memory was evoked in participants by asking them to smell an odor that was nostalgic to them. Participants experienced positive emotions and autobiographic memories when nostalgic odors were presented to them. The levels of peripheral proinflammatory cytokines, such as the tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ), were significantly reduced after experiencing odor-evoked autobiographic memory. Subtraction analysis of PET images indicated that the medial orbitofrontal cortex (mOFC) and precuneus/posterior cingulate cortex (PCC) were significantly activated during experiences of odor-evoked autobiographic memory. Furthermore, a correlation analysis indicated that activities of the mOFC and precuneus/PCC were negatively correlated with IFN-γ concentration. These results indicate that the neural networks including the precuneus/PCC and mOFC might regulate the secretion of peripheral proinflammatory cytokines during the experience of odor-evoked autobiographic memories accompanied with positive emotions. PMID:23977312

Brain-immune interaction accompanying odor-evoked autobiographic memory.

Directory of Open Access Journals (Sweden)

Masahiro Matsunaga

Full Text Available The phenomenon in which a certain smell evokes a specific memory is known as the Proust phenomenon. Odor-evoked autobiographic memories are more emotional than those elicited by other sensory stimuli. The results of our previous study indicated that odor-evoked autobiographic memory accompanied by positive emotions has remarkable effects on various psychological and physiological activities, including the secretion of cytokines, which are immune-signaling molecules that modulate systemic inflammation. In this study, we aimed to clarify the neural substrates associated with the interaction between odor-evoked autobiographic memory and peripheral circulating cytokines. We recruited healthy male and female volunteers and investigated the association between brain responses and the concentration of several cytokines in the plasma by using positron emission tomography (PET recordings when an autographic memory was evoked in participants by asking them to smell an odor that was nostalgic to them. Participants experienced positive emotions and autobiographic memories when nostalgic odors were presented to them. The levels of peripheral proinflammatory cytokines, such as the tumor necrosis factor-α (TNF-α and interferon-γ (IFN-γ, were significantly reduced after experiencing odor-evoked autobiographic memory. Subtraction analysis of PET images indicated that the medial orbitofrontal cortex (mOFC and precuneus/posterior cingulate cortex (PCC were significantly activated during experiences of odor-evoked autobiographic memory. Furthermore, a correlation analysis indicated that activities of the mOFC and precuneus/PCC were negatively correlated with IFN-γ concentration. These results indicate that the neural networks including the precuneus/PCC and mOFC might regulate the secretion of peripheral proinflammatory cytokines during the experience of odor-evoked autobiographic memories accompanied with positive emotions.

The impact of specialist trauma service on major trauma mortality.

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Wong, Ting Hway; Lumsdaine, William; Hardy, Benjamin M; Lee, Keegan; Balogh, Zsolt J

2013-03-01

Trauma services throughout the world have had positive effects on trauma-related mortality. Australian trauma services are generally more consultative in nature rather than the North American model of full trauma admission service. We hypothesized that the introduction of a consultative specialist trauma service in a Level I Australian trauma center would reduce mortality of the severely injured. A 10-year retrospective study (January 1, 2002-December 31, 2011) was performed on all trauma patients admitted with an Injury Severity Score (ISS) > 15. Patients were identified from the trauma registry, and data for age, sex, mechanism of injury, ISS, survival to discharge, and length of stay were collected. Mortality was examined for patients with severe injury (ISS > 15) and patients with critical injury (ISS > 24) and compared for the three periods: 2002-2004 (without trauma specialist), 2005-2007 (with trauma specialist), and 2008-2011 (with specialist trauma service). A total of 3,869 severely injured (ISS > 15) trauma patients were identified during the 10-year period. Of these, 2,826 (73%) were male, 1,513 (39%) were critically injured (ISS > 24), and more than 97% (3,754) were the victim of blunt trauma. Overall mortality decreased from 12.4% to 9.3% (relative risk, 0.75) from period one to period three and from 25.4% to 20.3% (relative risk, 0.80) for patients with critical injury. A 0.46% per year decrease (p = 0.018) in mortality was detected (odds ratio, 0.63; p 24), the trend was (0.61% per year; odds ratio, 0.68; p = 0.039). The introduction of a specialist trauma service decreased the mortality of patients with severe injury, the model of care should be considered to implement state- and nationwide in Australia. Epidemiologic study, level III.

Cumulative childhood interpersonal trauma is associated with reduced cortical differentiation between threat and non-threat faces in posttraumatic stress disorder adults.

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Chu, Denise A; Bryant, Richard A; Gatt, Justine M; Harris, Anthony Wf

2018-03-01

Posttraumatic stress disorder and childhood trauma frequently co-occur. Both are associated with abnormal neural responses to salient emotion stimuli. As childhood trauma is a risk factor for posttraumatic stress disorder, differentiating between their neurophysiological effects is necessary to elucidate the neural pathways by which childhood trauma exposure contributes to increased posttraumatic stress disorder risks. Face-specific N170 evoked response potentials for backward-masked (non-conscious) and conscious threat (fear, angry) and non-threat (happy) faces were measured in 77 adults (18-64 years old, 64% women, 78% right-handed) symptomatic for posttraumatic stress disorder. Differences in N170 peak amplitudes for fear-versus-happy and angry-versus-happy faces at bilateral temporo-occipital (T5, T6) sites were computed. The effect of cumulative exposure to childhood interpersonal trauma, other childhood trauma, adult trauma, depression and posttraumatic stress disorder symptom severity on the N170 response was assessed using hierarchical multiple regression analyses. T5 N170 peak amplitudes for non-conscious fear-versus-happy faces were inversely related to cumulative childhood interpersonal trauma after accounting for socio-demographic, clinical symptom and other trauma factors. Posttraumatic stress disorder Avoidance was positively associated with N170 peak amplitudes for non-conscious fear-versus-happy faces, primarily due to reduced N170 responsivity to happy faces. Childhood interpersonal trauma exposure is associated with reduced discrimination between fear and happy faces, while avoidance symptom severity is associated with dampened responsivity to automatically processed happy faces in posttraumatic stress disorder adults. Results are discussed in terms of the likely contributions of impaired threat discrimination and deficient reward processing during neural processing of salient emotion stimuli, to increased risks of posttraumatic stress disorder

Incremental cost-effectiveness of trauma service improvements for road trauma casualties: experience of an Australian major trauma centre.

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Dinh, Michael M; Bein, Kendall J; Hendrie, Delia; Gabbe, Belinda; Byrne, Christopher M; Ivers, Rebecca

2016-09-01

Objective The aim of the present study was to estimate the cost-effectiveness of trauma service funding enhancements at an inner city major trauma centre. Methods The present study was a cost-effectiveness analysis using retrospective trauma registry data of all major trauma patients (injury severity score >15) presenting after road trauma between 2001 and 2012. The primary outcome was cost per life year gained associated with the intervention period (2007-12) compared with the pre-intervention period (2001-06). Incremental costs were represented by all trauma-related funding enhancements undertaken between 2007 and 2010. Risk adjustment for years of life lost was conducted using zero-inflated negative binomial regression modelling. All costs were expressed in 2012 Australian dollar values. Results In all, 876 patients were identified during the study period. The incremental cost of trauma enhancements between 2007 and 2012 totalled $7.91million, of which $2.86million (36%) was attributable to road trauma patients. After adjustment for important covariates, the odds of in-hospital mortality reduced by around half (adjusted odds ratio (OR) 0.48; 95% confidence interval (CI) 0.27, 0.82; P=0.01). The incremental cost-effectiveness ratio was A$7600 per life year gained (95% CI A$5524, $19333). Conclusion Trauma service funding enhancements that enabled a quality improvement program at a single major trauma centre were found to be cost-effective based on current international and Australian standards. What is known about this topic? Trauma quality improvement programs have been implemented across most designated trauma hospitals in an effort to improve hospital care processes and outcomes for injured patients. These involve a combination of education and training, the use of audit and key performance indicators. What does this paper add? A trauma quality improvement program initiated at an Australian Major Trauma Centre was found to be cost-effective over 12 years with

The Role of Cumulative Trauma, Betrayal, and Appraisals in Understanding Trauma Symptomatology.

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Martin, Christina Gamache; Cromer, Lisa Demarni; Deprince, Anne P; Freyd, Jennifer J

2013-03-01

Poor psychological outcomes are common among trauma survivors, yet not all survivors experience adverse sequelae. The current study examined links between cumulative trauma exposure as a function of the level of betrayal (measured by the relational closeness of the survivor and the perpetrator), trauma appraisals, gender, and trauma symptoms. Participants were 273 college students who reported experiencing at least one traumatic event on a trauma checklist. Three cumulative indices were constructed to assess the number of different types of traumas experienced that were low (LBTs), moderate (MBTs), or high in betrayal (HBTs). Greater trauma exposure was related to more symptoms of depression, dissociation, and PTSD, with exposure to HBTs contributing the most. Women were more likely to experience HBTs than men, but there were no gender differences in trauma-related symptoms. Appraisals of trauma were predictive of trauma-related symptoms over and above the effects explained by cumulative trauma at each level of betrayal. The survivor's relationship with the perpetrator, the effect of cumulative trauma, and their combined impact on trauma symptomatology are discussed.

Trauma Center Staffing, Infrastructure, and Patient Characteristics that Influence Trauma Center Need

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Faul, Mark

2014-11-01

Full Text Available Introduction: The most effective use of trauma center resources helps reduce morbidity and mortality, while saving costs. Identifying critical infrastructure characteristics, patient characteristics and staffing components of a trauma center associated with the proportion of patients needing major trauma care will help planners create better systems for patient care.   Methods: We used the 2009 National Trauma Data Bank-Research Dataset to determine the proportion of critically injured patients requiring the resources of a trauma center within each Level I-IV trauma center (n=443. The outcome variable was defined as the portion of treated patients who were critically injured. We defined the need for critical trauma resources and interventions (“trauma center need” as death prior to hospital discharge, admission to the intensive care unit, or admission to the operating room from the emergency department as a result of acute traumatic injury. Generalized Linear Modeling (GLM was used to determine how hospital infrastructure, staffing Levels, and patient characteristics contributed to trauma center need.     Results: Nonprofit Level I and II trauma centers were significantly associated with higher levels of trauma center need. Trauma centers that had a higher percentage of transferred patients or a lower percentage of insured patients were associated with a higher proportion of trauma center need.  Hospital infrastructure characteristics, such as bed capacity and intensive care unit capacity, were not associated with trauma center need. A GLM for Level III and IV trauma centers showed that the number of trauma surgeons on staff was associated with trauma center need. Conclusion: Because the proportion of trauma center need is predominantly influenced by hospital type, transfer frequency, and insurance status, it is important for administrators to consider patient population characteristics of the catchment area when planning the

Towards a neural basis of music-evoked emotions.

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Koelsch, Stefan

2010-03-01

Music is capable of evoking exceptionally strong emotions and of reliably affecting the mood of individuals. Functional neuroimaging and lesion studies show that music-evoked emotions can modulate activity in virtually all limbic and paralimbic brain structures. These structures are crucially involved in the initiation, generation, detection, maintenance, regulation and termination of emotions that have survival value for the individual and the species. Therefore, at least some music-evoked emotions involve the very core of evolutionarily adaptive neuroaffective mechanisms. Because dysfunctions in these structures are related to emotional disorders, a better understanding of music-evoked emotions and their neural correlates can lead to a more systematic and effective use of music in therapy. Copyright 2010 Elsevier Ltd. All rights reserved.

Brainstem auditory evoked potentials with the use of acoustic clicks and complex verbal sounds in young adults with learning disabilities.

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Kouni, Sophia N; Giannopoulos, Sotirios; Ziavra, Nausika; Koutsojannis, Constantinos

2013-01-01

Acoustic signals are transmitted through the external and middle ear mechanically to the cochlea where they are transduced into electrical impulse for further transmission via the auditory nerve. The auditory nerve encodes the acoustic sounds that are conveyed to the auditory brainstem. Multiple brainstem nuclei, the cochlea, the midbrain, the thalamus, and the cortex constitute the central auditory system. In clinical practice, auditory brainstem responses (ABRs) to simple stimuli such as click or tones are widely used. Recently, complex stimuli or complex auditory brain responses (cABRs), such as monosyllabic speech stimuli and music, are being used as a tool to study the brainstem processing of speech sounds. We have used the classic 'click' as well as, for the first time, the artificial successive complex stimuli 'ba', which constitutes the Greek word 'baba' corresponding to the English 'daddy'. Twenty young adults institutionally diagnosed as dyslexic (10 subjects) or light dyslexic (10 subjects) comprised the diseased group. Twenty sex-, age-, education-, hearing sensitivity-, and IQ-matched normal subjects comprised the control group. Measurements included the absolute latencies of waves I through V, the interpeak latencies elicited by the classical acoustic click, the negative peak latencies of A and C waves, as well as the interpeak latencies of A-C elicited by the verbal stimulus 'baba' created on a digital speech synthesizer. The absolute peak latencies of waves I, III, and V in response to monoaural rarefaction clicks as well as the interpeak latencies I-III, III-V, and I-V in the dyslexic subjects, although increased in comparison with normal subjects, did not reach the level of a significant difference (pwave C and the interpeak latencies of A-C elicited by verbal stimuli were found to be increased in the dyslexic group in comparison with the control group (p=0.0004 and p=0.045, respectively). In the subgroup consisting of 10 patients suffering from

A Case of Acoustic Shock with Post-trauma Trigeminal-Autonomic Activation

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Alain Londero

2017-08-01

Full Text Available This study reports the case of an acoustic shock injury (ASI, which did not result in a significant hearing loss, but was followed by manifold chronic symptoms both within (tinnitus, otalgia, tingling in the ear, tension in the ear, and red tympanum and outside the ears (blocked nose, pain in the neck/temporal region. We suggest that these symptoms may result from a loop involving injury to middle ear muscles, peripheral inflammatory processes, activation and sensitization of the trigeminal nerve, the autonomic nervous system, and central feedbacks. The pathophysiology of this ASI is reminiscent of that observed in post-traumatic trigeminal-autonomic cephalalgia. This framework opens new and promising perspectives on the understanding and medical management of ASI.

The role of the trauma nurse leader in a pediatric trauma center.

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Wurster, Lee Ann; Coffey, Carla; Haley, Kathy; Covert, Julia

2009-01-01

The trauma nurse leader role was developed by a group of trauma surgeons, hospital administrators, and emergency department and trauma leaders at Nationwide Children's Hospital who recognized the need for the development of a core group of nurses who provided expert trauma care. The intent was to provide an experienced group of nurses who could identify and resolve issues in the trauma room. Through increased education, exposure, mentoring, and professional development, the trauma nurse leader role has become an essential part of the specialized pediatric trauma care provided at Nationwide Children's Hospital.

The trauma ecosystem: The impact and economics of new trauma centers on a mature statewide trauma system.

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Ciesla, David J; Pracht, Etienne E; Leitz, Pablo T; Spain, David A; Staudenmayer, Kristan L; Tepas, Joseph J

2017-06-01

Florida serves as a model for the study of trauma system performance. Between 2010 and 2104, 5 new trauma centers were opened alongside 20 existing centers. The purpose of this study was to explore the impact of trauma system expansion on system triage performance and trauma center patients' profiles. A statewide data set was queried for all injury-related discharges from adult acute care hospitals using International Classification of Diseases, Ninth Revision (ICD-9) codes for 2010 and 2014. The data set, inclusion criteria, and definitions of high-risk injury were chosen to match those used by the Florida Department of Health in its trauma registry. Hospitals were classified as existing Level I (E1) or Level II (E2) trauma centers and new E2 (N2) centers. Five N2 centers were established 11.6 to 85.3 miles from existing centers. Field and overall trauma system triage of high-risk patients was less accurate with increased overtriage and no change in undertriage. Annual volume at N2 centers increased but did not change at E1 and E2 centers. In 2014, Patients at E1 and E2 centers were slightly older and less severely injured, while those at N2 centers were substantially younger and more severely injured than in 2010. The injured patient-payer mix changed with a decrease in self-pay and commercial patients and an increase in government-sponsored patients at E1 and E2 centers and an increase in self-pay and commercial patients with a decrease in government-sponsored patients at N2 centers. Designation of new trauma centers in a mature system was associated with a change in established trauma center demographics and economics without an improvement in trauma system triage performance. These findings suggest that the health of an entire trauma system network must be considered in the design and implementation of a regional trauma system. Therapeutic/care management study, level IV; epidemiological, level IV.

Trauma pattern in a level I east-European trauma center

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Bogdan Stoica

2015-10-01

Conclusions: Our trauma pattern profile is similar to the one found in west-European countries, with a predominance of traffic-related injuries and falls. The severity and anatomical puzzle for trauma lesions were more complex secondary to motorcycle or bicycle-to-auto vehicles collisions. A trauma registry, with prospective enrollment of patients, is a very effective tool for constant improvements in trauma care.

Skin denervation does not alter cortical potentials to surface concentric electrode stimulation: A comparison with laser evoked potentials and contact heat evoked potentials.

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La Cesa, S; Di Stefano, G; Leone, C; Pepe, A; Galosi, E; Alu, F; Fasolino, A; Cruccu, G; Valeriani, M; Truini, A

2018-01-01

In the neurophysiological assessment of patients with neuropathic pain, laser evoked potentials (LEPs), contact heat evoked potentials (CHEPs) and the evoked potentials by the intraepidermal electrical stimulation via concentric needle electrode are widely agreed as nociceptive specific responses; conversely, the nociceptive specificity of evoked potentials by surface concentric electrode (SE-PREPs) is still debated. In this neurophysiological study we aimed at verifying the nociceptive specificity of SE-PREPs. We recorded LEPs, CHEPs and SE-PREPs in eleven healthy participants, before and after epidermal denervation produced by prolonged capsaicin application. We also used skin biopsy to verify the capsaicin-induced nociceptive nerve fibre loss in the epidermis. We found that whereas LEPs and CHEPs were suppressed after capsaicin-induced epidermal denervation, the surface concentric electrode stimulation of the same denervated skin area yielded unchanged SE-PREPs. The suppression of LEPs and CHEPs after nociceptive nerve fibre loss in the epidermis indicates that these techniques are selectively mediated by nociceptive system. Conversely, the lack of SE-PREP changes suggests that SE-PREPs do not provide selective information on nociceptive system function. Capsaicin-induced epidermal denervation abolishes laser evoked potentials (LEPs) and contact heat evoked potentials (CHEPs), but leaves unaffected pain-related evoked potentials by surface concentric electrode (SE-PREPs). These findings suggest that unlike LEPs and CHEPs, SE-PREPs are not selectively mediated by nociceptive system. © 2017 European Pain Federation - EFIC®.

Use of acoustic vortices in acoustic levitation

DEFF Research Database (Denmark)

Cutanda Henriquez, Vicente; Santillan, Arturo Orozco; Juhl, Peter Møller

2009-01-01

Acoustic fields are known to exert forces on the surfaces of objects. These forces are noticeable if the sound pressure is sufficiently high. Two phenomena where acoustic forces are relevant are: i) acoustic levitation, where strong standing waves can hold small objects at certain positions......, counterbalancing their weight, and ii) acoustic vortices, spinning sound fields that can impinge angular momentum and cause rotation of objects. In this contribution, both force-creating sound fields are studied by means of numerical simulations. The Boundary Element Method is employed to this end. The simulation...... of acoustical vortices uses an efficient numerical implementation based on the superposition of two orthogonal sound fields with a delay of 90° between them. It is shown that acoustic levitation and the use of acoustic vortices can be combined to manipulate objects in an efficient and controlled manner without...

Childhood trauma and dissociation among women with genito-pelvic pain/penetration disorder

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Özen B

2018-02-01

Full Text Available Beliz Özen, Y Özay Özdemir, E Emrem Beştepe Erenköy Mental Health and Neurological Diseases Education and Research Hospital, Istanbul, Turkey Objective: Causes such as childhood trauma, negative attitude about sexuality, inadequate sexual knowledge and education, relationship problems, and unconscious motivation are reported about psychosexual development in the etiology of genito-pelvic pain/penetration disorder (GPP/PD. There are few studies that focus directly on research etiology of GPP/PD and use structured scales. The aim of this study was to research childhood trauma and dissociation forms among women with GPP/PD.Patients and methods: Fifty-five women with GPP/PD according to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and 61 healthy women with no complaints of sexual function as a control group, in the age range of 18–60 years, were included in this study. Sociodemographic data form, Childhood Trauma Questionnaire (CTQ-28, Dissociative Experiences Scale (DES, and Somatoform Dissociation Questionnaire (SDQ-20 were administered to all participants.Results: Sexual abuse, emotional abuse, and emotional neglect scores, which comprise the subgroups of CTQ, were found high among women with GPP/PD compared with the control group (p=0.003, p=0.006, p=0.001. While a significant difference between the two groups’ SDQ scores was obtained (p=0.000, no significant difference was detected between the two groups’ DES scores (p=0.392.Discussion: The results evoke the question are genitopelvic pain conditions, vaginismus and dyspareunia, that cannot be explained with a medical cause and that cause penetration disorder, a kind of dissociative symptom prone to develop in some women with childhood psychogenic trauma. Keywords: dyspareunia, sexual phobia, abuse, sexual dysfunction, intercourse, avoidance 

Brainstem Auditory Evoked Potential in HIV-Positive Adults.

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Matas, Carla Gentile; Samelli, Alessandra Giannella; Angrisani, Rosanna Giaffredo; Magliaro, Fernanda Cristina Leite; Segurado, Aluísio C

2015-10-20

To characterize the findings of brainstem auditory evoked potential in HIV-positive individuals exposed and not exposed to antiretroviral treatment. This research was a cross-sectional, observational, and descriptive study. Forty-five HIV-positive individuals (18 not exposed and 27 exposed to the antiretroviral treatment - research groups I and II, respectively - and 30 control group individuals) were assessed through brainstem auditory evoked potential. There were no significant between-group differences regarding wave latencies. A higher percentage of altered brainstem auditory evoked potential was observed in the HIV-positive groups when compared to the control group. The most common alteration was in the low brainstem. HIV-positive individuals have a higher percentage of altered brainstem auditory evoked potential that suggests central auditory pathway impairment when compared to HIV-negative individuals. There was no significant difference between individuals exposed and not exposed to antiretroviral treatment.

Ultrasonography in trauma

DEFF Research Database (Denmark)

Weile, Jesper; Nielsen, Klaus; Primdahl, Stine C

2017-01-01

BACKGROUND: The Focused Assessment with Sonography in Trauma (FAST) protocol is considered beneficial in emergent evaluation of trauma patients with blunt or penetrating injury and has become integrated into the Advanced Trauma Life Support (ATLS) protocol. No guidelines exist as to the use...... of ultrasonography in trauma in Denmark. We aimed to determine the current use of ultrasonography for assessing trauma patients in Denmark. METHODS: We conducted a nation-wide cross-sectional investigation of ultrasonography usage in trauma care. The first phase consisted of an Internet-based investigation....... Twenty-one (95.5%) of the guidelines included and recommended FAST as part of trauma assessment. The recommended person to perform the examination was the radiologist in n = 11 (50.0%), the surgeon in n = 6 (27.3%), the anesthesiologist in n = 1 (4.5%), and unspecified in n = 3 (13.6%) facilities. FAST...

Acoustic emission

International Nuclear Information System (INIS)

Nichols, R.W.

1976-01-01

The volume contains six papers which together provide an overall review of the inspection technique known as acoustic emission or stress wave emission. The titles are: a welder's introduction to acoustic emission technology; use of acoustic emission for detection of defects as they arise during fabrication; examples of laboratory application and assessment of acoustic emission in the United Kingdom; (Part I: acoustic emission behaviour of low alloy steels; Part II: fatigue crack assessment from proof testing and continuous monitoring); inspection of selected areas of engineering structures by acoustic emission; Japanese experience in laboratory and practical applications of acoustic emission to welded structures; and ASME acoustic emission code status. (U.K.)

Facial trauma.

Science.gov (United States)

Peeters, N; Lemkens, P; Leach, R; Gemels B; Schepers, S; Lemmens, W

Facial trauma. Patients with facial trauma must be assessed in a systematic way so as to avoid missing any injury. Severe and disfiguring facial injuries can be distracting. However, clinicians must first focus on the basics of trauma care, following the Advanced Trauma Life Support (ATLS) system of care. Maxillofacial trauma occurs in a significant number of severely injured patients. Life- and sight-threatening injuries must be excluded during the primary and secondary surveys. Special attention must be paid to sight-threatening injuries in stabilized patients through early referral to an appropriate specialist or the early initiation of emergency care treatment. The gold standard for the radiographic evaluation of facial injuries is computed tomography (CT) imaging. Nasal fractures are the most frequent isolated facial fractures. Isolated nasal fractures are principally diagnosed through history and clinical examination. Closed reduction is the most frequently performed treatment for isolated nasal fractures, with a fractured nasal septum as a predictor of failure. Ear, nose and throat surgeons, maxillofacial surgeons and ophthalmologists must all develop an adequate treatment plan for patients with complex maxillofacial trauma.

Psychological and physiological responses to odor-evoked autobiographic memory.

Science.gov (United States)

Matsunaga, Masahiro; Isowa, Tokiko; Yamakawa, Kaori; Kawanishi, Yoko; Tsuboi, Hirohito; Kaneko, Hiroshi; Sadato, Norihiro; Oshida, Akiko; Katayama, Atsushi; Kashiwagi, Mitsuyoshi; Ohira, Hideki

2011-01-01

The "Proust phenomenon" occurs when a certain smell evokes a specific memory. Recent studies have demonstrated that odor-evoked autobiographic memories are more emotional than those elicited by other sensory stimuli because of the direct neural communication between the olfactory system and the amygdala. The amygdala is known to regulate various physiological activities including the endocrine and immune systems; therefore, odor-evoked autobiographic memory may trigger various psychological and physiological responses; however, the responses elicited by this memory remains obscure. In this study, we aimed to investigate the psychological and physiological responses accompanying odor-evoked autobiographic memory. We recruited healthy male and female volunteers and investigated changes in their mood states and autonomic nervous, endocrine, and immune activities when autobiographic memory was evoked in the participants by asking them to smell an odor(s) that was nostalgic to them. The autobiographic memories associated with positive emotion resulted in increased positive mood states, such as comfort and happiness, and decreased negative mood states, such as anxiety. Furthermore, heart rate was decreased, skin-conductance level was increased, and peripheral interleukin-2 level was decreased after smelling the nostalgic odor. These psychological and physiological responses were significantly correlated. The present study suggests that odor-evoked autobiographic memory along with a positive feeling induce various physiological responses, including the autonomic nervous and immune activities. To the best of our knowledge, the present study is the first to observe an interaction between odor-evoked autobiographic memories and immune function.

Translational illusion of acoustic sources by transformation acoustics.

Science.gov (United States)

Sun, Fei; Li, Shichao; He, Sailing

2017-09-01

An acoustic illusion of creating a translated acoustic source is designed by utilizing transformation acoustics. An acoustic source shifter (ASS) composed of layered acoustic metamaterials is designed to achieve such an illusion. A practical example where the ASS is made with naturally available materials is also given. Numerical simulations verify the performance of the proposed device. The designed ASS may have some applications in, e.g., anti-sonar detection.

Brainstem auditory evoked potential testing in Dalmatian dogs in Brazil

Directory of Open Access Journals (Sweden)

M.I.P. Palumbo

2014-04-01

Full Text Available The brain stem auditory-evoked potential (BAEP is an electrophysiologic test that detects and records the electrical activity in the auditory system from cochlea to midbrain, generated after an acoustic stimulus applied to the external ear. The aim of this study is to obtain normative data for BAEP in Dalmatian dogs in order to apply this to the evaluation of deafness and other neurologic disorders. BAEP were recorded from 30 Dalmatian dogs for a normative Brazilian study. Mean latencies for waves I, III, and V were 1.14 (±0.09, 2.62 (±0.10, and 3.46 (±0.14 ms, respectively. Mean inter-peak latencies for I-III, III-V, and I-V intervals were 1.48 (±0.17, 0.84 (±0.12, and 2.31 (±0.18 ms, respectively. Unilateral abnormalities were found in 16.7% of animals and bilateral deafness was seen in one dog. The normative data obtained in this paper is compatible with other published data. As far as we know this is the first report of deafness occurrence in Dalmatian dogs in Brazil.

Brainstem evoked potentials in infantile spasms

International Nuclear Information System (INIS)

Miyazaki, Masahito; Hashimoto, Toshiaki; Murakawa, Kazuyoshi; Tayama, Masanobu; Kuroda, Yasuhiro

1992-01-01

In ten patients with infantile spasms, brainstem evoked potentials and MRI examinations were performed to evaluate the brainstem involvement. The result of short latency somatosensory evoked potentials (SSEP) following the right median nerve stimulation revealed abnormal findings including the absence or low amplitudes of the waves below wave P3 and delayed central conduction time in 7 of the ten patients. The result of auditory brainstem responses (ABR) revealed abnormal findings including low amplitudes of wave V, prolonged interpeak latency of waves I-V and absence of the waves below wave IV in 5 of the ten patients. The result of the MRI examinations revealed various degrees of the brainstem atrophy in 6 of the ten patients, all of whom showed abnormal brainstem evoked potentials. The result of this study demonstrates that patients with infantile spasms are frequently associated with brainstem dysfunction and raises the possibility that brainstem atrophy might be a cause of infantile spasms. (author)

Trauma facilities in Denmark

DEFF Research Database (Denmark)

Weile, Jesper; Nielsen, Klaus; Primdahl, Stine C

2018-01-01

Background: Trauma is a leading cause of death among adults aged challenge. Evidence supports the centralization of trauma facilities and the use multidisciplinary trauma teams. Because knowledge is sparse on the existing distribution of trauma facilities...... and the organisation of trauma care in Denmark, the aim of this study was to identify all Danish facilities that care for traumatized patients and to investigate the diversity in organization of trauma management. Methods: We conducted a systematic observational cross-sectional study. First, all hospitals in Denmark...... were identified via online services and clarifying phone calls to each facility. Second, all trauma care manuals on all facilities that receive traumatized patients were gathered. Third, anesthesiologists and orthopedic surgeons on call at all trauma facilities were contacted via telephone...

The Role of Cumulative Trauma, Betrayal, and Appraisals in Understanding Trauma Symptomatology

OpenAIRE

Martin, Christina Gamache; Cromer, Lisa DeMarni; DePrince, Anne P.; Freyd, Jennifer J.

2011-01-01

Poor psychological outcomes are common among trauma survivors, yet not all survivors experience adverse sequelae. The current study examined links between cumulative trauma exposure as a function of the level of betrayal (measured by the relational closeness of the survivor and the perpetrator), trauma appraisals, gender, and trauma symptoms. Participants were 273 college students who reported experiencing at least one traumatic event on a trauma checklist. Three cumulative indices were const...

Can visual evoked potentials be used in biometric identification?

Science.gov (United States)

Power, Alan J; Lalor, Edmund C; Reilly, Richard B

2006-01-01

Due to known differences in the anatomical structure of the visual pathways and generators in different individuals, the use of visual evoked potentials offers the possibility of an alternative to existing biometrics methods. A study based on visual evoked potentials from 13 individuals was carried out to assess the best combination of temporal, spectral and AR modeling features to realize a robust biometric. From the results it can be concluded that visual evoked potentials show considerable biometric qualities, with classification accuracies reaching a high of 86.54% and that a specific temporal and spectral combination was found to be optimal. Based on these results the visual evoked potential may be a useful tool in biometric identification when used in conjunction with more established biometric methods.

Geriatric trauma.

Science.gov (United States)

Adams, Sasha D; Holcomb, John B

2015-12-01

The landscape of trauma is changing due to an aging population. Geriatric patients represent an increasing number and proportion of trauma admissions and deaths. This review explores recent literature on geriatric trauma, including triage criteria, assessment of frailty, fall-related injury, treatment of head injury complicated by coagulopathy, goals of care, and the need for ongoing education of all surgeons in the care of the elderly. Early identification of high-risk geriatric patients is imperative to initiate early resuscitative efforts. Geriatric patients are typically undertriaged because of their baseline frailty being underappreciated; however, centers that see more geriatric patients do better. Rapid reversal of anticoagulation is important in preventing progression of brain injury. Anticipation of difficult disposition necessitates early involvement of physical therapy for rehabilitation and case management for appropriate placement. Optimal care of geriatric trauma patients will be based on the well established tenets of trauma resuscitation and injury repair, but with distinct elements that address the physiological and anatomical challenges presented by geriatric patients.

Binaural interaction in auditory evoked potentials: Brainstem, middle- and long-latency components

OpenAIRE

McPherson, DL; Starr, A

1993-01-01

Binaural interaction occurs in the auditory evoked potentials when the sum of the monaural auditory evoked potentials are not equivalent to the binaural evoked auditory potentials. Binaural interaction of the early- (0-10 ms), middle- (10-50 ms) and long-latency (50-200 ms) auditory evoked potentials was studied in 17 normal young adults. For the early components, binaural interaction was maximal at 7.35 ms accounting for a reduction of 21% of the amplitude of the binaural evoked potentials. ...

Trauma Africa

Directory of Open Access Journals (Sweden)

Victor Y. Kong

2013-11-01

Full Text Available “Major Trauma. Dr. Kong, please come to the Trauma Unit immediately. Dr. Kong, please come to the Trauma Unit immediately.” Even though I have been working at Edendale Hospital as a trauma registrar for over a year, whenever I hear this announcement over the hospital intercom system, my heart beats just a little faster than normal. When I first arrived at Edendale my colleagues told me that the adrenaline rush I would experience after being called out to attend a new emergency would decrease over time, and indeed they were right. However, it is also true to say that on some occasions more than others, it is still felt more strongly than ever.

Trauma, stress, and self-care in clinical training: Predictors of burnout, decline in health status, secondary traumatic stress symptoms, and compassion satisfaction.

Science.gov (United States)

Butler, Lisa D; Carello, Janice; Maguin, Eugene

2017-07-01

[Correction Notice: An Erratum for this article was reported in Vol 9(4) of Psychological Trauma: Theory, Research, Practice, and Policy (see record 2016-54155-001). In the article, there was an error in Table 4 of the Results. The Outcomes and Predictors columns were not clearly categorized from one another. The corrected table is present in the erratum.] Objective: Courtois and Gold (2009) have called for the inclusion of trauma in the curriculum for all mental health training programs. The present study investigated the impact of trauma-related content, stress, and self-care (SC) on trainees in such a program. Method: The study examined potential risk factors (trauma exposures in training [being faced with or reacting to trauma-related field work experiences and course content] and perceptions of stress in field and coursework) and protective factors (SC effort and importance) in relation to burnout (BO), health status (HS), secondary traumatic stress symptoms (STSS), and compassion satisfaction (CS) among 195 students in a graduate social work training program. Results: All students reported trauma exposures in their field placements and/or coursework, including retraumatization experiences that were associated with higher STSS and BO. Field stress and SC effort were both consistent predictors across outcomes. Higher field stress levels predicted higher BO and STSS, a greater likelihood of decline in HS, and lower CS. Lower SC effort was also associated with higher BO and STSS, and a greater likelihood of decline in HS, while higher SC effort predicted higher CS. Older students, those with traumatized field clients, and those whose field work addressed trauma, also reported higher CS. Conclusions: These findings suggest that clinical training involving trauma content can be both rewarding and stressful, and may evoke distress in some trainees. Given that learning about and working with trauma are essential to adequate clinical training, the authors suggest

Cervical Vestibular Evoked Myogenic Potential in Hypoglossal Nerve Schwannoma: A Case Report.

Science.gov (United States)

Rajasekaran, Aravind Kumar; Savardekar, Amey Rajan; Shivashankar, Nagaraja Rao

2018-02-01

Schwannoma of the hypoglossal nerve is rare. This case report documents an atypical abnormality of the cervical vestibular evoked myogenic potential (cVEMP) in a patient with schwannoma of the hypoglossal nerve. The observed abnormality was attributed to the proximity of the hypoglossal nerve to the spinal accessory nerve in the medullary cistern and base of the skull. To report cVEMP abnormality in a patient with hypoglossal nerve schwannoma and provide an anatomical correlation for this abnormality. Case report. A 44-yr-old woman. Pure-tone and speech audiometry, tympanometry, acoustic stapedial reflex, auditory brainstem response, and cVEMP testing were performed. The audiological test results were normal except for the absence of cVEMP on the lesion side (right). A cVEMP abnormality indicating a compromised spinal accessory nerve was observed in a patient with hypoglossal nerve schwannoma. This case report highlights the importance of recording cVEMP in relevant neurological conditions and provides clinical proof for the involvement of the spinal accessory nerve in the vestibulocollic reflex pathway. American Academy of Audiology

Fundamentals of Acoustics. Psychoacoustics and Hearing. Acoustical Measurements

Science.gov (United States)

Begault, Durand R.; Ahumada, Al (Technical Monitor)

1997-01-01

These are 3 chapters that will appear in a book titled "Building Acoustical Design", edited by Charles Salter. They are designed to introduce the reader to fundamental concepts of acoustics, particularly as they relate to the built environment. "Fundamentals of Acoustics" reviews basic concepts of sound waveform frequency, pressure, and phase. "Psychoacoustics and Hearing" discusses the human interpretation sound pressure as loudness, particularly as a function of frequency. "Acoustic Measurements" gives a simple overview of the time and frequency weightings for sound pressure measurements that are used in acoustical work.

Communication Acoustics

DEFF Research Database (Denmark)

Blauert, Jens

Communication Acoustics deals with the fundamentals of those areas of acoustics which are related to modern communication technologies. Due to the advent of digital signal processing and recording in acoustics, these areas have enjoyed an enormous upswing during the last 4 decades. The book...... the book a source of valuable information for those who want to improve or refresh their knowledge in the field of communication acoustics - and to work their way deeper into it. Due to its interdisciplinary character Communication Acoustics is bound to attract readers from many different areas, such as......: acoustics, cognitive science, speech science, and communication technology....

Slow cortical evoked potentials after noise exposure

Energy Technology Data Exchange (ETDEWEB)

von Wedel, H; Opitz, H J

1979-07-01

Human cortical evoked potentials under conditions of stimuation are registrated in the post-stimulatory phase of a five minutes lasting equally masking white noise (90 dB HL). Changes of the evoked potentials during adaptation, possible analogy with high tone losses after noise representation and the origin of tinnitus are examined. Stimulation was started 3 sec after the off-effect of the noise. For five minutes periodically tone bursts were represented. Each train of stimulation consists of tone bursts of three frequencies: 2 kcs, 4 kcs, 8 kcs. The 0.5 sec lasting tones were separated by pauses of 2 sec. During the experiment stimulation and analysis were controlled by a computer. Changes in latency and amplitudes of the cortical evoked potentials were registered. Changes of the adaptation patterns as a function of the poststimulatory time are discussed.

Head Trauma: First Aid

Science.gov (United States)

First aid Head trauma: First aid Head trauma: First aid By Mayo Clinic Staff Most head trauma involves injuries that are minor and don't require ... 21, 2015 Original article: http://www.mayoclinic.org/first-aid/first-aid-head-trauma/basics/ART-20056626 . Mayo ...

Prevalence of interpersonal trauma exposure and trauma-related disorders in severe mental illness

NARCIS (Netherlands)

Mauritz, M.W.; Goossens, P.J.J.; Draijer, N.; Achterberg, T. van

2013-01-01

BACKGROUND: Interpersonal trauma exposure and trauma-related disorders in people with severe mental illness (SMI) are often not recognized in clinical practice. OBJECTIVE: To substantiate the prevalence of interpersonal trauma exposure and trauma-related disorders in people with SMI. METHODS: We

Prevalence of interpersonal trauma exposure and trauma-related disorders in severe mental illness

NARCIS (Netherlands)

Mauritz, M.W.; Goossens, P.J.J.; Draijer, N.; van Achterberg, T.

2013-01-01

Background: Interpersonal trauma exposure and trauma-related disorders in people with severe mental illness (SMI) are often not recognized in clinical practice. Objective: To substantiate the prevalence of interpersonal trauma exposure and trauma-related disorders in people with SMI. Methods: We

Acoustic source for generating an acoustic beam

Science.gov (United States)

Vu, Cung Khac; Sinha, Dipen N.; Pantea, Cristian

2016-05-31

An acoustic source for generating an acoustic beam includes a housing; a plurality of spaced apart piezo-electric layers disposed within the housing; and a non-linear medium filling between the plurality of layers. Each of the plurality of piezoelectric layers is configured to generate an acoustic wave. The non-linear medium and the plurality of piezo-electric material layers have a matching impedance so as to enhance a transmission of the acoustic wave generated by each of plurality of layers through the remaining plurality of layers.

The Paradox of Music-Evoked Sadness: An Online Survey

Science.gov (United States)

Taruffi, Liila; Koelsch, Stefan

2014-01-01

This study explores listeners’ experience of music-evoked sadness. Sadness is typically assumed to be undesirable and is therefore usually avoided in everyday life. Yet the question remains: Why do people seek and appreciate sadness in music? We present findings from an online survey with both Western and Eastern participants (N = 772). The survey investigates the rewarding aspects of music-evoked sadness, as well as the relative contribution of listener characteristics and situational factors to the appreciation of sad music. The survey also examines the different principles through which sadness is evoked by music, and their interaction with personality traits. Results show 4 different rewards of music-evoked sadness: reward of imagination, emotion regulation, empathy, and no “real-life” implications. Moreover, appreciation of sad music follows a mood-congruent fashion and is greater among individuals with high empathy and low emotional stability. Surprisingly, nostalgia rather than sadness is the most frequent emotion evoked by sad music. Correspondingly, memory was rated as the most important principle through which sadness is evoked. Finally, the trait empathy contributes to the evocation of sadness via contagion, appraisal, and by engaging social functions. The present findings indicate that emotional responses to sad music are multifaceted, are modulated by empathy, and are linked with a multidimensional experience of pleasure. These results were corroborated by a follow-up survey on happy music, which indicated differences between the emotional experiences resulting from listening to sad versus happy music. This is the first comprehensive survey of music-evoked sadness, revealing that listening to sad music can lead to beneficial emotional effects such as regulation of negative emotion and mood as well as consolation. Such beneficial emotional effects constitute the prime motivations for engaging with sad music in everyday life. PMID:25330315

The paradox of music-evoked sadness: an online survey.

Directory of Open Access Journals (Sweden)

Liila Taruffi

Full Text Available This study explores listeners' experience of music-evoked sadness. Sadness is typically assumed to be undesirable and is therefore usually avoided in everyday life. Yet the question remains: Why do people seek and appreciate sadness in music? We present findings from an online survey with both Western and Eastern participants (N = 772. The survey investigates the rewarding aspects of music-evoked sadness, as well as the relative contribution of listener characteristics and situational factors to the appreciation of sad music. The survey also examines the different principles through which sadness is evoked by music, and their interaction with personality traits. Results show 4 different rewards of music-evoked sadness: reward of imagination, emotion regulation, empathy, and no "real-life" implications. Moreover, appreciation of sad music follows a mood-congruent fashion and is greater among individuals with high empathy and low emotional stability. Surprisingly, nostalgia rather than sadness is the most frequent emotion evoked by sad music. Correspondingly, memory was rated as the most important principle through which sadness is evoked. Finally, the trait empathy contributes to the evocation of sadness via contagion, appraisal, and by engaging social functions. The present findings indicate that emotional responses to sad music are multifaceted, are modulated by empathy, and are linked with a multidimensional experience of pleasure. These results were corroborated by a follow-up survey on happy music, which indicated differences between the emotional experiences resulting from listening to sad versus happy music. This is the first comprehensive survey of music-evoked sadness, revealing that listening to sad music can lead to beneficial emotional effects such as regulation of negative emotion and mood as well as consolation. Such beneficial emotional effects constitute the prime motivations for engaging with sad music in everyday life.

The paradox of music-evoked sadness: an online survey.

Science.gov (United States)

Taruffi, Liila; Koelsch, Stefan

2014-01-01

This study explores listeners' experience of music-evoked sadness. Sadness is typically assumed to be undesirable and is therefore usually avoided in everyday life. Yet the question remains: Why do people seek and appreciate sadness in music? We present findings from an online survey with both Western and Eastern participants (N = 772). The survey investigates the rewarding aspects of music-evoked sadness, as well as the relative contribution of listener characteristics and situational factors to the appreciation of sad music. The survey also examines the different principles through which sadness is evoked by music, and their interaction with personality traits. Results show 4 different rewards of music-evoked sadness: reward of imagination, emotion regulation, empathy, and no "real-life" implications. Moreover, appreciation of sad music follows a mood-congruent fashion and is greater among individuals with high empathy and low emotional stability. Surprisingly, nostalgia rather than sadness is the most frequent emotion evoked by sad music. Correspondingly, memory was rated as the most important principle through which sadness is evoked. Finally, the trait empathy contributes to the evocation of sadness via contagion, appraisal, and by engaging social functions. The present findings indicate that emotional responses to sad music are multifaceted, are modulated by empathy, and are linked with a multidimensional experience of pleasure. These results were corroborated by a follow-up survey on happy music, which indicated differences between the emotional experiences resulting from listening to sad versus happy music. This is the first comprehensive survey of music-evoked sadness, revealing that listening to sad music can lead to beneficial emotional effects such as regulation of negative emotion and mood as well as consolation. Such beneficial emotional effects constitute the prime motivations for engaging with sad music in everyday life.

Choroidal osteoma secondary to ocular trauma

International Nuclear Information System (INIS)

Rua Martinez, Raul; Perez Garcia, Diley; Alemanny Rubio, Ernesto

2012-01-01

The choroidal osteoma is a benign bony tumor described for the first time in 1978 by Gass and collaborators. It is generally unilateral, with juxtapapillary localization and more frequent in young adult females. It presents unknown etiology, but it is associated to different factors as inflammatory processes, congenital malformations, hormonal alterations and ocular traumas among others. The patient was a 54 year-old woman with a personal history of rheumatic fibromyalgia (osteoarthrosis and osteoporosis) and hypertension. Her ophthalmological antecedent showed myopia and arteriolosclerotic retinopathy. At the beginning of the year, she suffered a traffic accident and was injured in her limbs and periocular region. After this, she began feeling blurred vision of the right eye and she went to our service 6 months later. She was performed an ophthalmologic exam. It was found that the right eye had visual acuity of 0.4, and after correction it reached 1.0. Funduscopy revealed vascular thinness, incomplete posterior vitreous detachment, and a white-orange lesion of 3 papillary diameters that involved inferior temporary arcade with well-defined borders. An angiography was performed, which showed sustained hyperfluorescence and non neovascularization; and the optic coherence tomography revealed a halo of serous retinal detachment. Additionally, the ocular ultrasound yielded a high reflectivity echogenic image that involves choroids with posterior acoustic shadow. It is for this reason that we affirm the traumatic etiology of the lesion. This is a rare pathology that should be diagnosed by imaging techniques. Notably, it is secondary to an ocular trauma

Acoustic calibration apparatus for calibrating plethysmographic acoustic pressure sensors

Science.gov (United States)

Zuckerwar, Allan J. (Inventor); Davis, David C. (Inventor)

1995-01-01

An apparatus for calibrating an acoustic sensor is described. The apparatus includes a transmission material having an acoustic impedance approximately matching the acoustic impedance of the actual acoustic medium existing when the acoustic sensor is applied in actual in-service conditions. An elastic container holds the transmission material. A first sensor is coupled to the container at a first location on the container and a second sensor coupled to the container at a second location on the container, the second location being different from the first location. A sound producing device is coupled to the container and transmits acoustic signals inside the container.

Genetic influence demonstrated for MEG-recorded somatosensory evoked responses

NARCIS (Netherlands)

van 't Ent, D.; van Soelen, I.L.C.; Stam, K.J.; de Geus, E.J.C.; Boomsma, D.I.

2010-01-01

We tested for a genetic influence on magnetoencephalogram (MEG)-recorded somatosensory evoked fields (SEFs) in 20 monozygotic (MZ) and 14 dizygotic (DZ) twin pairs. Previous electroencephalogram (EEG) studies that demonstrated a genetic contribution to evoked responses generally focused on

[Chest trauma].

Science.gov (United States)

Freixinet Gilart, Jorge; Ramírez Gil, María Elena; Gallardo Valera, Gregorio; Moreno Casado, Paula

2011-01-01

Chest trauma is a frequent problem arising from lesions caused by domestic and occupational activities and especially road traffic accidents. These injuries can be analyzed from distinct points of view, ranging from consideration of the most severe injuries, especially in the context of multiple trauma, to the specific characteristics of blunt and open trauma. In the present article, these injuries are discussed according to the involvement of the various thoracic structures. Rib fractures are the most frequent chest injuries and their diagnosis and treatment is straightforward, although these injuries can be severe if more than three ribs are affected and when there is major associated morbidity. Lung contusion is the most common visceral lesion. These injuries are usually found in severe chest trauma and are often associated with other thoracic and intrathoracic lesions. Treatment is based on general support measures. Pleural complications, such as hemothorax and pneumothorax, are also frequent. Their diagnosis is also straightforward and treatment is based on pleural drainage. This article also analyzes other complex situations, notably airway trauma, which is usually very severe in blunt chest trauma and less severe and even suitable for conservative treatment in iatrogenic injury due to tracheal intubation. Rupture of the diaphragm usually causes a diaphragmatic hernia. Treatment is always surgical. Myocardial contusions should be suspected in anterior chest trauma and in sternal fractures. Treatment is conservative. Other chest injuries, such as those of the great thoracic and esophageal vessels, are less frequent but are especially severe. Copyright © 2011 Sociedad Española de Neumología y Cirugía Torácica. Published by Elsevier Espana. All rights reserved.

Visually Evoked Spiking Evolves While Spontaneous Ongoing Dynamics Persist

DEFF Research Database (Denmark)

Huys, Raoul; Jirsa, Viktor K; Darokhan, Ziauddin

2016-01-01

attractor. Its existence guarantees that evoked spiking return to the spontaneous state. However, the spontaneous ongoing spiking state and the visual evoked spiking states are qualitatively different and are separated by a threshold (separatrix). The functional advantage of this organization...

The impact of patient volume on surgical trauma training in a Scandinavian trauma centre.

Science.gov (United States)

Gaarder, Christine; Skaga, Nils Oddvar; Eken, Torsten; Pillgram-Larsen, Johan; Buanes, Trond; Naess, Paal Aksel

2005-11-01

Some of the problems faced in trauma surgery are increasing non-operative management of abdominal injuries, decreasing work hours and increasing sub-specialisation. We wanted to document the experience of trauma team leaders at the largest trauma centre in Norway, hypothesising that the patient volume would be inadequate to secure optimal trauma care. Patients registered in the hospital based Trauma Registry during the 2-year period from 1 August 2000 to 31 July 2002 were included. Of a total of 1667 patients registered, 645 patients (39%) had an Injury Severity Score (ISS)>15. Abdominal injuries were diagnosed in 205 patients with a median ISS of 30. An average trauma team leader assessed a total of 119 trauma cases a year (46 patients with ISS>15) and participated in 10 trauma laparotomies. Although the total number of trauma cases seems adequate, the experience of the trauma team leaders with challenging abdominal injuries is limited. With increasing sub-specialisation and general surgery vanishing, fewer surgical specialties provide operative competence in dealing with complicated torso trauma. A system of additional education and quality assurance measures is a prerequisite of high quality, and has consequently been introduced in our institution.

Prevalence of interpersonal trauma exposure and trauma-related disorders in severe mental illness

OpenAIRE

Mauritz, Maria W.; Goossens, Peter J.J.; Draijer, Nel; Achterberg, Theo van

2013-01-01

Background: Interpersonal trauma exposure and trauma-related disorders in people with severe mental illness (SMI) are often not recognized in clinical practice.Objective: To substantiate the prevalence of interpersonal trauma exposure and trauma-related disorders in people with SMI.Methods: We conducted a systematic review of four databases (1980-2010) and then described and analysed 33 studies in terms of primary diagnosis and instruments used to measure trauma exposure and traumarelated dis...

Acoustically Induced Vibration of Structures: Reverberant Vs. Direct Acoustic Testing

Science.gov (United States)

Kolaini, Ali R.; O'Connell, Michael R.; Tsoi, Wan B.

2009-01-01

Large reverberant chambers have been used for several decades in the aerospace industry to test larger structures such as solar arrays and reflectors to qualify and to detect faults in the design and fabrication of spacecraft and satellites. In the past decade some companies have begun using direct near field acoustic testing, employing speakers, for qualifying larger structures. A limited test data set obtained from recent acoustic tests of the same hardware exposed to both direct and reverberant acoustic field testing has indicated some differences in the resulting structural responses. In reverberant acoustic testing, higher vibration responses were observed at lower frequencies when compared with the direct acoustic testing. In the case of direct near field acoustic testing higher vibration responses appeared to occur at higher frequencies as well. In reverberant chamber testing and direct acoustic testing, standing acoustic modes of the reverberant chamber or the speakers and spacecraft parallel surfaces can strongly couple with the fundamental structural modes of the test hardware. In this paper data from recent acoustic testing of flight hardware, that yielded evidence of acoustic standing wave coupling with structural responses, are discussed in some detail. Convincing evidence of the acoustic standing wave/structural coupling phenomenon will be discussed, citing observations from acoustic testing of a simple aluminum plate. The implications of such acoustic coupling to testing of sensitive flight hardware will be discussed. The results discussed in this paper reveal issues with over or under testing of flight hardware that could pose unanticipated structural and flight qualification issues. Therefore, it is of paramount importance to understand the structural modal coupling with standing acoustic waves that has been observed in both methods of acoustic testing. This study will assist the community to choose an appropriate testing method and test setup in

Prevalence of interpersonal trauma exposure and trauma-related disorders in severe mental illness.

Science.gov (United States)

Mauritz, Maria W; Goossens, Peter J J; Draijer, Nel; van Achterberg, Theo

2013-01-01

Interpersonal trauma exposure and trauma-related disorders in people with severe mental illness (SMI) are often not recognized in clinical practice. To substantiate the prevalence of interpersonal trauma exposure and trauma-related disorders in people with SMI. We conducted a systematic review of four databases (1980-2010) and then described and analysed 33 studies in terms of primary diagnosis and instruments used to measure trauma exposure and trauma-related disorders. Population-weighted mean prevalence rates in SMI were physical abuse 47% (range 25-72%), sexual abuse 37% (range 24-49%), and posttraumatic stress disorder (PTSD) 30% (range 20-47%). Compared to men, women showed a higher prevalence of sexual abuse in schizophrenia spectrum disorder, bipolar disorder, and mixed diagnosis groups labelled as having SMI. Prevalence rates of interpersonal trauma and trauma-related disorders were significantly higher in SMI than in the general population. Emotional abuse and neglect, physical neglect, complex PTSD, and dissociative disorders have been scarcely examined in SMI.

TRAUMA SURGERY

African Journals Online (AJOL)

interest in developing an appropriate and sustainable trauma system in South ... trauma evolved with the social instability which accompanied political change in the ... increased use of military style assault weapons resulted in severe injuries ...

Trauma-Focused CBT for Youth with Complex Trauma

Science.gov (United States)

Cohen, Judith A.; Mannarino, Anthony P.; Kliethermes, Matthew; Murray, Laura A.

2012-01-01

Objectives: Many youth develop complex trauma, which includes regulation problems in the domains of affect, attachment, behavior, biology, cognition, and perception. Therapists often request strategies for using evidence-based treatments (EBTs) for this population. This article describes practical strategies for applying Trauma-Focused Cognitive…

Joint angle affects volitional and magnetically-evoked neuromuscular performance differentially.

Science.gov (United States)

Minshull, C; Rees, D; Gleeson, N P

2011-08-01

This study examined the volitional and magnetically-evoked neuromuscular performance of the quadriceps femoris at functional knee joint angles adjacent to full extension. Indices of volitional and magnetically-evoked neuromuscular performance (N=15 healthy males, 23.5 ± 2.9 years, 71.5 ± 5.4 kg, 176.5 ± 5.5 cm) were obtained at 25°, 35° and 45° of knee flexion. Results showed that volitional and magnetically-evoked peak force (PF(V) and P(T)F(E), respectively) and electromechanical delay (EMD(V) and EMD(E), respectively) were enhanced by increased knee flexion. However, greater relative improvements in volitional compared to evoked indices of neuromuscular performance were observed with increasing flexion from 25° to 45° (e.g. EMD(V), EMD(E): 36% vs. 11% improvement, respectively; F([2,14])=6.8, pjoint positions. These findings suggest that the extent of the relative differential between volitional and evoked neuromuscular performance capabilities is joint angle-specific and not correlated with performance capabilities at adjacent angles, but tends to be smaller with increased flexion. As such, effective prediction of volitional from evoked performance capabilities at both analogous and adjacent knee joint positions would lack robustness. Copyright © 2011 Elsevier Ltd. All rights reserved.

“I can't tell whether it's my hand”: a pilot study of the neurophenomenology of body representation during the rubber hand illusion in trauma-related disorders

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Daniela Rabellino

2016-11-01

Full Text Available Background: Early traumatic experiences are thought to be causal factors in the development of trauma-related dissociative experiences, including depersonalization and derealization. The rubber hand illusion (RHI, a well-known paradigm that measures multi-sensorial integration of a rubber hand into one's own body representation, has been used to investigate alterations in the experience of body ownership and of body representation. Critically, however, it has never been studied in individuals with trauma-related disorders. Objective: To investigate body representation distortions occurring in trauma-related disorders in response to the RHI. Method: The RHI was administered to three individuals with the dissociative subtype of posttraumatic stress disorder (PTSD, and subjective, behavioral, cardiovascular and skin conductance responses were recorded. Results: Participants’ subjective experiences of the RHI were differentiated and complex. The illusion was induced following both synchronous and asynchronous brushing and variably evoked subjective distress, depersonalization and derealization experiences, tonic immobility, increased physiological arousal and flashbacks. Conclusions: The present findings point towards the RHI as a strong provocation stimulus that elicits individual patterns of symptom presentation, including experiences of distress and dissociation, in individuals with trauma-related disorders, including the dissociative subtype of PTSD. Highlights of the article:

Interior acoustic cloak

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Wael Akl

2014-12-01

Full Text Available Acoustic cloaks have traditionally been intended to externally surround critical objects to render these objects acoustically invisible. However, in this paper, the emphasis is placed on investigating the application of the acoustic cloaks to the interior walls of acoustic cavities in an attempt to minimize the noise levels inside these cavities. In this manner, the acoustic cloaks can serve as a viable and efficient alternative to the conventional passive noise attenuation treatments which are invariably heavy and bulky. The transformation acoustics relationships that govern the operation of this class of interior acoustic cloaks are presented. Physical insights are given to relate these relationships to the reasons behind the effectiveness of the proposed interior acoustic cloaks. Finite element models are presented to demonstrate the characteristics of interior acoustic cloaks used in treating the interior walls of circular and square cavities both in the time and frequency domains. The obtained results emphasize the effectiveness of the proposed interior cloaks in eliminating the reflections of the acoustic waves from the walls of the treated cavities and thereby rendering these cavities acoustically quiet. It is important to note here that the proposed interior acoustic cloaks can find applications in acoustic cavities such as aircraft cabins and auditoriums as well as many other critical applications.

International Evoked Potentials Symposium

CERN Document Server

1980-01-01

The past decade has seen great progress in the measurement of evoked potentials in man; a steady increase in our understanding of their charac­ teristics, their origins and their usefulness; and a growing application in the field of clinical diagnosis. The topic is a truly multidisciplinary one. Important research contributions have been made by workers of many different backgrounds and clinical applications span the specialities. This book represents a revised and updated version of the work originally presented at the international evoked potential symposium held in Nottingham 4-6 1978. The Nottingham Symposium provided a forum for a state-of-the-art discussion amongst workers from many different disciplines and from many different countries. For each major topic in the field an expert review set the scene for discussion of current research presentations. This format is retained in the book: the chapters in Part A provide the context in which the research presented in Part B is set. The task of selecting m...

Major trauma: the unseen financial burden to trauma centres, a descriptive multicentre analysis.

Science.gov (United States)

Curtis, Kate; Lam, Mary; Mitchell, Rebecca; Dickson, Cara; McDonnell, Karon

2014-02-01

This research examines the existing funding model for in-hospital trauma patient episodes in New South Wales (NSW), Australia and identifies factors that cause above-average treatment costs. Accurate information on the treatment costs of injury is needed to guide health-funding strategy and prevent inadvertent underfunding of specialist trauma centres, which treat a high trauma casemix. Admitted trauma patient data provided by 12 trauma centres were linked with financial data for 2008-09. Actual costs incurred by each hospital were compared with state-wide Australian Refined Diagnostic Related Groups (AR-DRG) average costs. Patient episodes where actual cost was higher than AR-DRG cost allocation were examined. There were 16693 patients at a total cost of AU$178.7million. The total costs incurred by trauma centres were $14.7million above the NSW peer-group average cost estimates. There were 10 AR-DRG where the total cost variance was greater than $500000. The AR-DRG with the largest proportion of patients were the upper limb injury categories, many of whom had multiple body regions injured and/or a traumatic brain injury (P<0.001). AR-DRG classifications do not adequately describe the trauma patient episode and are not commensurate with the expense of trauma treatment. A revision of AR-DRG used for trauma is needed. WHAT IS KNOWN ABOUT THIS TOPIC? Severely injured trauma patients often have multiple injuries, in more than one body region and the determination of appropriate AR-DRG can be difficult. Pilot research suggests that the AR-DRG do not accurately represent the care that is required for these patients. WHAT DOES THIS PAPER ADD? This is the first multicentre analysis of treatment costs and coding variance for major trauma in Australia. This research identifies the limitations of the current AR-DRGS and those that are particularly problematic. The value of linking trauma registry and financial data within each trauma centre is demonstrated. WHAT ARE THE

Responsive acoustic surfaces

DEFF Research Database (Denmark)

Peters, Brady; Tamke, Martin; Nielsen, Stig Anton

2011-01-01

Acoustic performance is defined by the parameter of reverberation time; however, this does not capture the acoustic experience in some types of open plan spaces. As many working and learning activities now take place in open plan spaces, it is important to be able to understand and design...... for the acoustic conditions of these spaces. This paper describes an experimental research project that studied the design processes necessary to design for sound. A responsive acoustic surface was designed, fabricated and tested. This acoustic surface was designed to create specific sonic effects. The design...... was simulated using custom integrated acoustic software and also using Odeon acoustic analysis software. The research demonstrates a method for designing space- and sound-defining surfaces, defines the concept of acoustic subspace, and suggests some new parameters for defining acoustic subspaces....

Flat acoustic lens by acoustic grating with curled slits

KAUST Repository

Peng, Pai

2014-10-01

We design a flat sub-wavelength lens that can focus acoustic wave. We analytically study the transmission through an acoustic grating with curled slits, which can serve as a material with tunable impedance and refractive index for acoustic waves. The effective parameters rely on the geometry of the slits and are independent of frequency. A flat acoustic focusing lens by such acoustic grating with gradient effective refractive index is designed. The focusing effect is clearly observed in simulations and well predicted by the theory. We demonstrate that despite the large impedance mismatch between the acoustic lens and the matrix, the intensity at the focal point is still high due to Fabry-Perot resonance.

Parametric Room Acoustic workflows with real-time acoustic simulation

DEFF Research Database (Denmark)

Parigi, Dario

2017-01-01

The paper investigates and assesses the opportunities that real-time acoustic simulation offer to engage in parametric acoustics workflow and to influence architectural designs from early design stages......The paper investigates and assesses the opportunities that real-time acoustic simulation offer to engage in parametric acoustics workflow and to influence architectural designs from early design stages...

[First aid and management of multiple trauma: in-hospital trauma care].

Science.gov (United States)

Boschin, Matthias; Vordemvenne, Thomas

2012-11-01

Injuries remain the leading cause of death in children and young adults. Management of multiple trauma patients has improved in recent years by quality initiatives (trauma network, S3 guideline "Polytrauma"). On this basis, strong links with preclinical management, structured treatment algorithms, training standards (ATLS®), clear diagnostic rules and an established risk- and quality management are the important factors of a modern emergency room trauma care. We describe the organizational components that lead to successful management of trauma in hospital. © Georg Thieme Verlag Stuttgart · New York.

Computed tomography in trauma

International Nuclear Information System (INIS)

Toombs, B.D.; Sandler, C.M.

1987-01-01

This book begins with a chapter dealing with the epidemiology and mechanisms of trauma. Trauma accounts for more lives lost in the United States than cancer and heart disease. The fact that 30%-40% of trauma-related deaths are caused by improper or delayed diagnoses or treatment emphasizes the importance of rapid and accurate methods to establish a diagnosis. Acute thoracic, abdominal, and pelvic trauma and their complications are discussed. A chapter on high-resolution CT of spinal and facial trauma and the role of three-dimensional reconstruction images is presented

Computed tomography in trauma

Energy Technology Data Exchange (ETDEWEB)

Toombs, B.D.; Sandler, C.M.

1987-01-01

This book begins with a chapter dealing with the epidemiology and mechanisms of trauma. Trauma accounts for more lives lost in the United States than cancer and heart disease. The fact that 30%-40% of trauma-related deaths are caused by improper or delayed diagnoses or treatment emphasizes the importance of rapid and accurate methods to establish a diagnosis. Acute thoracic, abdominal, and pelvic trauma and their complications are discussed. A chapter on high-resolution CT of spinal and facial trauma and the role of three-dimensional reconstruction images is presented.

Prevalence of interpersonal trauma exposure and trauma-related disorders in severe mental illness

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Maria W. Mauritz

2013-04-01

Full Text Available Background: Interpersonal trauma exposure and trauma-related disorders in people with severe mental illness (SMI are often not recognized in clinical practice. Objective: To substantiate the prevalence of interpersonal trauma exposure and trauma-related disorders in people with SMI. Methods: We conducted a systematic review of four databases (1980–2010 and then described and analysed 33 studies in terms of primary diagnosis and instruments used to measure trauma exposure and trauma-related disorders. Results: Population-weighted mean prevalence rates in SMI were physical abuse 47% (range 25–72%, sexual abuse 37% (range 24–49%, and posttraumatic stress disorder (PTSD 30% (range 20–47%. Compared to men, women showed a higher prevalence of sexual abuse in schizophrenia spectrum disorder, bipolar disorder, and mixed diagnosis groups labelled as having SMI. Conclusions: Prevalence rates of interpersonal trauma and trauma-related disorders were significantly higher in SMI than in the general population. Emotional abuse and neglect, physical neglect, complex PTSD, and dissociative disorders have been scarcely examined in SMI.

Trauma care system in Iran

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Zargar Moussa

2011-06-01

Full Text Available 【Abstract】Objective: The high burden of injuries in Iran necessitates the establishment of a comprehensive trauma care system. The purpose of this paper is to de- scribe the current status of trauma system regarding the components and function. Methods: The current status of trauma system in all components of a trauma system was described through ex- pert panels and semi-structured interviews with trauma spe- cialists and policy makers. Results: Currently, various organizations are involved in prevention, management and rehabilitation of injuries, but an integrative system approach to trauma is rather deficient. There has been ongoing progress in areas of pub- lic education through media, traffic regulation reinforcement, hospital care and prehospital services. Meanwhile, there are gaps regarding financing, legislations and education of high risk groups. The issues on education and training stan- dards of the front line medical team and continuing educa- tion and evaluation are yet to be addressed. Trauma regis- try has been piloted in some provinces, but as it needs the well-developed infrastructure (regarding staff, maintenance, financial resources, it is not yet established in our system of trauma care. Conclusions: It seems that one of the problems with trauma care in Iran is lack of coordination among trauma system organizations. Although the clinical management of trauma patients has improved in our country in the recent decade, decreasing the burden of injuries necessitates an organized approach to prevention and management of trauma in the context of a trauma system. Key words: Emergency medical services; Trauma centers; Wounds and injuries

Cortical evoked potentials to an auditory illusion: binaural beats.

Science.gov (United States)

Pratt, Hillel; Starr, Arnold; Michalewski, Henry J; Dimitrijevic, Andrew; Bleich, Naomi; Mittelman, Nomi

2009-08-01

To define brain activity corresponding to an auditory illusion of 3 and 6Hz binaural beats in 250Hz or 1000Hz base frequencies, and compare it to the sound onset response. Event-Related Potentials (ERPs) were recorded in response to unmodulated tones of 250 or 1000Hz to one ear and 3 or 6Hz higher to the other, creating an illusion of amplitude modulations (beats) of 3Hz and 6Hz, in base frequencies of 250Hz and 1000Hz. Tones were 2000ms in duration and presented with approximately 1s intervals. Latency, amplitude and source current density estimates of ERP components to tone onset and subsequent beats-evoked oscillations were determined and compared across beat frequencies with both base frequencies. All stimuli evoked tone-onset P(50), N(100) and P(200) components followed by oscillations corresponding to the beat frequency, and a subsequent tone-offset complex. Beats-evoked oscillations were higher in amplitude with the low base frequency and to the low beat frequency. Sources of the beats-evoked oscillations across all stimulus conditions located mostly to left lateral and inferior temporal lobe areas in all stimulus conditions. Onset-evoked components were not different across stimulus conditions; P(50) had significantly different sources than the beats-evoked oscillations; and N(100) and P(200) sources located to the same temporal lobe regions as beats-evoked oscillations, but were bilateral and also included frontal and parietal contributions. Neural activity with slightly different volley frequencies from left and right ear converges and interacts in the central auditory brainstem pathways to generate beats of neural activity to modulate activities in the left temporal lobe, giving rise to the illusion of binaural beats. Cortical potentials recorded to binaural beats are distinct from onset responses. Brain activity corresponding to an auditory illusion of low frequency beats can be recorded from the scalp.

Brain correlates of music-evoked emotions.

Science.gov (United States)

Koelsch, Stefan

2014-03-01

Music is a universal feature of human societies, partly owing to its power to evoke strong emotions and influence moods. During the past decade, the investigation of the neural correlates of music-evoked emotions has been invaluable for the understanding of human emotion. Functional neuroimaging studies on music and emotion show that music can modulate activity in brain structures that are known to be crucially involved in emotion, such as the amygdala, nucleus accumbens, hypothalamus, hippocampus, insula, cingulate cortex and orbitofrontal cortex. The potential of music to modulate activity in these structures has important implications for the use of music in the treatment of psychiatric and neurological disorders.

Trauma no idoso Trauma in the elderly

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JOSÉ ANTONIO GOMES DE SOUZA

2002-03-01

Full Text Available O crescimento populacional de idosos, associado a uma forma de vida mais saudável e mais ativa, deixa este grupo de pessoas mais exposto ao risco de acidentes. Em alguns países, o trauma do idoso responde por uma elevada taxa de mortalidade, a qual se apresenta de forma desproporcionalmente maior do que a observada entre a população de adultos jovens. Tal fato acarreta um grande consumo de recursos financeiros destinados à assistência da saúde e um elevado custo social. As características fisiológicas próprias do idoso, assim como a presença freqüente de doenças associadas, faz com que estes pacientes se comportem diferentemente e de forma mais complexa do que os demais grupos etários. Estas particularidades fazem com que o atendimento ao idoso vítima de trauma se faça de forma diferenciada. A presente revisão aborda aspectos da epidemiologia, da prevenção, da fisiologia, do atendimento e da reabilitação do idoso vítima de trauma.The populational growth of the elderly, associated to a healthier and more active life, make this group of people more exposed to accidents. In some countries, trauma in the elderly is responsible for a high mortality rate, desproportionately higher than in the adults. This fact consumes a great portion of health care resources and implies in a high social cost. The distinct physiologic characteristics of the elderly and the frequent presence of associated diseases make that these patients behave diferently and in a more complex way than patients of other ages. These particularities make that health care to the elderly victims of trauma have to be different. The present revision is about aspects of epidemiology, prevention, physiology, health care and reabilitation of the elderly victims of trauma.

An inventory and update of jealousy-evoking partner behaviours in modern society.

NARCIS (Netherlands)

Dijkstra, Pieternel; Barelds, Dick P. H.; Groothof, Hinke A. K.

2010-01-01

The goal of the present study was to identify the most important jealousy-evoking partner behaviours and to examine the extent to which these behaviours evoke jealousy. Based on the literature, a questionnaire was constructed containing 42 jealousy-evoking partner behaviours, including a partner's

Images in kidney trauma

International Nuclear Information System (INIS)

Rodriguez, Jose Luis; Rodriguez, Sonia Pilar; Manzano, Ana Cristina

2007-01-01

A case of a 3 years old female patient, who suffered blunt lumbar trauma (horse kick) with secondary kidney trauma, is reported. Imaging findings are described. Renal trauma classification and imaging findings are reviewed

Development of Brainstem-Evoked Responses in Congenital Auditory Deprivation

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J. Tillein

2012-01-01

Full Text Available To compare the development of the auditory system in hearing and completely acoustically deprived animals, naive congenitally deaf white cats (CDCs and hearing controls (HCs were investigated at different developmental stages from birth till adulthood. The CDCs had no hearing experience before the acute experiment. In both groups of animals, responses to cochlear implant stimulation were acutely assessed. Electrically evoked auditory brainstem responses (E-ABRs were recorded with monopolar stimulation at different current levels. CDCs demonstrated extensive development of E-ABRs, from first signs of responses at postnatal (p.n. day 3 through appearance of all waves of brainstem response at day 8 p.n. to mature responses around day 90 p.n.. Wave I of E-ABRs could not be distinguished from the artifact in majority of CDCs, whereas in HCs, it was clearly separated from the stimulus artifact. Waves II, III, and IV demonstrated higher thresholds in CDCs, whereas this difference was not found for wave V. Amplitudes of wave III were significantly higher in HCs, whereas wave V amplitudes were significantly higher in CDCs. No differences in latencies were observed between the animal groups. These data demonstrate significant postnatal subcortical development in absence of hearing, and also divergent effects of deafness on early waves II–IV and wave V of the E-ABR.

Comparison of quality control for trauma management between Western and Eastern European trauma center

Directory of Open Access Journals (Sweden)

Gambale Giorgio

2008-11-01

Full Text Available Abstract Background Quality control of trauma care is essential to define the effectiveness of trauma center and trauma system. To identify the troublesome issues of the system is the first step for validation of the focused customized solutions. This is a comparative study of two level I trauma centers in Italy and Romania and it has been designed to give an overview of the entire trauma care program adopted in these two countries. This study was aimed to use the results as the basis for recommending and planning changes in the two trauma systems for a better trauma care. Methods We retrospectively reviewed a total of 182 major trauma patients treated in the two hospitals included in the study, between January and June 2002. Every case was analyzed according to the recommended minimal audit filters for trauma quality assurance by The American College of Surgeons Committee on Trauma (ACSCOT. Results Satisfactory yields have been reached in both centers for the management of head and abdominal trauma, airway management, Emergency Department length of stay and early diagnosis and treatment. The main significant differences between the two centers were in the patients' transfers, the leadership of trauma team and the patients' outcome. The main concerns have been in the surgical treatment of fractures, the outcome and the lacking of documentation. Conclusion The analyzed hospitals are classified as Level I trauma center and are within the group of the highest quality level centers in their own countries. Nevertheless, both of them experience major lacks and for few audit filters do not reach the mmum standard requirements of ACS Audit Filters. The differences between the western and the eastern European center were slight. The parameters not reaching the minimum requirements are probably occurring even more often in suburban settings.

A numerical study on acoustic behavior in gas turbine combustor with acoustic resonator

International Nuclear Information System (INIS)

Park, I Sun; Sohn, Chae Hoon

2005-01-01

Acoustic behavior in gas turbine combustor with acoustic resonator is investigated numerically by adopting linear acoustic analysis. Helmholtz-type resonator is employed as acoustic resonator to suppress acoustic instability passively. The tuning frequency of acoustic resonator is adjusted by varying its length. Through harmonic analysis, acoustic-pressure responses of chamber to acoustic excitation are obtained and the resonant acoustic modes are identified. Acoustic damping effect of acoustic resonator is quantified by damping factor. As the tuning frequency of acoustic resonator approaches the target frequency of the resonant mode to be suppressed, mode split from the original resonant mode to lower and upper modes appears and thereby complex patterns of acoustic responses show up. Considering mode split and damping effect as a function of tuning frequency, it is desirable to make acoustic resonator tuned to broad-band frequencies near the maximum frequency of those of the possible upper modes

Acoustical Imaging

CERN Document Server

Litniewski, Jerzy; Kujawska, Tamara; 31st International Symposium on Acoustical Imaging

2012-01-01

The International Symposium on Acoustical Imaging is a unique forum for advanced research, covering new technologies, developments, methods and theories in all areas of acoustics. This interdisciplinary Symposium has been taking place continuously since 1968. In the course of the years the proceedings volumes in the Acoustical Imaging Series have become a reference for cutting-edge research in the field. In 2011 the 31st International Symposium on Acoustical Imaging was held in Warsaw, Poland, April 10-13. Offering both a broad perspective on the state-of-the-art as well as  in-depth research contributions by the specialists in the field, this Volume 31 in the Series contains an excellent collection of papers in six major categories: Biological and Medical Imaging Physics and Mathematics of Acoustical Imaging Acoustic Microscopy Transducers and Arrays Nondestructive Evaluation and Industrial Applications Underwater Imaging

Trauma facilities in Denmark - a nationwide cross-sectional benchmark study of facilities and trauma care organisation.

Science.gov (United States)

Weile, Jesper; Nielsen, Klaus; Primdahl, Stine C; Frederiksen, Christian A; Laursen, Christian B; Sloth, Erik; Mølgaard, Ole; Knudsen, Lars; Kirkegaard, Hans

2018-03-27

Trauma is a leading cause of death among adults aged facilities and the use multidisciplinary trauma teams. Because knowledge is sparse on the existing distribution of trauma facilities and the organisation of trauma care in Denmark, the aim of this study was to identify all Danish facilities that care for traumatized patients and to investigate the diversity in organization of trauma management. We conducted a systematic observational cross-sectional study. First, all hospitals in Denmark were identified via online services and clarifying phone calls to each facility. Second, all trauma care manuals on all facilities that receive traumatized patients were gathered. Third, anesthesiologists and orthopedic surgeons on call at all trauma facilities were contacted via telephone for structured interviews. A total of 22 facilities in Denmark were found to receive traumatized patients. All facilities used a trauma care manual and all had a multidisciplinary trauma team. The study found three different trauma team activation criteria and nine different compositions of teams who participate in trauma care. Training was heterogeneous and, beyond the major trauma centers, databases were only maintained in a few facilities. The study established an inventory of the existing Danish facilities that receive traumatized patients. The trauma team activation criteria and the trauma teams were heterogeneous in both size and composition. A national database for traumatized patients, research on nationwide trauma team activation criteria, and team composition guidelines are all called for.

Childhood trauma, combat trauma, and substance use in National Guard and reserve soldiers.

Science.gov (United States)

Vest, Bonnie M; Hoopsick, Rachel A; Homish, D Lynn; Daws, Rachel C; Homish, Gregory G

2018-02-27

The goal of this work was to examine associations among childhood trauma, combat trauma, and substance use (alcohol problems, frequent heavy drinking [FHD], current cigarette smoking, and current/lifetime drug use) and the interaction effects of childhood trauma and combat exposure on those associations among National Guard/reserve soldiers. Participants (N = 248) completed an electronic survey asking questions about their military experiences, physical and mental health, and substance use. Childhood trauma and combat exposure were examined jointly in regression models, controlling for age, marital satisfaction, and number of deployments. Childhood trauma was associated with current drug use (trend level, odds ratio [OR] = 1.44, 95% confidence interval [CI]: 0.97, 2.14; P = .072) in the main effect model; however, there was not a significant interaction with combat. Combat exposure had a significant interaction with childhood trauma on alcohol problems (b = -0.56, 95% CI: -1.12, -0.01; P = .048), FHD (b = -0.27, 95% CI: -0.47, -0.08; P = .007), and lifetime drug use (OR = 1.78, 95% CI: 1.04, 3.04; P = .035). There were no associations with either of the trauma measures and current cigarette smoking. These results demonstrate that childhood and combat trauma have differential effects on alcohol use, such that combat trauma may not add to the effect on alcohol use in those with greater child maltreatment but may contribute to greater alcohol use among those with low child maltreatment. As expected, childhood and combat trauma had synergistic effects on lifetime drug use. Screening for multiple types of trauma prior to enlistment and/or deployment may help to identify at-risk individuals and allow time for early intervention to prevent future adverse outcomes.

Music-evoked emotions: principles, brain correlates, and implications for therapy.

Science.gov (United States)

Koelsch, Stefan

2015-03-01

This paper describes principles underlying the evocation of emotion with music: evaluation, resonance, memory, expectancy/tension, imagination, understanding, and social functions. Each of these principles includes several subprinciples, and the framework on music-evoked emotions emerging from these principles and subprinciples is supposed to provide a starting point for a systematic, coherent, and comprehensive theory on music-evoked emotions that considers both reception and production of music, as well as the relevance of emotion-evoking principles for music therapy. © 2015 New York Academy of Sciences.

Vibration and muscle contraction affect somatosensory evoked potentials

OpenAIRE

Cohen, LG; Starr, A

1985-01-01

We recorded potentials evoked by specific somatosensory stimuli over peripheral nerve, spinal cord, and cerebral cortex. Vibration attenuated spinal and cerebral potentials evoked by mixed nerve and muscle spindle stimulation; in one subject that was tested, there was no effect on cutaneous input. Presynaptic inhibition of Ia input in the spinal cord and muscle spindle receptor occupancy are probably the responsible mechanisms. In contrast, muscle contraction attenuated cerebral potentials to...

Topological Acoustics

Science.gov (United States)

Yang, Zhaoju; Gao, Fei; Shi, Xihang; Lin, Xiao; Gao, Zhen; Chong, Yidong; Zhang, Baile

2015-03-01

The manipulation of acoustic wave propagation in fluids has numerous applications, including some in everyday life. Acoustic technologies frequently develop in tandem with optics, using shared concepts such as waveguiding and metamedia. It is thus noteworthy that an entirely novel class of electromagnetic waves, known as "topological edge states," has recently been demonstrated. These are inspired by the electronic edge states occurring in topological insulators, and possess a striking and technologically promising property: the ability to travel in a single direction along a surface without backscattering, regardless of the existence of defects or disorder. Here, we develop an analogous theory of topological fluid acoustics, and propose a scheme for realizing topological edge states in an acoustic structure containing circulating fluids. The phenomenon of disorder-free one-way sound propagation, which does not occur in ordinary acoustic devices, may have novel applications for acoustic isolators, modulators, and transducers.

Muscle synergies evoked by microstimulation are preferentially encoded during behavior

Directory of Open Access Journals (Sweden)

Simon Alexander Overduin

2014-03-01

Full Text Available Electrical microstimulation studies provide some of the most direct evidence for the neural representation of muscle synergies. These synergies, i.e. coordinated activations of groups of muscles, have been proposed as building blocks for the construction of motor behaviors by the nervous system. Intraspinal or intracortical microstimulation has been shown to evoke muscle patterns that can be resolved into a small set of synergies similar to those seen in natural behavior. However, questions remain about the validity of microstimulation as a probe of neural function, particularly given the relatively long trains of supratheshold stimuli used in these studies. Here, we examined whether muscle synergies evoked during intracortical microstimulation in two rhesus macaques were similarly encoded by nearby motor cortical units during a purely voluntary behavior involving object reach, grasp, and carry movements. At each microstimulation site we identified the synergy most strongly evoked among those extracted from muscle patterns evoked over all microstimulation sites. For each cortical unit recorded at the same microstimulation site, we then identified the synergy most strongly encoded among those extracted from muscle patterns recorded during the voluntary behavior. We found that the synergy most strongly evoked at an intracortical microstimulation site matched the synergy most strongly encoded by proximal units more often than expected by chance. These results suggest a common neural substrate for microstimulation-evoked motor responses and for the generation of muscle patterns during natural behaviors.

The involuntary nature of music-evoked autobiographical memories in Alzheimer's disease.

Science.gov (United States)

El Haj, Mohamad; Fasotti, Luciano; Allain, Philippe

2012-03-01

The main objective of this paper was to examine the involuntary nature of music-evoked autobiographical memories. For this purpose, young adults, older adults, and patients with a clinical diagnosis of probable Alzheimer's disease (AD) were asked to remember autobiographical events in two conditions: after being exposed to their own chosen music, and in silence. Compared to memories evoked in silence, memories evoked in the "Music" condition were found to be more specific, accompanied by more emotional content and impact on mood, and retrieved faster. In addition, these memories engaged less executive processes. Thus, with all these characteristics and the fact that they are activated by a perceptual cue (i.e., music), music-evoked autobiographic memories have all the features to be considered as involuntary memories. Our paper reveals several characteristics of music-evoked autobiographical memories in AD patients and offers a theoretical background for this phenomenon. Copyright © 2012 Elsevier Inc. All rights reserved.

Focused abdominal sonography for trauma (FAST) in blunt paediatric abdominal trauma

International Nuclear Information System (INIS)

Faruque, A. V.; Qazi, S. H.; Khan, M. A. M.

2013-01-01

Objective: To evaluate the role of focussed abdominal sonography for trauma in blunt paediatric abdominal trauma patients, and to see if the role of computed tomography scan could be limited to only those cases in which sonography was positive. Methods: The retrospective study covered 10 years, from January 1, 2000 to December 31, 2009, and was conducted at the Department of Radiology and Department of Emergency Medicine, Aga Khan University Hospital, Karachi. It comprised cases of 174 children from birth to 14 years who had presented with blunt abdominal trauma and had focussed abdominal sonography for trauma done at the hospital. The findings were correlated with computed tomography scan of the abdomen and clinical follow-up. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of focussed abdominal sonography for trauma were calculated for blunt abdominal trauma. SPSS 17 was used for statistical analysis. Results: Of the total 174 cases, 31 (17.81%) were later confirmed by abdominal scan. Of these 31 children, sonography had been positive in 29 (93.54%) children. In 21 (67.74%) of the 31 children, sonography had been true positive; 8 (25%) (8/31) were false positive; and 2 (6%) (2/31) were false negative. There were 6 (19.3%) children in which sonography was positive and converted to laparotomy. There was no significant difference on account of gender (p>0.356). Focussed abdominal sonography for trauma in the study had sensitivity of 91%, specificity of 95%, positive predictive value of 73%, and negative predictive value of 73% with accuracy of 94%. All patients who had negative sonography were discharged later, and had no complication on clinical follow-up. Conclusions: Focussed abdominal sonography for trauma is a fairly reliable mode to assess blunt abdominal trauma in children. It is a useful tool to pick high-grade solid and hollow viscous injury. The results suggest that the role of computed tomography scan can be

Focused abdominal sonography for trauma (FAST) in blunt paediatric abdominal trauma.

Science.gov (United States)

Faruque, Ahmad Vaqas; Qazi, Saqib Hamid; Khan, Muhammad Arif Mateen; Akhtar, Wassem; Majeed, Amina

2013-03-01

To evaluate the role of focussed abdominal sonography for trauma in blunt paediatric abdominal trauma patients, and to see if the role of computed tomography scan could be limited to only those cases in which sonography was positive. The retrospective study covered 10 years, from January 1,2000 to December 31,2009, and was conducted at the Department of Radiology and Department of Emergency Medicine, Aga Khan University Hospital, Karachi. It comprised cases of 174 children from birth to 14 years who had presented with blunt abdominal trauma and had focussed abdominal sonography for trauma done at the hospital. The findings were correlated with computed tomography scan of the abdomen and clinical follow-up. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of focussed abdominal sonography for trauma were calculated for blunt abdominal trauma. SPSS 17 was used for statistical analysis. Of the total 174 cases, 31 (17.81%) were later confirmed by abdominal scan. Of these 31 children, sonography had been positive in 29 (93.54%) children. In 21 (67.74%) of the 31 children, sonograpy had been true positive; 8 (25%) (8/31) were false positive; and 2 (6%) (2/31) were false negative. There were 6 (19.3%) children in which sonography was positive and converted to laparotomy. There was no significant difference on account of gender (p>0.356). Focussed abdominal sonography for trauma in the study had sensitivity of 91%, specificity of 95%, positive predictive value of 73%, and negative predictive value of 73% with accuracy of 94%. All patients who had negative sonography were discharged later, and had no complication on clinical follow-up. Focussed abdominal sonography for trauma is a fairly reliable mode to assess blunt abdominal trauma in children. It is a useful tool to pick high-grade solid and hollow viscous injury. The results suggest that the role of computed tomography scan can be limited to those cases in which focussed

The value of trauma registries.

Science.gov (United States)

Moore, Lynne; Clark, David E

2008-06-01

Trauma registries are databases that document acute care delivered to patients hospitalised with injuries. They are designed to provide information that can be used to improve the efficiency and quality of trauma care. Indeed, the combination of trauma registry data at regional or national levels can produce very large databases that allow unprecedented opportunities for the evaluation of patient outcomes and inter-hospital comparisons. However, the creation and upkeep of trauma registries requires a substantial investment of money, time and effort, data quality is an important challenge and aggregated trauma data sets rarely represent a population-based sample of trauma. In addition, trauma hospitalisations are already routinely documented in administrative hospital discharge databases. The present review aims to provide evidence that trauma registry data can be used to improve the care dispensed to victims of injury in ways that could not be achieved with information from administrative databases alone. In addition, we will define the structure and purpose of contemporary trauma registries, acknowledge their limitations, and discuss possible ways to make them more useful.

High transmission acoustic focusing by impedance-matched acoustic meta-surfaces

KAUST Repository

Al Jahdali, Rasha

2016-01-19

Impedance is an important issue in the design of acoustic lenses because mismatched impedance is detrimental to real focusing applications. Here, we report two designs of acoustic lenses that focus acoustic waves in water and air, respectively. They are tailored by acoustic meta-surfaces, which are rigid thin plates decorated with periodically distributed sub-wavelength slits. Their respective building blocks are constructed from the coiling-up spaces in water and the layered structures in air. Analytic analysis based on coupled-mode theory and transfer matrix reveals that the impedances of the lenses are matched to those of the background media. With these impedance-matched acoustic lenses, we demonstrate the acoustic focusing effect by finite-element simulations.

High transmission acoustic focusing by impedance-matched acoustic meta-surfaces

KAUST Repository

Al Jahdali, Rasha; Wu, Ying

2016-01-01

Impedance is an important issue in the design of acoustic lenses because mismatched impedance is detrimental to real focusing applications. Here, we report two designs of acoustic lenses that focus acoustic waves in water and air, respectively. They are tailored by acoustic meta-surfaces, which are rigid thin plates decorated with periodically distributed sub-wavelength slits. Their respective building blocks are constructed from the coiling-up spaces in water and the layered structures in air. Analytic analysis based on coupled-mode theory and transfer matrix reveals that the impedances of the lenses are matched to those of the background media. With these impedance-matched acoustic lenses, we demonstrate the acoustic focusing effect by finite-element simulations.

Analysis of the Revised Trauma Score (RTS) in 200 victims of different trauma mechanisms.

Science.gov (United States)

Alvarez, Bruno Durante; Razente, Danilo Mardegam; Lacerda, Daniel Augusto Mauad; Lother, Nicole Silveira; VON-Bahten, Luiz Carlos; Stahlschmidt, Carla Martinez Menini

2016-01-01

to analyze the epidemiological profile and mortality associated with the Revised Trauma Score (RTS) in trauma victims treated at a university hospital. we conducted a descriptive, cross-sectional study of trauma protocols (prospectively collected) from December 2013 to February 2014, including trauma victims admitted in the emergency room of the Cajuru University Hospital. We set up three groups: (G1) penetrating trauma to the abdomen and chest, (G2) blunt trauma to the abdomen and chest, and (G3) traumatic brain injury. The variables we analyzed were: gender, age, day of week, mechanism of injury, type of transportation, RTS, hospitalization time and mortality. we analyzed 200 patients, with a mean age of 36.42 ± 17.63 years, and 73.5% were male. The mean age was significantly lower in G1 than in the other groups (p grupos foram criados: (G1) trauma penetrante em abdome e tórax, (G2) trauma contuso em abdome e tórax, e (G3) trauma cranioencefálico. As variáveis analisadas foram: sexo, idade, dia da semana, mecanismo de trauma, tipo de transporte, RTS, tempo de internamento e mortalidade. analisou-se 200 pacientes, com média de idade de 36,42 ± 17,63 anos, sendo 73,5% do sexo masculino. A média de idade no G1 foi significativamente menor do que nos demais grupos (p grupos (p grupos G1, G2 e G3, respectivamente. A mediana do RTS entre os óbitos foi 5,49, 7,84 e 1,16, respectivamente, para os três grupos. a maioria dos pacientes eram homens jovens. O RTS mostrou-se efetivo na predição de mortalidade no trauma cranioencefálico, entretanto falhou ao analisar pacientes vítimas de trauma contuso e penetrante.

Management of duodenal trauma

Directory of Open Access Journals (Sweden)

CHEN Guo-qing

2011-02-01

Full Text Available 【Abstract】Duodenal trauma is uncommon but nowadays seen more and more frequently due to the increased automobile accidents and violent events. The management of duodenal trauma can be complicated, especially when massive injury to the pancreatic-duodenal-biliary complex occurs simultaneously. Even the patients receive surgeries in time, multiple postoperative complications and high mortality are common. To know and manage duodenal trauma better, we searched the recent related literature in PubMed by the keywords of duodenal trauma, therapy, diagnosis and abdomen. It shows that because the diagnosis and management are complicated and the mortality is high, duodenal trauma should be treated in time and tactfully. And application of new technology can help improve the management. In this review, we discussed the incidence, diagnosis, management, and complications as well as mortality of duodenal trauma. Key words: Duodenum; Wounds and injuries; Diagnosis; Therapeutics

Vibro-acoustics

CERN Document Server

Nilsson, Anders

2015-01-01

This three-volume book gives a thorough and comprehensive presentation of vibration and acoustic theories. Different from traditional textbooks which typically deal with some aspects of either acoustic or vibration problems, it is unique of this book to combine those two correlated subjects together. Moreover, it provides fundamental analysis and mathematical descriptions for several crucial phenomena of Vibro-Acoustics which are quite useful in noise reduction, including how structures are excited, energy flows from an excitation point to a sound radiating surface, and finally how a structure radiates noise to a surrounding fluid. Many measurement results included in the text make the reading interesting and informative. Problems/questions are listed at the end of each chapter and the solutions are provided. This will help the readers to understand the topics of Vibro-Acoustics more deeply. The book should be of interest to anyone interested in sound and vibration, vehicle acoustics, ship acoustics and inter...

Acoustics an introduction

CERN Document Server

Kuttruff, Heinrich

2006-01-01

This definitive textbook provides students with a comprehensive introduction to acoustics. Beginning with the basic physical ideas, Acoustics balances the fundamentals with engineering aspects, applications and electroacoustics, also covering music, speech and the properties of human hearing. The concepts of acoustics are exposed and applied in:room acousticssound insulation in buildingsnoise controlunderwater sound and ultrasoundScientifically thorough, but with mathematics kept to a minimum, Acoustics is the perfect introduction to acoustics for students at any level of mechanical, electrical or civil engineering courses and an accessible resource for architects, musicians or sound engineers requiring a technical understanding of acoustics and their applications.

Trauma facilities in Denmark - A nationwide cross-sectional benchmark study of facilities and trauma care organisation

DEFF Research Database (Denmark)

Weile, Jesper; Nielsen, Klaus; Primdahl, Stine C.

2018-01-01

Background: Trauma is a leading cause of death among adults aged trauma facilities and the use multidisciplinary trauma teams. Because knowledge is sparse on the existing distribution of trauma facilities...... and the organisation of trauma care in Denmark, the aim of this study was to identify all Danish facilities that care for traumatized patients and to investigate the diversity in organization of trauma management. Methods: We conducted a systematic observational cross-sectional study. First, all hospitals in Denmark...... were identified via online services and clarifying phone calls to each facility. Second, all trauma care manuals on all facilities that receive traumatized patients were gathered. Third, anesthesiologists and orthopedic surgeons on call at all trauma facilities were contacted via telephone...

TraumaTutor: Perceptions of a Smartphone Application as a Learning Resource for Trauma Management

Directory of Open Access Journals (Sweden)

James Wigley

2013-01-01

Full Text Available Aim. We investigated perceptions of a new smartphone application (app as a learning resource. Methods. We developed TraumaTutor, an iPhone app consisting of 150 questions and explanatory answers on trauma management. This was used by 20 hospital staff that either had a special interest in managing trauma or who were studying for relevant exams, such as ATLS. A subsequent questionnaire assessed users’ experience of smartphone applications and their perceptions of TraumaTutor. Results. Of those surveyed, 85% had a device capable of running app software, and 94% of them had used apps for medical education. Specific to TraumaTutor, 85% agreed that it was pitched at the right level, 95% felt that the explanations improved understanding of trauma management, and 100% found the app easy to use. In fact, on open questioning, the clear user interface and the quality of the educational material were seen as the major advantages of TraumaTutor, and 85% agreed that the app would be a useful learning resource. Conclusions. Smartphone applications are considered a valuable educational adjunct and are commonly used by our target audience. TraumaTutor shows overwhelming promise as a learning supplement due to its immediacy, accessibility, and relevance to those preparing for courses and managing trauma.

Gender differences in binaural speech-evoked auditory brainstem response: are they clinically significant?

Science.gov (United States)

Jalaei, Bahram; Azmi, Mohd Hafiz Afifi Mohd; Zakaria, Mohd Normani

2018-05-17

Binaurally evoked auditory evoked potentials have good diagnostic values when testing subjects with central auditory deficits. The literature on speech-evoked auditory brainstem response evoked by binaural stimulation is in fact limited. Gender disparities in speech-evoked auditory brainstem response results have been consistently noted but the magnitude of gender difference has not been reported. The present study aimed to compare the magnitude of gender difference in speech-evoked auditory brainstem response results between monaural and binaural stimulations. A total of 34 healthy Asian adults aged 19-30 years participated in this comparative study. Eighteen of them were females (mean age=23.6±2.3 years) and the remaining sixteen were males (mean age=22.0±2.3 years). For each subject, speech-evoked auditory brainstem response was recorded with the synthesized syllable /da/ presented monaurally and binaurally. While latencies were not affected (p>0.05), the binaural stimulation produced statistically higher speech-evoked auditory brainstem response amplitudes than the monaural stimulation (p0.80), substantive gender differences were noted in most of speech-evoked auditory brainstem response peaks for both stimulation modes. The magnitude of gender difference between the two stimulation modes revealed some distinct patterns. Based on these clinically significant results, gender-specific normative data are highly recommended when using speech-evoked auditory brainstem response for clinical and future applications. The preliminary normative data provided in the present study can serve as the reference for future studies on this test among Asian adults. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Interior acoustic cloak

OpenAIRE

Wael Akl; A. Baz

2014-01-01

Acoustic cloaks have traditionally been intended to externally surround critical objects to render these objects acoustically invisible. However, in this paper, the emphasis is placed on investigating the application of the acoustic cloaks to the interior walls of acoustic cavities in an attempt to minimize the noise levels inside these cavities. In this manner, the acoustic cloaks can serve as a viable and efficient alternative to the conventional passive noise attenuation treatments which a...

External Validation of the Emergency Trauma Score for Early Prediction of Mortality in Trauma Patients

NARCIS (Netherlands)

Joosse, Pieter; de Jong, Willem-Jan J.; Wendt, Klaus W.; Schep, Niels W.; Goslings, J. Carel; Reitsma, J.

Objectives: The Emergency Trauma Score has been developed for early estimation of mortality risk in adult trauma patients with an Injury Severity Score of 16 or higher. Emergency Trauma Score combines four early predictors available at the trauma resuscitation room: age, Glasgow Coma Scale, base

Effects of chronic furosemide on central neural hyperactivity and cochlear thresholds after cochlear trauma in guinea pig

Directory of Open Access Journals (Sweden)

Wilhelmina eMulders

2014-08-01

Full Text Available Increased neuronal spontaneous firing rates have been observed throughout the central auditory system after trauma to the cochlea and this hyperactivity is believed to be associated with the phantom perception of tinnitus. Previously we have shown in an animal model of hearing loss, that an acute injection with furosemide can significantly decrease hyperactivity after cochlear trauma and eliminate behavioural evidence of tinnitus of early onset. However, furosemide also has the potential to affect cochlear thresholds. In this paper we measured the effects of a chronic (daily injections for 7 days furosemide treatment on the spontaneous firing rate of inferior colliculus neurons and on cochlear thresholds in order to establish whether a beneficial effect on hyperactivity can be obtained without causing additional hearing loss. Guinea pigs were exposed to a 10 kHz, 124dB, 2 hour acoustic trauma, and after 5 days of recovery, were given daily i.p. injections of 80mg/kg furosemide or an equivalent amount of saline. The activity of single IC neurons was recorded 24 hours following the last injection. The furosemide treatment had no effect on cochlear thresholds compared to saline injections but did result in significant reductions in spontaneous firing rates recorded in inferior colliculus. These results that suggest a long term beneficial effect of furosemide on hyperactivity after cochlear trauma may be achievable without detrimental effects on hearing, which is important when considering therapeutic potential.

Acoustic energy harvesting based on a planar acoustic metamaterial

Science.gov (United States)

Qi, Shuibao; Oudich, Mourad; Li, Yong; Assouar, Badreddine

2016-06-01

We theoretically report on an innovative and practical acoustic energy harvester based on a defected acoustic metamaterial (AMM) with piezoelectric material. The idea is to create suitable resonant defects in an AMM to confine the strain energy originating from an acoustic incidence. This scavenged energy is converted into electrical energy by attaching a structured piezoelectric material into the defect area of the AMM. We show an acoustic energy harvester based on a meta-structure capable of producing electrical power from an acoustic pressure. Numerical simulations are provided to analyze and elucidate the principles and the performances of the proposed system. A maximum output voltage of 1.3 V and a power density of 0.54 μW/cm3 are obtained at a frequency of 2257.5 Hz. The proposed concept should have broad applications on energy harvesting as well as on low-frequency sound isolation, since this system acts as both acoustic insulator and energy harvester.

Trauma and Coagulation

Directory of Open Access Journals (Sweden)

Murat Yılmaz

2011-08-01

Full Text Available Bleeding and coagulation disorders related to trauma are pathological processes which are frequently seen and increase mortality. For the purpose, trauma patients should be protected from hypoperfusion, hypothermia, acidosis and hemodilution which may aggravate the increase in physiological responses to trauma as anticoagulation and fibrinolysis. Performing damage control surgery and resuscitation and transfusion of adequate blood and blood products in terms of amount and content as stated in protocols may increase the rate of survival. Medical treatments augmenting fibrin formation (fibrinogen, desmopressin, factor VIIa or preventing fibrin degradation (tranexamic acid have been proposed in selected cases but the efficacy of these agents in trauma patients are not proven. (Journal of the Turkish Society Intensive Care 2011; 9:71-6

Hepatic trauma: a 21-year experience.

Science.gov (United States)

Zago, Thiago Messias; Pereira, Bruno Monteiro; Nascimento, Bartolomeu; Alves, Maria Silveira Carvalho; Calderan, Thiago Rodrigues Araujo; Fraga, Gustavo Pereira

2013-01-01

To evaluate the epidemiological aspects, behavior, morbidity and treatment outcomes for liver trauma. We conducted a retrospective study of patients over 13 years of age admitted to a university hospital from 1990 to 2010, submitted to surgery or nonoperative management (NOM). 748 patients were admitted with liver trauma. The most common mechanism of injury was penetrating trauma (461 cases, 61.6%), blunt trauma occurring in 287 patients (38.4%). According to the degree of liver injury (AAST-OIS) in blunt trauma we predominantly observed Grades I and II and in penetrating trauma, Grade III. NOM was performed in 25.7% of patients with blunt injury. As for surgical procedures, suturing was performed more frequently (41.2%). The liver-related morbidity was 16.7%. The survival rate for patients with liver trauma was 73.5% for blunt and 84.2% for penetrating trauma. Mortality in complex trauma was 45.9%. trauma remains more common in younger populations and in males. There was a reduction of penetrating liver trauma. NOM proved safe and effective, and often has been used to treat patients with penetrating liver trauma. Morbidity was high and mortality was higher in victims of blunt trauma and complex liver injuries.

Panel acoustic contribution analysis.

Science.gov (United States)

Wu, Sean F; Natarajan, Logesh Kumar

2013-02-01

Formulations are derived to analyze the relative panel acoustic contributions of a vibrating structure. The essence of this analysis is to correlate the acoustic power flow from each panel to the radiated acoustic pressure at any field point. The acoustic power is obtained by integrating the normal component of the surface acoustic intensity, which is the product of the surface acoustic pressure and normal surface velocity reconstructed by using the Helmholtz equation least squares based nearfield acoustical holography, over each panel. The significance of this methodology is that it enables one to analyze and rank relative acoustic contributions of individual panels of a complex vibrating structure to acoustic radiation anywhere in the field based on a single set of the acoustic pressures measured in the near field. Moreover, this approach is valid for both interior and exterior regions. Examples of using this method to analyze and rank the relative acoustic contributions of a scaled vehicle cabin are demonstrated.

Pancreatic trauma.

Science.gov (United States)

Lahiri, R; Bhattacharya, S

2013-05-01

Pancreatic trauma occurs in approximately 4% of all patients sustaining abdominal injuries. The pancreas has an intimate relationship with the major upper abdominal vessels, and there is significant morbidity and mortality associated with severe pancreatic injury. Immediate resuscitation and investigations are essential to delineate the nature of the injury, and to plan further management. If main pancreatic duct injuries are identified, specialised input from a tertiary hepatopancreaticobiliary (HPB) team is advised. A comprehensive online literature search was performed using PubMed. Relevant articles from international journals were selected. The search terms used were: 'pancreatic trauma', 'pancreatic duct injury', 'radiology AND pancreas injury', 'diagnosis of pancreatic trauma', and 'management AND surgery'. Articles that were not published in English were excluded. All articles used were selected on relevance to this review and read by both authors. Pancreatic trauma is rare and associated with injury to other upper abdominal viscera. Patients present with non-specific abdominal findings and serum amylase is of little use in diagnosis. Computed tomography is effective in diagnosing pancreatic injury but not duct disruption, which is most easily seen on endoscopic retrograde cholangiopancreaticography or operative pancreatography. If pancreatic injury is suspected, inspection of the entire pancreas and duodenum is required to ensure full evaluation at laparotomy. The operative management of pancreatic injury depends on the grade of injury found at laparotomy. The most important prognostic factor is main duct disruption and, if found, reconstructive options should be determined by an experienced HPB surgeon. The diagnosis of pancreatic trauma requires a high index of suspicion and detailed imaging studies. Grading pancreatic injury is important to guide operative management. The most important prognostic factor is pancreatic duct disruption and in these cases

External validation of the Emergency Trauma Score for early prediction of mortality in trauma patients

NARCIS (Netherlands)

Joosse, Pieter; de Jong, Willem-Jan J.; Reitsma, Johannes B.; Wendt, Klaus W.; Schep, Niels W.; Goslings, J. Carel

2014-01-01

The Emergency Trauma Score has been developed for early estimation of mortality risk in adult trauma patients with an Injury Severity Score of 16 or higher. Emergency Trauma Score combines four early predictors available at the trauma resuscitation room: age, Glasgow Coma Scale, base excess, and

Classifying and Standardizing Panfacial Trauma With a New Bony Facial Trauma Score.

Science.gov (United States)

Casale, Garrett G A; Fishero, Brian A; Park, Stephen S; Sochor, Mark; Heltzel, Sara B; Christophel, J Jared

2017-01-01

The practice of facial trauma surgery would benefit from a useful quantitative scale that measures the extent of injury. To develop a facial trauma scale that incorporates only reducible fractures and is able to be reliably communicated to health care professionals. A cadaveric tissue study was conducted from October 1 to 3, 2014. Ten cadaveric heads were subjected to various degrees of facial trauma by dropping a fixed mass onto each head. The heads were then imaged with fine-cut computed tomography. A Bony Facial Trauma Scale (BFTS) for grading facial trauma was developed based only on clinically relevant (reducible) fractures. The traumatized cadaveric heads were then scored using this scale as well as 3 existing scoring systems. Regression analysis was used to determine correlation between degree of incursion of the fixed mass on the cadaveric heads and trauma severity as rated by the scoring systems. Statistical analysis was performed to determine correlation of the scores obtained using the BFTS with those of the 3 existing scoring systems. Scores obtained using the BFTS were not correlated with dentition (95% CI, -0.087 to 1.053; P = .08; measured as absolute number of teeth) or age of the cadaveric donor (95% CI, -0.068 to 0.944; P = .08). Facial trauma scores. Among all 10 cadaveric specimens (9 male donors and 1 female donor; age range, 41-87 years; mean age, 57.2 years), the facial trauma scores obtained using the BFTS correlated with depth of penetration of the mass into the face (odds ratio, 4.071; 95% CI, 1.676-6.448) P = .007) when controlling for presence of dentition and age. The BFTS scores also correlated with scores obtained using 3 existing facial trauma models (Facial Fracture Severity Scale, rs = 0.920; Craniofacial Disruption Score, rs = 0.945; and ZS Score, rs = 0.902; P trauma scales. Scores obtained using the BFTS were not correlated with dentition (odds ratio, .482; 95% CI, -0.087 to 1.053; P = .08; measured

Hearing in the Juvenile Green Sea Turtle (Chelonia mydas: A Comparison of Underwater and Aerial Hearing Using Auditory Evoked Potentials.

Directory of Open Access Journals (Sweden)

Wendy E D Piniak

Full Text Available Sea turtles spend much of their life in aquatic environments, but critical portions of their life cycle, such as nesting and hatching, occur in terrestrial environments, suggesting that it may be important for them to detect sounds in both air and water. In this study we compared underwater and aerial hearing sensitivities in five juvenile green sea turtles (Chelonia mydas by measuring auditory evoked potential responses to tone pip stimuli. Green sea turtles detected acoustic stimuli in both media, responding to underwater stimuli between 50 and 1600 Hz and aerial stimuli between 50 and 800 Hz, with maximum sensitivity between 200 and 400 Hz underwater and 300 and 400 Hz in air. When underwater and aerial hearing sensitivities were compared in terms of pressure, green sea turtle aerial sound pressure thresholds were lower than underwater thresholds, however they detected a wider range of frequencies underwater. When thresholds were compared in terms of sound intensity, green sea turtle sound intensity level thresholds were 2-39 dB lower underwater particularly at frequencies below 400 Hz. Acoustic stimuli may provide important environmental cues for sea turtles. Further research is needed to determine how sea turtles behaviorally and physiologically respond to sounds in their environment.

Specific trauma subtypes improve the predictive validity of the Harvard Trauma Questionnaire in Iraqi refugees.

Science.gov (United States)

Arnetz, Bengt B; Broadbridge, Carissa L; Jamil, Hikmet; Lumley, Mark A; Pole, Nnamdi; Barkho, Evone; Fakhouri, Monty; Talia, Yousif Rofa; Arnetz, Judith E

2014-12-01

Trauma exposure contributes to poor mental health among refugees, and exposure often is measured using a cumulative index of items from the Harvard Trauma Questionnaire (HTQ). Few studies, however, have asked whether trauma subtypes derived from the HTQ could be superior to this cumulative index in predicting mental health outcomes. A community sample of recently arrived Iraqi refugees (N = 298) completed the HTQ and measures of posttraumatic stress disorder (PTSD) and depression symptoms. Principal components analysis of HTQ items revealed a 5-component subtype model of trauma that accounted for more item variance than a 1-component solution. These trauma subtypes also accounted for more variance in PTSD and depression symptoms (12 and 10%, respectively) than did the cumulative trauma index (7 and 3%, respectively). Trauma subtypes provided more information than cumulative trauma in the prediction of negative mental health outcomes. Therefore, use of these subtypes may enhance the utility of the HTQ when assessing at-risk populations.

Specific Trauma Subtypes Improve the Predictive Validity of the Harvard Trauma Questionnaire in Iraqi Refugees

Science.gov (United States)

Arnetz, Bengt B.; Broadbridge, Carissa L.; Jamil, Hikmet; Lumley, Mark A.; Pole, Nnamdi; Barkho, Evone; Fakhouri, Monty; Talia, Yousif Rofa; Arnetz, Judith E.

2014-01-01

Background Trauma exposure contributes to poor mental health among refugees, and exposure often is measured using a cumulative index of items from the Harvard Trauma Questionnaire (HTQ). Few studies, however, have asked whether trauma subtypes derived from the HTQ could be superior to this cumulative index in predicting mental health outcomes. Methods A community sample of recently arrived Iraqi refugees (N = 298) completed the HTQ and measures of posttraumatic stress disorder (PTSD) and depression symptoms. Results Principal components analysis of HTQ items revealed a 5-component subtype model of trauma that accounted for more item variance than a 1-component solution. These trauma subtypes also accounted for more variance in PTSD and depression symptoms (12% and 10%, respectively) than did the cumulative trauma index (7% and 3%, respectively). Discussion Trauma subtypes provided more information than cumulative trauma in the prediction of negative mental health outcomes. Therefore, use of these subtypes may enhance the utility of the HTQ when assessing at-risk populations. PMID:24549491

Music-Evoked Emotions—Current Studies

Science.gov (United States)

Schaefer, Hans-Eckhardt

2017-01-01

The present study is focused on a review of the current state of investigating music-evoked emotions experimentally, theoretically and with respect to their therapeutic potentials. After a concise historical overview and a schematic of the hearing mechanisms, experimental studies on music listeners and on music performers are discussed, starting with the presentation of characteristic musical stimuli and the basic features of tomographic imaging of emotional activation in the brain, such as functional magnetic resonance imaging (fMRI) and positron emission tomography (PET), which offer high spatial resolution in the millimeter range. The progress in correlating activation imaging in the brain to the psychological understanding of music-evoked emotion is demonstrated and some prospects for future research are outlined. Research in psychoneuroendocrinology and molecular markers is reviewed in the context of music-evoked emotions and the results indicate that the research in this area should be intensified. An assessment of studies involving measuring techniques with high temporal resolution down to the 10 ms range, as, e.g., electroencephalography (EEG), event-related brain potentials (ERP), magnetoencephalography (MEG), skin conductance response (SCR), finger temperature, and goose bump development (piloerection) can yield information on the dynamics and kinetics of emotion. Genetic investigations reviewed suggest the heredity transmission of a predilection for music. Theoretical approaches to musical emotion are directed to a unified model for experimental neurological evidence and aesthetic judgment. Finally, the reports on musical therapy are briefly outlined. The study concludes with an outlook on emerging technologies and future research fields. PMID:29225563

Stimulator with arbitrary waveform for auditory evoked potentials

International Nuclear Information System (INIS)

Martins, H R; Romao, M; Placido, D; Provenzano, F; Tierra-Criollo, C J

2007-01-01

The technological improvement helps many medical areas. The audiometric exams involving the auditory evoked potentials can make better diagnoses of auditory disorders. This paper proposes the development of a stimulator based on Digital Signal Processor. This stimulator is the first step of an auditory evoked potential system based on the ADSP-BF533 EZ KIT LITE (Analog Devices Company - USA). The stimulator can generate arbitrary waveform like Sine Waves, Modulated Amplitude, Pulses, Bursts and Pips. The waveforms are generated through a graphical interface programmed in C++ in which the user can define the parameters of the waveform. Furthermore, the user can set the exam parameters as number of stimuli, time with stimulation (Time ON) and time without stimulus (Time OFF). In future works will be implemented another parts of the system that includes the acquirement of electroencephalogram and signal processing to estimate and analyze the evoked potential

Stimulator with arbitrary waveform for auditory evoked potentials

Energy Technology Data Exchange (ETDEWEB)

Martins, H R; Romao, M; Placido, D; Provenzano, F; Tierra-Criollo, C J [Universidade Federal de Minas Gerais (UFMG), Departamento de Engenharia Eletrica (DEE), Nucleo de Estudos e Pesquisa em Engenharia Biomedica NEPEB, Av. Ant. Carlos, 6627, sala 2206, Pampulha, Belo Horizonte, MG, 31.270-901 (Brazil)

2007-11-15

The technological improvement helps many medical areas. The audiometric exams involving the auditory evoked potentials can make better diagnoses of auditory disorders. This paper proposes the development of a stimulator based on Digital Signal Processor. This stimulator is the first step of an auditory evoked potential system based on the ADSP-BF533 EZ KIT LITE (Analog Devices Company - USA). The stimulator can generate arbitrary waveform like Sine Waves, Modulated Amplitude, Pulses, Bursts and Pips. The waveforms are generated through a graphical interface programmed in C++ in which the user can define the parameters of the waveform. Furthermore, the user can set the exam parameters as number of stimuli, time with stimulation (Time ON) and time without stimulus (Time OFF). In future works will be implemented another parts of the system that includes the acquirement of electroencephalogram and signal processing to estimate and analyze the evoked potential.

Evoking prescribed spike times in stochastic neurons

Science.gov (United States)

Doose, Jens; Lindner, Benjamin

2017-09-01

Single cell stimulation in vivo is a powerful tool to investigate the properties of single neurons and their functionality in neural networks. We present a method to determine a cell-specific stimulus that reliably evokes a prescribed spike train with high temporal precision of action potentials. We test the performance of this stimulus in simulations for two different stochastic neuron models. For a broad range of parameters and a neuron firing with intermediate firing rates (20-40 Hz) the reliability in evoking the prescribed spike train is close to its theoretical maximum that is mainly determined by the level of intrinsic noise.

Male genital trauma

International Nuclear Information System (INIS)

Jordan, G.H.; Gilbert, D.A.

1988-01-01

We have attempted to discuss genital trauma in relatively broad terms. In most cases, patients present with relatively minimal trauma. However, because of the complexity of the structures involved, minimal trauma can lead to significant disability later on. The process of erection requires correct functioning of the arterial, neurologic, and venous systems coupled with intact erectile bodies. The penis is composed of structures that are compliant and distensible to the limits of their compliance. These structures therefore tumesce in equal proportion to each other, allowing for straight erection. Relatively minimal trauma can upset this balance of elasticity, leading to disabling chordee. Likewise, relatively minimal injuries to the vascular erectile structures can lead to significantly disabling spongiofibrosis. The urethra is a conduit of paramount importance. Whereas the development of stricture is generally related to the nature of the trauma, the extent of stricture and of attendant complications is clearly a function of the immediate management. Overzealous debridement can greatly complicate subsequent reconstruction. A delicate balance between aggressive initial management and maximal preservation of viable structures must be achieved. 38 references

Radiology in chest trauma

International Nuclear Information System (INIS)

Wenz, W.; Kloehn, I.; Wolfart, W.; Freiburg Univ.

1979-01-01

In chest trauma, a routine chest film, preferably in the lateral as well as the frontal projection, is the basic part of the work-up. Occasionally valuable additional methods are fluoroscopy, tomography, bronchography, contrast studies of the GI Tract and angiography and angiocardiography. In 679 chest trauma patients, traffic accidents and falls were the main reason for the trauma. There were 248 fractures; then - in order of frequency - hemopneumothorax (76), lung contusion (58), subcutaneous emphysema (33) cardiac (16) and vascular trauma (12) and damage to other organs. While 20-30% mistakes are made in diagnosing rib fractures in acute trauma, there is high accuracy in the diagnosis of the other injuries. Many cases are shown to demonstrate the value of diagnostic radiology. (orig.) [de

Visual evoked potentials in patients after methanol poisoning.

Science.gov (United States)

Urban, Pavel; Zakharov, Sergey; Diblík, Pavel; Pelclová, Daniela; Ridzoň, Petr

2016-01-01

We report the results of the visual evoked potentials (VEP) examination in patients after severe poisoning by methanol. The group of 47 patients (38 males and 9 females) was assembled out of persons who survived an outbreak of poisoning by the methanol adulterated alcohol beverages, which happened in the Czech Republic in 2012-2013. The visual evoked potentials examination was performed using monocular checkerboard pattern-reversal stimulation. Two criteria of abnormality were chosen: missing evoked response, and wave P1 latency > 117 ms. Non-parametric statistical methods (median, range, and the median test) were used to analyze factors influencing the VEP abnormality. The visual evoked potential was abnormal in 20 patients (43%), 5 of them had normal visual acuity on the Snellen chart. The VEP abnormality did not correlate significantly with initial serum concentrations of methanol, formic acid or lactate; however, it showed statistically significant inverse relation to the initial serum pH: the subgroup with the abnormal VEP had significantly lower median pH in comparison with the subgroup with the normal VEP (7.16 vs. 7.34, p = 0.04). The abnormality was not related to chronic alcohol abuse. The visual evoked potentials examination appeared sensitive enough to detected even subclinical impairment of the optic system. Metabolic acidosis is likely to be the key factor related to the development of visual damage induced by methanol. The examination performed with a delay of 1-9 months after the poisoning documented the situation relatively early after the event. It is considered as a baseline for the planned long-term follow-up of the patients, which will make it possible to assess the dynamics of the observed changes, their reversibility, and the occurrence of potential late sequelae. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Impact of a TeamSTEPPS Trauma Nurse Academy at a Level 1 Trauma Center.

Science.gov (United States)

Peters, V Kristen; Harvey, Ellen M; Wright, Andi; Bath, Jennifer; Freeman, Dan; Collier, Bryan

2018-01-01

Nurses are crucial members of the team caring for the acutely injured trauma patient. Until recently, nurses and physicians gained an understanding of leadership and supportive roles separately. With the advent of a multidisciplinary team approach to trauma care, formal team training and simulation has transpired. Since 2007, our Level I trauma system has integrated TeamSTEPPS (Team Strategies & Tools to Enhance Performance & Patient Safety; Agency for Healthcare Research and Quality, Rockville, MD) into our clinical care, joint training of nurses and physicians, using simulations with participation of all health care providers. With the increased expectations of a well-orchestrated team and larger number of emergency nurses, our program created the Trauma Nurse Academy. This academy provides a core of experienced nurses with an advanced level of training while decreasing the variability of personnel in the trauma bay. Components of the academy include multidisciplinary didactic education, the Essentials of TeamSTEPPS, and interactive trauma bay learning, to include both equipment and drug use. Once completed, academy graduates participate in the orientation and training of General Surgery and Emergency Medicine residents' trauma bay experience and injury prevention activities. Internal and published data have demonstrated growing evidence linking trauma teamwork training to knowledge and self-confidence in clinical judgment to team performance, patient outcomes, and quality of care. Although trauma resuscitations are stressful, high risk, dynamic, and a prime environment for error, new methods of teamwork training and collaboration among trauma team members have become essential. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

Benchmarking of trauma care worldwide: the potential value of an International Trauma Data Bank (ITDB).

Science.gov (United States)

Haider, Adil H; Hashmi, Zain G; Gupta, Sonia; Zafar, Syed Nabeel; David, Jean-Stephane; Efron, David T; Stevens, Kent A; Zafar, Hasnain; Schneider, Eric B; Voiglio, Eric; Coimbra, Raul; Haut, Elliott R

2014-08-01

National trauma registries have helped improve patient outcomes across the world. Recently, the idea of an International Trauma Data Bank (ITDB) has been suggested to establish global comparative assessments of trauma outcomes. The objective of this study was to determine whether global trauma data could be combined to perform international outcomes benchmarking. We used observed/expected (O/E) mortality ratios to compare two trauma centers [European high-income country (HIC) and Asian lower-middle income country (LMIC)] with centers in the North American National Trauma Data Bank (NTDB). Patients (≥16 years) with blunt/penetrating injuries were included. Multivariable logistic regression, adjusting for known predictors of trauma mortality, was performed. Estimates were used to predict the expected deaths at each center and to calculate O/E mortality ratios for benchmarking. A total of 375,433 patients from 301 centers were included from the NTDB (2002-2010). The LMIC trauma center had 806 patients (2002-2010), whereas the HIC reported 1,003 patients (2002-2004). The most important known predictors of trauma mortality were adequately recorded in all datasets. Mortality benchmarking revealed that the HIC center performed similarly to the NTDB centers [O/E = 1.11 (95% confidence interval (CI) 0.92-1.35)], whereas the LMIC center showed significantly worse survival [O/E = 1.52 (1.23-1.88)]. Subset analyses of patients with blunt or penetrating injury showed similar results. Using only a few key covariates, aggregated global trauma data can be used to adequately perform international trauma center benchmarking. The creation of the ITDB is feasible and recommended as it may be a pivotal step towards improving global trauma outcomes.

Evoked Emotions Predict Food Choice

NARCIS (Netherlands)

Dalenberg, Jelle R.; Gutjar, Swetlana; ter Horst, Gert J.; de Graaf, Kees; Renken, Remco J.; Jager, Gerry

2014-01-01

In the current study we show that non-verbal food-evoked emotion scores significantly improve food choice prediction over merely liking scores. Previous research has shown that liking measures correlate with choice. However, liking is no strong predictor for food choice in real life environments.

The effects of curiosity-evoking events on activity enjoyment.

Science.gov (United States)

Isikman, Elif; MacInnis, Deborah J; Ülkümen, Gülden; Cavanaugh, Lisa A

2016-09-01

Whereas prior literature has studied the positive effects of curiosity-evoking events that are integral to focal activities, we explore whether and how a curiosity-evoking event that is incidental to a focal activity induces negative outcomes for enjoyment. Four experiments and 1 field study demonstrate that curiosity about an event that is incidental to an activity in which individuals are engaged, significantly affects enjoyment of a concurrent activity. The reason why is that curiosity diverts attention away from the concurrent activity and focuses attention on the curiosity-evoking event. Thus, curiosity regarding an incidental event decreases enjoyment of a positive focal activity but increases enjoyment of a negative focal activity. PsycINFO Database Record (c) 2016 APA, all rights reserved

Posttraumatic Stress Among Syrian Refugees: Trauma Exposure Characteristics, Trauma Centrality, and Emotional Suppression.

Science.gov (United States)

Chung, Man Cheung; Shakra, Mudar; AlQarni, Nowf; AlMazrouei, Mariam; Al Mazrouei, Sara; Al Hashimi, Shurooq

2018-03-01

This study revisited the prevalence of posttraumatic stress disorder (PTSD) and examined a hypothesized model describing the interrelationship between trauma exposure characteristics, trauma centrality, emotional suppression, PTSD, and psychiatric comorbidity among Syrian refugees. A total of 564 Syrian refugees participated in the study and completed the Harvard Trauma Questionnaire, General Health Questionnaire (GHQ-28), Centrality of Event Scale, and Courtauld Emotional Control Scale. Of the participants, 30% met the cutoff for PTSD. Trauma exposure characteristics (experiencing or witnessing horror and murder, kidnapping or disappearance of family members or friends) were associated with trauma centrality, which was associated with emotional suppression. Emotional suppression was associated with PTSD and psychiatric comorbid symptom severities. Suppression mediated the path between trauma centrality and distress outcomes. Almost one-third of refugees can develop PTSD and other psychiatric problems following exposure to traumatic events during war. A traumatized identity can develop, of which life-threatening experiences is a dominant feature, leading to suppression of depression with associated psychological distress.

Trauma Induced Coagulopathy

DEFF Research Database (Denmark)

Genét, Gustav Folmer; Johansson, Per; Meyer, Martin Abild Stengaard

2013-01-01

It remains debated whether traumatic brain injury (TBI) induces a different coagulopathy compared to non-TBI. This study investigated traditional coagulation tests, biomarkers of coagulopathy and endothelial damage in trauma patients with and without TBI. Blood from 80 adult trauma patients were...... sampled (median of 68 min (IQR 48-88) post-injury) upon admission to our trauma centre. Plasma/serum were retrospectively analysed for biomarkers reflecting sympathoadrenal activation (adrenaline, noradrenaline), coagulation activation/inhibition and fibrinolysis (protein C, activated protein C, tissue...

High frequency oscillations evoked by peripheral magnetic stimulation.

Science.gov (United States)

Biller, S; Simon, L; Fiedler, P; Strohmeier, D; Haueisen, J

2011-01-01

The analysis of somatosensory evoked potentials (SEP) and / or fields (SEF) is a well-established and important tool for investigating the functioning of the peripheral and central human nervous system. A standard technique to evoke SEPs / SEFs is the stimulation of the median nerve by using a bipolar electrical stimulus. We aim at an alternative stimulation technique enabling stimulation of deep nerve structures while reducing patient stress and error susceptibility. In the current study, we apply a commercial transcranial magnetic stimulation system for peripheral magnetic stimulation of the median nerve. We compare the results of simultaneously recorded EEG signals to prove applicability of our technique to evoke SEPs including low frequency components (LFC) as well as high frequency oscillations (HFO). Therefore, we compare amplitude, latency and time-frequency characteristics of the SEP of 14 healthy volunteers after electric and magnetic stimulation. Both low frequency components and high frequency oscillations were detected. The HFOs were superimposed onto the primary cortical response N20. Statistical analysis revealed significantly lower amplitudes and increased latencies for LFC and HFO components after magnetic stimulation. The differences indicate the inability of magnetic stimulation to elicit supramaximal responses. A psycho-perceptual evaluation showed that magnetic stimulation was less unpleasant for 12 out of the 14 volunteers. In conclusion, we showed that LFC and HFO components related to median nerve stimulation can be evoked by peripheral magnetic stimulation.

Abdominal trauma

International Nuclear Information System (INIS)

Giordany, B.R.

1985-01-01

Abdominal injury is an important cause of morbidity and mortality in childhood. Ten percent of trauma-related deaths are due to abdominal injury. Thousands of children are involved in auto accidents annually; many suffer severe internal injury. Child abuse is a second less frequent but equally serious cause of internal abdominal injury. The descriptions of McCort and Eisenstein and their associates in the 1960s first brought to attention the frequency and severity of visceral injury as important manifestations of the child abuse syndrome. Blunt abdominal trauma often causes multiple injuries; in the past, many children have been subjected to exploratory surgery to evaluate the extent of possible hidden injury. Since the advent of noninvasive radiologic imaging techniques including radionuclide scans and ultrasound and, especially, computed tomography (CT), the radiologist has been better able to assess (accurately) the extent of abdominal injury and thus allow conservative therapy in many cases. Penetrating abdominal trauma occurs following gunshot wounds, stabbing, and other similar injury. This is fortunately, a relatively uncommon occurrence in most pediatric centers and will not be discussed specifically here, although many principles of blunt trauma diagnosis are valid for evaluation of penetrating abdominal trauma. If there is any question that a wound has extended intraperitonelly, a sinogram with water-soluble contrast material allows quick, accurate diagnosis. The presence of large amounts of free intraperitoneal gas suggests penetrating injury to the colon or other gas-containing viscus and is generally considered an indication for surgery

Springer Handbook of Acoustics

CERN Document Server

Rossing, Thomas D

2007-01-01

Acoustics, the science of sound, has developed into a broad interdisciplinary field encompassing the academic disciplines of physics, engineering, psychology, speech, audiology, music, architecture, physiology, neuroscience, and others. The Springer Handbook of Acoustics is an unparalleled modern handbook reflecting this richly interdisciplinary nature edited by one of the acknowledged masters in the field, Thomas Rossing. Researchers and students benefit from the comprehensive contents spanning: animal acoustics including infrasound and ultrasound, environmental noise control, music and human speech and singing, physiological and psychological acoustics, architectural acoustics, physical and engineering acoustics, signal processing, medical acoustics, and ocean acoustics. This handbook reviews the most important areas of acoustics, with emphasis on current research. The authors of the various chapters are all experts in their fields. Each chapter is richly illustrated with figures and tables. The latest rese...

Steady-state evoked potentials possibilities for mental-state estimation

Science.gov (United States)

Junker, Andrew M.; Schnurer, John H.; Ingle, David F.; Downey, Craig W.

1988-01-01

The use of the human steady-state evoked potential (SSEP) as a possible measure of mental-state estimation is explored. A method for evoking a visual response to a sum-of-ten sine waves is presented. This approach provides simultaneous multiple frequency measurements of the human EEG to the evoking stimulus in terms of describing functions (gain and phase) and remnant spectra. Ways in which these quantities vary with the addition of performance tasks (manual tracking, grammatical reasoning, and decision making) are presented. Models of the describing function measures can be formulated using systems engineering technology. Relationships between model parameters and performance scores during manual tracking are discussed. Problems of unresponsiveness and lack of repeatability of subject responses are addressed in terms of a need for loop closure of the SSEP. A technique to achieve loop closure using a lock-in amplifier approach is presented. Results of a study designed to test the effectiveness of using feedback to consciously connect humans to their evoked response are presented. Findings indicate that conscious control of EEG is possible. Implications of these results in terms of secondary tasks for mental-state estimation and brain actuated control are addressed.

Trauma abdominal em grávidas Abdominal trauma in pregnant women

Directory of Open Access Journals (Sweden)

Gustavo Pereira Fraga

2005-09-01

Full Text Available OBJETIVOS: avaliar os fatores indicativos (parâmetros clínicos e índices de gravidade fisiológicos e anatômicos da evolução materna e fetal entre gestantes vítimas de trauma abdominal submetidas à laparotomia e discutir as particularidades do atendimento nesta situação. MÉTODOS: análise retrospectiva dos prontuários de 245 mulheres com trauma abdominal e tratamento operatório, atendidas entre 1990 e 2002. Foram identificadas 13 gestantes com lesão abdominal submetidas à laparotomia. Para registro e análise estatística dos dados foram utilizados o protocolo Epi-Info 6.04 e o teste exato de Fisher, com intervalo de confiança de 95%. Foram relacionados com a mortalidade fetal: escore na escala de coma de Glasgow, pressão arterial sistólica, índices de trauma (RTS, ATI, ISS e lesão uterina. RESULTADOS: a idade variou de 13 a 34 anos (média de 22,5. Seis mulheres (46,2% estavam no terceiro trimestre de gestação. O trauma penetrante correspondeu a 53,8% das lesões e em seis dessas pacientes o mecanismo de trauma foi ferimento por projétil de arma de fogo. Três pacientes tiveram lesões uterinas, associadas com óbito fetal. Não houve óbito materno e a mortalidade fetal foi de 30,7%. Não houve associação entre os índices de trauma e a mortalidade materna e fetal. A lesão uterina foi o único fator preditivo de risco para perda fetal (p=0,014. CONCLUSÕES: apesar da casuística pequena e de se tratar de estudo retrospectivo de gestantes com trauma grave, os achados deste estudo mostram que não há indicadores com boa acurácia para indicação da evolução materna e fetal.PURPOSE: to evaluate the predictors (clinical findings and physiological and anatomical scores of the maternal and fetal outcomes among pregnant women victims of abdominal trauma who were submitted to laparotomy and to discuss particularities of assessment in this situation. METHODS: retrospective analysis of the medical records of 245 women with

Trauma Systems. An Era of Development

NARCIS (Netherlands)

Lansink, K.W.W.

2017-01-01

The introduction of an inclusive trauma system in the Netherlands during last decade of the past century, has led to an improvement in Dutch trauma care. Eleven trauma regions were formed nationwide each surrounding a level I trauma center. All hospitals in a trauma region were assigned levels I, II

Dentoalveolar trauma and minor trauma as precipitating factors for medication-related osteonecrosis of the jaw (ONJ)

DEFF Research Database (Denmark)

Yazdi, Pouya Masroori; Schiodt, Morten

2015-01-01

OBJECTIVE: Medication-related osteonecrosis of the jaw (ONJ) is often preceded by dentoalveolar trauma. The aim of this study was to examine the frequency of dentoalveolar trauma precipitated ONJ and compare trauma-precipitated ONJ with spontaneously developing ONJ. STUDY DESIGN......: This was a retrospective study. All patients were examined according to a standard ONJ chart. RESULTS: Among 149 consecutive ONJ patients from the Copenhagen Cohort, 95 (64%) had a dentoalveolar trauma before referral (trauma group): dental extractions (n = 80); denture-related sore mouth (n = 12); and others (n = 3......). The remaining 54 patients had spontaneous ONJ (spontaneous group). The mean time from oral trauma to referral for ONJ was 8 months. CONCLUSION: This study documented that dentoalveolar trauma precipitated ONJ in the majority of cases. However, even minor trauma, such as intubation and impression tray lesions...

Acoustic processing of temporally modulated sounds in infants: evidence from a combined near-infrared spectroscopy and EEG study

Directory of Open Access Journals (Sweden)

Silke eTelkemeyer

2011-04-01

Full Text Available Speech perception requires rapid extraction of the linguistic content from the acoustic signal. The ability to efficiently process rapid changes in auditory information is important for decoding speech and thereby crucial during language acquisition. Investigating functional networks of speech perception in infancy might elucidate neuronal ensembles supporting perceptual abilities that gate language acquisition. Interhemispheric specializations for language have been demonstrated in infants. How these asymmetries are shaped by basic temporal acoustic properties is under debate. We recently provided evidence that newborns process non-linguistic sounds sharing temporal features with language in a differential and lateralized fashion. The present study used the same material while measuring brain responses of 6 and 3 month old infants using simultaneous recordings of electroencephalography (EEG and near-infrared spectroscopy (NIRS. NIRS reveals that the lateralization observed in newborns remains constant over the first months of life. While fast acoustic modulations elicit bilateral neuronal activations, slow modulations lead to right-lateralized responses. Additionally, auditory evoked potentials and oscillatory EEG responses show differential responses for fast and slow modulations indicating a sensitivity for temporal acoustic variations. Oscillatory responses reveal an effect of development, that is, 6 but not 3 month old infants show stronger theta-band desynchronization for slowly modulated sounds. Whether this developmental effect is due to increasing fine-grained perception for spectrotemporal sounds in general remains speculative. Our findings support the notion that a more general specialization for acoustic properties can be considered the basis for lateralization of speech perception. The results show that concurrent assessment of vascular based imaging and electrophysiological responses have great potential in the research on language

Influence of socioeconomic status on trauma center performance evaluations in a Canadian trauma system.

Science.gov (United States)

Moore, Lynne; Turgeon, Alexis F; Sirois, Marie-Josée; Murat, Valérie; Lavoie, André

2011-09-01

Trauma center performance evaluations generally include adjustment for injury severity, age, and comorbidity. However, disparities across trauma centers may be due to other differences in source populations that are not accounted for, such as socioeconomic status (SES). We aimed to evaluate whether SES influences trauma center performance evaluations in an inclusive trauma system with universal access to health care. The study was based on data collected between 1999 and 2006 in a Canadian trauma system. Patient SES was quantified using an ecologic index of social and material deprivation. Performance evaluations were based on mortality adjusted using the Trauma Risk Adjustment Model. Agreement between performance results with and without additional adjustment for SES was evaluated with correlation coefficients. The study sample comprised a total of 71,784 patients from 48 trauma centers, including 3,828 deaths within 30 days (4.5%) and 5,549 deaths within 6 months (7.7%). The proportion of patients in the highest quintile of social and material deprivation varied from 3% to 43% and from 11% to 90% across hospitals, respectively. The correlation between performance results with or without adjustment for SES was almost perfect (r = 0.997; 95% CI 0.995-0.998) and the same hospital outliers were identified. We observed an important variation in SES across trauma centers but no change in risk-adjusted mortality estimates when SES was added to adjustment models. Results suggest that after adjustment for injury severity, age, comorbidity, and transfer status, disparities in SES across trauma center source populations do not influence trauma center performance evaluations in a system offering universal health coverage. Copyright © 2011 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Airway management in trauma.

Science.gov (United States)

Langeron, O; Birenbaum, A; Amour, J

2009-05-01

Maintenance of a patent and prevention of aspiration are essential for the management of the trauma patient, that requires experienced physicians in airway control techniques. Difficulties of the airway control in the trauma setting are increased by the vital failures, the risk of aspiration, the potential cervical spine injury, the combative patient, and the obvious risk of difficult tracheal intubation related to specific injury related to the trauma. Endotracheal intubation remains the gold standard in trauma patient airway management and should be performed via the oral route with a rapid sequence induction and a manual in-line stabilization maneuver, to decrease the risks previously mentioned. Different techniques to control the airway in trauma patients are presented: improvement of the laryngoscopic vision, lighted stylet tracheal intubation, retrograde technique for orotracheal intubation, the laryngeal mask and the intubating laryngeal mask airways, the combitube and cricothyroidotomy. Management of the airway in trauma patients requires regular training in these techniques and the knowledge of complementary techniques allowing tracheal intubation or oxygenation to overcome difficult intubation and to prevent major complications as hypoxemia and aspiration.

Trauma teams and time to early management during in situ trauma team training.

Science.gov (United States)

Härgestam, Maria; Lindkvist, Marie; Jacobsson, Maritha; Brulin, Christine; Hultin, Magnus

2016-01-29

To investigate the association between the time taken to make a decision to go to surgery and gender, ethnicity, years in profession, experience of trauma team training, experience of structured trauma courses and trauma in the trauma team, as well as use of closed-loop communication and leadership styles during trauma team training. In situ trauma team training. The patient simulator was preprogrammed to represent a severely injured patient (injury severity score: 25) suffering from hypovolemia due to external trauma. An emergency room in an urban Scandinavian level one trauma centre. A total of 96 participants were divided into 16 trauma teams. Each team consisted of six team members: one surgeon/emergency physician (designated team leader), one anaesthesiologist, one registered nurse anaesthetist, one registered nurse from the emergency department, one enrolled nurse from the emergency department and one enrolled nurse from the operating theatre. HRs with CIs (95% CI) for the time taken to make a decision to go to surgery was computed from a Cox proportional hazards model. Three variables remained significant in the final model. Closed-loop communication initiated by the team leader increased the chance of a decision to go to surgery (HR: 3.88; CI 1.02 to 14.69). Only 8 of the 16 teams made the decision to go to surgery within the timeframe of the trauma team training. Conversely, call-outs and closed-loop communication initiated by the team members significantly decreased the chance of a decision to go to surgery, (HR: 0.82; CI 0.71 to 0.96, and HR: 0.23; CI 0.08 to 0.71, respectively). Closed-loop communication initiated by the leader appears to be beneficial for teamwork. In contrast, a high number of call-outs and closed-loop communication initiated by team members might lead to a communication overload. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Is trauma in Switzerland any different? epidemiology and patterns of injury in major trauma - a 5-year review from a Swiss trauma centre.

Science.gov (United States)

Heim, C; Bosisio, F; Roth, A; Bloch, J; Borens, O; Daniel, R T; Denys, A; Oddo, M; Pasquier, M; Schmidt, S; Schoettker, P; Zingg, T; Wasserfallen, J B

2014-01-01

Switzerland, the country with the highest health expenditure per capita, is lacking data on trauma care and system planning. Recently, 12 trauma centres were designated to be reassessed through a future national trauma registry by 2015. Lausanne University Hospital launched the first Swiss trauma registry in 2008, which contains the largest database on trauma activity nationwide. Prospective analysis of data from consecutively admitted shock room patients from 1 January 2008 to 31 December 2012. Shock room admission is based on physiology and mechanism of injury, assessed by prehospital physicians. Management follows a surgeon-led multidisciplinary approach. Injuries are coded by Association for the Advancement of Automotive Medicine (AAAM) certified coders. Over the 5 years, 1,599 trauma patients were admitted, predominantly males with a median age of 41.4 years and median injury severity score (ISS) of 13. Rate of ISS >15 was 42%. Principal mechanisms of injury were road traffic (40.4%) and falls (34.4%), with 91.5% blunt trauma. Principal patterns were brain (64.4%), chest (59.8%) and extremity/pelvic girdle (52.9%) injuries. Severe (abbreviated injury scale [AIS] score ≥ 3) orthopaedic injuries, defined as extremity and spine injuries together, accounted for 67.1%. Overall, 29.1% underwent immediate intervention, mainly by orthopaedics (27.3%), neurosurgeons (26.3 %) and visceral surgeons (13.9%); 43.8% underwent a surgical intervention within the first 24 hours and 59.1% during their hospitalisation. In-hospital mortality for patients with ISS >15 was 26.2%. This is the first 5-year report on trauma in Switzerland. Trauma workload was similar to other European countries. Despite high levels of healthcare, mortality exceeds published rates by >50%. Regardless of the importance of a multidisciplinary approach, trauma remains a surgical disease and needs dedicated surgical resources.

Epidemiological Trends of Spine Trauma: An Australian Level 1 Trauma Centre Study

OpenAIRE

Tee, J. W.; Chan, C. H. P.; Fitzgerald, M. C. B.; Liew, S. M.; Rosenfeld, J. V.

2013-01-01

Knowledge of current epidemiology and spine trauma trends assists in public resource allocation, fine-tuning of primary prevention methods, and benchmarking purposes. Data on all patients with traumatic spine injuries admitted to the Alfred Hospital, Melbourne between May 1, 2009, and January 1, 2011, were collected from the Alfred Trauma Registry, Alfred Health medical database, and Victorian Orthopaedic Trauma Outcomes Registry. Epidemiological trends were analyzed as a general cohort, with...

Dental Trauma Guide

DEFF Research Database (Denmark)

Andreasen, Jens Ove; Lauridsen, Eva Fejerskov; Christensen, Søren Steno Ahrensburg

2012-01-01

Diagnose and treatment of traumatic dental injuries is very complex due to the multiple trauma entities represented by 6 lunation types and 9 fracture types affecting both the primary and the permanent dentition. When it is further considered that fracture and lunation injuries are often combined...... problems in selecting proper treatment for some of these trauma types. To remedy this situation, an internet based knowledge base consisting of 4000 dental trauma cases with long term follow up is now available to the public and professionals, on the internet using the address www...

Dental Trauma Guide

DEFF Research Database (Denmark)

Andreasen, Jens Ove; Lauridsen, Eva; Gerds, Thomas Alexander

2012-01-01

Diagnosis and treatment for traumatic dental injuries are very complex owing to the multiple trauma entities represented by six luxation types and nine fracture types affecting both the primary and the permanent dentition. When it is further considered that fracture and luxation injuries are often...... problems in selecting proper treatment for some of these trauma types. To remedy this situation, an Internet-based knowledge base consisting of 4000 dental trauma cases with long-term follow up is now available to the public and the professions on the Internet using the address http://www.Dental...

Odor-evoked inhibition of olfactory sensory neurons drives olfactory perception in Drosophila.

Science.gov (United States)

Cao, Li-Hui; Yang, Dong; Wu, Wei; Zeng, Xiankun; Jing, Bi-Yang; Li, Meng-Tong; Qin, Shanshan; Tang, Chao; Tu, Yuhai; Luo, Dong-Gen

2017-11-07

Inhibitory response occurs throughout the nervous system, including the peripheral olfactory system. While odor-evoked excitation in peripheral olfactory cells is known to encode odor information, the molecular mechanism and functional roles of odor-evoked inhibition remain largely unknown. Here, we examined Drosophila olfactory sensory neurons and found that inhibitory odors triggered outward receptor currents by reducing the constitutive activities of odorant receptors, inhibiting the basal spike firing in olfactory sensory neurons. Remarkably, this odor-evoked inhibition of olfactory sensory neurons elicited by itself a full range of olfactory behaviors from attraction to avoidance, as did odor-evoked olfactory sensory neuron excitation. These results indicated that peripheral inhibition is comparable to excitation in encoding sensory signals rather than merely regulating excitation. Furthermore, we demonstrated that a bidirectional code with both odor-evoked inhibition and excitation in single olfactory sensory neurons increases the odor-coding capacity, providing a means of efficient sensory encoding.

The associations of earlier trauma exposures and history of mental disorders with PTSD after subsequent traumas.

Science.gov (United States)

Kessler, R C; Aguilar-Gaxiola, S; Alonso, J; Bromet, E J; Gureje, O; Karam, E G; Koenen, K C; Lee, S; Liu, H; Pennell, B-E; Petukhova, M V; Sampson, N A; Shahly, V; Stein, D J; Atwoli, L; Borges, G; Bunting, B; de Girolamo, G; Gluzman, S F; Haro, J M; Hinkov, H; Kawakami, N; Kovess-Masfety, V; Navarro-Mateu, F; Posada-Villa, J; Scott, K M; Shalev, A Y; Ten Have, M; Torres, Y; Viana, M C; Zaslavsky, A M

2017-09-19

Although earlier trauma exposure is known to predict posttraumatic stress disorder (PTSD) after subsequent traumas, it is unclear whether this association is limited to cases where the earlier trauma led to PTSD. Resolution of this uncertainty has important implications for research on pretrauma vulnerability to PTSD. We examined this issue in the World Health Organization (WHO) World Mental Health (WMH) Surveys with 34 676 respondents who reported lifetime trauma exposure. One lifetime trauma was selected randomly for each respondent. DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition) PTSD due to that trauma was assessed. We reported in a previous paper that four earlier traumas involving interpersonal violence significantly predicted PTSD after subsequent random traumas (odds ratio (OR)=1.3-2.5). We also assessed 14 lifetime DSM-IV mood, anxiety, disruptive behavior and substance disorders before random traumas. We show in the current report that only prior anxiety disorders significantly predicted PTSD in a multivariate model (OR=1.5-4.3) and that these disorders interacted significantly with three of the earlier traumas (witnessing atrocities, physical violence victimization and rape). History of witnessing atrocities significantly predicted PTSD after subsequent random traumas only among respondents with prior PTSD (OR=5.6). Histories of physical violence victimization (OR=1.5) and rape after age 17 years (OR=17.6) significantly predicted only among respondents with no history of prior anxiety disorders. Although only preliminary due to reliance on retrospective reports, these results suggest that history of anxiety disorders and history of a limited number of earlier traumas might usefully be targeted in future prospective studies as distinct foci of research on individual differences in vulnerability to PTSD after subsequent traumas.Molecular Psychiatry advance online publication, 19 September 2017; doi:10.1038/mp.2017.194.

Acoustic Neuroma Association

Science.gov (United States)

... EVENTS DONATE NEWS Home Learn Back Learn about acoustic neuroma AN Facts What is acoustic neuroma? Diagnosing ... Brain Freeze ? READ MORE Read More What is acoustic neuroma? Identifying an AN Learn More Get Info ...

Norepinephrine-evoked pain in fibromyalgia. A randomized pilot study [ISRCTN70707830

Directory of Open Access Journals (Sweden)

Casanova Jose-Miguel

2002-01-01

Full Text Available Abstract Background Fibromyalgia syndrome displays sympathetically maintained pain features such as frequent post-traumatic onset and stimuli-independent pain accompanied by allodynia and paresthesias. Heart rate variability studies showed that fibromyalgia patients have changes consistent with ongoing sympathetic hyperactivity. Norepinephrine-evoked pain test is used to assess sympathetically maintained pain syndromes. Our objective was to define if fibromyalgia patients have norepinephrine-evoked pain. Methods Prospective double blind controlled study. Participants: Twenty FM patients, and two age/sex matched control groups; 20 rheumatoid arthritis patients and 20 healthy controls. Ten micrograms of norepinephrine diluted in 0.1 ml of saline solution were injected in a forearm. The contrasting substance, 0.1 ml of saline solution alone, was injected in the opposite forearm. Maximum local pain elicited during the 5 minutes post-injection was graded on a visual analog scale (VAS. Norepinephrine-evoked pain was diagnosed when norepinephrine injection induced greater pain than placebo injection. Intensity of norepinephrine-evoked pain was calculated as the difference between norepinephrine minus placebo-induced VAS scores. Results Norepinephrine-evoked pain was seen in 80 % of FM patients (95% confidence intervals 56.3 – 94.3%, in 30 % of rheumatoid arthritis patients and in 30 % of healthy controls (95% confidence intervals 11.9 – 54.3 (p Conclusions Fibromyalgia patients have norepinephrine-evoked pain. This finding supports the hypothesis that fibromyalgia may be a sympathetically maintained pain syndrome.

Multiple trauma in children: critical care overview.

Science.gov (United States)

Wetzel, Randall C; Burns, R Cartland

2002-11-01

Multiple trauma is more than the sum of the injuries. Management not only of the physiologic injury but also of the pathophysiologic responses, along with integration of the child's emotional and developmental needs and the child's family, forms the basis of trauma care. Multiple trauma in children also elicits profound psychological responses from the healthcare providers involved with these children. This overview will address the pathophysiology of multiple trauma in children and the general principles of trauma management by an integrated trauma team. Trauma is a systemic disease. Multiple trauma stimulates the release of multiple inflammatory mediators. A lethal triad of hypothermia, acidosis, and coagulopathy is the direct result of trauma and secondary injury from the systemic response to trauma. Controlling and responding to the secondary pathophysiologic sequelae of trauma is the cornerstone of trauma management in the multiply injured, critically ill child. Damage control surgery is a new, rational approach to the child with multiple trauma. The selection of children for damage control surgery depends on the severity of injury. Major abdominal vascular injuries and multiple visceral injuries are best considered for this approach. The effective management of childhood multiple trauma requires a combined team approach, consideration of the child and family, an organized trauma system, and an effective quality assurance and improvement mechanism.

Role of focused assessment with sonography for trauma as a screening tool for blunt abdominal trauma in young children after high energy trauma

NARCIS (Netherlands)

Tummers, W.; Schuppen, J.V. (J Van); H.R. Langeveld-Benders (Hester); Wilde, J.; Banderker, E.; Van, A.

2016-01-01

textabstractBackground: The objective of the study was to review the utility of focused assessement with sonography for trauma (FAST) as a screening tool for blunt abdominal trauma (BAT) in children involved in high energy trauma (HET), and to determine whether a FAST could replace computed

Objective correlate of subjective pain perception by contact heat-evoked potentials.

Science.gov (United States)

Granovsky, Yelena; Granot, Michal; Nir, Rony-Reuven; Yarnitsky, David

2008-01-01

The method of pain-evoked potentials has gained considerable acceptance over the last 3 decades regarding its objectivity, repeatability, and quantifiability. The present study explored whether the relationship between pain-evoked potentials and pain psychophysics obtained by contact heat stimuli is similar to those observed for the conventionally used laser stimulation. Evoked potentials (EPs) were recorded in response to contact heat stimuli at different body sites in 24 healthy volunteers. Stimuli at various temperatures were applied to the forearm (43 degrees C, 46 degrees C, 49 degrees C, and 52 degrees C) and leg (46 degrees C and 49 degrees C). The amplitudes of both components (N2 and P2) were strongly associated with the intensity of the applied stimuli and with subjective pain perception. Yet, regression analysis revealed pain perception and not stimulus intensity as the major contributing factor. A significant correlation was found between the forearm and the leg for both psychophysics and EPs amplitude. Contact heat can generate readily distinguishable evoked potentials on the scalp, consistent between upper and lower limbs. Although these potentials bear positive correlation with both stimulus intensity and pain magnitude, the latter is the main contributor to the evoked brain response.

Effects of single cycle binaural beat duration on auditory evoked potentials.

Science.gov (United States)

Mihajloski, Todor; Bohorquez, Jorge; Özdamar, Özcan

2014-01-01

Binaural beat (BB) illusions are experienced as continuous central pulsations when two sounds with slightly different frequencies are delivered to each ear. It has been shown that steady-state auditory evoked potentials (AEPs) to BBs can be captured and investigated. The authors recently developed a new method of evoking transient AEPs to binaural beats using frequency modulated stimuli. This methodology was able to create single BBs in predetermined intervals with varying carrier frequencies. This study examines the effects of the BB duration and the frequency modulating component of the stimulus on the binaural beats and their evoked potentials. Normal hearing subjects were tested with a set of four durations (25, 50, 100, and 200 ms) with two stimulation configurations, binaural dichotic (binaural beats) and diotic (frequency modulation). The results obtained from the study showed that out of the given durations, the 100 ms beat, was capable of evoking the largest amplitude responses. The frequency modulation effect showed a decrease in peak amplitudes with increasing beat duration until their complete disappearance at 200 ms. Even though, at 200 ms, the frequency modulation effects were not present, the binaural beats were still perceived and captured as evoked potentials.

Development of ion-acoustic double layers through ion-acoustic fluctuations

International Nuclear Information System (INIS)

Sekar, A.N.; Saxena, Y.C.

1985-01-01

Experimental results on the formation of ion acoustic double layers resembling asymmetric ion-holes are presented. In a double plasma device, modified suitably to inject electron beam into the target plasma, modulation of the beam through step potential leads to excitation of ion-acoustic fluctuation. The ion-acoustic fluctuation, growing away from the grids separating source and target plasmas, developed into weak asymmetric ion-acoustic double layer. The observations are in qualitative agreement with theoretical models and computer simulations. (author)

Acoustic tweezers via sub-time-of-flight regime surface acoustic waves.

Science.gov (United States)

Collins, David J; Devendran, Citsabehsan; Ma, Zhichao; Ng, Jia Wei; Neild, Adrian; Ai, Ye

2016-07-01

Micrometer-scale acoustic waves are highly useful for refined optomechanical and acoustofluidic manipulation, where these fields are spatially localized along the transducer aperture but not along the acoustic propagation direction. In the case of acoustic tweezers, such a conventional acoustic standing wave results in particle and cell patterning across the entire width of a microfluidic channel, preventing selective trapping. We demonstrate the use of nanosecond-scale pulsed surface acoustic waves (SAWs) with a pulse period that is less than the time of flight between opposing transducers to generate localized time-averaged patterning regions while using conventional electrode structures. These nodal positions can be readily and arbitrarily positioned in two dimensions and within the patterning region itself through the imposition of pulse delays, frequency modulation, and phase shifts. This straightforward concept adds new spatial dimensions to which acoustic fields can be localized in SAW applications in a manner analogous to optical tweezers, including spatially selective acoustic tweezers and optical waveguides.

Spectrum and outcome of pancreatic trauma.

Science.gov (United States)

Kantharia, Chetan V; Prabhu, R Y; Dalvi, A N; Raut, Abhijit; Bapat, R D; Supe, Avinash N

2007-01-01

Pancreatic trauma is associated with high morbidity and mortality. Diagnosis is often difficult and surgery poses a formidable challenge. Data from 17 patients of pancreatic trauma gathered from a prospectively maintained database were analysed and the following parameters were considered: mode of injury, diagnostic modalities, associated injury, grade of pancreatic trauma and management. Pancreatic trauma was graded from I through IV, as per Modified Lucas Classification. The median age was 39 years (range 19-61). The aetiology of pancreatic trauma was blunt abdominal trauma in 14 patients and penetrating injury in 3. Associated bowel injury was present in 4 cases (3 penetrating injury and 1 blunt trauma) and 1 case had associated vascular injury. 5 patients had grade I, 3 had grade II, 7 had grade III and 2 had grade IV pancreatic trauma. Contrast enhanced computed tomography scan was used to diagnose pancreatic trauma in all patients with blunt abdominal injury. Immediate diagnosis could be reached in only 4 (28.5%) patients. 7 patients responded to conservative treatment. Of the 10 patients who underwent surgery, 6 required it for the pancreas and the duodenum. (distal pancreatectomy with splenectomy-3, pylorus preserving pancreatoduodenectomy-1, debridement with external drainage-1, associated injuries-duodenum-1). Pancreatic fistula, recurrent pancreatitis and pseudocyst formation were seen in 3 (17.05%), 2 (11.7%) and 1 (5.4%) patient respectively. Death occurred in 4 cases (23.5%), 2 each in grades III and IV pancreatic trauma. Contrast enhanced computed tomography scan is a useful modality for diagnosing, grading and following up patients with pancreatic trauma. Although a majority of cases with pancreatic trauma respond to conservative treatment, patients with penetrating trauma, and associated bowel injury and higher grade pancreatic trauma require surgical intervention and are also associated with higher morbidity and mortality.

Role of focused assessment with sonography for trauma as a screening tool for blunt abdominal trauma in young children after high energy trauma

NARCIS (Netherlands)

Tummers, W.; van Schuppen, J.; Langeveld, H.; Wilde, J.; Banderker, E.; van As, A.

2016-01-01

The objective of the study was to review the utility of focused assessement with sonography for trauma (FAST) as a screening tool for blunt abdominal trauma (BAT) in children involved in high energy trauma (HET), and to determine whether a FAST could replace computed tomography (CT) in clinical

[Trauma-Informed Peer Counselling in the Care of Refugees with Trauma-Related Disorders].

Science.gov (United States)

Wöller, Wolfgang

2016-09-01

Providing adequate culture-sensitive care for a large number of refugees with trauma-related disorders constitutes a major challenge. In this context, peer support and trauma-informed peer counselling can be regarded as a valuable means to complement the psychosocial care systems. In recent years, peer support and peer education have been successfully implemented e. g. in health care education, in psychiatric care, and in the treatment of traumatized individuals. Only little research data is available for traumatized refugees. However, results are encouraging. A program is presented which integrates trauma-informed peer educators (TIP) with migration background in the care of traumatized refugees. Peers' responsibility includes emotional support and understanding the refugees' needs, sensitizing for trauma-related disorders, providing psychoeducation, and teaching trauma-specific stabilization techniques under supervision of professional psychotherapists. © Georg Thieme Verlag KG Stuttgart · New York.

Evaluating trauma team performance in a Level I trauma center: Validation of the trauma team communication assessment (TTCA-24).

Science.gov (United States)

DeMoor, Stephanie; Abdel-Rehim, Shady; Olmsted, Richard; Myers, John G; Parker-Raley, Jessica

2017-07-01

Nontechnical skills (NTS), such as team communication, are well-recognized determinants of trauma team performance and good patient care. Measuring these competencies during trauma resuscitations is essential, yet few valid and reliable tools are available. We aimed to demonstrate that the Trauma Team Communication Assessment (TTCA-24) is a valid and reliable instrument that measures communication effectiveness during activations. Two tools with adequate psychometric strength (Trauma Nontechnical Skills Scale [T-NOTECHS], Team Emergency Assessment Measure [TEAM]) were identified during a systematic review of medical literature and compared with TTCA-24. Three coders used each tool to evaluate 35 stable and 35 unstable patient activations (defined according to Advanced Trauma Life Support criteria). Interrater reliability was calculated between coders using the intraclass correlation coefficient. Spearman rank correlation coefficient was used to establish concurrent validity between TTCA-24 and the other two validated tools. Coders achieved an intraclass correlation coefficient of 0.87 for stable patient activations and 0.78 for unstable activations scoring excellent on the interrater agreement guidelines. The median score for each assessment showed good team communication for all 70 videos (TEAM, 39.8 of 54; T-NOTECHS, 17.4 of 25; and TTCA-24, 87.4 of 96). A significant correlation between TTTC-24 and T-NOTECHS was revealed (p = 0.029), but no significant correlation between TTCA-24 and TEAM (p = 0.77). Team communication was rated slightly better across all assessments for stable versus unstable patient activations, but not statistically significant. TTCA-24 correlated with T-NOTECHS, an instrument measuring nontechnical skills for trauma teams, but not TEAM, a tool that assesses communication in generic emergency settings. TTCA-24 is a reliable and valid assessment that can be a useful adjunct when evaluating interpersonal and team communication during trauma

Imaging of thoracic trauma

International Nuclear Information System (INIS)

Uffmann, M.; Herold, C.J.; Fuchs, M.

1998-01-01

Blunt trauma to the chest results from transfer of kinetic energy to the human body. It may cause a wide range of mostly life-threatening injuries, including fractures of the thoracic skeleton, disintegration of the pleural space, contusion or laceration of pulmonary parenchyma and damage to the mediastinal structures. For a systematic approach it may be helpful to follow an organ-based evaluation of thoracic trauma. However, it should be borne in mind that subtle injuries may be associated with serious complications. Trauma to the chest may affect different anatomic compartments at the same time, requiring and extending diagnostic approach. Conventional radiography plays a major role in diagnosting thoracic trauma, complemented by ultrasound examination of the pleura and abdomen. It is well documented that CT scanning represents a major technological improvement for assessment of thoracic trauma. With the advent of fast helical CT scanning this method becomes more applicable for severly traumatized patients and potentially replaces other time-consuming procedures. State-of-the-art imaging of both projection and cross-sectional techniques provides useful information for immediate and appropriate treatment mandatory in patients with thoracic trauma. (orig.) [de

Head trauma and CT with special reference to diagnosis of complications of head trauma

International Nuclear Information System (INIS)

Samejima, Kanji; Yoshii, Nobuo; Tobari, Chitose

1979-01-01

Cases in which CT was useful for the diagnosis of complications of head trauma were reported. First, complications of head trauma were given an outline, and then, cases of protrusion of the brain, traumatic pneumocephalus, and cerebro-vascular disorders caused by head trauma were mentioned. (Tsunoda, M.)

Disseminated intravascular coagulation or acute coagulopathy of trauma shock early after trauma? A prospective observational study

DEFF Research Database (Denmark)

Johansson, Per Ingemar; Sorensen, Anne Marie; Perner, Anders

2011-01-01

the prevalence of overt DIC and ACoTS in trauma patients and characterized these conditions based on their biomarker profiles. METHODS: Observational study at a single Level I Trauma Centre. Inclusion of 80 adult trauma patients ([greater than or equal to]18 years) who met criteria for full trauma team...

Is Trauma Memory Special? Trauma Narrative Fragmentation in PTSD: Effects of Treatment and Response.

Science.gov (United States)

Bedard-Gilligan, Michele; Zoellner, Lori A; Feeny, Norah C

2017-03-01

Seminal theories posit that fragmented trauma memories are critical to posttraumatic stress disorder (PTSD; van der Kolk & Fisler, 1995; Brewin, 2014) and that elaboration of the trauma narrative is necessary for recovery (e.g., Foa, Huppert, & Cahill, 2006). According to fragmentation theories, trauma narrative changes, particularly for those receiving trauma-focused treatment, should accompany symptom reduction. Trauma and control narratives in 77 men and women with chronic PTSD were examined pre- and post-treatment, comparing prolonged exposure (PE) and sertraline. Utilizing self-report, rater coding, and objective coding of narrative content, fragmentation was compared across narrative types (trauma, negative, positive) by treatment modality and response, controlling for potential confounds. Although sensory components increased with PE ( d = 0.23 - 0.44), there were no consistent differences in fragmentation from pre- to post-treatment between PE and sertraline or treatment responders and non-responders. Contrary to theories, changes in fragmentation may not be a crucial mechanism underlying PTSD therapeutic recovery.

[Trauma registry and injury].

Science.gov (United States)

Shapira, S C

2001-10-01

The trauma registry network constitutes an essential database in every injury prevention system. In order to rationally estimate the extent of injury in general, and injuries from traffic accidents in particular, the trauma registry systems should contain the most comprehensive and broad database possible, in line with the operational definitions. Ideally, the base of the injury pyramid should also include mild injuries and even "near-misses". The Israeli National Trauma Registry has come a long way in the last few years. The eventual inclusion of all trauma centers in Israel will enable the establishment of a firm base for the allocation of resources by decision-makers.

Acoustic textiles

CERN Document Server

Nayak, Rajkishore

2016-01-01

This book highlights the manufacturing and applications of acoustic textiles in various industries. It also includes examples from different industries in which acoustic textiles can be used to absorb noise and help reduce the impact of noise at the workplace. Given the importance of noise reduction in the working environment in several industries, the book offers a valuable guide for companies, educators and researchers involved with acoustic materials.

Architectural acoustics

National Research Council Canada - National Science Library

Long, Marshall

2014-01-01

.... Beginning with a brief history, it reviews the fundamentals of acoustics, human perception and reaction to sound, acoustic noise measurements, noise metrics, and environmental noise characterization...

Gender differences among recidivist trauma patients.

Science.gov (United States)

Kwan, Rita O; Cureton, Elizabeth L; Dozier, Kristopher C; Victorino, Gregory P

2011-01-01

Gender differences among trauma recidivist patients are not well-understood. We hypothesized that males are more likely to be repeatedly involved in the trauma system and have a shorter time to recurrence between repeat episodes of injury compared with females. A retrospective analysis of trauma patients treated at an urban university-based trauma center was performed. Variables including gender, race, insurance status, age, mechanism of injury, outcomes, and injury secondary to domestic violence were compared. Differences were compared using χ(2) tests and log-rank (Mantel-Cox) Kaplan-Meier cumulative event curves. We identified 689 trauma recidivist patients (4.0% of all trauma visits) over a 10-y period. Compared to single-visit patients, recidivist patients were more likely to be male (87% versus 73%), uninsured (78% versus 66%), and have injuries secondary to assaults (54% versus 37%) (P trauma visit was shorter for females compared with males (23 ± 2.5 versus 30 ± 1.2 mo, P trauma than were male recidivists (69% versus 43%, P trauma patients have a much shorter time to recurrence for a second traumatic injury than do males. Female recidivists have a high likelihood of assault-associated injuries and domestic violence. Trauma centers should screen for domestic violence among trauma patients to aid in preventing further repeat episodes of injury. Copyright © 2011 Elsevier Inc. All rights reserved.

Epidemiological Trends of Spine Trauma: An Australian Level 1 Trauma Centre Study

Science.gov (United States)

Tee, J. W.; Chan, C. H. P.; Fitzgerald, M. C. B.; Liew, S. M.; Rosenfeld, J. V.

2013-01-01

Knowledge of current epidemiology and spine trauma trends assists in public resource allocation, fine-tuning of primary prevention methods, and benchmarking purposes. Data on all patients with traumatic spine injuries admitted to the Alfred Hospital, Melbourne between May 1, 2009, and January 1, 2011, were collected from the Alfred Trauma Registry, Alfred Health medical database, and Victorian Orthopaedic Trauma Outcomes Registry. Epidemiological trends were analyzed as a general cohort, with comparison cohorts of nonsurvivors versus survivors and elderly versus nonelderly. Linear regression analysis was utilized to demonstrate trends with statistical significance. There were 965 patients with traumatic spine injuries with 2,333 spine trauma levels. The general cohort showed a trimodal age distribution, male-to-female ratio of 2:2, motor vehicle accidents as the primary spine trauma mechanism, 47.7% patients with severe polytrauma as graded using the Injury Severity Score (ISS), 17.3% with traumatic brain injury (TBI), the majority of patients with one spine injury level, 7% neurological deficit rate, 12.8% spine trauma operative rate, and 5.2% mortality rate. Variables with statistical significance trending toward mortality were the elderly, motor vehicle occupants, severe ISS, TBI, C1–2 dissociations, and American Spinal Injury Association (ASIA) A, B, and C neurological grades. Variables with statistical significance trending toward the elderly were females; low falls; one spine injury level; type 2 odontoid fractures; subaxial cervical spine distraction injuries; ASIA A, B, and C neurological grades; and patients without neurological deficits. Of the general cohort, 50.3% of spine trauma survivors were discharged home, and 48.1% were discharged to rehabilitation facilities. This study provides baseline spine trauma epidemiological data. The trimodal age distribution of patients with traumatic spine injuries calls for further studies and intervention targeted

Isolated hip fracture care in an inclusive trauma system : A trauma system wide evaluation

NARCIS (Netherlands)

van Laarhoven, J. J E M; van Lammeren, G. W.; Houwert, R. M.; van Laarhoven, Constance; Hietbrink, F.; Leenen, L. P H; Verleisdonk, E. J M M

2015-01-01

Introduction: Elderly patients with a hip fracture represent a large proportion of the trauma population; however, little is known about outcome differences between different levels of trauma care for these patients. The aim of this study is to analyse the outcome of trauma care in patients with a

A Telehealth System for Remote Auditory Evoked Potential Monitoring

OpenAIRE

Millan, Jorge; Yunda, Leonardo

2013-01-01

A portable, Internet-based EEG/Auditory Evoked Potential (AEP) monitoring system was developed for remote electrophysiological studies during sleep. The system records EEG/AEP simultaneously at the subject?s home for increased comfort and flexibility. The system provides simultaneous recording and remote viewing of EEG, EMG and EOG waves and allows on-line averaging of auditory evoked potentials. The design allows the recording of all major AEP components (brainstem, middle and late latency E...

Supersonic acoustic intensity with statistically optimized near-field acoustic holography

DEFF Research Database (Denmark)

Fernandez Grande, Efren; Jacobsen, Finn

2011-01-01

The concept of supersonic acoustic intensity was introduced some years ago for estimating the fraction of the flow of energy radiated by a source that propagates to the far field. It differs from the usual (active) intensity by excluding the near-field energy resulting from evanescent waves...... to the information provided by the near-field acoustic holography technique. This study proposes a version of the supersonic acoustic intensity applied to statistically optimized near-field acoustic holography (SONAH). The theory, numerical results and an experimental study are presented. The possibility of using...

The Role of Odor-Evoked Memory in Psychological and Physiological Health.

Science.gov (United States)

Herz, Rachel S

2016-07-19

This article discusses the special features of odor-evoked memory and the current state-of-the-art in odor-evoked memory research to show how these unique experiences may be able to influence and benefit psychological and physiological health. A review of the literature leads to the conclusion that odors that evoke positive autobiographical memories have the potential to increase positive emotions, decrease negative mood states, disrupt cravings, and reduce physiological indices of stress, including systemic markers of inflammation. Olfactory perception factors and individual difference characteristics that would need to be considered in therapeutic applications of odor-evoked-memory are also discussed. This article illustrates how through the experimentally validated mechanisms of odor-associative learning and the privileged neuroanatomical relationship that exists between olfaction and the neural substrates of emotion, odors can be harnessed to induce emotional and physiological responses that can improve human health and wellbeing.

The Role of Odor-Evoked Memory in Psychological and Physiological Health

Directory of Open Access Journals (Sweden)

Rachel S. Herz

2016-07-01

Full Text Available This article discusses the special features of odor-evoked memory and the current state-of-the-art in odor-evoked memory research to show how these unique experiences may be able to influence and benefit psychological and physiological health. A review of the literature leads to the conclusion that odors that evoke positive autobiographical memories have the potential to increase positive emotions, decrease negative mood states, disrupt cravings, and reduce physiological indices of stress, including systemic markers of inflammation. Olfactory perception factors and individual difference characteristics that would need to be considered in therapeutic applications of odor-evoked-memory are also discussed. This article illustrates how through the experimentally validated mechanisms of odor-associative learning and the privileged neuroanatomical relationship that exists between olfaction and the neural substrates of emotion, odors can be harnessed to induce emotional and physiological responses that can improve human health and wellbeing.

Paediatric Blunt Liver Trauma in a Dutch Level 1 Trauma Center

NARCIS (Netherlands)

Nellensteijn, D.; Porte, R. J.; van Zuuren, W.; ten Duis, H. J.; Hulscher, J. B. F.

2009-01-01

Introduction: Paediatric blunt hepatic trauma treatment is changing from operative treatment (OT) to non-operative treatment (NOT). In 2000 the American Pediatric Surgical Association has published guidelines for NOT of these injuries. Little is known about the treatment of paediatric liver trauma

Thought-evoking approaches in engineering problems

CERN Document Server

2014-01-01

In creating the value-added product in not distant future, it is necessary and inevitable to establish a holistic and though-evoking approach to the engineering problem, which should be at least associated with the inter-disciplinary knowledge and thought processes across the whole engineering spheres. It is furthermore desirable to integrate it with trans-disciplinary aspects ranging from manufacturing culture, through liberal-arts engineering, and industrial sociology.   The thought-evoking approach can be exemplified and typified by representative engineering problems: unveiling essential features in ‘Tangential Force Ratio and Interface Pressure’, prototype development for ‘Bio-mimetic Needle’ and application of ‘Water-jet Machining to Artificial Hip Joint’, product innovation in ‘Heat Sink for Computer’, application of ‘Graph Theory’ to similarity evaluation of production systems, leverage among reciprocity attributes in ‘Industrial and Engineering Designs for Machine Enclosure’,...

History of the Dental Trauma Guide

DEFF Research Database (Denmark)

Andreasen, Jens Ove; Christensen, Søren Steno Ahrensburg

2012-01-01

The history of the Dental Trauma Guide dates back to 1965, where guidelines were developed for trauma records and treatment of various trauma entities at the Department of Oral and Maxillofacial Surgery at the University Hospital in Copenhagen. In 1972, a unique possibility came up at the Serum...... Institute in Copenhagen to test various dental trauma procedures in monkeys, which served as kidney donors in the polio vaccine production. Over the years, 40 000 dental trauma patients were treated at the Trauma Centre according to established guidelines, and 4000 of these have been enrolled in long...

Attachment Dimensions and Post-traumatic Symptoms Following Interpersonal Traumas versus Impersonal Traumas in Young Adults in Taiwan.

Science.gov (United States)

Huang, Yu-Lien; Chen, Sue-Huei; Su, Yi-Jen; Kung, Yi-Wen

2017-08-01

Greater risk of post-traumatic stress disorder (PTSD) is seen in individuals exposed to interpersonal traumatic events. Based on an attachment perspective, interpersonal trauma exposure may activate one's attachment insecurity system and disrupt affect, behaviour and interpersonal function, which may in turn create more difficulties to cope with interpersonal traumas and exacerbate PTSD symptomatology. The present study examined whether attachment anxiety relative to attachment avoidance would be a stronger predictor of greater PTSD symptoms following interpersonal traumas versus impersonal traumas in a Taiwanese sample. One hundred and sixty-two trauma-exposed Taiwanese young adults completed the measures of symptoms of depression, anxiety and PTSD, and attachment anxiety and attachment avoidance. In this Taiwanese study, higher attachment anxiety was observed in individuals who were exposed to interpersonal traumas. The interpersonal trauma group reported greater PTSD symptoms than did the impersonal trauma group. Specifically, after controlling for age, occurrence of trauma and distress of trauma, attachment anxiety, but not attachment avoidance, predicted more PTSD total severity and avoidance symptoms in the interpersonal trauma group. The findings may be pertinent to attachment anxiety-related hyperactivating strategies, as well as specific cultural values and a forbearance strategy applied to regulate traumatic distress in a collectivist society. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Speech-evoked auditory brainstem responses in children with hearing loss.

Science.gov (United States)

Koravand, Amineh; Al Osman, Rida; Rivest, Véronique; Poulin, Catherine

2017-08-01

The main objective of the present study was to investigate subcortical auditory processing in children with sensorineural hearing loss. Auditory Brainstem Responses (ABRs) were recorded using click and speech/da/stimuli. Twenty-five children, aged 6-14 years old, participated in the study: 13 with normal hearing acuity and 12 with sensorineural hearing loss. No significant differences were observed for the click-evoked ABRs between normal hearing and hearing-impaired groups. For the speech-evoked ABRs, no significant differences were found for the latencies of the following responses between the two groups: onset (V and A), transition (C), one of the steady-state wave (F), and offset (O). However, the latency of the steady-state waves (D and E) was significantly longer for the hearing-impaired compared to the normal hearing group. Furthermore, the amplitude of the offset wave O and of the envelope frequency response (EFR) of the speech-evoked ABRs was significantly larger for the hearing-impaired compared to the normal hearing group. Results obtained from the speech-evoked ABRs suggest that children with a mild to moderately-severe sensorineural hearing loss have a specific pattern of subcortical auditory processing. Our results show differences for the speech-evoked ABRs in normal hearing children compared to hearing-impaired children. These results add to the body of the literature on how children with hearing loss process speech at the brainstem level. Copyright © 2017 Elsevier B.V. All rights reserved.

Management of duodenal trauma

OpenAIRE

CHEN Guo-qing; YANG Hua

2011-01-01

【Abstract】Duodenal trauma is uncommon but nowadays seen more and more frequently due to the increased automobile accidents and violent events. The management of duodenal trauma can be complicated, especially when massive injury to the pancreatic-duodenal-biliary complex occurs simultaneously. Even the patients receive surgeries in time, multiple postoperative complications and high mortality are common. To know and manage duodenal trauma better, we searched the recent related literature...

Behavioral analyses of wind-evoked escape of the cricket, Gryllodes sigillatus.

Science.gov (United States)

Kanou, Masamichi; Konishi, Atsuko; Suenaga, Rie

2006-04-01

The wind-evoked escape behavior of the cricket Gryllodes sigillatus was investigated using an air puff stimulus. A high velocity air puff elicited the escape behavior in many crickets. The crickets tended to escape away from the stimulus source, but the direction was not accurately oriented 180 degrees from the stimulus. After bilateral cercal ablation, only a few crickets showed wind-evoked escape behavior, and their response rates did not increase even 19 days after ablation. Therefore, information on air motion detected by cercal filiform hairs is essential for triggering wind-evoked behavior. After unilateral cercal ablation, the 81.3% response rate of intact crickets decreased to 16.5%, that is, it decreased to almost 20% that of intact crickets. One week after unilateral cercal ablation, the response rate recovered to more than 60% that of intact crickets. However, the accuracy rate of the escape direction of G. sigillatus showed no change even immediately after the unilateral cercal ablation. Therefore, both cerci are not necessarily required to determine the escape direction. The behavioral characteristics of wind-evoked escape of G. sigillatus are compared with those of another species of cricket, Gryllus bimaculatus. The two species of cricket employ different strategies for wind-evoked escape.

Acoustic Metamaterials in Aeronautics

Directory of Open Access Journals (Sweden)

Giorgio Palma

2018-06-01

Full Text Available Metamaterials, man-made composites that are scaled smaller than the wavelength, have demonstrated a huge potential for application in acoustics, allowing the production of sub-wavelength acoustic absorbers, acoustic invisibility, perfect acoustic mirrors and acoustic lenses for hyper focusing, and acoustic illusions and enabling new degrees of freedom in the control of the acoustic field. The zero, or even negative, refractive sound index of metamaterials offers possibilities for the control of acoustic patterns and sound at sub-wavelength scales. Despite the tremendous growth in research on acoustic metamaterials during the last decade, the potential of metamaterial-based technologies in aeronautics has still not been fully explored, and its utilization is still in its infancy. Thus, the principal concepts mentioned above could very well provide a means to develop devices that allow the mitigation of the impact of civil aviation noise on the community. This paper gives a review of the most relevant works on acoustic metamaterials, analyzing them for their potential applicability in aeronautics, and, in this process, identifying possible implementation areas and interesting metabehaviors. It also identifies some technical challenges and possible future directions for research with the goal of unveiling the potential of metamaterials technology in aeronautics.

Skinfold thickness affects the isometric knee extension torque evoked by Neuromuscular Electrical Stimulation.

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Medeiros, Flávia V A; Vieira, Amilton; Carregaro, Rodrigo L; Bottaro, Martim; Maffiuletti, Nicola A; Durigan, João L Q

2015-01-01

Subcutaneous adipose tissue may influence the transmission of electrical stimuli through to the skin, thus affecting both evoked torque and comfort perception associated with neuromuscular electrical stimulation (NMES). This could seriously affect the effectiveness of NMES for either rehabilitation or sports purposes. To investigate the effects of skinfold thickness (SFT) on maximal NMES current intensity, NMES-evoked torque, and NMES-induced discomfort. First, we compared NMES current intensity, NMES-induced discomfort, and NMES-evoked torque between two subgroups of subjects with thicker (n=10; 20.7 mm) vs. thinner (n=10; 29.4 mm) SFT. Second, we correlated SFT to NMES current intensity, NMES-induced discomfort, and NMES-evoked knee extension torque in 20 healthy women. The NMES-evoked torque was normalized to the maximal voluntary contraction (MVC) torque. The discomfort induced by NMES was assessed with a visual analog scale (VAS). NMES-evoked torque was 27.5% lower in subjects with thicker SFT (p=0.01) while maximal current intensity was 24.2% lower in subjects with thinner SFT (p=0.01). A positive correlation was found between current intensity and SFT (r=0.540, p=0.017). A negative correlation was found between NMES-evoked torque and SFT (r=-0.563, p=0.012). No significant correlation was observed between discomfort scores and SFT (rs=0.15, p=0.53). These results suggest that the amount of subcutaneous adipose tissue (as reflected by skinfold thickness) affected NMES current intensity and NMES-evoked torque, but had no effect on discomfort perception. Our findings may help physical therapists to better understand the impact of SFT on NMES and to design more rational stimulation strategies.

[Surgical tactics in duodenal trauma].

Science.gov (United States)

Ivanov, P A; Grishin, A V

2004-01-01

Results of surgical treatment of 61 patients with injuries of the duodenum are analyzed. The causes of injuries were stab-incised wounds in 24 patients, missile wound -- in 7, closed abdominal trauma -- in 26, trauma of the duodenum during endoscopic papillosphincterotomy -- in 4. All the patients underwent surgery. Complications were seen in 32 (52.5%) patients, 21 patients died, lethality was 34.4%. Within the first 24 hours since the trauma 7 patients died due to severe combined trauma, blood loss, 54 patients survived acute period of trauma, including 28 patients after open trauma, 26 -- after closed and 4 -- after trauma of the duodenum during endoscopic papillosphincterotomy. Diagnostic and surgical policies are discussed. Results of treatment depending on kind and time of surgery are regarded. It is demonstrated that purulent complications due to retroperitoneal phlegmona, traumatic pancreatitis, pneumonia are the causes of significant number of unfavorable outcomes. Therefore, it is important to adequately incise and drainage infected parts of retroperitoneal fat tissue with two-lumen drainages. Decompression through duodenal tube is the effective procedure for prophylaxis of suture insufficiency and traumatic pancreatitis. Suppression of pancreatic and duodenal secretion with octreotid improves significantly surgical treatment results.

Pharmacology of Bradykinin-Evoked Coughing in Guinea Pigs.

Science.gov (United States)

Hewitt, Matthew M; Adams, Gregory; Mazzone, Stuart B; Mori, Nanako; Yu, Li; Canning, Brendan J

2016-06-01

Bradykinin has been implicated as a mediator of the acute pathophysiological and inflammatory consequences of respiratory tract infections and in exacerbations of chronic diseases such as asthma. Bradykinin may also be a trigger for the coughing associated with these and other conditions. We have thus set out to evaluate the pharmacology of bradykinin-evoked coughing in guinea pigs. When inhaled, bradykinin induced paroxysmal coughing that was abolished by the bradykinin B2 receptor antagonist HOE 140. These cough responses rapidly desensitized, consistent with reports of B2 receptor desensitization. Bradykinin-evoked cough was potentiated by inhibition of both neutral endopeptidase and angiotensin-converting enzyme (with thiorphan and captopril, respectively), but was largely unaffected by muscarinic or thromboxane receptor blockade (atropine and ICI 192605), cyclooxygenase, or nitric oxide synthase inhibition (meclofenamic acid and N(G)-nitro-L-arginine). Calcium influx studies in bronchopulmonary vagal afferent neurons dissociated from vagal sensory ganglia indicated that the tachykinin-containing C-fibers arising from the jugular ganglia mediate bradykinin-evoked coughing. Also implicating the jugular C-fibers was the observation that simultaneous blockade of neurokinin2 (NK2; SR48968) and NK3 (SR142801 or SB223412) receptors nearly abolished the bradykinin-evoked cough responses. The data suggest that bradykinin induces coughing in guinea pigs by activating B2 receptors on bronchopulmonary C-fibers. We speculate that therapeutics targeting the actions of bradykinin may prove useful in the treatment of cough. Copyright © 2016 by The American Society for Pharmacology and Experimental Therapeutics.

An evolution of trauma care evaluation: A thesis on trauma registry and outcome prediction models

NARCIS (Netherlands)

Joosse, P.

2013-01-01

Outcome prediction models play an invaluable role in the evaluation and improvement of modern trauma care. Trauma registries underlying these outcome prediction models need to be accurate, complete and consistent. This thesis focused on the opportunities and limitations of trauma registries and

Do video games evoke specific types of epileptic seizures?

Science.gov (United States)

Piccioli, Marta; Vigevano, Federico; Buttinelli, Carla; Kasteleijn-Nolst Trenité, Dorothée G A

2005-11-01

We determined whether epileptic clinical manifestations evoked by playing video games (VG) differ from those evoked by intermittent photic stimulation (IPS) or striped patterns (P). We exposed nine children who had TV- and VG-evoked seizures in daily life to 12 VG after standardized photic stimulation and pattern stimulation. Their EEGs were recorded continuously, analyzed, and then correlated with a video of their behavior. Similar types of clinical signs were seen during VG, P, and IPS, but the signs we observed were more subtle during the VG. Eight patients showed a clear lateralization. A new observation was the lowering of the eyelids to a state of half-closed. Our study suggests that the type of visual stimulus provoking a photoparoxysmal response or seizure is not particularly relevant. The children belonged to different epilepsy groups, and our findings add to the discussion on the boundaries of the epilepsy types.

Survivors of early childhood trauma: evaluating a two-dimensional diagnostic model of the impact of trauma and neglect

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Marleen Wildschut

2014-04-01

Full Text Available Background: A two-dimensional diagnostic model for (complex trauma-related and personality disorders has been proposed to assess the severity and prognosis of the impact of early childhood trauma and emotional neglect. An important question that awaits empirical examination is whether a distinction between trauma-related disorders and personality disorders reflects reality when focusing on survivors of early childhood trauma. And, is a continuum of trauma diagnoses a correct assumption and, if yes, what does it look like? Objective: We describe the design of a cross-sectional cohort study evaluating this two-dimensional model of the impact of trauma and neglect. To provide the rationale of our study objectives, we review the existing literature on the impact of early childhood trauma and neglect on trauma-related disorders and personality disorders. Aims of the study are to: (1 quantify the two-dimensional model and test the relation with trauma and neglect; and (2 compare the two study groups. Method: A total of 200 consecutive patients referred to two specific treatment programs (100 from a personality disorder program and 100 from a trauma-related disorder program in the north of Holland will be included. Data are collected at the start of treatment. The assessments include all DSM-5 trauma-related and personality disorders, and general psychiatric symptoms, trauma history, and perceived emotional neglect. Discussion: The results will provide an evaluation of the model and an improvement of the understanding of the relationship between trauma-related disorders and personality disorders and early childhood trauma and emotional neglect. This may improve both diagnostic as well as indication procedures. We will discuss possible strengths and limitations of the design.

Awareness during anaesthesia for surgery requiring evoked potential monitoring: A pilot study

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Pritish J Korula

2017-01-01

Full Text Available Background: Evoked potential monitoring such as somatosensory-evoked potential (SSEP or motor-evoked potential (MEP monitoring during surgical procedures in proximity to the spinal cord requires minimising the minimum alveolar concentrations (MACs below the anaesthetic concentrations normally required (1 MAC to prevent interference in amplitude and latency of evoked potentials. This could result in awareness. Our primary objective was to determine the incidence of awareness while administering low MAC inhalational anaesthetics for these unique procedures. The secondary objective was to assess the adequacy of our anaesthetic technique from neurophysiologist′s perspective. Methods: In this prospective observational pilot study, 61 American Society of Anesthesiologists 1 and 2 patients undergoing spinal surgery for whom intraoperative evoked potential monitoring was performed were included; during the maintenance phase, 0.7-0.8 MAC of isoflurane was targeted. We evaluated the intraoperative depth of anaesthesia using a bispectral (BIS index monitor as well as the patients response to surgical stimulus (PRST scoring system. Post-operatively, a modified Bruce questionnaire was used to verify awareness. The adequacy of evoked potential readings was also assessed. Results: Of the 61 patients, no patient had explicit awareness. Intraoperatively, 19 of 61 patients had a BIS value of above sixty at least once, during surgery. There was no correlation with PRST scoring and BIS during surgery. Fifty-four out of 61 patient′s evoked potential readings were deemed ′good′ or ′fair′ for the conduct of electrophysiological monitoring. Conclusions: This pilot study demonstrates that administering low MAC inhalational anaesthetics to facilitate evoked potential monitoring does not result in explicit awareness. However, larger studies are needed to verify this. The conduct of SSEP electrophysiological monitoring was satisfactory with the use of this

Transmitter modulation of spike-evoked calcium transients in arousal related neurons

DEFF Research Database (Denmark)

Kohlmeier, Kristi Anne; Leonard, Christopher S

2006-01-01

Nitric oxide synthase (NOS)-containing cholinergic neurons in the laterodorsal tegmentum (LDT) influence behavioral and motivational states through their projections to the thalamus, ventral tegmental area and a brainstem 'rapid eye movement (REM)-induction' site. Action potential-evoked intracel......Nitric oxide synthase (NOS)-containing cholinergic neurons in the laterodorsal tegmentum (LDT) influence behavioral and motivational states through their projections to the thalamus, ventral tegmental area and a brainstem 'rapid eye movement (REM)-induction' site. Action potential......-evoked intracellular calcium transients dampen excitability and stimulate NO production in these neurons. In this study, we investigated the action of several arousal-related neurotransmitters and the role of specific calcium channels in these LDT Ca(2+)-transients by simultaneous whole-cell recording and calcium...... of cholinergic LDT neurons and that inhibition of spike-evoked Ca(2+)-transients is a common action of neurotransmitters that also activate GIRK channels in these neurons. Because spike-evoked calcium influx dampens excitability, our findings suggest that these 'inhibitory' transmitters could boost firing rate...

Calibration of acoustic emission transducers

International Nuclear Information System (INIS)

Leschek, W.C.

1976-01-01

A method is described for calibrating an acoustic emission transducer to be used in a pre-set frequency range. The absolute reception sensitivity of a reference transducer is determined at frequencies selected within the frequency range. The reference transducer and the acoustic emission transducer are put into acoustic communication with the surface of a limited acoustic medium representing an equivalent acoustic load appreciably identical to that of the medium in which the use of the acoustic emission transducer is intended. A blank random acoustic noise is emitted in the acoustic medium in order to establish a diffuse and reverberating sound field, after which the output responses of the reference transducer and of the acoustic emission transducer are obtained with respect to the diffuse and reverberating field, for selected frequencies. The output response of the acoustic emission transducer is compared with that of the reference transducer for the selected frequencies, so as to determine the reception sensitivity of the acoustic emission transducer [fr

Childhood trauma and compulsive buying.

Science.gov (United States)

Sansone, Randy A; Chang, Joy; Jewell, Bryan; Rock, Rachel

2013-02-01

Childhood trauma has been empirically associated with various types of self-regulatory difficulties in adulthood. However, according to the extant literature, no study has examined relationships between various types of childhood trauma and compulsive buying behavior in adulthood. Using a self-report survey methodology in a cross-sectional consecutive sample of 370 obstetrics/gynecology patients, we examined five types of childhood trauma before the age of 12 years (i.e. witnessing violence, physical neglect, emotional abuse, physical abuse, sexual abuse) in relationship to compulsive buying as assessed by the Compulsive Buying Scale (CBS). All forms of trauma demonstrated statistically significant correlations with the CBS. Using a linear regression analysis, both witnessing violence and emotional abuse significantly contributed to CBS scores. Further analyses indicated that race did not moderate the relationship between childhood trauma and compulsive buying. Findings indicate that various forms of childhood trauma are correlated with compulsive buying behavior, particularly witnessing violence and emotional abuse.

Analysis of the Revised Trauma Score (RTS in 200 victims of different trauma mechanisms

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BRUNO DURANTE ALVAREZ

Full Text Available ABSTRACT Objective: to analyze the epidemiological profile and mortality associated with the Revised Trauma Score (RTS in trauma victims treated at a university hospital. Methods: we conducted a descriptive, cross-sectional study of trauma protocols (prospectively collected from December 2013 to February 2014, including trauma victims admitted in the emergency room of the Cajuru University Hospital. We set up three groups: (G1 penetrating trauma to the abdomen and chest, (G2 blunt trauma to the abdomen and chest, and (G3 traumatic brain injury. The variables we analyzed were: gender, age, day of week, mechanism of injury, type of transportation, RTS, hospitalization time and mortality. Results: we analyzed 200 patients, with a mean age of 36.42 ± 17.63 years, and 73.5% were male. The mean age was significantly lower in G1 than in the other groups (p <0.001. Most (40% of the visits occurred on weekends and the most common pre-hospital transport service (58% was the SIATE (Emergency Trauma Care Integrated Service. The hospital stay was significantly higher in G1 compared with the other groups (p <0.01. Regarding mortality, there were 12%, 1.35% and 3.95% of deaths in G1, G2 and G3, respectively. The median RTS among the deaths was 5.49, 7.84 and 1.16, respectively, for the three groups. Conclusion: the majority of patients were young men. RTS was effective in predicting mortality in traumatic brain injury, however failing to predict it in patients suffering from blunt and penetrating trauma.

Acoustical and optical radiation pressure and the development of single beam acoustical tweezers

International Nuclear Information System (INIS)

Thomas, Jean-Louis; Marchiano, Régis; Baresch, Diego

2017-01-01

Studies on radiation pressure in acoustics and optics have enriched one another and have a long common history. Acoustic radiation pressure is used for metrology, levitation, particle trapping and actuation. However, the dexterity and selectivity of single-beam optical tweezers are still to be matched with acoustical devices. Optical tweezers can trap, move and position micron size particles, biological samples or even atoms with subnanometer accuracy in three dimensions. One limitation of optical tweezers is the weak force that can be applied without thermal damage due to optical absorption. Acoustical tweezers overcome this limitation since the radiation pressure scales as the field intensity divided by the speed of propagation of the wave. However, the feasibility of single beam acoustical tweezers was demonstrated only recently. In this paper, we propose a historical review of the strong similarities but also the specificities of acoustical and optical radiation pressures, from the expression of the force to the development of single-beam acoustical tweezers. - Highlights: • Studies on radiation pressure in acoustics and optics have enriched one another and have a long common history. • Acoustic radiation pressure is used for metrology, levitation, particle trapping and actuation. • However, the dexterity and selectivity of single-beam optical tweezers are still to be matched with acoustical devices. • Optical tweezers can trap, move and positioned micron size particles with subnanometer accuracy in three dimensions. • One limitation of optical tweezers is the weak force that can be applied without thermal damage due to optical absorption. • Acoustical tweezers overcome this limitation since the force scales as the field intensity divided by its propagation speed. • However, the feasibility of single beam acoustical tweezers was demonstrated only recently. • We propose a review of the strong similarities but also the specificities of acoustical

Do Puzzle Pieces and Autism Puzzle Piece Logos Evoke Negative Associations?

Science.gov (United States)

Gernsbacher, Morton Ann; Raimond, Adam R.; Stevenson, Jennifer L.; Boston, Jilana S.; Harp, Bev

2018-01-01

Puzzle pieces have become ubiquitous symbols for autism. However, puzzle-piece imagery stirs debate between those who support and those who object to its use because they believe puzzle-piece imagery evokes negative associations. Our study empirically investigated whether puzzle pieces evoke negative associations in the general public.…

A comparison of severely injured trauma patients admitted to level 1 trauma centres in Queensland and Germany

NARCIS (Netherlands)

Nijboer, Johanna M. M.; Wullschleger, Martin E.; Nielsen, Susan E.; McNamee, Anitia M.; Lefering, Rolf; ten Duis, Hendrik-Jan; Schuetz, Michael A.

Background: The allocation of a trauma network in Queensland is still in the developmental phase. In a search for indicators to improve trauma care both locally as state-wide, a study was carried out comparing trauma patients in Queensland to trauma patients in Germany, a country with 82.4 million

Acute coagulopathy of trauma

DEFF Research Database (Denmark)

Johansson, P I; Ostrowski, S R

2010-01-01

Acute coagulopathy of trauma predicts a poor clinical outcome. Tissue trauma activates the sympathoadrenal system resulting in high circulating levels of catecholamines that influence hemostasis dose-dependently through immediate effects on the two major compartments of hemostasis, i.......e., the circulating blood and the vascular endothelium. There appears to be a dose-dependency with regards to injury severity and the hemostatic response to trauma evaluated in whole blood by viscoelastic assays like thrombelastography (TEG), changing from normal to hypercoagulable, to hypocoagulable and finally......, is an evolutionary developed response that counterbalances the injury and catecholamine induced endothelial activation and damage. Given this, the rise in circulating catecholamines in trauma patients may favor a switch from hyper- to hypocoagulability in the blood to keep the progressively more procoagulant...

Radiation acoustics and its applications

International Nuclear Information System (INIS)

Lyamshev, L.M.

1992-01-01

Radiation acoustics is a new branch of acoustics, developing on the boundary of acoustics, nuclear physics, elementary particles and high-energy physics. Its fundamentals are laying in the research of acoustical effects due to the interaction of penetrating radiation with matter. The study of radiation-acoustical effects leads to the new opportunities in the penetration radiation research (acoustical detection, radiation-acoustical dosimetry), study of the physical parameters of matter, in a solution of some applied problems of nondestructive testing, and also for the radiation-acoustical influence on physical and chemical structure of the matter. Results of theoretical and experimental investigations are given. Different mechanisms of the sound generation by penetrating radiation of liquids and solids are considered. Some applications - the radiation acoustical microscopy and visualisation, the acoustical detection of high energy X-ray particles and possibility of using of high energy neutrino beams in geoacoustics - are discussed

Parametric Room Acoustic Workflows

DEFF Research Database (Denmark)

Parigi, Dario; Svidt, Kjeld; Molin, Erik

2017-01-01

The paper investigates and assesses different room acoustics software and the opportunities they offer to engage in parametric acoustics workflow and to influence architectural designs. The first step consists in the testing and benchmarking of different tools on the basis of accuracy, speed...... and interoperability with Grasshopper 3d. The focus will be placed to the benchmarking of three different acoustic analysis tools based on raytracing. To compare the accuracy and speed of the acoustic evaluation across different tools, a homogeneous set of acoustic parameters is chosen. The room acoustics parameters...... included in the set are reverberation time (EDT, RT30), clarity (C50), loudness (G), and definition (D50). Scenarios are discussed for determining at different design stages the most suitable acoustic tool. Those scenarios are characterized, by the use of less accurate but fast evaluation tools to be used...

An in-situ simulation-based educational outreach project for pediatric trauma care in a rural trauma system.

Science.gov (United States)

Bayouth, Lilly; Ashley, Sarah; Brady, Jackie; Lake, Bryan; Keeter, Morgan; Schiller, David; Robey, Walter C; Charles, Stephen; Beasley, Kari M; Toschlog, Eric A; Longshore, Shannon W

2018-02-01

Outcome disparities between urban and rural pediatric trauma patients persist, despite regionalization of trauma systems. Rural patients are initially transported to the nearest emergency department (ED), where pediatric care is infrequent. We aim to identify educational intervention targets and increase provider experience via pediatric trauma simulation. Prospective study of simulation-based pediatric trauma resuscitation was performed at three community EDs. Level one trauma center providers facilitated simulations, providing educational feedback. Provider performance comfort and skill with tasks essential to initial trauma care were assessed, comparing pre-/postsimulations. Primary outcomes were: 1) improved comfort performing skills, and 2) team performance during resuscitation. Provider comfort with the following improved (p-values education improves provider comfort and performance. Comparison of patient outcomes to evaluate improvement in pediatric trauma care is warranted. IV. Copyright © 2017 Elsevier Inc. All rights reserved.

What Are the Costs of Trauma Center Readiness? Defining and Standardizing Readiness Costs for Trauma Centers Statewide.

Science.gov (United States)

Ashley, Dennis W; Mullins, Robert F; Dente, Christopher J; Garlow, Laura; Medeiros, Regina S; Atkins, Elizabeth V; Solomon, Gina; Abston, Dena; Ferdinand, Colville H

2017-09-01

Trauma center readiness costs are incurred to maintain essential infrastructure and capacity to provide emergent services on a 24/7 basis. These costs are not captured by traditional hospital cost accounting, and no national consensus exists on appropriate definitions for each cost. Therefore, in 2010, stakeholders from all Level I and II trauma centers developed a survey tool standardizing and defining trauma center readiness costs. The survey tool underwent minor revisions to provide further clarity, and the survey was repeated in 2013. The purpose of this study was to provide a follow-up analysis of readiness costs for Georgia's Level I and Level II trauma centers. Using the American College of Surgeons Resources for Optimal Care of the Injured Patient guidelines, four readiness cost categories were identified: Administrative, Clinical Medical Staff, Operating Room, and Education/Outreach. Through conference calls, webinars and face-to-face meetings with financial officers, trauma medical directors, and program managers from all trauma centers, standardized definitions for reporting readiness costs within each category were developed. This resulted in a survey tool for centers to report their individual readiness costs for one year. The total readiness cost for all Level I trauma centers was $34,105,318 (avg $6,821,064) and all Level II trauma centers was $20,998,019 (avg $2,333,113). Methodology to standardize and define readiness costs for all trauma centers within the state was developed. Average costs for Level I and Level II trauma centers were identified. This model may be used to help other states define and standardize their trauma readiness costs.

Acoustic Neuroma

Science.gov (United States)

An acoustic neuroma is a benign tumor that develops on the nerve that connects the ear to the brain. ... can press against the brain, becoming life-threatening. Acoustic neuroma can be difficult to diagnose, because the ...

Evaluating trauma care capabilities in Mexico with the World Health Organization's Guidelines for Essential Trauma Care publication.

Science.gov (United States)

Arreola-Risa, Carlos; Mock, Charles; Vega Rivera, Felipe; Romero Hicks, Eduardo; Guzmán Solana, Felipe; Porras Ramírez, Giovanni; Montiel Amoroso, Gilberto; de Boer, Melanie

2006-02-01

To identify affordable, sustainable methods to strengthen trauma care capabilities in Mexico, using the standards in the Guidelines for Essential Trauma Care, a publication that was developed by the World Health Organization and the International Society of Surgery to provide recommendations on elements of trauma care that should be in place in the various levels of health facilities in all countries. The Guidelines publication was used as a basis for needs assessments conducted in 2003 and 2004 in three Mexican states. The states were selected to represent the range of geographic and economic conditions in the country: Oaxaca (south, lower economic status), Puebla (center, middle economic status), and Nuevo León (north, higher economic status). The sixteen facilities that were assessed included rural clinics, small hospitals, and large hospitals. Site visits incorporated direct inspection of physical resources as well as interviews with key administrative and clinical staff. Human and physical resources for trauma care were adequate in the hospitals, especially the larger ones. The survey did identify some deficiencies, such as shortages of stiff suction tips, pulse oximetry equipment, and some trauma-related medications. All of the clinics had difficulties with basic supplies for resuscitation, even though some received substantial numbers of trauma patients. In all levels of facilities there was room for improvement in administrative functions to assure quality trauma care, including trauma registries, trauma-related quality improvement programs, and uniform in-service training. This study identified several low-cost ways to strengthen trauma care in Mexico. The study also highlighted the usefulness of the recommended norms in the Guidelines for Essential Trauma Care publication in providing a standardized template by which to assess trauma care capabilities in nations worldwide.

Vascular emergencies in liver trauma

Energy Technology Data Exchange (ETDEWEB)

Taourel, P. [Centre Hospitalier Universitaire Lapeyronie, Montpellier (France)], E-mail: p-taourel@chu-montpellier.fr; Vernhet, H. [Centre Hospitalier Universitaire Arnaud de Villeneuve, Montpellier (France); Suau, A.; Granier, C. [Centre Hospitalier Universitaire Lapeyronie, Montpellier (France); Lopez, F.M. [Centre Hospitalier Universitaire, Nimes (France); Aufort, S. [Centre Hospitalier Universitaire Lapeyronie, Montpellier (France)

2007-10-15

The use of CT in the diagnosis and management of liver trauma is responsible for the shift from routine surgical versus non-surgical treatment in the management of traumatic liver injuries, even when they are of high grade. The main cause of compli cation and of death in liver trauma is related to vascular injury. The goal of this review focussed on the vascular complications of liver trauma is to describe the elementary lesions shown by CT in liver trauma including laceration, parenchymal hematoma and contusions, partial devascularisation, subcapsular hematomas, hemoperitoneum, active bleeding, pseudoaneurysm of the hepatic artery, bile leak, and periportal oedema, to illustrate the possible pitfalls in CT diagnosis of liver trauma and to underline the key-points which may absolutely be present in a CT report of liver trauma. Then we will remind the grading system based on the CT features and we will analyze the interest and limitations of such grading systems. Last we will discuss the diagnostic strategy at the early phase in patients with suspected liver trauma according to their clinical conditions and underline the conditions of arterial embolization, and then we will discuss the diagnosis strategy at the delayed phase according to the suspected complications.

Vascular emergencies in liver trauma

International Nuclear Information System (INIS)

Taourel, P.; Vernhet, H.; Suau, A.; Granier, C.; Lopez, F.M.; Aufort, S.

2007-01-01

The use of CT in the diagnosis and management of liver trauma is responsible for the shift from routine surgical versus non-surgical treatment in the management of traumatic liver injuries, even when they are of high grade. The main cause of compli cation and of death in liver trauma is related to vascular injury. The goal of this review focussed on the vascular complications of liver trauma is to describe the elementary lesions shown by CT in liver trauma including laceration, parenchymal hematoma and contusions, partial devascularisation, subcapsular hematomas, hemoperitoneum, active bleeding, pseudoaneurysm of the hepatic artery, bile leak, and periportal oedema, to illustrate the possible pitfalls in CT diagnosis of liver trauma and to underline the key-points which may absolutely be present in a CT report of liver trauma. Then we will remind the grading system based on the CT features and we will analyze the interest and limitations of such grading systems. Last we will discuss the diagnostic strategy at the early phase in patients with suspected liver trauma according to their clinical conditions and underline the conditions of arterial embolization, and then we will discuss the diagnosis strategy at the delayed phase according to the suspected complications

High-Frequency Seafloor Acoustics

CERN Document Server

Jackson, Darrell R

2007-01-01

High-Frequency Seafloor Acoustics is the first book in a new series sponsored by the Office of Naval Research on the latest research in underwater acoustics. This exciting new title provides ready access to experimental data, theory, and models relevant to high-frequency seafloor acoustics and will be of interest to sonar engineers and researchers working in underwater acoustics. The physical characteristics of the seafloor affecting acoustic propagation and scattering are covered, including physical and geoacoustic properties and surface roughness. Current theories for acoustic propagation in sediments are presented along with corresponding models for reflection, scattering, and seafloor penetration. The main text is backed up by an extensive bibliography and technical appendices.

Refractory episodic vertigo: role of intratympanic gentamicin and vestibular evoked myogenic potentials,

Directory of Open Access Journals (Sweden)

Erika Celis-Aguilar

Full Text Available Abstract Introduction: Even today, the treatment of intractable vertigo remains a challenge. Vestibular ablation with intratympanic gentamicin stands as a good alternative in the management of refractory vertigo patients. Objective: To control intractable vertigo through complete saccular and horizontal canal vestibular ablation with intratympanic gentamicin treatment. Methods: Patients with refractory episodic vertigo were included. The inclusion criteria were: unilateral ear disease, moderate to profound sensorineural hearing loss, and failure to other treatments. Included patients underwent 0.5-0.8 mL of gentamicin intratympanic application at a 30 mg/mL concentration. Vestibular ablation was confirmed by the absence of response on cervical vestibular evoked myogenic potentials and no response on caloric tests. Audiometry, electronystagmography with iced water, and vestibular evoked myogenic potentials were performed in all patients. Results: Ten patients were included; nine patients with Meniere's disease and one patient with (late onset delayed hydrops. Nine patients showed an absent response on vestibular evoked myogenic potentials and no response on caloric tests. The only patient with low amplitude on cervical vestibular evoked myogenic potentials had vertigo recurrence. Vertigo control was achieved in 90% of the patients. One patient developed hearing loss >30 dB. Conclusions: Cervical vestibular evoked myogenic potentials confirmed vestibular ablation in patients treated with intratympanic gentamicin. High-grade vertigo control was due to complete saccular and horizontal canal ablation (no response to iced water in electronystagmography and no response on cervical vestibular evoked myogenic potentials.

Radiologic findings of thoracic trauma

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Akgul Ozmen C

2017-08-01

Full Text Available Cihan Akgul Ozmen,1 Serdar Onat,2 Delal Aycicek3 1Department of Radiology, 2Department of Chest Surgery, Dicle University School of Medicine, Diyarbakir, 3Radiology Unit, Siirt State Hospital, Siirt, Turkey Introduction: Chest trauma may be blunt or penetrating and the chest is the third most common trauma region. It is a significant cause of mortality. Multidetector computed tomography (MDCT has been an increasingly used method to evaluate chest trauma because of its high success in detecting tissue and organ injuries. Herein, we aimed to present MDCT findings in patients with blunt and penetrating chest trauma admitted to our department. Methods: A total of 240 patients admitted to the emergency department of our hospital between April 2012 and July 2013 with a diagnosis of chest trauma who underwent MDCT evaluations were included. Most of the patients were male (83.3% and victims of a blunt chest trauma. The images were analyzed with respect to the presence of fractures of bony structures, hemothorax, pneumothorax, mediastinal organ injury, and pulmonary and vascular injuries. Results: MDCT images of the 240 patients yielded a prevalence of 41.7% rib fractures, 11.2% scapular fractures, and 7.5% clavicle fractures. The prevalence of thoracic vertebral fracture was 13.8% and that of sternal fracture was 3.8%. The prevalence of hemothorax, pneumothorax, pneumomediastinum, and subcutaneous emphysema was 34.6%, 62.1%, 9.6%, and 35.4%, respectively. The prevalence of rib, clavicle, and thoracic vertebral fractures and pulmonary contusion was higher in the blunt trauma group, whereas the prevalence of hemothorax, subcutaneous emphysema, diaphragmatic injury, and other vascular lacerations was significantly higher in the penetrating trauma group than in the blunt trauma group (p<0.05. Conclusion: MDCT images may yield a high prevalence of fracture of bony structures, soft tissue lacerations, and vascular lesions, which should be well understood by

Hepatic trauma: a 21-year experience

OpenAIRE

Zago, Thiago Messias; Pereira, Bruno Monteiro; Nascimento, Bartolomeu; Alves, Maria Silveira Carvalho; Calderan, Thiago Rodrigues Araujo; Fraga, Gustavo Pereira

2013-01-01

OBJETIVO: avaliar os aspectos epidemiológicos, conduta, morbidade e resultados do tratamento trauma hepático. MÉTODOS: estudo retrospectivo de doentes com mais de 13 anos de idade admitidos em um hospital universitário de 1990 a 2010, submetidos ao tratamento cirúrgico ou não operatório (TNO). RESULTADOS: foram admitidos 748 pacientes com trauma hepático. O mecanismo de trauma mais frequente foi o trauma penetrante (461 casos; 61,6%). O trauma fechado ocorreu em 287 pacientes (38,4%). De acor...

Phantom somatosensory evoked potentials following selective intraneural electrical stimulation in two amputees.

Science.gov (United States)

Granata, Giuseppe; Di Iorio, Riccardo; Romanello, Roberto; Iodice, Francesco; Raspopovic, Stanisa; Petrini, Francesco; Strauss, Ivo; Valle, Giacomo; Stieglitz, Thomas; Čvančara, Paul; Andreu, David; Divoux, Jean-Louis; Guiraud, David; Wauters, Loic; Hiairrassary, Arthur; Jensen, Winnie; Micera, Silvestro; Rossini, Paolo Maria

2018-06-01

The aim of the paper is to objectively demonstrate that amputees implanted with intraneural interfaces are truly able to feel a sensation in the phantom hand by recording "phantom" somatosensory evoked potentials from the corresponding brain areas. We implanted four transverse intrafascicular multichannel electrodes, available with percutaneous connections to a multichannel electrical stimulator, in the median and ulnar nerves of two left trans-radial amputees. Two channels of the implants that were able to elicit sensations during intraneural nerve stimulation were chosen, in both patients, for recording somatosensory evoked potentials. We recorded reproducible evoked responses by stimulating the median and the ulnar nerves in both cases. Latencies were in accordance with the arrival of somatosensory information to the primary somatosensory cortex. Our results provide evidence that sensations generated by intraneural stimulation are truly perceived by amputees and located in the phantom hand. Moreover, our results strongly suggest that sensations perceived in different parts of the phantom hand result in different evoked responses. Somatosensory evoked potentials obtained by selective intraneural electrical stimulation in amputee patients are a useful tool to provide an objective demonstration of somatosensory feedback in new generation bidirectional prostheses. Copyright © 2018. Published by Elsevier B.V.

Comparing premodern melancholy/mania and modern trauma: an argument in favor of historical experiences of trauma.

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Trembinski, Donna

2011-02-01

Historians and psychiatrists have repeatedly looked to both real and imagined individuals of the past, like Achilles and Samuel Pepys, and found evidence that they were suffering from symptoms of trauma and posttraumatic stress disorder. The assumptions that allow such historical "diagnoses" have, however, recently been called into question by philosophers such as lan Hacking, anthropologists like Allan Young and psychiatrists such as Patrick Bracken. These scholars have all suggested in various ways that experiences of trauma could not have occurred until the diagnosis of trauma and its symptoms had been formalized and the language of trauma had been developed in the late 19th century. This article attempts to resolve this bifurcation of opinion on the universality of the mind and historical experiences of trauma in two ways. First, it argues for the necessity of applying modern categories of analysis to further present understandings of the past. Second, it considers discussions of"melancholia" and "mania" in premodern medical literature and argues that there are enough similarities between the causes and symptoms of these premodern disorders and modern trauma to suggest that experiences of trauma may not be wholly culturally bound to the modern world, as the above scholars have suggested. While melancholy or mania cannot simply be understood as premodern names for trauma, and it is not always correct to "diagnose" a premodern person who exhibits symptoms of these illnesses with trauma, such an assumption is not always ahistorical or incorrect either.

An inventory and update of jealousy-evoking partner behaviours in modern society.

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Dijkstra, Pieternel; Barelds, Dick P H; Groothof, Hinke A K

2010-01-01

The goal of the present study was to identify the most important jealousy-evoking partner behaviours and to examine the extent to which these behaviours evoke jealousy. Based on the literature, a questionnaire was constructed containing 42 jealousy-evoking partner behaviours, including a partner's extra-dyadic involvement with someone else by means of modern communication devices, such as the Internet. A second study examined the extent to which undergraduates and a community sample experienced jealousy in response to these partner behaviours. Results showed that explicit unfaithful behaviours evoked most feelings of jealousy, followed by a partner's emotional or romantic involvement with someone else by means of modern communication devices. In general, older individuals responded with less jealousy in response to a partner's unfaithful and suspicious behaviours. Clinical implications are discussed. (c) 2009 John Wiley & Sons, Ltd.

Acoustic evaluation of wood quality in standing trees. Part I, Acoustic wave behavior

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Xiping Wang; Robert J. Ross; Peter Carter

2007-01-01

Acoustic wave velocities in standing trees or live softwood species were measured by the time-of-flight (TOF) method. Tree velocities were compared with acoustic velocities measured in corresponding butt logs through a resonance acoustic method. The experimental data showed a skewed relationship between tree and log acoustic measurements. For most trees tested,...

Organizational network in trauma management in Italy

Directory of Open Access Journals (Sweden)

Osvaldo Chiara

2005-10-01

Full Text Available In Italy, as in other western countries, trauma is a leading cause of death during the first four decades of life, with almost 18.000 of deaths per year. Since 80s organized systems for trauma care, including a pre-hospital emergency medical system and a network of hospitals designated as Trauma Centres, have been developed in north American countries. Effectiveness of trauma systems has been investigated comparing the post-system to the pre-system trauma care with the method of panel evaluation of preventable death rates and comparison of observed survival with expected probability of survival. In Italy, a pre-hospital emergency medical system has been implemented on a national scale, while a trauma network has not been developed. Nowadays, trauma patients are often admitted to the closest hospital, independently from local resources. The Superior Council of Ministry of Health has presented in 2004 a new trauma system model (SIAT based on the recognition in the field of patients with more serious injuries and the transportation to general hospitals with resources and multidisciplinary teams specialized in trauma care (trauma team. The designation of few trauma team hospitals, one highly specialized Centre (CTS and two area Centres (CTZ every two millions of inhabitants allows each Centre to treat at least 250 severe trauma patients per year to increase experience. Less severe injured patients may be treated in non-trauma team acute care facilities, according to the inclusive system model. The development of trauma team services in some Italian hospitals has demonstrated an increase in survival and a decrease in preventable death rate from 42% to 7,6%. Economic studies of Ministry of Health have established that the implementation of a trauma system model on a national scale with a 25% decrease of preventable trauma deaths and disabilities would save 7500 million of euros of public money. Therefore, in our country the concentration of severely

Imaging of blunt chest trauma

International Nuclear Information System (INIS)

Wicky, S.; Wintermark, M.; Schnyder, P.; Capasso, P.; Denys, A.

2000-01-01

In western European countries most blunt chest traumas are associated with motor vehicle and sport-related accidents. In Switzerland, 39 of 10,000 inhabitants were involved and severely injured in road accidents in 1998. Fifty two percent of them suffered from blunt chest trauma. According to the Swiss Federal Office of Statistics, traumas represented in men the fourth major cause of death (4 %) after cardiovascular disease (38 %), cancer (28 %), and respiratory disease (7 %) in 1998. The outcome of chest trauma patients is determined mainly by the severity of the lesions, the prompt appropriate treatment delivered on the scene of the accident, the time needed to transport the patient to a trauma center, and the immediate recognition of the lesions by a trained emergency team. Other determining factors include age as well as coexisting cardiac, pulmonary, and renal diseases. Our purpose was to review the wide spectrum of pathologies related to blunt chest trauma involving the chest wall, pleura, lungs, trachea and bronchi, aorta, aortic arch vessels, and diaphragm. A particular focus on the diagnostic impact of CT is demonstrated. (orig.)

Room Acoustics

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Kuttruff, Heinrich; Mommertz, Eckard

The traditional task of room acoustics is to create or formulate conditions which ensure the best possible propagation of sound in a room from a sound source to a listener. Thus, objects of room acoustics are in particular assembly halls of all kinds, such as auditoria and lecture halls, conference rooms, theaters, concert halls or churches. Already at this point, it has to be pointed out that these conditions essentially depend on the question if speech or music should be transmitted; in the first case, the criterion for transmission quality is good speech intelligibility, in the other case, however, the success of room-acoustical efforts depends on other factors that cannot be quantified that easily, not least it also depends on the hearing habits of the listeners. In any case, absolutely "good acoustics" of a room do not exist.

Acoustic scaling: A re-evaluation of the acoustic model of Manchester Studio 7

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Walker, R.

1984-12-01

The reasons for the reconstruction and re-evaluation of the acoustic scale mode of a large music studio are discussed. The design and construction of the model using mechanical and structural considerations rather than purely acoustic absorption criteria is described and the results obtained are given. The results confirm that structural elements within the studio gave rise to unexpected and unwanted low-frequency acoustic absorption. The results also show that at least for the relatively well understood mechanisms of sound energy absorption physical modelling of the structural and internal components gives an acoustically accurate scale model, within the usual tolerances of acoustic design. The poor reliability of measurements of acoustic absorption coefficients, is well illustrated. The conclusion is reached that such acoustic scale modelling is a valid and, for large scale projects, financially justifiable technique for predicting fundamental acoustic effects. It is not appropriate for the prediction of fine details because such small details are unlikely to be reproduced exactly at a different size without extensive measurements of the material's performance at both scales.

"Trauma, stress, and self-care in clinical training: Predictors of burnout, decline in health status, secondary traumatic stress symptoms, and compassion satisfaction": Correction to Butler, Carello, and Maguin (2016).

Science.gov (United States)

2017-07-01

: These findings suggest that clinical training involving trauma content can be both rewarding and stressful, and may evoke distress in some trainees. Given that learning about and working with trauma are essential to adequate clinical training, the authors suggest adopting a trauma-informed approach within clinical training programs. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Systematic analysis of ocular trauma by a new proposed ocular trauma classification

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Bhartendu Shukla

2017-01-01

Full Text Available Purpose: The current classification of ocular trauma does not incorporate adnexal trauma, injuries that are attributable to a nonmechanical cause and destructive globe injuries. This study proposes a new classification system of ocular trauma which is broader-based to allow for the classification of a wider range of ocular injuries not covered by the current classification. Methods: A clinic-based cross-sectional study to validate the proposed classification. We analyzed 535 cases of ocular injury from January 1, 2012 to February 28, 2012 over a 4-year period in an eye hospital in central India using our proposed classification system and compared it with conventional classification. Results: The new classification system allowed for classification of all 535 cases of ocular injury. The conventional classification was only able to classify 364 of the 535 trauma cases. Injuries involving the adnexa, nonmechanical injuries and destructive globe injuries could not be classified by the conventional classification, thus missing about 33% of cases. Conclusions: Our classification system shows an improvement over existing ocular trauma classification as it allows for the classification of all type of ocular injuries and will allow for better and specific prognostication. This system has the potential to aid communication between physicians and result in better patient care. It can also provide a more authentic, wide spectrum of ocular injuries in correlation with etiology. By including adnexal injuries and nonmechanical injuries, we have been able to classify all 535 cases of trauma. Otherwise, about 30% of cases would have been excluded from the study.

Spinal trauma. An imaging approach

Energy Technology Data Exchange (ETDEWEB)

Cassar-Pullicino, V.N. [The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire (United Kingdom). Dept. of Radiology; Imhof, H. [University and General Hospital Vienna (Austria). Dept. of Radiodiagnostics

2006-07-01

The diagnosis of trauma to the spine - where the slightest oversight may have catastrophic results - requires a thorough grasp of the spectrum of resultant pathology as well as the imaging modalities used in making an accurate diagnosis. In Spinal Trauma, the internationally renowned team of experts provides a comprehensive, cutting-edge exposition of the current vital role of imaging in the diagnosis and treatment of injuries to the axial skeleton. Beginning with a valuable clinical perspective of spinal trauma, the book offers the reader a unique overview of the biomechanics underlying the pathology of cervical trauma. Acute trauma topics include: - Optimization of imaging modalities - Malalignment - signs and significance - Vertebral fractures - detection and implications - Classification of thoraco-lumbar fractures - rationale and relevance - Neurovascular injury. Distilling decades of clinical and teaching expertise, the contributors further discuss the current role of imaging in special focus topics, which include: - The pediatric spine - Sports injuries - The rigid spine - Trauma in the elderly - Vertebral collapse, benign and malignant - Spinal trauma therapy - Vertebral fractures and osteoporosis - Neuropathic spine. All throughout the book, the focus is on understanding the injury, and its implications and complications, through 'an imaging approach'. Lavishly illustrated with hundreds of superb MR images and CT scans, and clear full-color drawings, the authors conclude with a look into the future, defining clinical trends and research directions. Spinal Trauma - with its broad scope, practical imaging approach, and current focus - is designed to enhance confidence and accuracy, making it essential reading for clinicians and radiologists at all levels. (orig.)

Spinal trauma. An imaging approach

International Nuclear Information System (INIS)

Cassar-Pullicino, V.N.; Imhof, H.

2006-01-01

The diagnosis of trauma to the spine - where the slightest oversight may have catastrophic results - requires a thorough grasp of the spectrum of resultant pathology as well as the imaging modalities used in making an accurate diagnosis. In Spinal Trauma, the internationally renowned team of experts provides a comprehensive, cutting-edge exposition of the current vital role of imaging in the diagnosis and treatment of injuries to the axial skeleton. Beginning with a valuable clinical perspective of spinal trauma, the book offers the reader a unique overview of the biomechanics underlying the pathology of cervical trauma. Acute trauma topics include: - Optimization of imaging modalities - Malalignment - signs and significance - Vertebral fractures - detection and implications - Classification of thoraco-lumbar fractures - rationale and relevance - Neurovascular injury. Distilling decades of clinical and teaching expertise, the contributors further discuss the current role of imaging in special focus topics, which include: - The pediatric spine - Sports injuries - The rigid spine - Trauma in the elderly - Vertebral collapse, benign and malignant - Spinal trauma therapy - Vertebral fractures and osteoporosis - Neuropathic spine. All throughout the book, the focus is on understanding the injury, and its implications and complications, through 'an imaging approach'. Lavishly illustrated with hundreds of superb MR images and CT scans, and clear full-color drawings, the authors conclude with a look into the future, defining clinical trends and research directions. Spinal Trauma - with its broad scope, practical imaging approach, and current focus - is designed to enhance confidence and accuracy, making it essential reading for clinicians and radiologists at all levels. (orig.)

Evoked Brain Activity and Personnel Performance

Science.gov (United States)

1987-10-01

Shucard and Horn (1972), Galbraith, Gliddon, and Busk (1970), and Callaway (1975), the latter using Navy recruits. Callaway’s own work was reported at...G.C., Gliddon, J.B., & Busk , J. (1970). Visual evoked responses in mentally retarded and nonretarded subjects. American Journal of Mental Deficiency

CALCULATION OF ACOUSTIC EFFICIENCY OF PORTABLE ACOUSTIC SCREEN

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Aleksandr Skvortsov

2016-03-01

Full Text Available The research of influence of life environment adverse factors on physical development and health of population is an actual problem of ecology. The aspects of the most actual problems of the modern world, namely environmental industrial noise pollution are considered in the article. Industrial facilities everywhere have noisy equipment. Noise is a significant factors of negative influenceon people and environment. Combined effects of noise and of other physical pollutions on people may cause amplification of their negative impact. If the noise pollution level from the object in a residential area exceeds the permissible levels (MPL, noise protection measures can be initiated. Today, the most common design decisions for noise protection are sound absorbing construction, noise screens and barriers, acousting housings, soundproff cabins. Many of them are popular, others are less known. The article deals with one of the most wide spread means of noise protection – a portable acoustic screen. The aim of the research is to determine the efficiency of portable acoustic screens. It is shown that the installation of such structures can reduce the average value of the sound level. The authors analyzed acoustic screens as device to reduce noise pollution. The authors offer a potable acoustic screen differing from the used easyness, mobility, minimum price and good sound protective properties. Effectiveness, a sound absorption coefficient and sound conductivity coefficient of a portable acoustic screen are evaluated. The descriptions of the algorithm calculations and the combination of technical solutions have practical originality. The results of the research demonstrate the advantages of the proposed solutions for reducing noise levels in the agro-industrial complex.

Evoked potentials in pediatric cerebral malaria

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Minal Bhanushali

2011-12-01

Full Text Available Cortical evoked potentials (EP provide localized data regarding brain function and may offer prognostic information and insights into the pathologic mechanisms of malariamediated cerebral injury. As part of a prospective cohort study, we obtained somatosensory evoked potentials (SSEPs and brainstem auditory EPs (AEPs within 24 hours of admission on 27 consecutive children admitted with cerebral malaria (CM. Children underwent follow-up for 12 months to determine if they had any long term neurologic sequelae. EPs were obtained in 27 pediatric CM admissions. Two children died. Among survivors followed an average of 514 days, 7/25 (28.0% had at least one adverse neurologic outcome. Only a single subject had absent cortical EPs on admission and this child had a good neurologic outcome. Among pediatric CM survivors, cortical EPs are generally intact and do not predict adverse neurologic outcomes. Further study is needed to determine if alterations in cortical EPs can be used to predict a fatal outcome in CM.

Impact of Sexual Trauma on HIV Care Engagement: Perspectives of Female Patients with Trauma Histories in Cape Town, South Africa.

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Watt, Melissa H; Dennis, Alexis C; Choi, Karmel W; Ciya, Nonceba; Joska, John A; Robertson, Corne; Sikkema, Kathleen J

2017-11-01

South African women have disproportionately high rates of both sexual trauma and HIV. To understand how sexual trauma impacts HIV care engagement, we conducted in-depth qualitative interviews with 15 HIV-infected women with sexual trauma histories, recruited from a public clinic in Cape Town. Interviews explored trauma narratives, coping behaviors and care engagement, and transcripts were analyzed using a constant comparison method. Participants reported multiple and complex traumas across their lifetimes. Sexual trauma hindered HIV care engagement, especially immediately following HIV diagnosis, and there were indications that sexual trauma may interfere with future care engagement, via traumatic stress symptoms including avoidance. Disclosure of sexual trauma was limited; no women had disclosed to an HIV provider. Routine screening for sexual trauma in HIV care settings may help to identify individuals at risk of poor care engagement. Efficacious treatments are needed to address the psychological and behavioral sequelae of trauma.

Adrenal trauma: Elvis Presley Memorial Trauma Center experience.

Science.gov (United States)

Mehrazin, Reza; Derweesh, Ithaar H; Kincade, Matthew C; Thomas, Adam C; Gold, Robert; Wake, Robert W

2007-11-01

Adrenal gland injury is a potentially devastating event if unrecognized in the treatment course of a trauma patient. We reviewed our single-center experience and outcomes in patients with adrenal gland trauma. We performed a retrospective review of all patients presenting with trauma to the Regional Medical Center at Memphis who had adrenal gland injuries from January 1991 through March 2006. Each chart was reviewed with attention to the demographics, associated injuries, complications, and outcomes. Patients were stratified into two subgroups according to age (35 years or younger and older than 35 years) to allow for an age-based comparison between the two groups. Of 58,000 patients presenting with trauma, 130 (0.22%) were identified with adrenal injuries, of which 8 (6.2%) were isolated and 122 (93.8%) were not. Of these 130 patients, 125 (96.2%) had their injury diagnosed by computed tomography and 5 (3.8%) had their injury diagnosed during exploratory laparotomy. Right-sided injuries predominated (78.5%), with six (4.6%) bilateral. Four patients (3.1%) underwent adrenalectomy. Seven patients (5.4%) with adrenal injuries died. One patient (0.77%) required chronic steroid therapy. Patients older than 35 years were more likely to have complications such as deep venous thrombosis, pneumonia, and urinary tract infections. Patient age of 35 years or younger was associated with a significantly increased incidence of liver lacerations. Adrenal gland injury is uncommon, although mostly associated with greater injury severity. Although adding to morbidity, most are self-limited and do not require intervention.

Contemporary management of high-grade renal trauma: Results from the American Association for the Surgery of Trauma Genitourinary Trauma study.

Science.gov (United States)

Keihani, Sorena; Xu, Yizhe; Presson, Angela P; Hotaling, James M; Nirula, Raminder; Piotrowski, Joshua; Dodgion, Christopher M; Black, Cullen M; Mukherjee, Kaushik; Morris, Bradley J; Majercik, Sarah; Smith, Brian P; Schwartz, Ian; Elliott, Sean P; DeSoucy, Erik S; Zakaluzny, Scott; Thomsen, Peter B; Erickson, Bradley A; Baradaran, Nima; Breyer, Benjamin N; Miller, Brandi; Santucci, Richard A; Carrick, Matthew M; Hewitt, Timothy; Burks, Frank N; Kocik, Jurek F; Askari, Reza; Myers, Jeremy B

2018-03-01

The rarity of renal trauma limits its study and the strength of evidence-based guidelines. Although management of renal injuries has shifted toward a nonoperative approach, nephrectomy remains the most common intervention for high-grade renal trauma (HGRT). We aimed to describe the contemporary management of HGRT in the United States and also evaluate clinical factors associated with nephrectomy after HGRT. From 2014 to 2017, data on HGRT (American Association for the Surgery of Trauma grades III-V) were collected from 14 participating Level-1 trauma centers. Data were gathered on demographics, injury characteristics, management, and short-term outcomes. Management was classified into three groups-expectant, conservative/minimally invasive, and open operative. Descriptive statistics were used to report management of renal trauma. Univariate and multivariate logistic mixed effect models with clustering by facility were used to look at associations between proposed risk factors and nephrectomy. A total of 431 adult HGRT were recorded; 79% were male, and mechanism of injury was blunt in 71%. Injuries were graded as III, IV, and V in 236 (55%), 142 (33%), and 53 (12%), respectively. Laparotomy was performed in 169 (39%) patients. Overall, 300 (70%) patients were managed expectantly and 47 (11%) underwent conservative/minimally invasive management. Eighty-four (19%) underwent renal-related open operative management with 55 (67%) of them undergoing nephrectomy. Nephrectomy rates were 15% and 62% for grades IV and V, respectively. Penetrating injuries had significantly higher American Association for the Surgery of Trauma grades and higher rates of nephrectomy. In multivariable analysis, only renal injury grade and penetrating mechanism of injury were significantly associated with undergoing nephrectomy. Expectant and conservative management is currently utilized in 80% of HGRT; however, the rate of nephrectomy remains high. Clinical factors, such as surrogates of

Effects of subsampling of passive acoustic recordings on acoustic metrics.

Science.gov (United States)

Thomisch, Karolin; Boebel, Olaf; Zitterbart, Daniel P; Samaran, Flore; Van Parijs, Sofie; Van Opzeeland, Ilse

2015-07-01

Passive acoustic monitoring is an important tool in marine mammal studies. However, logistics and finances frequently constrain the number and servicing schedules of acoustic recorders, requiring a trade-off between deployment periods and sampling continuity, i.e., the implementation of a subsampling scheme. Optimizing such schemes to each project's specific research questions is desirable. This study investigates the impact of subsampling on the accuracy of two common metrics, acoustic presence and call rate, for different vocalization patterns (regimes) of baleen whales: (1) variable vocal activity, (2) vocalizations organized in song bouts, and (3) vocal activity with diel patterns. To this end, above metrics are compared for continuous and subsampled data subject to different sampling strategies, covering duty cycles between 50% and 2%. The results show that a reduction of the duty cycle impacts negatively on the accuracy of both acoustic presence and call rate estimates. For a given duty cycle, frequent short listening periods improve accuracy of daily acoustic presence estimates over few long listening periods. Overall, subsampling effects are most pronounced for low and/or temporally clustered vocal activity. These findings illustrate the importance of informed decisions when applying subsampling strategies to passive acoustic recordings or analyses for a given target species.

Gênero e trauma Gender and trauma

Directory of Open Access Journals (Sweden)

Gláucio Ary Dillon Soares

2005-04-01

Full Text Available As conseqüências sociais e psicológicas da violência urbana sobre os parentes e amigos de pessoas vitimadas por mortes violentas (homicídio, suicídio ou acidentes são analisadas à luz das diferenças de gênero. A literatura especializada nesta área propõe que mulheres e homens vivenciam experiências traumáticas de forma peculiar. Porém, os traumas típicos são diferentes em cada gênero, deixando em aberto a questão sobre quanto das diferenças entre as respostas se devem a gênero e quanto se devem ao tipo de trauma. Testamos a hipótese de que as mulheres são mais suscetíveis à desordem de estresse pós-trauma (DEPT numa situação traumática comum, usando dados qualitativos e quantitativos. Comparamos os sintomas do trauma e as percepções sobre o significado da perda de seus entes queridos. A amostra, de 425 mulheres (62% e 265 homens (38%, foi retirada de uma lista de parentes de pessoas que sofreram morte violenta na cidade do Rio de Janeiro. Incluímos trinta relatos de parentes e amigos próximos das vítimas diretas. Os resultados revelaram que 54% das mulheres e 41% dos homens tiveram o cotidiano alterado depois da morte de um parente/amigo. Há diferenças estatisticamente significativas nos problemas de saúde e na diversão. Essa área foi a mais afetada, atingindo metade dos entrevistados. Uma variável intimamente correlacionada com os sintomas da DEPT é o contato com o corpo: controlando a extensão do contato (fez o reconhecimento do corpo; viu, mas não reconheceu e nem viu nem reconheceu. Em cada uma dessas categorias, as mulheres foram mais afetadas do que os homens. O artigo conclui que as mulheres sentem mais as perdas do que os homens, mas que parte das diferenças não são internas aos gêneros, mas externas a eles, dependendo das interações e dos contatos pessoais.The social and psychological consequences endured by friends and relatives of people victimized by violent death (homicide, suicide or

Laser-evoked coloration in polymers

International Nuclear Information System (INIS)

Zheng, H.Y.; Rosseinsky, David; Lim, G.C.

2005-01-01

Laser-evoked coloration in polymers has long been a major aim of polymer technology for potential applications in product surface decoration, marking personalised images and logos. However, the coloration results reported so far were mostly attributed to laser-induced thermal-chemical reactions. The laser-irradiated areas are characterized with grooves due to material removal. Furthermore, only single color was laser-induced in any given polymer matrix. To induce multiple colors in a given polymer matrix with no apparent surface material removal is most desirable and challenging and may be achieved through laser-induced photo-chemical reactions. However, little public information is available at present. We report that two colors of red and green have been produced on an initially transparent CPV/PVA samples through UV laser-induced photo-chemical reactions. This is believed the first observation of laser-induced multiple-colors in the given polymer matrix. It is believed that the colorants underwent photo-effected electron transfer with suitable electron donors from the polymers to change from colorless bipyridilium Bipm 2+ to the colored Bipm + species. The discovery may lead to new approaches to the development of laser-evoked multiple coloration in polymers

Trauma Imaging: A Literature Review.

Science.gov (United States)

Vela, Jason Heath; Wertz, Christopher Ira; Onstott, Kimberly L; Wertz, Joss R

2017-01-01

To inform radiologic technologists about which imaging modalities and examinations are best suited for evaluating specific anatomical structures in patients who have sustained a traumatic injury. Two scholarly research databases were searched to identify articles focused on trauma imaging of the head, cervical spine, thorax, abdomen, and pelvis. Articles focused on trauma diagnosis were excluded. Thirty-two articles were selected for analysis. Physical examination and plain-film radiographs typically are used to assess nasal bone fracures. Computed tomography (CT) can be used to assess zygomaticomaxillary complex, mandibular, and temporal bone fractures. Traumatic brain injuries are difficult to assess, and broad classifications are used. Depending on the severity of cervical spine trauma, plain-film radiographs or CT imaging is adequate, with magnetic resonance imaging used as a means for further evaluation. Trauma to the thorax typically is assessed with radiography and CT, and CT is recommended for assesment of abdominal and pelvic trauma. The literature was consistent regarding which examinations to perform to best evaluate suspected injuries to the chest, abdomen, and pelvis. The need for, and correct use of, imaging in evaluating trauma to the head and cervical spine is more controversial. Despite the need for additional research, emergency department care providers should be familiar with the structures most commonly injured during trauma and the role of medical imaging for diagnosis.

Patterns of ocular trauma

International Nuclear Information System (INIS)

Babar, T.F.; Khan, M.T.; Marwat, M.; Shah, A.; Murad, Y.; Khan, M.D.

2007-01-01

To describe the patterns of ocular trauma, cause of injury and its effects on eye. A retrospective case series. Medical records of 1105 patients admitted with ocular trauma were reviewed. The details of patients regarding age, gender, literacy, cause of injury and its effects on eye were entered into specially-designed performa. Sample selection consisted of all patients with history of ocular trauma and who were admitted to hospital. Population details consisted patients who were referred to the hospital from all parts of N.W.F.P. Thus, the frequency of trauma in the hospital admissions was analysed. Ophthalmic trauma comprised 6.78% of the hospital admission. One thousand one hundred and five patients presented with eye injuries. Out of them, 21 patients suffered from trauma to both eyes. Almost 80% patients were male and 69% patients were below 30 years of age. Delayed presentation was more common and 63.61% patients presented after one week. Open globe injuries were more common (520 eyes (46.18%)) than closed globe injuries (484 eyes (42.98%)). 23.26% of open globe injuries were associated with intraocular and intra-orbital foreign bodies. Superficial non-perforating, eyelid and adnexal and burns were seen in 122 eyes (10.83%). Among the complications, lens damage and hyphema was seen in more than 50% of the patients, 16.60% eyes were infected at the time of admission and 4.88% of eyes needed enucleation or evisceration. The common causes of injury were violence in 37.37%, occupational in 24.43% and domestic accidents in 19.18%. Ophthalmic trauma is a major public health problem. Majority of the involved are male and under 30 years of age. Delayed presentation is more common. Open globe injuries are more frequent. Violence and occupational injuries are the major causes. (author)

Epidemiology of severe trauma.

Science.gov (United States)

Alberdi, F; García, I; Atutxa, L; Zabarte, M

2014-12-01

Major injury is the sixth leading cause of death worldwide. Among those under 35 years of age, it is the leading cause of death and disability. Traffic accidents alone are the main cause, fundamentally in low- and middle-income countries. Patients over 65 years of age are an increasingly affected group. For similar levels of injury, these patients have twice the mortality rate of young individuals, due to the existence of important comorbidities and associated treatments, and are more likely to die of medical complications late during hospital admission. No worldwide, standardized definitions exist for documenting, reporting and comparing data on severely injured trauma patients. The most common trauma scores are the Abbreviated Injury Scale (AIS), the Injury Severity Score (ISS) and the Trauma and Injury severity Score (TRISS). Documenting the burden of injury also requires evaluation of the impact of post-trauma impairments, disabilities and handicaps. Trauma epidemiology helps define health service and research priorities, contributes to identify disadvantaged groups, and also facilitates the elaboration of comparable measures for outcome predictions. Copyright © 2014 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

Anti-sound and Acoustical Cloaks

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Veturia CHIROIU

2016-12-01

Full Text Available The principles by which the acoustics can be mimicked in order to reduce or cancel the vibrational field are based on anti-sound concept which can be materialized by acoustic cloaks. Geometric transformations open an elegant way towards the unconstrained control of sound through acoustic metamaterials. Acoustic cloaks can be achieved through geometric transformations which bring exotic metamaterial properties into the acoustic equations. Our paper brings new ideas concerning the technological keys for manufacturing of novel metamaterials based on the spatial compression of Cantor structures, and the architecture of 3D acoustic cloaks in a given frequency band, with application to architectural acoustics.

Emergency Department Management of Trauma

DEFF Research Database (Denmark)

MacKenzie, Colin; Lippert, Freddy

1999-01-01

Initial assessment and management of severely injured patients may occur in a specialized area of an emergency department or in a specialized area of a trauma center. The time from injury until definitive management is of essence for survival of life-threatening trauma. The initial care delivered...... injured patients after these patients reach a hospital emergency department or a trauma center....

Refractory episodic vertigo: role of intratympanic gentamicin and vestibular evoked myogenic potentials.

Science.gov (United States)

Celis-Aguilar, Erika; Hinojosa-González, Ramon; Vales-Hidalgo, Olivia; Coutinho-Toledo, Heloisa

Even today, the treatment of intractable vertigo remains a challenge. Vestibular ablation with intratympanic gentamicin stands as a good alternative in the management of refractory vertigo patients. To control intractable vertigo through complete saccular and horizontal canal vestibular ablation with intratympanic gentamicin treatment. Patients with refractory episodic vertigo were included. The inclusion criteria were: unilateral ear disease, moderate to profound sensorineural hearing loss, and failure to other treatments. Included patients underwent 0.5-0.8mL of gentamicin intratympanic application at a 30mg/mL concentration. Vestibular ablation was confirmed by the absence of response on cervical vestibular evoked myogenic potentials and no response on caloric tests. Audiometry, electronystagmography with iced water, and vestibular evoked myogenic potentials were performed in all patients. Ten patients were included; nine patients with Meniere's disease and one patient with (late onset) delayed hydrops. Nine patients showed an absent response on vestibular evoked myogenic potentials and no response on caloric tests. The only patient with low amplitude on cervical vestibular evoked myogenic potentials had vertigo recurrence. Vertigo control was achieved in 90% of the patients. One patient developed hearing loss >30dB. Cervical vestibular evoked myogenic potentials confirmed vestibular ablation in patients treated with intratympanic gentamicin. High-grade vertigo control was due to complete saccular and horizontal canal ablation (no response to iced water in electronystagmography and no response on cervical vestibular evoked myogenic potentials). Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Acoustical and optical radiation pressure and the development of single beam acoustical tweezers

Science.gov (United States)

Thomas, Jean-Louis; Marchiano, Régis; Baresch, Diego

2017-07-01

Studies on radiation pressure in acoustics and optics have enriched one another and have a long common history. Acoustic radiation pressure is used for metrology, levitation, particle trapping and actuation. However, the dexterity and selectivity of single-beam optical tweezers are still to be matched with acoustical devices. Optical tweezers can trap, move and position micron size particles, biological samples or even atoms with subnanometer accuracy in three dimensions. One limitation of optical tweezers is the weak force that can be applied without thermal damage due to optical absorption. Acoustical tweezers overcome this limitation since the radiation pressure scales as the field intensity divided by the speed of propagation of the wave. However, the feasibility of single beam acoustical tweezers was demonstrated only recently. In this paper, we propose a historical review of the strong similarities but also the specificities of acoustical and optical radiation pressures, from the expression of the force to the development of single-beam acoustical tweezers.

Urological injuries following trauma

International Nuclear Information System (INIS)

Bent, C.; Iyngkaran, T.; Power, N.; Matson, M.; Hajdinjak, T.; Buchholz, N.; Fotheringham, T.

2008-01-01

Blunt renal trauma is the third most common injury in abdominal trauma following splenic and hepatic injuries, respectively. In the majority, such injuries are associated with other abdominal organ injuries. As urological injuries are not usually life-threatening, and clinical signs and symptoms are non-specific, diagnosis is often delayed. We present a practical approach to the diagnosis and management of these injuries based on our experience in a busy inner city trauma hospital with a review of the current evidence-based practice. Diagnostic imaging signs are illustrated

Urological injuries following trauma

Energy Technology Data Exchange (ETDEWEB)

Bent, C. [Department of Diagnostic Imaging, Barts and The London NHS Trust, London (United Kingdom)], E-mail: clare.bent@bartsandthelondon.nhs.uk; Iyngkaran, T.; Power, N.; Matson, M. [Department of Diagnostic Imaging, Barts and The London NHS Trust, London (United Kingdom); Hajdinjak, T.; Buchholz, N. [Department of Urology, Barts and The London NHS Trust, London (United Kingdom); Fotheringham, T. [Department of Diagnostic Imaging, Barts and The London NHS Trust, London (United Kingdom)

2008-12-15

Blunt renal trauma is the third most common injury in abdominal trauma following splenic and hepatic injuries, respectively. In the majority, such injuries are associated with other abdominal organ injuries. As urological injuries are not usually life-threatening, and clinical signs and symptoms are non-specific, diagnosis is often delayed. We present a practical approach to the diagnosis and management of these injuries based on our experience in a busy inner city trauma hospital with a review of the current evidence-based practice. Diagnostic imaging signs are illustrated.

Urological injuries following trauma.

Science.gov (United States)

Bent, C; Iyngkaran, T; Power, N; Matson, M; Hajdinjak, T; Buchholz, N; Fotheringham, T

2008-12-01

Blunt renal trauma is the third most common injury in abdominal trauma following splenic and hepatic injuries, respectively. In the majority, such injuries are associated with other abdominal organ injuries. As urological injuries are not usually life-threatening, and clinical signs and symptoms are non-specific, diagnosis is often delayed. We present a practical approach to the diagnosis and management of these injuries based on our experience in a busy inner city trauma hospital with a review of the current evidence-based practice. Diagnostic imaging signs are illustrated.

Acoustic transparency and slow sound using detuned acoustic resonators

DEFF Research Database (Denmark)

Santillan, Arturo Orozco; Bozhevolnyi, Sergey I.

2011-01-01

We demonstrate that the phenomenon of acoustic transparency and slowsound propagation can be realized with detuned acoustic resonators (DAR), mimicking thereby the effect of electromagnetically induced transparency (EIT) in atomic physics. Sound propagation in a pipe with a series of side...

Computational Ocean Acoustics

CERN Document Server

Jensen, Finn B; Porter, Michael B; Schmidt, Henrik

2011-01-01

Since the mid-1970s, the computer has played an increasingly pivotal role in the field of ocean acoustics. Faster and less expensive than actual ocean experiments, and capable of accommodating the full complexity of the acoustic problem, numerical models are now standard research tools in ocean laboratories. The progress made in computational ocean acoustics over the last thirty years is summed up in this authoritative and innovatively illustrated new text. Written by some of the field's pioneers, all Fellows of the Acoustical Society of America, Computational Ocean Acoustics presents the latest numerical techniques for solving the wave equation in heterogeneous fluid–solid media. The authors discuss various computational schemes in detail, emphasizing the importance of theoretical foundations that lead directly to numerical implementations for real ocean environments. To further clarify the presentation, the fundamental propagation features of the techniques are illustrated in color. Computational Ocean A...

Tram-related trauma in Melbourne, Victoria.

Science.gov (United States)

Mitra, Biswadev; Al Jubair, Jubair; Cameron, Peter A; Gabbe, Belinda J

2010-08-01

To establish the incidence and pattern of injuries in patients presenting to hospital with tram-related injuries. Data on tram-related injury pertaining to 2001-2008 calendar years were extracted from three datasets: the population-based Victorian State Trauma Registry for major trauma cases, the Victorian Emergency Minimum Dataset for ED presentations and the National Coroners' Information System for deaths. Incidence rates adjusted for the population of Melbourne, and trends in the incidence of tram-related ED presentations and major trauma cases, were analysed and presented as incidence rate ratios (IRR). There were 1769 patients who presented to ED after trauma related to trams in Melbourne during the study period. Of these, 107 patients had injuries classified as major trauma. There was a significant increase in the rate of ED presentations (IRR 1.03, P = 0.010) with falls (46%) the most commonly reported mechanism. Most falls occurred inside the trams. There was also a significant increase in the incidence rates of major trauma cases (IRR 1.12, P = 0.006) with pedestrians accounting for most major trauma cases. Most cases of trauma related to trams have minor injuries and are discharged following ED management. Primary prevention of falls in trams and the separation of pedestrians from trams are key areas requiring immediate improvement. In the face of increasing trauma associated with trams, continuing safety surveillance and targeted public safety messages are important to sustain trams as safe and effective mode of transport.

Study on change of multi-modally evoked potentials in nasopharyngeal carcinoma patients after radiotherapy

International Nuclear Information System (INIS)

Qin Ling; Chen Jiaxin; Zhang Lixiang; Wang Tiejian; Han Min; Lu Xiaoling

2001-01-01

Objective: To investigate possible changes of multi-modally evoked potentials in nasopharyngeal carcinoma patients after radiotherapy. Methods: Altogether 48 nasopharyngeal carcinoma patients receiving primary conventional external beam irradiation were examined before and after radiotherapy to determine their brainstem auditory-evoked potential (BAEP), short-latency somatosensory-evoked potential (SLSEP) and pattern reversal visual-evoked potential (PRVEP). Results: In comparison with the conditions before radiotherapy, in different periods after radiotherapy abnormal peak latency and interval latency difference were found in BAEP, SLSEP and PRVEP. Conclusion: Nasopharyngeal carcinoma after radiotherapy may cause abnormal function of nerve conduction in early periods, which can be showed by BAEP, SLSEP, PRVEP, and injury can be timely detected if the three evoked potentials are used together. Thus authors suggest BAEP, SLSEP, PRVEP should be examined in nasopharyngeal carcinoma patients during and after the radiotherapy so as to find early damage in auditory somatosensory and visual conduction pathways

Evaluating trauma center structural performance: The experience of a Canadian provincial trauma system

Directory of Open Access Journals (Sweden)

Lynne Moore

2013-01-01

Full Text Available Background: Indicators of structure, process, and outcome are required to evaluate the performance of trauma centers to improve the quality and efficiency of care. While periodic external accreditation visits are part of most trauma systems, a quantitative indicator of structural performance has yet to be proposed. The objective of this study was to develop and validate a trauma center structural performance indicator using accreditation report data. Materials and Methods: Analyses were based on accreditation reports completed during on-site visits in the Quebec trauma system (1994-2005. Qualitative report data was retrospectively transposed onto an evaluation grid and the weighted average of grid items was used to quantify performance. The indicator of structural performance was evaluated in terms of test-retest reliability (kappa statistic, discrimination between centers (coefficient of variation, content validity (correlation with accreditation decision, designation level, and patient volume and forecasting (correlation between visits performed in 1994-1999 and 1998-2005. Results: Kappa statistics were >0.8 for 66 of the 73 (90% grid items. Mean structural performance score over 59 trauma centers was 47.4 (95% CI: 43.6-51.1. Two centers were flagged as outliers and the coefficient of variation was 31.2% (95% CI: 25.5% to 37.6%, showing good discrimination. Correlation coefficients of associations with accreditation decision, designation level, and volume were all statistically significant (r = 0.61, -0.40, and 0.24, respectively. No correlation was observed over time (r = 0.03. Conclusion: This study demonstrates the feasibility of quantifying trauma center structural performance using accreditation reports. The proposed performance indicator shows good test-retest reliability, between-center discrimination, and construct validity. The observed variability in structural performance across centers and over-time underlines the importance of

Splenic Trauma

International Nuclear Information System (INIS)

Cortes Diaz, Fabio F; Buitrago Mejia, Francisco; Ulloa Guerrero, Luis Heber

2001-01-01

The spleen is the organ that is injured during the closed trauma with more frequency and it is the cause more common of foregone death in the patients with wounded abdominal. At the present time the complications of the splenic trauma are related with their severity, associate wounds, diagnostic fail or inadequate treatments. The lesions that are diagnosed in early form are managed quick and satisfactorily, but the forgotten wounds or the diagnoses and late treatments take for themselves high rates of morbid-mortality. The paper includes their phyto pathology, diagnoses, classification and treatment

Thoracic Trauma.

Science.gov (United States)

Dennis, Bradley M; Bellister, Seth A; Guillamondegui, Oscar D

2017-10-01

Management of chest trauma is integral to patient outcomes owing to the vital structures held within the thoracic cavity. Understanding traumatic chest injuries and appropriate management plays a pivotal role in the overall well-being of both blunt and penetrating trauma patients. Whether the injury includes rib fractures, associated pulmonary injuries, or tracheobronchial tree injuries, every facet of management may impact the short- and long-term outcomes, including mortality. This article elucidates the workup and management of the thoracic cage, pulmonary and tracheobronchial injuries. Copyright © 2017 Elsevier Inc. All rights reserved.

Blunt abdominal trauma in children.

Science.gov (United States)

Schonfeld, Deborah; Lee, Lois K

2012-06-01

This review will examine the current evidence regarding pediatric blunt abdominal trauma and the physical exam findings, laboratory values, and radiographic imaging associated with the diagnosis of intra-abdominal injuries (IAI), as well as review the current literature on pediatric hollow viscus injuries and emergency department disposition after diagnosis. The importance of the seat belt sign on physical examination and screening laboratory data remains controversial, although screening hepatic enzymes are recommended in the evaluation of nonaccidental trauma to identify occult abdominal organ injuries. Focused Assessment with Sonography for Trauma (FAST) has modest sensitivity for hemoperitoneum and IAI in the pediatric trauma patient. Patients with concern for undiagnosed IAI, including bowel injury, may be considered for hospital admission and serial abdominal exams without an increased risk of complications, if an exploratory laparotomy is not performed emergently. Although the FAST exam is not recommended as the sole screening tool to rule out IAI in hemodynamically stable trauma patients, it may be used in conjunction with the physical exam and laboratory findings to identify children at risk for IAI. Children with a normal physical exam and normal abdominal CT may not require routine hospitalization after blunt abdominal trauma.

Prehospital Trauma Care in Singapore.

Science.gov (United States)

Ho, Andrew Fu Wah; Chew, David; Wong, Ting Hway; Ng, Yih Yng; Pek, Pin Pin; Lim, Swee Han; Anantharaman, Venkataraman; Hock Ong, Marcus Eng

2015-01-01

Prehospital emergency care in Singapore has taken shape over almost a century. What began as a hospital-based ambulance service intended to ferry medical cases was later complemented by an ambulance service under the Singapore Fire Brigade to transport trauma cases. The two ambulance services would later combine and come under the Singapore Civil Defence Force. The development of prehospital care systems in island city-state Singapore faces unique challenges as a result of its land area and population density. This article defines aspects of prehospital trauma care in Singapore. It outlines key historical milestones and current initiatives in service, training, and research. It makes propositions for the future direction of trauma care in Singapore. The progress Singapore has made given her circumstances may serve as lessons for the future development of prehospital trauma systems in similar environments. Key words: Singapore; trauma; prehospital emergency care; emergency medical services.

Psychiatric diagnoses, trauma, and suicidiality

Directory of Open Access Journals (Sweden)

Elklit Ask

2007-04-01

Full Text Available Abstract Background This study aimed to examine the associations between psychiatric diagnoses, trauma and suicidiality in psychiatric patients at intake. Methods During two months, all consecutive patients (n = 139 in a psychiatric hospital in Western Norway were interviewed (response rate 72%. Results Ninety-one percent had been exposed to at least one trauma; 69 percent had been repeatedly exposed to trauma for longer periods of time. Only 7% acquired a PTSD diagnosis. The comorbidity of PTSD and other psychiatric diagnoses were 78%. A number of diagnoses were associated with specific traumas. Sixty-seven percent of the patients reported suicidal thoughts in the month prior to intake; thirty-one percent had attempted suicide in the preceding week. Suicidal ideation, self-harming behaviour, and suicide attempts were associated with specific traumas. Conclusion Traumatised patients appear to be under- or misdiagnosed which could have an impact on the efficiency of treatment.

Acoustic Test Results of Melamine Foam with Application to Payload Fairing Acoustic Attenuation Systems

Science.gov (United States)

Hughes, William O.; McNelis, Anne M.

2014-01-01

A spacecraft at launch is subjected to a harsh acoustic and vibration environment resulting from the passage of acoustic energy, created during the liftoff of a launch vehicle, through the vehicle's payload fairing. In order to ensure the mission success of the spacecraft it is often necessary to reduce the resulting internal acoustic sound pressure levels through the usage of acoustic attenuation systems. Melamine foam, lining the interior walls of the payload fairing, is often utilized as the main component of such a system. In order to better understand the acoustic properties of melamine foam, with the goal of developing improved acoustic attenuation systems, NASA has recently performed panel level testing on numerous configurations of melamine foam acoustic treatments at the Riverbank Acoustical Laboratory. Parameters assessed included the foam's thickness and density, as well as the effects of a top outer cover sheet material and mass barriers embedded within the foam. This testing followed the ASTM C423 standard for absorption and the ASTM E90 standard for transmission loss. The acoustic test data obtained and subsequent conclusions are the subjects of this paper.

Utilisation of a trauma meeting handover proforma to improve trauma patient pathway.

Science.gov (United States)

Smyth, Rachel; Parton, Felicity; Trikha, Paul

2015-01-01

Decision making within orthopaedic centres predominantly occurs at the trauma meeting, where all decisions are made as a part of the multidisciplinary process. This is an essential handover process. Difficulties occur when teaching and detailed case discussions detract from the actual decision making process, leading to failure in documentation and implementing treatment plans. An audit was carried out in a busy district general hospital (DGH), assessing the quality of trauma meeting documentation in patient records, and assessing whether the introduction of a proforma document would improve this. Prospective clinical reviews were performed on all patients discussed in the trauma meeting over a one month period. Following the initial audit cycle a proforma was introduced, and the audit process was repeated at a two month and six month interval. The quality of the entries were assessed and compared to the Academy of Medical Royal Colleges Standards for the clinical structure and content of patient records, and The Royal College of Surgeons (RCS) of England Guidelines for Clinicians on Medical Records and Notes. Sixty three patient records during a one month period from 1 August 2014 found that only 16% had any documentation of the trauma meeting, none of which met the standard set at the beginning of the audit. Following the introduction of the proforma, 102 patient records were reviewed from October 2014, showing 70% had documentation of the trauma meeting. This improved further to 84% in February 2015. The proforma has provided an effective means of documenting and communicating management plans, and in turn also improved the trauma patient pathway to theatre or discharge.

Triage and mortality in 2875 consecutive trauma patients

DEFF Research Database (Denmark)

Meisler, Rikke; Thomsen, A B; Abildstrøm, H

2010-01-01

Most studies on trauma and trauma systems have been conducted in the United States. We aimed to describe the factors predicting mortality in European trauma patients, with focus on triage.......Most studies on trauma and trauma systems have been conducted in the United States. We aimed to describe the factors predicting mortality in European trauma patients, with focus on triage....

Density-near-zero using the acoustically induced transparency of a Fano acoustic resonator

KAUST Repository

Elayouch, A.

2017-01-05

We report experimental results of near-zero mass density involving an acoustic metamaterial supporting Fano resonance. For this, we designed and fabricated an acoustic resonator with two closely coupled modes and measured its transmission properties. Our study reveals that the phenomenon of acoustically induced transparency is accompanied by an effect of near-zero density. Indeed, the dynamic effective parameters obtained from experimental data show the presence of a frequency band where the effective mass density is close to zero, with high transmission levels reaching 0.7. Furthermore, we demonstrate that such effective parameters lead to wave guiding in a 90-degrees-bent channel. This kind of acoustic metamaterial can, therefore, give rise to acoustic functions like controlling the wavefront, which may lead to very promising applications in acoustic cloacking or imaging.

Introducing passive acoustic filter in acoustic based condition monitoring: Motor bike piston-bore fault identification

Science.gov (United States)

Jena, D. P.; Panigrahi, S. N.

2016-03-01

Requirement of designing a sophisticated digital band-pass filter in acoustic based condition monitoring has been eliminated by introducing a passive acoustic filter in the present work. So far, no one has attempted to explore the possibility of implementing passive acoustic filters in acoustic based condition monitoring as a pre-conditioner. In order to enhance the acoustic based condition monitoring, a passive acoustic band-pass filter has been designed and deployed. Towards achieving an efficient band-pass acoustic filter, a generalized design methodology has been proposed to design and optimize the desired acoustic filter using multiple filter components in series. An appropriate objective function has been identified for genetic algorithm (GA) based optimization technique with multiple design constraints. In addition, the sturdiness of the proposed method has been demonstrated in designing a band-pass filter by using an n-branch Quincke tube, a high pass filter and multiple Helmholtz resonators. The performance of the designed acoustic band-pass filter has been shown by investigating the piston-bore defect of a motor-bike using engine noise signature. On the introducing a passive acoustic filter in acoustic based condition monitoring reveals the enhancement in machine learning based fault identification practice significantly. This is also a first attempt of its own kind.

Acoustic comfort in eating establishments

DEFF Research Database (Denmark)

Svensson, David; Jeong, Cheol-Ho; Brunskog, Jonas

2014-01-01

The subjective concept of acoustic comfort in eating establishments has been investigated in this study. The goal was to develop a predictive model for the acoustic comfort, by means of simple objective parameters, while also examining which other subjective acoustic parameters could help explain...... the feeling of acoustic comfort. Through several layers of anal ysis, acoustic comfort was found to be rather complex, and could not be explained entirely by common subjective parameters such as annoyance, intelligibility or privacy. A predictive model for the mean acoustic comfort for an eating establishment...

Penetrating ureteral trauma

Directory of Open Access Journals (Sweden)

Gustavo P. Fraga

2007-04-01

Full Text Available OBJECTIVE: The purpose of this series is to report our experience in managing ureteral trauma, focusing on the importance of early diagnosis, correct treatment, and the impact of associated injuries on the management and morbid-mortality. MATERIALS AND METHODS: From January 1994 to December 2002, 1487 laparotomies for abdominal trauma were performed and 20 patients with ureteral lesions were identified, all of them secondary to penetrating injury. Medical charts were analyzed as well as information about trauma mechanisms, diagnostic routine, treatment and outcome. RESULTS: All patients were men. Mean age was 27 years. The mechanisms of injury were gunshot wounds in 18 cases (90% and stab wounds in two (10%. All penetrating abdominal injuries had primary indication of laparotomy, and neither excretory urography nor computed tomography were used in any case before surgery. The diagnosis of ureteric injury was made intra-operatively in 17 cases (85%. Two ureteral injuries (10% were initially missed. All patients had associated injuries. The treatment was dictated by the location, extension and time necessary to identify the injury. The overall incidence of complications was 55%. The presence of shock on admission, delayed diagnosis, Abdominal Trauma Index > 25, Injury Severity Score > 25 and colon injuries were associated to a high complication rate, however, there was no statistically significant difference. There were no mortalities in this group. CONCLUSIONS: A high index of suspicion is required for diagnosis of ureteral injuries. A thorough exploration of all retroperitoneal hematoma after penetrating trauma should be an accurate method of diagnosis; even though it failed in 10% of our cases.

Springer handbook of acoustics

CERN Document Server

2014-01-01

Acoustics, the science of sound, has developed into a broad interdisciplinary field encompassing the academic disciplines of physics, engineering, psychology, speech, audiology, music, architecture, physiology, neuroscience, and electronics. The Springer Handbook of Acoustics is also in his 2nd edition an unparalleled modern handbook reflecting this richly interdisciplinary nature edited by one of the acknowledged masters in the field, Thomas Rossing. Researchers and students benefit from the comprehensive contents. This new edition of the Handbook features over 11 revised and expanded chapters, new illustrations, and 2 new chapters covering microphone arrays  and acoustic emission.  Updated chapters contain the latest research and applications in, e.g. sound propagation in the atmosphere, nonlinear acoustics in fluids, building and concert hall acoustics, signal processing, psychoacoustics, computer music, animal bioacousics, sound intensity, modal acoustics as well as new chapters on microphone arrays an...

Trauma team leaders' non-verbal communication: video registration during trauma team training.

Science.gov (United States)

Härgestam, Maria; Hultin, Magnus; Brulin, Christine; Jacobsson, Maritha

2016-03-25

There is widespread consensus on the importance of safe and secure communication in healthcare, especially in trauma care where time is a limiting factor. Although non-verbal communication has an impact on communication between individuals, there is only limited knowledge of how trauma team leaders communicate. The purpose of this study was to investigate how trauma team members are positioned in the emergency room, and how leaders communicate in terms of gaze direction, vocal nuances, and gestures during trauma team training. Eighteen trauma teams were audio and video recorded during trauma team training in the emergency department of a hospital in northern Sweden. Quantitative content analysis was used to categorize the team members' positions and the leaders' non-verbal communication: gaze direction, vocal nuances, and gestures. The quantitative data were interpreted in relation to the specific context. Time sequences of the leaders' gaze direction, speech time, and gestures were identified separately and registered as time (seconds) and proportions (%) of the total training time. The team leaders who gained control over the most important area in the emergency room, the "inner circle", positioned themselves as heads over the team, using gaze direction, gestures, vocal nuances, and verbal commands that solidified their verbal message. Changes in position required both attention and collaboration. Leaders who spoke in a hesitant voice, or were silent, expressed ambiguity in their non-verbal communication: and other team members took over the leader's tasks. In teams where the leader had control over the inner circle, the members seemed to have an awareness of each other's roles and tasks, knowing when in time and where in space these tasks needed to be executed. Deviations in the leaders' communication increased the ambiguity in the communication, which had consequences for the teamwork. Communication cannot be taken for granted; it needs to be practiced

Emotional intelligence, trauma severity, and emotional expression.

Science.gov (United States)

Kao, Min C; Chen, Yung Y

2016-07-01

This study investigated Emotional Intelligence (EI) as a moderator for the association between emotional expression and adaptive trauma processing, as measured by depressive symptoms. Using Pennebaker's written emotional expression paradigm, 105 participants were assigned to either a conventional trauma-writing or religious trauma-writing condition. Depressive symptoms were assessed at baseline and again at one-month post writing. No significant association between EI and religiousness was found at baseline. Results indicated a three-way interaction among EI, trauma severity, and writing condition on depressive symptoms at follow-up. For the religious trauma-writing condition only, there was a significant difference between high- versus low-EI participants who experienced more severe trauma in depressive symptoms at follow-up, such that low-EI participants registered less depressive symptoms than high-EI participants; while there was no significant difference between low versus high EI for participants with less severe trauma. These findings encourage further investigation of the conditions under which religion may be a beneficial factor in trauma adaptation.

Acoustical Imaging

CERN Document Server

Akiyama, Iwaki

2009-01-01

The 29th International Symposium on Acoustical Imaging was held in Shonan Village, Kanagawa, Japan, April 15-18, 2007. This interdisciplinary Symposium has been taking place every two years since 1968 and forms a unique forum for advanced research, covering new technologies, developments, methods and theories in all areas of acoustics. In the course of the years the volumes in the Acoustical Imaging Series have developed and become well-known and appreciated reference works. Offering both a broad perspective on the state-of-the-art in the field as well as an in-depth look at its leading edge research, this Volume 29 in the Series contains again an excellent collection of seventy papers presented in nine major categories: Strain Imaging Biological and Medical Applications Acoustic Microscopy Non-Destructive Evaluation and Industrial Applications Components and Systems Geophysics and Underwater Imaging Physics and Mathematics Medical Image Analysis FDTD method and Other Numerical Simulations Audience Researcher...

Battlefield acoustics

CERN Document Server

Damarla, Thyagaraju

2015-01-01

This book presents all aspects of situational awareness in a battlefield using acoustic signals. It starts by presenting the science behind understanding and interpretation of sound signals. The book then goes on to provide various signal processing techniques used in acoustics to find the direction of sound source, localize gunfire, track vehicles, and detect people. The necessary mathematical background and various classification and fusion techniques are presented. The book contains majority of the things one would need to process acoustic signals for all aspects of situational awareness in one location. The book also presents array theory, which is pivotal in finding the direction of arrival of acoustic signals. In addition, the book presents techniques to fuse the information from multiple homogeneous/heterogeneous sensors for better detection. MATLAB code is provided for majority of the real application, which is a valuable resource in not only understanding the theory but readers, can also use the code...

Drug abuse in hospitalized trauma patients in a university trauma care center: an explorative study

Directory of Open Access Journals (Sweden)

A.R. Soroush

2006-08-01

Full Text Available Background: Drug abuse has been known as a growing contributing factor to all types of trauma in the world. The goal of this article is to provide insight into demographic and substance use factors associated with trauma and to determine the prevalence of drug abuse in trauma patients. Methods: Evidence of substance abuse was assessed in trauma patients presenting to Sina trauma hospital over a 3-month period. They were interviewed and provided urine samples to detect the presence of drug/metabolites of opium, morphine, cannabis and heroin by “Morphine Check” kits. Demographic data, mechanisms of injury, history of smoking and drug abuse were recorded. Results: A total of 358 patients with a mean age of 28.4 years were studied. The Patients were predominantly male (94.7%. There was a history of smoking in 136 cases (38%. 58 cases (16.2% reported to abuse drugs (91.5% opium. The commonest route of administration was smoke inhalation (37.2%. Screening by Morphine Check test revealed 95 samples to be positive (26.5%. The preponderance of test-positive cases was among young people (of 20-30 years of age with a history of smoking. Victims of violence and those with penetrating injuries also showed a higher percentage of positive screens (P=0.038 and P<0.001, respectively. Conclusion: These results suggest that drug abuse is a contributing factor to trauma especially in violent injuries and among the young. Regarding the considerable prevalence of drug abuse among trauma patients, it’s highly recommended that all trauma patients be screened for illicit drugs

Index finger somatosensory evoked potentials in blind Braille readers.

Science.gov (United States)

Giriyappa, Dayananda; Subrahmanyam, Roopakala Mysore; Rangashetty, Srinivasa; Sharma, Rajeev

2009-01-01

Traditionally, vision has been considered the dominant modality in our multi-sensory perception of the surrounding world. Sensory input via non-visual tracts becomes of greater behavioural relevance in totally blind individuals to enable effective interaction with the world around them. These include audition and tactile perceptions, leading to an augmentation in these perceptions when compared with normal sighted individuals. The objective of the present work was to study the index finger somatosensory evoked potentials (SEPs) in totally blind and normal sighted individuals. SEPs were recorded in 15 Braille reading totally blind females and compared with 15 age-matched normal sighted females. Latency and amplitudes of somatosensory evoked potential waveforms (N9, N13, and N20) were measured. Amplitude of N20 SEP (a cortical somatosensory evoked potential) was significantly larger in the totally blind than in normal sighted individuals (p Braille reading right index finger. Totally blind Braille readers have larger N20 amplitude, suggestive of greater somatosensory cortical representation of the Braille reading index finger.

Transfusion practices in trauma

Directory of Open Access Journals (Sweden)

V Trichur Ramakrishnan

2014-01-01

Full Text Available Resuscitation of a severely traumatised patient with the administration of crystalloids, or colloids along with blood products is a common transfusion practice in trauma patients. The determination of this review article is to update on current transfusion practices in trauma. A search of PubMed, Google Scholar, and bibliographies of published studies were conducted using a combination of key-words. Recent articles addressing the transfusion practises in trauma from 2000 to 2014 were identified and reviewed. Trauma induced consumption and dilution of clotting factors, acidosis and hypothermia in a severely injured patient commonly causes trauma-induced coagulopathy. Early infusion of blood products and early control of bleeding decreases trauma-induced coagulopathy. Hypothermia and dilutional coagulopathy are associated with infusion of large volumes of crystalloids. Hence, the predominant focus is on damage control resuscitation, which is a combination of permissive hypotension, haemorrhage control and haemostatic resuscitation. Massive transfusion protocols improve survival in severely injured patients. Early recognition that the patient will need massive blood transfusion will limit the use of crystalloids. Initially during resuscitation, fresh frozen plasma, packed red blood cells (PRBCs and platelets should be transfused in the ratio of 1:1:1 in severely injured patients. Fresh whole blood can be an alternative in patients who need a transfusion of 1:1:1 thawed plasma, PRBCs and platelets. Close monitoring of bleeding and point of care coagulation tests are employed, to allow goal-directed plasma, PRBCs and platelets transfusions, in order to decrease the risk of transfusion-related acute lung injury.

Acoustic insulator for combined well equipment of acoustic and radioactivity logging

International Nuclear Information System (INIS)

Arkad'ev, E.A.; Gorbachev, Yu.I.; Dseban', I.P.; Yagodov, G.I.

1977-01-01

The design of an acoustic insulator for cobined well equipment of acoustic and radioactivity logaing made on the basis of studying the velocity of elastic waves propagation and attenuation in cable structures of various marks is described. It is shown that the cable probe of electric loggign equipment which is recommended as an acoustic insulator for combined well equipment has the necessary sound-insulating properties

Temporal bone trauma: correlative study between CT findings and clinical manifestations

Energy Technology Data Exchange (ETDEWEB)

Kim, Jung Hee; Kim, Hyung Jin; Kim, Jae Hyoung [College of Medicine, Gyeongsang National University, Jinju (Korea, Republic of)

1994-11-15

To assess how accurately computed tomography (CT) can demonstrate the abnormal findings which are believed to cause the clinical signs and symptoms of hearing loss (HL), vertigo and facial paralysis (FP) in patients with temporal bone trauma. The authors studied CT scans of 39 ears in 35 patients with temporal bone trauma. CT scans were performed with 1-1.5 mm slice thickness and table incrementation. Both axial and coronal scans were obtained in 32 patients and in three patients only axial scans were obtained. We analyzed CT with special reference to the structural abnormalities of the external auditory canal, middle ear cavity, bony labyrinth, and facial nerve canal, and correlated these findings with the actual clinical signs and symptoms. As to hearing loss, we evaluated 32 ears in which pure tone audiometry or brainstem evoked response audiometry had been performed. With respect to the specific types of HL, CT accurately showed the abnormalities in 84% (16/19) in conductive HL, 100% (2/2) in sensorineural HL, and 25% (2/8) for mixed HL. When we categorized HL simply as conductive and sensorineural, assuming that mixed be the result of combined conductive and sensorineural HL, CT demonstrated the abnormalities in 89% (24/27) for conductive HL and 50% (5/10) for sensorineural HL. Concerning vertigo and FP, CT demonstrated abnormalities in 67%(4/6), and 29% (4/14), respectively. Except for conductive HL, CT seems to have a variable degree of limitation for the demonstration of the structural abnormalities resulting sensorineural HL, vertigo or facial paralysis. It is imperative to correlate the CT findings with the signs and symptoms in those clinical settings.

Temporal bone trauma: correlative study between CT findings and clinical manifestations

International Nuclear Information System (INIS)

Kim, Jung Hee; Kim, Hyung Jin; Kim, Jae Hyoung

1994-01-01

To assess how accurately computed tomography (CT) can demonstrate the abnormal findings which are believed to cause the clinical signs and symptoms of hearing loss (HL), vertigo and facial paralysis (FP) in patients with temporal bone trauma. The authors studied CT scans of 39 ears in 35 patients with temporal bone trauma. CT scans were performed with 1-1.5 mm slice thickness and table incrementation. Both axial and coronal scans were obtained in 32 patients and in three patients only axial scans were obtained. We analyzed CT with special reference to the structural abnormalities of the external auditory canal, middle ear cavity, bony labyrinth, and facial nerve canal, and correlated these findings with the actual clinical signs and symptoms. As to hearing loss, we evaluated 32 ears in which pure tone audiometry or brainstem evoked response audiometry had been performed. With respect to the specific types of HL, CT accurately showed the abnormalities in 84% (16/19) in conductive HL, 100% (2/2) in sensorineural HL, and 25% (2/8) for mixed HL. When we categorized HL simply as conductive and sensorineural, assuming that mixed be the result of combined conductive and sensorineural HL, CT demonstrated the abnormalities in 89% (24/27) for conductive HL and 50% (5/10) for sensorineural HL. Concerning vertigo and FP, CT demonstrated abnormalities in 67%(4/6), and 29% (4/14), respectively. Except for conductive HL, CT seems to have a variable degree of limitation for the demonstration of the structural abnormalities resulting sensorineural HL, vertigo or facial paralysis. It is imperative to correlate the CT findings with the signs and symptoms in those clinical settings

Use of laparoscopy in trauma at a level II trauma center.

Science.gov (United States)

Barzana, Daniel C; Kotwall, Cyrus A; Clancy, Thomas V; Hope, William W

2011-01-01

Enthusiasm for the use of laparoscopy in trauma has not rivaled that for general surgery. The purpose of this study was to evaluate our experience with laparoscopy at a level II trauma center. A retrospective review of all trauma patients undergoing diagnostic or therapeutic laparoscopy was performed from January 2004 to July 2010. Laparoscopy was performed in 16 patients during the study period. The average age was 35 years. Injuries included left diaphragm in 4 patients, mesenteric injury in 2, and vaginal laceration, liver laceration, small bowel injury, renal laceration, urethral/pelvic, and colon injury in 1 patient each. Diagnostic laparoscopy was performed in 11 patients (69%) with 3 patients requiring conversion to an open procedure. Successful therapeutic laparoscopy was performed in 5 patients for repair of isolated diaphragm injuries (2), a small bowel injury, a colon injury, and placement of a suprapubic bladder catheter. Average length of stay was 5.6 days (range, 0 to 23), and 75% of patients were discharged home. Morbidity rate was 13% with no mortalities or missed injuries. Laparoscopy is a seldom-used modality at our trauma center; however, it may play a role in a select subset of patients.

Trauma and the transference-countertransference: working with the bad object and the wounded self.

Science.gov (United States)

West, Marcus

2013-02-01

This paper focuses on the transference-countertransference dynamics that manifest in work with those individuals who experienced severe early relational trauma and, in particular, childhood sexual abuse. The literature is surveyed from Davies and Frawley's (1992a) seminal paper through to more current trauma-related and sensorimotor approaches, which deepen our understanding greatly. The rapidly shifting, powerful, conflicting and kaleidoscopic transference-countertransference dynamics are explored in the light of these views and in relation to a lengthy clinical example. The author elucidates the dual-aspect of the traumatic complex, whereby the abuser figure, which is disavowed by the patient, becomes manifest in prosecuting the analyst for the 'wounds' that the analysis evokes. The paper also explores the particular nature of the splitting processes, whereby pressure is put on the analyst to adopt an idealized role, in particular to act as a self-object, in order to enable the patient to safely express and 'be' themselves in an attempt to make up for what was not possible in childhood; the analyst will necessarily fail in this task. In the context of powerful masochisto-sadistic dynamics, the analyst's masochism is likely to be called up in the spirit of caring 'humanity' (another inevitable enactment), which can impede the progress of the analysis if not addressed. The extreme woundedness, intense affect and moral outrage associated with these dynamics are characteristic and compelling. Issues relating to disclosure, enactment and analytic attitude are also discussed. © 2013, The Society of Analytical Psychology.

Acoustic and streaming velocity components in a resonant waveguide at high acoustic levels.

Science.gov (United States)

Daru, Virginie; Reyt, Ida; Bailliet, Hélène; Weisman, Catherine; Baltean-Carlès, Diana

2017-01-01

Rayleigh streaming is a steady flow generated by the interaction between an acoustic wave and a solid wall, generally assumed to be second order in a Mach number expansion. Acoustic streaming is well known in the case of a stationary plane wave at low amplitude: it has a half-wavelength spatial periodicity and the maximum axial streaming velocity is a quadratic function of the acoustic velocity amplitude at antinode. For higher acoustic levels, additional streaming cells have been observed. Results of laser Doppler velocimetry measurements are here compared to direct numerical simulations. The evolution of axial and radial velocity components for both acoustic and streaming velocities is studied from low to high acoustic amplitudes. Two streaming flow regimes are pointed out, the axial streaming dependency on acoustics going from quadratic to linear. The evolution of streaming flow is different for outer cells and for inner cells. Also, the hypothesis of radial streaming velocity being of second order in a Mach number expansion, is not valid at high amplitudes. The change of regime occurs when the radial streaming velocity amplitude becomes larger than the radial acoustic velocity amplitude, high levels being therefore characterized by nonlinear interaction of the different velocity components.

Prospects after Major Trauma

NARCIS (Netherlands)

Holtslag, H.R.

2007-01-01

Introduction. After patients survived major trauma, their prospects, in terms of the consequences for functioning, are uncertain, which may impact severely on patient, family and society. The studies in this thesis describes the long-term outcomes of severe injured patients after major trauma. In

Controlling sound with acoustic metamaterials

DEFF Research Database (Denmark)

Cummer, Steven A. ; Christensen, Johan; Alù, Andrea

2016-01-01

Acoustic metamaterials can manipulate and control sound waves in ways that are not possible in conventional materials. Metamaterials with zero, or even negative, refractive index for sound offer new possibilities for acoustic imaging and for the control of sound at subwavelength scales....... The combination of transformation acoustics theory and highly anisotropic acoustic metamaterials enables precise control over the deformation of sound fields, which can be used, for example, to hide or cloak objects from incident acoustic energy. Active acoustic metamaterials use external control to create......-scale metamaterial structures and converting laboratory experiments into useful devices. In this Review, we outline the designs and properties of materials with unusual acoustic parameters (for example, negative refractive index), discuss examples of extreme manipulation of sound and, finally, provide an overview...

Helicopter overtriage in pediatric trauma.

Science.gov (United States)

Michailidou, Maria; Goldstein, Seth D; Salazar, Jose; Aboagye, Jonathan; Stewart, Dylan; Efron, David; Abdullah, Fizan; Haut, Elliot R

2014-11-01

Helicopter Emergency Medical Services (HEMS) have been designed to provide faster access to trauma center care in cases of life-threatening injury. However, the ideal recipient population is not fully characterized, and indications for helicopter transport in pediatric trauma vary dramatically by county, state, and region. Overtriage, or unnecessary utilization, can lead to additional patient risk and expense. In this study we perform a nationwide descriptive analysis of HEMS for pediatric trauma and assess the incidence of overtriage in this group. We reviewed records from the American College of Surgeons National Trauma Data Bank (2008-11) and included patients less than 16 years of age who were transferred from the scene of injury to a trauma center via HEMS. Overtriage was defined as patients meeting all of the following criteria: Glasgow Coma Scale (GCS) equal to 15, absence of hypotension, an Injury Severity Score (ISS) less than 9, no need for procedure or critical care, and a hospital length of stay of less than 24 hours. A total of 19,725 patients were identified with a mean age of 10.5 years. The majority of injuries were blunt (95.6%) and resulted from motor vehicle crashes (48%) and falls (15%). HEMS transported patients were predominately normotensive (96%), had a GCS of 15 (67%), and presented with minor injuries (ISS<9, 41%). Overall, 28 % of patients stayed in the hospital for less than 24 hours, and the incidence of overtriage was 17%. Helicopter overtriage is prevalent among pediatric trauma patients nationwide. The ideal model to predict need for HEMS must consider clinical outcomes in the context of judicious resource utilization. The development of guidelines for HEMS use in pediatric trauma could potentially limit unnecessary transfers while still identifying children who require trauma center care in a timely fashion. Copyright © 2014. Published by Elsevier Inc.

Trauma team activation criteria in managing trauma patients at an emergency room in Thailand.

Science.gov (United States)

Wuthisuthimethawee, P

2017-02-01

Trauma team activation (TTA) criteria were first implemented in the Emergency Department (ED) of Songklanagarind Hospital in 2009 to treat severe trauma patients. To determine the efficacy of the TTA criteria on the acute trauma care process in the ED and the 28-day mortality rate. A 1-year prospective cohort study was conducted at the ED. Trauma patients who were 18 years old and over who met the TTA criteria were enrolled. Demographic data, physiologic parameters, ED length of stay (EDLOS), and the injury severity score (ISS) were recorded. Multiple logistic regression was used to determine the factors affecting 28-day mortality. Institutional review board approval was obtained from the Prince of Songkla University. A total of 80 patients (74 male and 6 female) were eligible with a mean age of 34.3 years old. Shock, penetrating torso injury, and pulse rate >120 beats per minute were the three most common criteria for trauma team consultation. At the ED, 9 patients (11.3 %) were non-survivors, 30 patients (37.5 %) needed immediate operation, and 41 patients (51.2 %) were admitted. All of the arrest patients died (p team activation criteria improved acute trauma care in the ED which was demonstrated by the decreased EDLOS and mortality rate. A high ISS is the sole parameter predicting mortality.

Education in acoustics in Argentina

Science.gov (United States)

Miyara, Federico

2002-11-01

Over the last decades, education in acoustics (EA) in Argentina has experienced ups and downs due to economic and political issues interfering with long term projects. Unlike other countries, like Chile, where EA has reached maturity in spite of the acoustical industry having shown little development, Argentina has several well-established manufacturers of acoustic materials and equipment but no specific career with a major in acoustics. At the university level, acoustics is taught as a complementary--often elective--course for careers such as architecture, communication engineering, or music. In spite of this there are several research centers with programs covering environmental and community noise, effects of noise on man, acoustic signal processing, musical acoustics and acoustic emission, and several national and international meetings are held each year in which results are communicated and discussed. Several books on a variety of topics such as sound system, architectural acoustics, and noise control have been published as well. Another chapter in EA is technical and vocational education, ranging between secondary and postsecondary levels, with technical training on sound system operation or design. Over the last years there have been several attempts to implement master degrees in acoustics or audio engineering, with little or no success.

Review of Progress in Acoustic Levitation

Science.gov (United States)

Andrade, Marco A. B.; Pérez, Nicolás; Adamowski, Julio C.

2018-04-01

Acoustic levitation uses acoustic radiation forces to counteract gravity and suspend objects in mid-air. Although acoustic levitation was first demonstrated almost a century ago, for a long time, it was limited to objects much smaller than the acoustic wavelength levitating at fixed positions in space. Recent advances in acoustic levitation now allow not only suspending but also rotating and translating objects in three dimensions. Acoustic levitation is also no longer restricted to small objects and can now be employed to levitate objects larger than the acoustic wavelength. This article reviews the progress of acoustic levitation, focusing on the working mechanism of different types of acoustic levitation devices developed to date. We start with a brief review of the theory. Then, we review the acoustic levitation methods to suspend objects at fixed positions, followed by the techniques that allow the manipulation of objects. Finally, we present a brief summary and offer some future perspectives for acoustic levitation.

Trauma research in Qatar: a literature review and discussion of progress after establishment of a trauma research centre.

Science.gov (United States)

El-Menyar, A; Asim, M; Zarour, A; Abdelrahman, H; Peralta, R; Parchani, A; Al-Thani, H

2016-02-01

A structured research programme is one of the main pillars of a trauma care system. Despite the high rate of injury-related mortalities, especially road traffic accidents, in Qatar, little consideration has been given to research in trauma. This review aimed to analyse research publications on the subject of trauma published from Qatar and to discuss the progress of clinical research in Qatar and the Gulf Cooperation Council countries with special emphasis on trauma research. A literature search using PubMed and Google Scholar search engines located 757 English-language articles within the fields of internal medicine, surgery and trauma originating from Qatar between the years 1993 and 2013. A steep increase in the number of trauma publications since 2010 could be linked to the setting up of a trauma research centre in Qatar in 2011. We believe that establishing a research unit has made a major impact on research productivity, which ultimately benefits health care.

Coagulation Profile Changes Due to Thromboprophylaxis and Platelets in Trauma Patients at High-Risk for Venous Thromboembolism.

Science.gov (United States)

Allen, Casey J; Murray, Clark R; Meizoso, Jonathan P; Ray, Juliet J; Teisch, Laura F; Ruiz, Xiomara D; Hanna, Mena M; Guarch, Gerardo A; Manning, Ronald J; Livingstone, Alan S; Ginzburg, Enrique; Schulman, Carl I; Namias, Nicholas; Proctor, Kenneth G

2015-07-01

We hypothesize there are coagulation profile changes associated both with initiation of thromboporphylaxis (TPX) and with change in platelet levels in trauma patients at high-risk for venous thromboembolism (VTE). A total of 1203 trauma intensive care unit patients were screened with a VTE risk assessment profile. In all, 302 high-risk patients (risk assessment profile score ≥ 10) were consented for weekly thromboelastography. TPX was initiated between initial and follow-up thromboelastography. Seventy-four patients were analyzed. Upon admission, 87 per cent were hypercoagulable, and 81 per cent remained hypercoagulable by Day 7 (P = 0.504). TPX was initiated 3.4 ± 1.4 days after admission; 68 per cent received unfractionated heparin and 32 per cent received low-molecular-weight heparin. The VTE rate was 18 per cent, length of stay 38 (25-37) days, and mortality of 17.6 per cent. In all, 76 per cent had a rapid clotting time at admission versus 39 per cent at Day 7 (P < 0.001); correcting from 7.75 (6.45-8.90) minutes to 10.45 (7.90-15.25) minutes (P < 0.001). At admission, 41 per cent had an elevated maximum clot formation (MCF) and 85 per cent had at Day 7 (P < 0.001); increasing from 61(55-65) mm to 75(69-80) mm (P < 0.001). Platelets positively correlated with MCF at admission (r = 0.308, R(2) = 0.095, P = 0.008) and at Day 7 (r = 0.516, R(2) = 0.266, P < 0.001). Change in platelet levels correlated with change in MCF (r = 0.332, R(2) = 0.110, P = 0.005). In conclusion, hypercoagulability persists despite the use of TPX. Although clotting time normalizes, MCF increases in correlation with platelet levels. As platelet function is a dominant contributor to sustained trauma-evoked hypercoagulability, antiplatelet therapy may be indicated in the management of severely injured trauma patients.

Predictors of Intrathoracic Injury after Blunt Torso Trauma in Children Presenting to an Emergency Department as Trauma Activations.

Science.gov (United States)

McNamara, Caitlin; Mironova, Irina; Lehman, Erik; Olympia, Robert P

2017-06-01

Thoracic injuries are a major cause of death associated with blunt trauma in children. Screening for injury with chest x-ray study, compared with chest computed tomography (CT) scan, has been controversial, weighing the benefits of specificity with the detriment of radiation exposure. To identify predictors of thoracic injury in children presenting as trauma activations to a Level I trauma center after blunt torso trauma, and to compare these predictors with those previously reported in the literature. We performed a retrospective chart review of pediatric patients (trauma center between June 2010 and June 2013 as a trauma activation after sustaining a blunt torso trauma and who received diagnostic imaging of the chest as part of their initial evaluation. Data analysis was performed on 166 patients. There were 33 patients (20%) with 45 abnormalities detected on diagnostic imaging of the chest, with the most common abnormalities being lung contusion (36%), pneumothorax (22%), and rib fracture (13%). Statistically significant predictors of abnormal diagnostic imaging of the chest included Glasgow Coma Scale score (GCS) trauma include GCS < 15, hypoxia, syncope/dizziness, cervical spine tenderness, thoraco-lumbar-sacral spine tenderness, and abdominal/pelvic tenderness. Copyright © 2016 Elsevier Inc. All rights reserved.

Fibrinogen depletion in trauma: early, easy to estimate and central to trauma-induced coagulopathy.

Science.gov (United States)

Davenport, Ross; Brohi, Karim

2013-09-24

Fibrinogen is fundamental to hemostasis and falls rapidly in trauma hemorrhage, although levels are not routinely measured in the acute bleeding episode. Prompt identification of critically low levels of fibrinogen and early supplementation has the potential to correct trauma-induced coagulation and improve outcomes. Early estimation of hypofibrinogenemia is possible using surrogate markers of shock and hemorrhage; for example, hemoglobin and base excess. Rapid replacement with fibrinogen concentrate or cryoprecipitate should be considered a clinical priority in major trauma hemorrhage.

Newborn hearing screening with transient evoked otoacoustic emissions and automatic auditory brainstem response

Directory of Open Access Journals (Sweden)

Renata Mota Mamede de Carvallo

2008-09-01

Full Text Available Objective: The aim of the present investigation was to check Transient Evoked Otoacoustic Emissions and Automatic Auditory Brainstem Response tests applied together in regular nurseries and Newborn Intensive Care Units (NICU, as well as to describe and compare the results obtained in both groups. Methods: We tested 150 newborns from regular nurseries and 70 from NICU. Rresults: The newborn hearing screening results using Transient Evoked Otoacoustic Emissions and Automatic Auditory Brainstem Response tests could be applied to all babies. The “pass” result for the group of babies from the nursery was 94.7% using Transient Evoked Otoacoustic Emissions and 96% using Automatic Auditory Brainstem Response. The newborn intensive care unit group obtained 87.1% on Transient Evoked Otoacoustic Emissions and 80% on the Automatic Auditory Brainstem Response, and there was no statistical difference between the procedures when the groups were evaluated individually. However, comparing the groups, Transient Evoked Otoacoustic Emissions were presented in 94.7% of the nursery babies and in 87.1% in the group from the newborn intensive care unit. Considering the Automatic Auditory Brainstem Response, we found 96 and 87%, respectively. Cconclusions: Transient Evoked Otoacoustic Emissions and Automatic Auditory Brainstem Response had similar “pass” and “fail” results when the procedures were applied to neonates from the regular nursery, and the combined tests were more precise to detect hearing impairment in the newborn intensive care unit babies.

Decolonizing Trauma Theory : Retrospect and Prospects

NARCIS (Netherlands)

Visser, Irene

2015-01-01

Decolonizing trauma theory has been a major project in postcolonial literary scholarship ever since its first sustained engagements with trauma theory. Since then, trauma theory and postcolonial literary studies have been uneasy bedfellows, and the time has now come to take stock of what remains in

Endovascular interventions for multiple trauma

International Nuclear Information System (INIS)

Kinstner, C.; Funovics, M.

2014-01-01

In recent years interventional radiology has significantly changed the management of injured patients with multiple trauma. Currently nearly all vessels can be reached within a reasonably short time with the help of specially preshaped catheters and guide wires to achieve bleeding control of arterial und venous bleeding. Whereas bleeding control formerly required extensive open surgery, current interventional methods allow temporary vessel occlusion (occlusion balloons), permanent embolization and stenting. In injured patients with multiple trauma preinterventional procedural planning is performed with the help of multidetector computed tomography whenever possible. Interventional radiology not only allows minimization of therapeutic trauma but also a considerably shorter treatment time. Interventional bleeding control has developed into a standard method in the management of vascular trauma of the chest and abdomen as well as in vascular injuries of the upper and lower extremities when open surgical access is associated with increased risk. Additionally, pelvic trauma, vascular trauma of the superior thoracic aperture and parenchymal arterial lacerations of organs that can be at least partially preserved are primarily managed by interventional methods. In an interdisciplinary setting interventional radiology provides a safe and efficient means of rapid bleeding control in nearly all vascular territories in addition to open surgical access. (orig.) [de

Radiographic evaluation of hepatic trauma

International Nuclear Information System (INIS)

Federle, M.P.

1985-01-01

The incidence of significant abdominal trauma continues to rise and accounts currently for approximately 10 percent of the annual 130,000 trauma-related deaths in the United States. Over 60 percent of patients are from 10 to 40 years of age, with a striking predominance of males. Children are mostly victims of blunt trauma, while some large reviews of liver trauma in adults show a prevalence of penetrating injuries. Injury to the liver is second only to the spleen in incidence of intraperitoneal injuries. Morbidity and mortality from hepatic trauma are related to the mechanism and extent of injury. Penetrating injuries generally have a lower mortality, about 5 percent, especially if they are due to stab wounds or low velocity gunshot wounds. Shotgun and high velocity gunshot wounds may cause massive fragmentation of the liver and are associated with proportionately greater mortality. The mortality from blunt trauma is from 15 to 45 percent in many large series. Death from isolated liver injury is uncommon, but is usually due to uncontrolled hemorrhage. Injury to other abdominal organs is associated in many cases, as are injuries to the head, chest, and limbs. The extraabdominal injuries are frequently more apparent clinically, but may mask potentially life-threatening abdominal visceral injuries

Sex differences in the jealousy-evoking nature of a rival's body build

NARCIS (Netherlands)

Dijkstra, Pieternel; Buunk, Abraham (Bram)

This study among 185 college students showed that potential rivals with a relatively low waist-to-hip ratio (WHR) evoked more jealousy in women than in men. In contrast, rivals with a relatively high shoulder-to-hip ratio (SHR) evoked more jealousy in men than in women, particularly when the rival

Enhanced brainstem and cortical evoked response amplitudes: single-trial covariance analysis.

Science.gov (United States)

Galbraith, G C

2001-06-01

The purpose of the present study was to develop analytic procedures that improve the definition of sensory evoked response components. Such procedures could benefit all recordings but would especially benefit difficult recordings where many trials are contaminated by muscle and movement artifacts. First, cross-correlation and latency adjustment analyses were applied to the human brainstem frequency-following response and cortical auditory evoked response recorded on the same trials. Lagged cross-correlation functions were computed, for each of 17 subjects, between single-trial data and templates consisting of the sinusoid stimulus waveform for the brainstem response and the subject's own smoothed averaged evoked response P2 component for the cortical response. Trials were considered in the analysis only if the maximum correlation-squared (r2) exceeded .5 (negatively correlated trials were thus included). Identical correlation coefficients may be based on signals with quite different amplitudes, but it is possible to assess amplitude by the nonnormalized covariance function. Next, an algorithm is applied in which each trial with negative covariance is matched to a trial with similar, but positive, covariance and these matched-trial pairs are deleted. When an evoked response signal is present in the data, the majority of trials positively correlate with the template. Thus, a residual of positively correlated trials remains after matched covariance trials are deleted. When these residual trials are averaged, the resulting brainstem and cortical responses show greatly enhanced amplitudes. This result supports the utility of this analysis technique in clarifying and assessing evoked response signals.

Evaluating trauma nursing education: An integrative literature review.

Science.gov (United States)

Ding, Min; Metcalfe, Helene; Gallagher, Olivia; Hamdorf, Jeffrey M

2016-09-01

A review of the current literature evaluating trauma nursing education. A variety of trauma nursing courses exist, to educate nurses working in trauma settings, and to maintain their continuing professional development. Despite an increase in the number of courses delivered, there appears to be a lack of evidence to demonstrate the effectiveness of trauma nursing education and in particular the justification for this resource allocation. Integrative literature review. A search of international literature on trauma nursing education evaluation published in English from 1985 to 2015 was conducted through electronic databases CINAHL Plus, Google Scholar, PubMed, Austhealth, Science Citation Index Expanded (Web of Science), Sciverse Science Direct (Elsevier) & One file (Gale). Only peer reviewed journal articles identifying trauma course and trauma nursing course evaluation have been included in the selection criteria. An integrative review of both quantitative and qualitative literature guided by Whittemore and Knafl's theoretical framework using Bowling's and Pearson's validated appraisal checklists, has been conducted for three months. Only 17 studies met the inclusion criteria, including 14 on trauma course evaluation and 3 on trauma nursing course evaluation. Study findings are presented as two main themes: the historical evolution of trauma nursing education and evaluation of trauma nursing education outcomes. Trauma nursing remains in its infancy and education in this specialty is mainly led by continuing professional development courses. The shortage of evaluation studies on trauma nursing courses reflects the similar status in continuing professional development course evaluation. A trauma nursing course evaluation study will address the gap in this under researched area. Copyright © 2016 Elsevier Ltd. All rights reserved.

Interaction of surface plasmon polaritons and acoustic waves inside an acoustic cavity.

Science.gov (United States)

Khokhlov, Nikolai; Knyazev, Grigoriy; Glavin, Boris; Shtykov, Yakov; Romanov, Oleg; Belotelov, Vladimir

2017-09-15

In this Letter, we introduce an approach for manipulation of active plasmon polaritons via acoustic waves at sub-terahertz frequency range. The acoustic structures considered are designed as phononic Fabry-Perot microresonators where mirrors are presented with an acoustic superlattice and the structure's surface, and a plasmonic grating is placed on top of the acoustic cavity so formed. It provides phonon localization in the vicinity of the plasmonic grating at frequencies within the phononic stop band enhancing phonon-light interaction. We consider phonon excitation by shining a femtosecond laser pulse on the plasmonic grating. Appropriate theoretical model was used to describe the acoustic process caused by the pump laser pulse in the GaAs/AlAs-based acoustic cavity with a gold grating on top. Strongest modulation is achieved upon excitation of propagating surface plasmon polaritons and hybridization of propagating and localized plasmons. The relative changes in the optical reflectivity of the structure are more than an order of magnitude higher than for the structure without the plasmonic film.

Estudo da morbimortalidade em pacientes com trauma pancreático Morbimortality in patients with pancreatic trauma

Directory of Open Access Journals (Sweden)

Olival Cirilo Lucena da Fonseca Neto

2007-03-01

Full Text Available RACIONAL: A lesão pancreática é pouco freqüente após traumas abdominais fechados ou penetrantes, e tem sido relatada entre 0,2 a 12% dos traumas abdominais fechados graves e em cinco a 7% dos traumas penetrantes. A maioria das lesões pancreáticas ocorre em homens jovens e está associada a alta incidência de lesões a órgãos adjacentes e estruturas vasculares importantes. OBJETIVO: Avaliar a morbimortalidade dos pacientes com trauma pancreático, o manuseio aplicado a esses pacientes e sua evolução. MÉTODOS: Estudo prospectivo realizado em pacientes admitidos em unidade de trauma. Treze adultos (> 13 anos foram estratificados em graves e não-graves de acordo com critérios clínicos no momento da identificação do início do quadro e de acordo com os critérios de Baltazar (A, B, C, D e E. O tipo de trauma externo (aberto ou fechado, a classificação do trauma pancreático, números de órgãos acometidos pelo trauma, número de reoperações, o tipo de suporte nutricional e o tempo de permanência hospitalar também foram analisados. A presença de síndrome compartimental abdominal e a necessidade de fechamento temporário foram estudados e comparados com a morbimortalidade nos pacientes. RESULTADOS: Todos os pacientes eram do sexo masculino com a idade média de 28,6 anos (13 a 60 anos e apresentaram pancreatite traumática no pós-operatório. Em sete, o ferimento era penetrante por projétil de arma de fogo; em três, abdominal fechado; em dois, por arma branca; em um, grande queimado (> 50% da área corporal. Quanto à classificação do trauma, os graus I e II ocorreram em 38,46; o grau III,15,38 % e o grau IV, 7,7 % . Foram realizadas drenagens da loja pancreática, hemostasia da lesão e pancreatectomia distal com esplenectomia associado à drenagem cavitária Foram classificados como não-grave, oito pacientes. Dentro dos critérios de Baltazar a predominância foi o grau D e C (quatro pacientes, cada. Não houve grau A

Response of cat cerebellar vermis induced by sound. II. The role of the mossy and climbing fibers in acoustic transmission to the cerebellar cortex and influence of stimuli parameters.

Science.gov (United States)

Jastreboff, P J; Tarnecki, R

1975-01-01

Experiments were performed on cats under Chloralose or Nembutal anesthesia. The parameters of the acoustic click stimuli were found to have a strong influence on the responses registered from both the surface of the cerebellar vermis lobuli V up VII as well as from single units. It was shown that a stimulus frequency rate not greater than 1/2 s should be used, since higher frequencies caused strong attenuation of the response. The type of anesthesia did not change the latencies of reactions of both evoked potentials and single units. However, decreasing the strength of the click resulted in increased response latencies, in the case of single unit reactions. A very strong influence of weak visual stimuli on units was also observed. It is suggested that mossy fibers are the most important fibers in the transmission of acoustic information to the cerebellar cortex.

Acoustic biosensors.

Science.gov (United States)

Fogel, Ronen; Limson, Janice; Seshia, Ashwin A

2016-06-30

Resonant and acoustic wave devices have been researched for several decades for application in the gravimetric sensing of a variety of biological and chemical analytes. These devices operate by coupling the measurand (e.g. analyte adsorption) as a modulation in the physical properties of the acoustic wave (e.g. resonant frequency, acoustic velocity, dissipation) that can then be correlated with the amount of adsorbed analyte. These devices can also be miniaturized with advantages in terms of cost, size and scalability, as well as potential additional features including integration with microfluidics and electronics, scaled sensitivities associated with smaller dimensions and higher operational frequencies, the ability to multiplex detection across arrays of hundreds of devices embedded in a single chip, increased throughput and the ability to interrogate a wider range of modes including within the same device. Additionally, device fabrication is often compatible with semiconductor volume batch manufacturing techniques enabling cost scalability and a high degree of precision and reproducibility in the manufacturing process. Integration with microfluidics handling also enables suitable sample pre-processing/separation/purification/amplification steps that could improve selectivity and the overall signal-to-noise ratio. Three device types are reviewed here: (i) bulk acoustic wave sensors, (ii) surface acoustic wave sensors, and (iii) micro/nano-electromechanical system (MEMS/NEMS) sensors. © 2016 The Author(s). Published by Portland Press Limited on behalf of the Biochemical Society.

Trauma patient discharge and care transition experiences: Identifying opportunities for quality improvement in trauma centres.

Science.gov (United States)

Gotlib Conn, Lesley; Zwaiman, Ashley; DasGupta, Tracey; Hales, Brigette; Watamaniuk, Aaron; Nathens, Avery B

2018-01-01

Challenges delivering quality care are especially salient during hospital discharge and care transitions. Severely injured patients discharged from a trauma centre will go either home, to rehabilitation or another acute care hospital with complex management needs. This purpose of this study was to explore the experiences of trauma patients and families treated in a regional academic trauma centre to better understand and improve their discharge and care transition experiences. A qualitative study using inductive thematic analysis was conducted between March and October 2016. Telephone interviews were conducted with trauma patients and/or a family member after discharge from the trauma centre. Data collection and analysis were completed inductively and iteratively consistent with a qualitative approach. Twenty-four interviews included 19 patients and 7 family members. Participants' experiences drew attention to discharge and transfer processes that either (1) Fostered quality discharge or (2) Impeded quality discharge. Fostering quality discharge was ward staff preparation efforts; establishing effective care continuity; and, adequate emotional support. Impeding discharge quality was perceived pressure to leave the hospital; imposed transfer decisions; and, sub-optimal communication and coordination around discharge. Patient-provider communication was viewed to be driven by system, rather than patient need. Inter-facility information gaps raised concern about receiving facilities' ability to care for injured patients. The quality of trauma patient discharge and transition experiences is undermined by system- and ward-level processes that compete, rather than align, in producing high quality patient-centred discharge. Local improvement solutions focused on modifiable factors within the trauma centre include patient-oriented discharge education and patient navigation; however, these approaches alone may be insufficient to enhance patient experiences. Trauma patients

The sequential trauma score - a new instrument for the sequential mortality prediction in major trauma*

Directory of Open Access Journals (Sweden)

Huber-Wagner S

2010-05-01

Full Text Available Abstract Background There are several well established scores for the assessment of the prognosis of major trauma patients that all have in common that they can be calculated at the earliest during intensive care unit stay. We intended to develop a sequential trauma score (STS that allows prognosis at several early stages based on the information that is available at a particular time. Study design In a retrospective, multicenter study using data derived from the Trauma Registry of the German Trauma Society (2002-2006, we identified the most relevant prognostic factors from the patients basic data (P, prehospital phase (A, early (B1, and late (B2 trauma room phase. Univariate and logistic regression models as well as score quality criteria and the explanatory power have been calculated. Results A total of 2,354 patients with complete data were identified. From the patients basic data (P, logistic regression showed that age was a significant predictor of survival (AUCmodel p, area under the curve = 0.63. Logistic regression of the prehospital data (A showed that blood pressure, pulse rate, Glasgow coma scale (GCS, and anisocoria were significant predictors (AUCmodel A = 0.76; AUCmodel P + A = 0.82. Logistic regression of the early trauma room phase (B1 showed that peripheral oxygen saturation, GCS, anisocoria, base excess, and thromboplastin time to be significant predictors of survival (AUCmodel B1 = 0.78; AUCmodel P +A + B1 = 0.85. Multivariate analysis of the late trauma room phase (B2 detected cardiac massage, abbreviated injury score (AIS of the head ≥ 3, the maximum AIS, the need for transfusion or massive blood transfusion, to be the most important predictors (AUCmodel B2 = 0.84; AUCfinal model P + A + B1 + B2 = 0.90. The explanatory power - a tool for the assessment of the relative impact of each segment to mortality - is 25% for P, 7% for A, 17% for B1 and 51% for B2. A spreadsheet for the easy calculation of the sequential trauma

Trauma and the endocrine system.

Science.gov (United States)

Mesquita, Joana; Varela, Ana; Medina, José Luís

2010-12-01

The endocrine system may be the target of different types of trauma with varied consequences. The present article discusses trauma of the hypothalamic-pituitary axes, adrenal glands, gonads, and pancreas. In addition to changes in circulating hormone levels due to direct injury to these structures, there may be an endocrine response in the context of the stress caused by the trauma. Copyright © 2010 SEEN. Published by Elsevier Espana. All rights reserved.

Assessing sexual trauma histories in homeless women.

Science.gov (United States)

Weinrich, Sally; Hardin, Sally; Glaser, Dale; Barger, Mary; Bormann, Jill; Lizarraga, Cabiria; Terry, Micheal; Criscenzo, Jeeni; Allard, Carolyn B

2016-01-01

Almost 1 out of every 3 homeless women (32%) in the United States, United Kingdom, and Australia has experienced childhood sexual trauma. We assessed lifetime sexual trauma histories among 29 homeless women from three Southern California community sites: one residential safe house and two safe parking areas. More than half of the women (54%) reported a history of sexual trauma. That rate was higher (86%) among women living at the safe home than among women staying at the safe parking sites (only 42%). All four of the women who had served in the military reported having experienced military sexual trauma. The high percentages of sexual trauma found in homeless women highlight the need for effective interventions for sexual trauma.

Is Urgent Evoke a Digital Ba?

DEFF Research Database (Denmark)

Wichmand, Mette

2018-01-01

of such a platform, the World Bank’s online game Urgent Evoke, which has been designed with the pur- pose of engaging citizens in developing innovative solutions for sociopolitical problems like poverty. The analysis is based on Nonaka’s concept of Ba, which means “place” and is described as a platform for advancing...

[First aid system for trauma: development and status].

Science.gov (United States)

Chen, D K; Lin, W C; Zhang, P; Kuang, S J; Huang, W; Wang, T B

2017-04-18

With the great progress of the economy, the level of industrialization has been increasing year by year, which leads to an increase in accidental trauma accidents. Chinese annual death of trauma is already more than 400 000, which makes trauma the fifth most common cause of death, following malignant tumor, heart, brain and respiratory diseases. Trauma is the leading cause of the death of young adults. At the same time, trauma has become a serious social problem in peace time. Trauma throws great treats on human health and life. As an important part in the medical and social security system, the emergency of trauma system occupies a very important position in the emergency medical service system. In European countries as well as the United States and also many other developed countries, trauma service system had a long history, and progressed to an advanced stage. However, Chinese trauma service system started late and is still developing. It has not turned into a complete and standardized system yet. This review summarizes the histories and current situations of the development of traumatic first aid system separately in European countries, the United States and our country. Special attentions are paid to the effects of the pre- and in-hospital emergency care. We also further try to explore the Chinese trauma emergency model that adapts to the situations of China and characteristics of different regions of China. Our review also introduces the trauma service system that suits the situations of China proposed by Professor Jiang Baoguo's team in details, taking Chinese conditions into account, they conducted a thematic study and made an expert consensus on pre-hospital emergency treatment of severe trauma, providing a basic routine and guidance of severe trauma treatment for those pre-hospital emergency physicians. They also advised to establish independent trauma disciplines and trauma specialist training systems, and to build the regional trauma care system as

Effectiveness of trauma team on medical resource utilization and quality of care for patients with major trauma.

Science.gov (United States)

Wang, Chih-Jung; Yen, Shu-Ting; Huang, Shih-Fang; Hsu, Su-Chen; Ying, Jeremy C; Shan, Yan-Shen

2017-07-24

Trauma is one of the leading causes of death in Taiwan, and its medical expenditure escalated drastically. This study aimed to explore the effectiveness of trauma team, which was established in September 2010, on medical resource utilization and quality of care among major trauma patients. This was a retrospective study, using trauma registry data bank and inpatient medical service charge databases. Study subjects were major trauma patients admitted to a medical center in Tainan during 2009 and 2013, and was divided into case group (from January, 2011 to August, 2013) and comparison group (from January, 2009 to August, 2010). Significant reductions in several items of medical resource utilization were identified after the establishment of trauma team. In the sub-group of patients who survived to discharge, examination, radiology and operation charges declined significantly. The radiation and examination charges reduced significantly in the subcategories of ISS = 16 ~ 24 and ISS > 24 respectively. However, no significant effectiveness on quality of care was identified. The establishment of trauma team is effective in containing medical resource utilization. In order to verify the effectiveness on quality of care, extended time frame and extra study subjects are needed.

Addressing Trauma in Substance Abuse Treatment

Science.gov (United States)

Giordano, Amanda L.; Prosek, Elizabeth A.; Stamman, Julia; Callahan, Molly M.; Loseu, Sahar; Bevly, Cynthia M.; Cross, Kaitlin; Woehler, Elliott S.; Calzada, Richard-Michael R.; Chadwell, Katie

2016-01-01

Trauma is prevalent among clients with substance abuse issues, yet addictions counselors' training in trauma approaches is limited. The purpose of the current article is to provide pertinent information regarding trauma treatment including the use of assessments, empirically supported clinical approaches, self-help groups and the risk of vicarious…

Acute appendicitis after blunt abdominal trauma

Directory of Open Access Journals (Sweden)

Marjan Joudi

2012-02-01

Full Text Available Appendecitis is one of the most frequent surgeries. Inflammation of appendix may be due to variable causes such as fecalit, hypertrophy of Peyer’s plaques, seeds of fruits and parasites. In this study we presented an uncommon type of appendicitis which occurred after abdominal blunt trauma. In this article three children present who involved acute appendicitis after blunt abdominal trauma. These patients were 2 boys (5 and 6-year-old and one girl (8-year-old who after blunt abdominal trauma admitted to the hospital with abdominal pain and symptoms of acute abdomen and appendectomy had been done for them.Trauma can induce intramural hematoma at appendix process and may cause appendicitis. Therefore, physicians should be aware of appendicitis after blunt abdominal trauma

Sexuality following trauma injury: A literature review

Directory of Open Access Journals (Sweden)

Kylie Marie Connell

2014-04-01

Full Text Available Restoration of the quality of life (QoL of trauma injury survivors is the aim of trauma rehabilitation. It is generally acknowledged that sexuality is an important component of QoL; however, rehabilitation services frequently fall short of including sexuality as a matter of routine. The literature was reviewed to examine the experiences of trauma survivors from three groups: spinal cord injury (SCI, traumatic brain injury (TBI and burns. The focus was on the impact of trauma on the QoL to identify future research directions and to advocate for the inclusion of sexuality as an integral part of rehabilitation. Databases searched were Proquest, Ovid, Cinahl, Medline, PsycInfo and Cochrane Central Register of controlled trials. A total of 36 eligible studies were included: SCI (n = 25, TBI (n = 6, burns (n = 5. Four themes were identified across the three trauma groups that were labeled as physiological impact of trauma on sexuality, cognitive-genital dissociation (CGD, sexual disenfranchisement (SD and sexual rediscovery (SR. Trauma injury has a significant impact on sexuality, which is not routinely addressed within rehabilitation services. Further sexuality research is required among all trauma groups to improve rehabilitation services and in turn QoL outcomes for all trauma survivors.

Validation of assessment tools for identifying trauma symptomatology in young children exposed to trauma

DEFF Research Database (Denmark)

Schandorph Løkkegaard, Sille; Elmose, Mette; Elklit, Ask

There is a lack of Danish validated, developmentally sensitive assessment tools for preschool and young school children exposed to psychological trauma. Consequently, young traumatised children are at risk of not being identified. The purpose of this project is to validate three assessment tools...... that identify trauma symptomatology in young children; a caregiver interview called the Diagnostic Infant and Preschool Assessment (DIPA), a structured play test called the Odense Child Trauma Screening (OCTS), and a child questionnaire called the Darryl Cartoon Test. Three validity studies were conducted...

Cave acoustics in prehistory: Exploring the association of Palaeolithic visual motifs and acoustic response.

Science.gov (United States)

Fazenda, Bruno; Scarre, Chris; Till, Rupert; Pasalodos, Raquel Jiménez; Guerra, Manuel Rojo; Tejedor, Cristina; Peredo, Roberto Ontañón; Watson, Aaron; Wyatt, Simon; Benito, Carlos García; Drinkall, Helen; Foulds, Frederick

2017-09-01

During the 1980 s, acoustic studies of Upper Palaeolithic imagery in French caves-using the technology then available-suggested a relationship between acoustic response and the location of visual motifs. This paper presents an investigation, using modern acoustic measurement techniques, into such relationships within the caves of La Garma, Las Chimeneas, La Pasiega, El Castillo, and Tito Bustillo in Northern Spain. It addresses methodological issues concerning acoustic measurement at enclosed archaeological sites and outlines a general framework for extraction of acoustic features that may be used to support archaeological hypotheses. The analysis explores possible associations between the position of visual motifs (which may be up to 40 000 yrs old) and localized acoustic responses. Results suggest that motifs, in general, and lines and dots, in particular, are statistically more likely to be found in places where reverberation is moderate and where the low frequency acoustic response has evidence of resonant behavior. The work presented suggests that an association of the location of Palaeolithic motifs with acoustic features is a statistically weak but tenable hypothesis, and that an appreciation of sound could have influenced behavior among Palaeolithic societies of this region.

Trauma outcome analysis of a Jakarta University Hospital using the TRISS method: validation and limitation in comparison with the major trauma outcome study. Trauma and Injury Severity Score

NARCIS (Netherlands)

Joosse, P.; Soedarmo, S.; Luitse, J. S.; Ponsen, K. J.

2001-01-01

In this prospective study, the TRISS methodology is used to compare trauma care at a University Hospital in Jakarta, Indonesia, with the standards reported in the Major Trauma Outcome Study (MTOS). Between February 24, 1999, and July 1, 1999, all consecutive patients with multiple and severe trauma

The effects of two counterpropagating surface acoustic wave beams on single electron acoustic charge transport

International Nuclear Information System (INIS)

He Jianhong; Guo Huazhong; Song Li; Zhang Wei; Gao Jie; Lu Chuan

2010-01-01

We present a comprehensive study of the effects of two counterpropagating surface acoustic waves on the acoustoelectric current of single electron transport devices. A significant improvement in the accuracy of current quantization is achieved as a result of an additional surface acoustic wave beam. The experiments reveal the sinusoidally periodical modulation in the acoustoelectric current characteristic as a function of the relative phase of the two surface acoustic wave beams. Besides, by using standing surface acoustic waves, the acoustoelectric current is detected which we consider as the so-called anomalous acoustoelectric current produced by acoustic wave mechanical deformations. This kind current is contributed to one component of the acoustoelectric current in surface acoustic wave device, which could enable us to establish a more adequate description of acoustoelectric effects on single-electron acoustic charge transport.

Helpers in Distress: Preventing Secondary Trauma

Science.gov (United States)

Whitfield, Natasha; Kanter, Deborah

2014-01-01

Those in close contact with trauma survivors are themselves at risk for trauma (e.g., Bride, 2007; Figley, 1995). Family, friends, and professionals who bear witness to the emotional retelling and re-enacting of traumatic events can experience what is called "secondary trauma" (Elwood, Mott, Lohr, & Galovski, 2011). The literature…

Patient perspectives of care in a regionalised trauma system: lessons from the Victorian State Trauma System.

Science.gov (United States)

Gabbe, Belinda J; Sleney, Jude S; Gosling, Cameron M; Wilson, Krystle; Hart, Melissa J; Sutherland, Ann M; Christie, Nicola

2013-02-18

To explore injured patients' experiences of trauma care to identify areas for improvement in service delivery. Qualitative study using in-depth, semi-structured interviews, conducted from 1 April 2011 to 31 January 2012, with 120 trauma patients registered by the Victorian State Trauma Registry and the Victorian Orthopaedic Trauma Outcomes Registry and managed at the major adult trauma services (MTS) in Victoria. Emergent themes from patients' experiences of acute, rehabilitation and post-discharge care in the Victorian State Trauma System (VSTS). Patients perceived their acute hospital care as high quality, although 3s with communication and surgical management delays were common. Discharge from hospital was perceived as stressful, and many felt ill prepared for discharge. A consistent emerging theme was the sense of a lack of coordination of post-discharge care, and the absence of a consistent point of contact for ongoing management. Most patients' primary point of contact after discharge was outpatient clinics at the MTS, which were widely criticised because of substantial delays in receiving an appointment, prolonged waiting times, limited time with clinicians, lack of continuity of care and inability to see senior clinicians. This study highlights perceived 3s in the patient care pathway in the VSTS, especially those relating to communication, information provision and post-discharge care. Trauma patients perceived the need for a single point of contact for coordination of post-discharge care.

Localized Acoustic Surface Modes

KAUST Repository

Farhat, Mohamed

2015-08-04

We introduce the concept of localized acoustic surface modes (ASMs). We demonstrate that they are induced on a two-dimensional cylindrical rigid surface with subwavelength corrugations under excitation by an incident acoustic plane wave. Our results show that the corrugated rigid surface is acoustically equivalent to a cylindrical scatterer with uniform mass density that can be represented using a Drude-like model. This, indeed, suggests that plasmonic-like acoustic materials can be engineered with potential applications in various areas including sensing, imaging, and cloaking.

Acoustic Signals and Systems

DEFF Research Database (Denmark)

2008-01-01

The Handbook of Signal Processing in Acoustics will compile the techniques and applications of signal processing as they are used in the many varied areas of Acoustics. The Handbook will emphasize the interdisciplinary nature of signal processing in acoustics. Each Section of the Handbook...... will present topics on signal processing which are important in a specific area of acoustics. These will be of interest to specialists in these areas because they will be presented from their technical perspective, rather than a generic engineering approach to signal processing. Non-specialists, or specialists...... from different areas, will find the self-contained chapters accessible and will be interested in the similarities and differences between the approaches and techniques used in different areas of acoustics....

Imaging of blunt chest trauma

International Nuclear Information System (INIS)

Prosch, H.; Negrin, L.

2014-01-01

Blunt chest trauma is associated with high morbidity and mortality. Consequently, all patients should be evaluated radiologically after blunt chest trauma to allow timely and appropriate treatment. Conventional chest radiographs and computed tomography (CT) are proven modalities with which to evaluate patients after blunt chest trauma. Over the last several years extended focused assessment with sonography for trauma (eFAST) has gained increasing importance for the initial assessment of seriously injured patients. In the acute phase of severely injured patients eFAST examinations are helpful to exclude pneumothorax, hemothorax and hemopericardium. Chest radiographs may also be used to diagnose a pneumothorax or hemothorax; however, the sensitivity is limited and CT is the diagnostic modality of choice to evaluate severely injured patients. (orig.) [de

Life Stories and Trauma

DEFF Research Database (Denmark)

Kongshøj, Inge Lise Lundsgaard; Bohn, Annette; Berntsen, Dorthe

Research has shown a connection between Posttraumatic Stress Disorder (PTSD) and integration of traumatic experiences into the life story. Furthermore, empirical evidence suggests that life story formation begins in mid to late adolescence. Following these findings, the present study investigated...... whether experiencing trauma in youth was associated with a greater risk to integrate the trauma into the life story compared to adult traumatic exposure. Life stories were collected from 115 participants recruited via Amazon Mechanical Turk. Moreover, participants filled out questionnaires regarding...... often integrate the trauma into their life story? Results will be discussed in relation to theories of development of life stories and of PTSD....

CT of chest trauma

International Nuclear Information System (INIS)

Goodman, P.C.

1986-01-01

There appears to be a limited role for computed tomography in the evaluation of chest trauma. The literature contains few papers specifically addressing the use of CT in the setting of chest trauma. Another series of articles relates anecdotal experiences in this regard. This paucity of reports attests to the remarkable amount of information present on conventional chest radiographs as well as the lack of clear indications for CT in the setting of chest trauma. In this chapter traumatic lesions of various areas of the thorax are discussed. The conventional radiographic findings are briefly described and the potential or proven application of CT is addressed

Platelet aggregation following trauma

DEFF Research Database (Denmark)

Windeløv, Nis A; Sørensen, Anne M; Perner, Anders

2014-01-01

We aimed to elucidate platelet function in trauma patients, as it is pivotal for hemostasis yet remains scarcely investigated in this population. We conducted a prospective observational study of platelet aggregation capacity in 213 adult trauma patients on admission to an emergency department (ED...... severity score (ISS) was 17; 14 (7%) patients received 10 or more units of red blood cells in the ED (massive transfusion); 24 (11%) patients died within 28 days of trauma: 17 due to cerebral injuries, four due to exsanguination, and three from other causes. No significant association was found between...... aggregation response and ISS. Higher TRAP values were associated with death due to cerebral injuries (P 

Prevalence of Domestic Violence Among Trauma Patients.

Science.gov (United States)

Joseph, Bellal; Khalil, Mazhar; Zangbar, Bardiya; Kulvatunyou, Narong; Orouji, Tahereh; Pandit, Viraj; O'Keeffe, Terence; Tang, Andrew; Gries, Lynn; Friese, Randall S; Rhee, Peter; Davis, James W

2015-12-01

Domestic violence is an extremely underreported crime and a growing social problem in the United States. However, the true burden of the problem remains unknown. To assess the reported prevalence of domestic violence among trauma patients. A 6-year (2007-2012) retrospective analysis of the prospectively maintained National Trauma Data Bank. Trauma patients who experienced domestic violence and who presented to trauma centers participating in the National Trauma Data Bank were identified using International Classification of Diseases, Ninth Revision diagnosis codes (995.80-995.85, 995.50, 995.52-995.55, and 995.59) and E codes (E967.0-E967.9). Patients were stratified by age into 3 groups: children (≤18 years), adults (19-54 years), and elderly patients (≥55 years). Trend analysis was performed on April 10, 2014, to assess the reported prevalence of domestic violence over the years. Trauma patients presenting to trauma centers participating in the National Trauma Data Bank. To assess the reported prevalence of domestic violence among trauma patients. A total of 16 575 trauma patients who experienced domestic violence were included. Of these trauma patients, 10 224 (61.7%) were children, 5503 (33.2%) were adults, and 848 (5.1%) were elderly patients. The mean (SD) age was 15.9 (20.6), the mean (SD) Injury Severity Score was 10.9 (9.6), and 8397 (50.7%) were male patients. Head injuries (46.8% of patients) and extremity fractures (31.2% of patients) were the most common injuries. A total of 12 515 patients (75.1%) were discharged home, and the overall mortality rate was 5.9% (n = 980). The overall reported prevalence of domestic violence among trauma patients was 5.7 cases per 1000 trauma center discharges. The prevalence of domestic violence increased among children (14.0 cases per 1000 trauma center discharges in 2007 to 18.5 case per 1000 trauma center discharges in 2012; P = .001) and adults (3.2 cases per 1000 discharges in 2007 to 4.5 cases per

Optical measurement of acoustic radiation pressure of the near-field acoustic levitation through transparent object

OpenAIRE

Nakamura, Satoshi; Furusawa, Toshiaki; Sasao, Yasuhiro; Katsura, Kogure; Naoki, Kondo

2013-01-01

It is known that macroscopic objects can be levitated for few to several hundred micrometers by near-field acoustic field and this phenomenon is called near-field acoustic levitation (NFAL). Although there are various experiments conducted to measure integrated acoustic pressure on the object surface, up to now there was no direct method to measure pressure distribution. In this study we measured the acoustic radiation pressure of the near-field acoustic levitation via pressure-sensitive paint.

Quality of trauma care and trauma registries.

Science.gov (United States)

Pino Sánchez, F I; Ballesteros Sanz, M A; Cordero Lorenzana, L; Guerrero López, F

2015-03-01

Traumatic disease is a major public health concern. Monitoring the quality of services provided is essential for the maintenance and improvement thereof. Assessing and monitoring the quality of care in trauma patient through quality indicators would allow identifying opportunities for improvement whose implementation would improve outcomes in hospital mortality, functional outcomes and quality of life of survivors. Many quality indicators have been used in this condition, although very few ones have a solid level of scientific evidence to recommend their routine use. The information contained in the trauma registries, spread around the world in recent decades, is essential to know the current health care reality, identify opportunities for improvement and contribute to the clinical and epidemiological research. Copyright © 2014 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

Trauma care in Africa: a status report from Botswana, guided by the World Health Organization's "Guidelines for Essential Trauma Care".

Science.gov (United States)

Hanche-Olsen, Terje Peder; Alemu, Lulseged; Viste, Asgaut; Wisborg, Torben; Hansen, Kari S

2012-10-01

Trauma represents a significant and increasing challenge to health care systems all over the world. This study aimed to evaluate the trauma care capabilities of Botswana, a middle-income African country, by applying the World Health Organization's Guidelines for Essential Trauma Care. All 27 government (16 primary, 9 district, 2 referral) hospitals were surveyed. A questionnaire and checklist, based on "Guidelines for Essential Trauma Care" and locally adapted, were developed as situation analysis tools. The questionnaire assessed local trauma organization, capacity, and the presence of quality improvement activity. The checklist assessed physical availability of equipment and timely availability of trauma-related skills. Information was collected by interviews with hospital administrators, key personnel within trauma care, and through on-site physical inspection. Hospitals in Botswana are reasonably well supplied with human and physical resources for trauma care, although deficiencies were noted. At the primary and district levels, both capacity and equipment for airway/breathing management and vascular access was limited. Trauma administrative functions were largely absent at all levels. No hospital in Botswana had any plans for trauma education, separate from or incorporated into other improvement activities. Team organization was nonexistent, and training activities in the emergency room were limited. This study draws a picture of trauma care capabilities of an entire African country. Despite good organizational structures, Botswana has room for substantial improvement. Administrative functions, training, and human and physical resources could be improved. By applying the guidelines, this study creates an objective foundation for improved trauma care in Botswana.

Intensive care nurses' perceptions of Inter Specialty Trauma Nursing Rounds to improve trauma patient care-A quality improvement project.

Science.gov (United States)

Jennings, Fiona L; Mitchell, Marion

2017-06-01

Trauma patient management is complex and challenging for nurses in the Intensive Care Unit. One strategy to promote quality and evidence based care may be through utilising specialty nursing experts both internal and external to the Intensive Care Unit in the form of a nursing round. Inter Specialty Trauma Nursing Rounds have the potential to improve patient care, collaboration and nurses' knowledge. The purpose of this quality improvement project was to improve trauma patient care and evaluate the nurses perception of improvement. The project included structured, weekly rounds that were conducted at the bedside. Nursing experts and others collaborated to assess and make changes to trauma patients' care. The rounds were evaluated to assess the nurse's perception of improvement. There were 132 trauma patients assessed. A total of 452 changes to patient care occurred. On average, three changes per patient resulted. Changes included nursing management, medical management and wound care. Nursing staff reported an overall improvement of trauma patient care, trauma knowledge, and collaboration with colleagues. Inter Specialty Trauma Nursing Rounds utilizes expert nursing knowledge. They are suggested as an innovative way to address the clinical challenges of caring for trauma patients and are perceived to enhance patient care and nursing knowledge. Copyright © 2017 Elsevier Ltd. All rights reserved.

Evoked Emotions Predict Food Choice

OpenAIRE

Dalenberg, Jelle R.; Gutjar, Swetlana; ter Horst, Gert J.; de Graaf, Kees; Renken, Remco J.; Jager, Gerry

2014-01-01

In the current study we show that non-verbal food-evoked emotion scores significantly improve food choice prediction over merely liking scores. Previous research has shown that liking measures correlate with choice. However, liking is no strong predictor for food choice in real life environments. Therefore, the focus within recent studies shifted towards using emotion-profiling methods that successfully can discriminate between products that are equally liked. However, it is unclear how well ...

Long-latency auditory evoked potentials with verbal and nonverbal stimuli.

Science.gov (United States)

Oppitz, Sheila Jacques; Didoné, Dayane Domeneghini; Silva, Débora Durigon da; Gois, Marjana; Folgearini, Jordana; Ferreira, Geise Corrêa; Garcia, Michele Vargas

2015-01-01

Long-latency auditory evoked potentials represent the cortical activity related to attention, memory, and auditory discrimination skills. Acoustic signal processing occurs differently between verbal and nonverbal stimuli, influencing the latency and amplitude patterns. To describe the latencies of the cortical potentials P1, N1, P2, N2, and P3, as well as P3 amplitude, with different speech stimuli and tone bursts, and to classify them in the presence and absence of these data. A total of 30 subjects with normal hearing were assessed, aged 18-32 years old, matched by gender. Nonverbal stimuli were used (tone burst; 1000Hz - frequent and 4000Hz - rare); and verbal (/ba/ - frequent; /ga/, /da/, and /di/ - rare). Considering the component N2 for tone burst, the lowest latency found was 217.45ms for the BA/DI stimulus; the highest latency found was 256.5ms. For the P3 component, the shortest latency with tone burst stimuli was 298.7 with BA/GA stimuli, the highest, was 340ms. For the P3 amplitude, there was no statistically significant difference among the different stimuli. For latencies of components P1, N1, P2, N2, P3, there were no statistical differences among them, regardless of the stimuli used. There was a difference in the latency of potentials N2 and P3 among the stimuli employed but no difference was observed for the P3 amplitude. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Long-latency auditory evoked potentials with verbal and nonverbal stimuli,

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Sheila Jacques Oppitz

2015-12-01

Full Text Available ABSTRACT INTRODUCTION: Long-latency auditory evoked potentials represent the cortical activity related to attention, memory, and auditory discrimination skills. Acoustic signal processing occurs differently between verbal and nonverbal stimuli, influencing the latency and amplitude patterns. OBJECTIVE: To describe the latencies of the cortical potentials P1, N1, P2, N2, and P3, as well as P3 amplitude, with different speech stimuli and tone bursts, and to classify them in the presence and absence of these data. METHODS: A total of 30 subjects with normal hearing were assessed, aged 18-32 years old, matched by gender. Nonverbal stimuli were used (tone burst; 1000 Hz - frequent and 4000 Hz - rare; and verbal (/ba/ - frequent; /ga/, /da/, and /di/ - rare. RESULTS: Considering the component N2 for tone burst, the lowest latency found was 217.45 ms for the BA/DI stimulus; the highest latency found was 256.5 ms. For the P3 component, the shortest latency with tone burst stimuli was 298.7 with BA/GA stimuli, the highest, was 340 ms. For the P3 amplitude, there was no statistically significant difference among the different stimuli. For latencies of components P1, N1, P2, N2, P3, there were no statistical differences among them, regardless of the stimuli used. CONCLUSION: There was a difference in the latency of potentials N2 and P3 among the stimuli employed but no difference was observed for the P3 amplitude.

Observation of self-excited acoustic vortices in defect-mediated dust acoustic wave turbulence.

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Tsai, Ya-Yi; I, Lin

2014-07-01

Using the self-excited dust acoustic wave as a platform, we demonstrate experimental observation of self-excited fluctuating acoustic vortex pairs with ± 1 topological charges through spontaneous waveform undulation in defect-mediated turbulence for three-dimensional traveling nonlinear longitudinal waves. The acoustic vortex pair has helical waveforms with opposite chirality around the low-density hole filament pair in xyt space (the xy plane is the plane normal to the wave propagation direction). It is generated through ruptures of sequential crest surfaces and reconnections with their trailing ruptured crest surfaces. The initial rupture is originated from the amplitude reduction induced by the formation of the kinked wave crest strip with strong stretching through the undulation instability. Increasing rupture causes the separation of the acoustic vortex pair after generation. A similar reverse process is followed for the acoustic vortex annihilating with the opposite-charged acoustic vortex from the same or another pair generation.

Acoustic Emission Technology and Application

International Nuclear Information System (INIS)

Joo, Y. S.; Lim, S. H.; Eom, H. S.; Kim, J. H.; Jung, H. K.

2003-10-01

Acoustic emission is the elastic wave that is generated by the rapid release of energy from the localized sources within a material. After the observation of acoustic emission phenomenon in 1950, the research and further investigation had been performed. Acoustic emission examination becomes a rapidly matured nondestructive testing method with demonstrated capabilities for characterizing material behavior and for detecting the defect. It is of interest as a possible passive monitoring technique for detecting, locating and characterizing the defects in component and structure. Acoustic emission technology has recently strengthened the on-line monitoring application for the detection of incipient failures and the assurance of structural integrity. The field of acoustic emission testing is still growing vigorously and presents many challenges. Especially, acoustic emission has been successfully applied in the leak detection of primary pressure boundary of nuclear power plants. In this state-of-art report, the principle, measurement and field applications of acoustic emission technique is reviewed and summarized. Acoustic emission technology will contribute to the assurance of nuclear safety as the on-line monitoring technique of structural integrity of NSSS components and structures

Transfusion therapy in paediatric trauma patients

DEFF Research Database (Denmark)

Nystrup, Kristin Brønnum; Stensballe, Jakob; Bøttger, Morten

2015-01-01

Haemorrhage is a leading cause of death in paediatric trauma patients. Predefined massive transfusion protocols (MTP) have the potential to significantly reduce mortality by treating haemorrhagic shock and coagulopathy, in adhering to the principles of haemostatic resuscitation with rapid...... in paediatric trauma patients is challenging, and the optimal blood product ratio that will increase survival in massively bleeding paediatric trauma patients has yet to be determined. To date, only a few small descriptive studies and case reports have investigated the use of predefined MTP in paediatric trauma...... patients.MTP with increased FFP or PLT to RBC ratios combined with viscoelastic haemostatic assay (VHA) guided haemostatic resuscitation have not yet been tested in paediatric populations but based on results from adult trauma patients, this therapeutic approach seems promising.Considering the high...

Crypts, Phantoms, and Cultural Trauma: A Hauntological Approach to Recent British First World War Fiction

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Anna Branach-Kallas

2017-10-01

Full Text Available In my article, I analyse selected British novels about the First World War published at the turn of the 20th century, from the theoretical perspectives proposed by Maria Torok and Nicolas Abraham in The Shell and the Kernel: Renewals of Psychoanalysis. Pat Barker in Toby’s Room (2012 and Sue Gee in Earth and Heaven (2000 imagine their protagonists’ difficult evolution from melancholia to mourning after the loss of brothers and/or lovers, at the front. The concepts of incorporation and illness of mourning are used to explore the complicated process of bereavement in Barker’s novel, where hauntology becomes a form of honte-ology, from the French honte, shame. In Gee’s beautifully melancholic novel, the haunting trauma of loss is subtly evoked by images of empty fields, neglected farms, urban vistas filled with spectral figures of unemployed veterans. Moreover, Earth and Heaven affects the reader so deeply because the understated pain of loss becomes movingly tangible after the accidental death of the central protagonist’s six-year-old son, which seems to “condense” the pain of war bereavements a decade after the conflict. My intention is also to demonstrate that Sebastian Faulks in Birdsong (1993, Esther Freud in Summer at Gaglow (1997 and Pat Barker in Another World (1998 approach the Great War as a phantom haunting their contemporary protagonists. The persistence of the unknown past has a profound impact on these characters and only by trying to relate to the Great War do they find answers to their existential dilemmas. This directs our attention to the incomplete processes of First World War mourning, the persistence of endless grief and the potential continuity of unresolved trauma(s in transgenerational memory. The five novels under consideration also problematise the issue of silence—the unsayable family secret and/or the collective disregard for the national past. The psychoanalytic concept of crypt illuminates the relation

Acoustic building infiltration measurement system

Science.gov (United States)

Muehleisen, Ralph T.; Raman, Ganesh

2018-04-10

Systems and methods of detecting and identifying a leak from a container or building. Acoustic pressure and velocity are measured. Acoustic properties are acquired from the measured values. The acoustic properties are converted to infiltration/leakage information. Nearfield Acoustic Holography (NAH) may be one method to detect the leakages from a container by locating the noise sources.

Trauma and the truth

NARCIS (Netherlands)

Meeter, Martijn

2016-01-01

Witnessing horrible things may leave a person scarred for life — an effect usually referred to as psychological trauma. We do not know exactly what it does or how it worms its way into our psyche, but psychological trauma has been linked to a wide range of fear- and depression-related symptoms

The accidental (acoustical) tourist

Science.gov (United States)

Van Kirk, Wayne

2002-11-01

The acoustical phenomenon observed at an ancient temple in the Great Ball Court at Chichen Itza was described as ''little short of amazing--an ancient whispering gallery'' by Silvanus G. Morley, leader of the Carnegie Institute's archaeological team that excavated and restored these structures in the 1920s. Since then, many others have experienced the extraordinary acoustics at Chichen Itza and other Maya sites. Despite these reports, archaeologists and acousticians have until recently shown little interest in understanding these phenomena. After experiencing Chichen Itza's remarkable acoustics as a tourist in 1994, the author commenced collecting and disseminating information about acoustical phenomena there and at other Mayan sites, hoping to stimulate interest among archaeologists and acousticians. Were these designs accidental or intentional? If intentional, how was the knowledge obtained? How were acoustical features used? This paper highlights the author's collection of anecdotal reports of mysterious Mayan acoustics (http://http://www.ianlawton.com/pa1.htm), recommended reading for scientists and engineers who wish to pursue this fascinating study. Also recounted are some of the reactions of archaeologists-ranging from curious, helpful, and insightful to humorous and appalling--to outsiders' efforts to bring serious scientific attention to the new field of acoustical archaeology.

Acoustic field modulation in regenerators

Science.gov (United States)

Hu, J. Y.; Wang, W.; Luo, E. C.; Chen, Y. Y.

2016-12-01

The regenerator is a key component that transfers energy between heat and work. The conversion efficiency is significantly influenced by the acoustic field in the regenerator. Much effort has been spent to quantitatively determine this influence, but few comprehensive experimental verifications have been performed because of difficulties in modulating and measuring the acoustic field. In this paper, a method requiring two compressors is introduced and theoretically investigated that achieves acoustic field modulation in the regenerator. One compressor outputs the acoustic power for the regenerator; the other acts as a phase shifter. A RC load dissipates the acoustic power out of both the regenerator and the latter compressor. The acoustic field can be modulated by adjusting the current in the two compressors and opening the RC load. The acoustic field is measured with pressure sensors instead of flow-field imaging equipment, thereby greatly simplifying the experiment.

Blocking mammalian target of rapamycin (mTOR) improves neuropathic pain evoked by spinal cord injury.

Science.gov (United States)

Wang, Xiaoping; Li, Xiaojia; Huang, Bin; Ma, Shuai

2016-01-01

Spinal cord injury (SCI) is an extremely serious type of physical trauma observed in clinics. Neuropathic pain resulting from SCI has a lasting and significant impact on most aspects of daily life. Thus, a better understanding of the molecular pathways responsible for the cause of neuropathic pain observed in SCI is important to develop effective therapeutic agents and treatment strategies. Mammalian target of rapamycin (mTOR) is a serine/threonine protein kinase that is well known for its critical roles in regulating protein synthesis and growth. Furthermore, compelling evidence supports the notion that widespread dysregulation of mTOR and its downstream pathways are involved in neuropathic pain. Thus, in this study we specifically examined the underlying mechanisms by which mTOR and its signaling pathways are involved in SCI-evoked neuropathic pain in a rat model. Overall, we demonstrated that SCI increased the protein expression of p-mTOR, and mTORmediated- phosphorylation of 4E-binding protein 4 (4E-BP1) and p70 ribosomal S6 protein kinase 1 (S6K1) in the superficial dorsal horn of the spinal cord. Also, we showed that blocking spinal mTOR by intrathecal injection of rapamycin significantly inhibited pain responses induced by mechanical and thermal stimulation. In addition, blocking spinal phosphatidylinositide 3-kinase (p-PI3K) pathway significantly attenuated activities of p-mTOR pathways as well as mechanical and thermal hyperalgesia in SCI rats. Moreover, blocking mTOR and PI3K decreased the enhanced levels of substance P and calcitonin gene-related peptide (CGRP) in the dorsal horn of SCI rats. We revealed specific signaling pathways leading to SCI-evoked neuropathic pain, including the activation of PI3K, mTOR and its downstream signaling pathways. Targeting one or more of these signaling molecules may present new opportunities for treatment and management of neuropathic pain often observed in patients with SCI.

Blocking mammalian target of rapamycin (mTOR improves neuropathic pain evoked by spinal cord injury

Directory of Open Access Journals (Sweden)

Wang Xiaoping

2016-01-01

Full Text Available Spinal cord injury (SCI is an extremely serious type of physical trauma observed in clinics. Neuropathic pain resulting from SCI has a lasting and significant impact on most aspects of daily life. Thus, a better understanding of the molecular pathways responsible for the cause of neuropathic pain observed in SCI is important to develop effective therapeutic agents and treatment strategies. Mammalian target of rapamycin (mTOR is a serine/threonine protein kinase that is well known for its critical roles in regulating protein synthesis and growth. Furthermore, compelling evidence supports the notion that widespread dysregulation of mTOR and its downstream pathways are involved in neuropathic pain. Thus, in this study we specifically examined the underlying mechanisms by which mTOR and its signaling pathways are involved in SCI-evoked neuropathic pain in a rat model. Overall, we demonstrated that SCI increased the protein expression of p-mTOR, and mTORmediated- phosphorylation of 4E–binding protein 4 (4E-BP1 and p70 ribosomal S6 protein kinase 1 (S6K1 in the superficial dorsal horn of the spinal cord. Also, we showed that blocking spinal mTOR by intrathecal injection of rapamycin significantly inhibited pain responses induced by mechanical and thermal stimulation. In addition, blocking spinal phosphatidylinositide 3-kinase (p-PI3K pathway significantly attenuated activities of p-mTOR pathways as well as mechanical and thermal hyperalgesia in SCI rats. Moreover, blocking mTOR and PI3K decreased the enhanced levels of substance P and calcitonin gene-related peptide (CGRP in the dorsal horn of SCI rats. We revealed specific signaling pathways leading to SCI-evoked neuropathic pain, including the activation of PI3K, mTOR and its downstream signaling pathways. Targeting one or more of these signaling molecules may present new opportunities for treatment and management of neuropathic pain often observed in patients with SCI.

Ares I Scale Model Acoustic Tests Instrumentation for Acoustic and Pressure Measurements

Science.gov (United States)

Vargas, Magda B.; Counter, Douglas D.

2011-01-01

The Ares I Scale Model Acoustic Test (ASMAT) was a development test performed at the Marshall Space Flight Center (MSFC) East Test Area (ETA) Test Stand 116. The test article included a 5% scale Ares I vehicle model and tower mounted on the Mobile Launcher. Acoustic and pressure data were measured by approximately 200 instruments located throughout the test article. There were four primary ASMAT instrument suites: ignition overpressure (IOP), lift-off acoustics (LOA), ground acoustics (GA), and spatial correlation (SC). Each instrumentation suite incorporated different sensor models which were selected based upon measurement requirements. These requirements included the type of measurement, exposure to the environment, instrumentation check-outs and data acquisition. The sensors were attached to the test article using different mounts and brackets dependent upon the location of the sensor. This presentation addresses the observed effect of the sensors and mounts on the acoustic and pressure measurements.

Agorá Acoustics - Effects of arcades on the acoustics of public squares

DEFF Research Database (Denmark)

Paini, Dario; Gade, Anders Christian; Rindel, Jens Holger

2005-01-01

This paper is part of a PhD work, dealing with the acoustics of the public squares (‘Agorá Acoustics’), especially when music (amplified or not) is played. Consequently, our approach will be to evaluate public squares using the same set of acoustics concepts for subjective evaluation and objective...... measurements as applied for concert halls and theatres. In this paper the acoustical effects of arcades will be studied, in terms of reverberation (EDT and T30), clarity (C80), intelligibility (STI) and other acoustical parameters. For this purpose, also the theory of coupled rooms is applied and compared...... with results. An acoustic modelling program, ODEON 7.0, was used for this investigation. Three different sizes of public squares were considered. In order to evaluate the ‘real’ effects of the arcades on the open square, models of all three squares were designed both with and without arcades. The sound source...

Understanding acoustics an experimentalist’s view of acoustics and vibration

CERN Document Server

Garrett, Steven L

2017-01-01

This textbook provides a unified approach to acoustics and vibration suitable for use in advanced undergraduate and first-year graduate courses on vibration and fluids. The book includes thorough treatment of vibration of harmonic oscillators, coupled oscillators, isotropic elasticity, and waves in solids including the use of resonance techniques for determination of elastic moduli. Drawing on 35 years of experience teaching introductory graduate acoustics at the Naval Postgraduate School and Penn State, the author presents a hydrodynamic approach to the acoustics of sound in fluids that provides a uniform methodology for analysis of lumped-element systems and wave propagation that can incorporate attenuation mechanisms and complex media. This view provides a consistent and reliable approach that can be extended with confidence to more complex fluids and future applications. Understanding Acoustics opens with a mathematical introduction that includes graphing and statistical uncertainty, followed by five chap...

Effect of peripherally and cortically evoked swallows on jaw reflex responses in anesthetized rabbits.

Science.gov (United States)

Suzuki, Taku; Yoshihara, Midori; Sakai, Shogo; Tsuji, Kojun; Nagoya, Kouta; Magara, Jin; Tsujimura, Takanori; Inoue, Makoto

2018-05-03

This study aimed to investigate whether the jaw-opening (JOR) and jaw-closing reflexes (JCR) are modulated during not only peripherally, but also centrally, evoked swallowing. Experiments were carried out on 24 adult male Japanese white rabbits. JORs were evoked by trigeminal stimulation at 1 Hz for 30 sec. In the middle 10 sec, either the superior laryngeal nerve (SLN) or cortical swallowing area (Cx) was simultaneously stimulated to evoke swallowing. The peak-to-peak JOR amplitude was reduced during the middle and late 10-sec periods (i.e., during and after SLN or Cx stimulation), and the reduction was dependent on the current intensity of SLN/Cx stimulation: greater SLN/Cx stimulus current resulted in greater JOR inhibition. The reduction rate was significantly greater during Cx stimulation than during SLN stimulation. The amplitude returned to baseline 2 min after 10-sec SLN/Cx stimulation. The effect of co-stimulation of SLN and Cx was significantly greater than that of SLN stimulation alone. There were no significant differences in any parameters of the JCR between conditions. These results clearly showed that JOR responses were significantly suppressed, not only during peripherally evoked swallowing but also during centrally evoked swallowing, and that the inhibitory effect is likely to be larger during centrally compared with peripherally evoked swallowing. The functional implications of these results are discussed. Copyright © 2018. Published by Elsevier B.V.

[Pancreatic trauma].

Science.gov (United States)

Arvieux, C; Guillon, F; Létoublon, Ch; Oughriss, M

2003-10-01

Early diagnosis of pancreatic trauma has always been challenging because of the lack of correlation between the initial clinical symptomatology, radiologic and laboratory findings, and the severity of the injury. Thanks to the improved performance of spiral CT scanning and magnetic resonance pancreatography, it is now often possible to make an early diagnosis of pancreatic contusion, to localize the site of the injury, and (most importantly) to identify injury to the main pancreatic duct which has major implications for the management of the case. When the trauma victim is unstable, radiologic work-up may be impossible and urgent laparotomy is required. Control of hemorrhage is the primary concern here and a damage control approach with packing may be appropriate; if the pancreatic head has been destroyed, a pancreaticoduodenectomy with delayed reconstruction may be required. If the trauma victim is stable, the treatment strategy will be governed by a variety of parameters--age, clinical condition, associated local anatomic findings (pancreatitis, injury to the duodenum or biliary tract), involvement of the pancreatic duct, and localization of the injury within the gland (to right or left of the mesenteric vessels).

Epidemiological evaluation of hepatic trauma victims undergoing surgery.

Science.gov (United States)

Kalil, Mitre; Amaral, Isaac Massaud Amim

2016-02-01

to evaluate the epidemiological variables and diagnostic and therapeutic modalities related to hepatic trauma patients undergoing laparotomy in a public referral hospital in the metropolitan region of Vitória-ES. we conducted a retrospective study, reviewing charts of trauma patients with liver injuries, whether isolated or in association with other organs, who underwent exploratory laparotomy, from January 2011 to December 2013. We studied 392 patients, 107 of these with liver injury. The male: female ratio was 6.6 : 1 and the mean age was 30.12 years. Penetrating liver trauma occurred in 78.5% of patients, mostly with firearms. Associated injuries occurred in 86% of cases and intra-abdominal injuries were more common in penetrating trauma (p trauma was 60%, and penetrating trauma, 87.5% (p trauma remain high, especially in patients suffering from blunt trauma in relation to penetrating one.

Influence of the 5-HT3A Receptor Gene Polymorphism and Childhood Sexual Trauma on Central Serotonin Activity.

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Kuk-In Jang

Full Text Available Gene-environment interactions are important for understanding alterations in human brain function. The loudness dependence of auditory evoked potential (LDAEP is known to reflect central serotonergic activity. Single nucleotide polymorphisms (SNPs in the 5-HT3A serotonin receptor gene are associated with psychiatric disorders. This study aimed to investigate the effect between 5-HT3A receptor gene polymorphisms and childhood sexual trauma on the LDAEP as an electrophysiological marker in healthy subjects.A total of 206 healthy subjects were recruited and evaluated using the childhood trauma questionnaire (CTQ and hospital anxiety and depression scale (HADS. Peak-to-peak N1/P2 was measured at five stimulus intensities, and the LDAEP was calculated as the linear-regression slope. In addition, the rs1062613 SNPs of 5-HT3A (CC, CT, and TT were analyzed in healthy subjects.There was a significant interaction between scores on the CTQ-sexual abuse subscale and 5-HT3A genotype on the LDAEP. Subjects with the CC polymorphism had a significantly higher LDEAP than T carriers in the sexually abused group. In addition, CC genotype subjects in the sexually abused group showed a significantly higher LDAEP compared with CC genotype subjects in the non-sexually abused group.Our findings suggest that people with the CC polymorphism of the 5-HT3A gene have a greater risk of developing mental health problems if they have experienced childhood sexual abuse, possibly due to low central serotonin activity. Conversely, the T polymorphism may be protective against any central serotonergic changes following childhood sexual trauma.

Simulated Trauma and Resuscitation Team Training course-evolution of a multidisciplinary trauma crisis resource management simulation course.

Science.gov (United States)

Gillman, Lawrence M; Brindley, Peter; Paton-Gay, John Damian; Engels, Paul T; Park, Jason; Vergis, Ashley; Widder, Sandy

2016-07-01

We previously reported on a pilot trauma multidisciplinary crisis resource course titled S.T.A.R.T.T. (Simulated Trauma and Resuscitative Team Training). Here, we study the course's evolution. Satisfaction was evaluated by postcourse survey. Trauma teams were evaluated using the Ottawa global rating scale and an Advanced Trauma Life Support primary survey checklist. Eleven "trauma teams," consisting of physicians, nurses, and respiratory therapists, each completed 4 crisis simulations over 3 courses. Satisfaction remained high among participants with overall mean satisfaction being 4.39 on a 5-point Likert scale. As participants progressed through scenarios, improvements in global rating scale scores were seen between the 1st and 4th (29.8 vs 36.1 of 42, P = .022), 2nd and 3rd (28.2 vs 34.6, P = .017), and 2nd and 4th (28.2 vs 36.1, P = .003) scenarios. There were no differences in Advanced Trauma Life Support checklist with mean scores for each scenario ranging 11.3 to 13.2 of 17. The evolved Simulated Trauma and Resuscitative Team Training curriculum has maintained high participant satisfaction and is associated with improvement in team crisis resource management skills over the duration of the course. Copyright © 2015 Elsevier Inc. All rights reserved.

Interdisciplinary trauma room management: staff-related apparative and logistic concepts in three level trauma centers in Europe

International Nuclear Information System (INIS)

Kroetz, M.; Linsenmaier, U.; Pfeifer, K.J.; Reiser, M.; Bode, P.J.; Haeuser, H.

2002-01-01

Objective. To analyse common and divergent features of staff-related, equipmental and spatial/logistical concepts of three large trauma centers of highest health care level.Methods. The health care mandate as well as the staff management, the organisational and the constructional-spacial structure of trauma room diagnostics and therapy of the trauma centers of the Universities of Leiden and Munich (Innenstadt) and the Zentralklinikum Augsburg are described. In particular the technical equipment and the process of the radiological diagnostic procedures in the trauma room are outlined.Results. Staff availability and basic technical equipment of the trauma rooms are comparable between the three hospitals. Divergent concepts exist concerning the complexity of the initial radiologic examination protocols. Spacial connection and importance of computed tomography are also discussed controversially. Urgent interventional procedures are increasingly performed within the trauma room. Magnetic-resonance-tomography does not play a role in early care from multiple injured patients.Conclusion. Trauma centers have to meet certain personnel and technical prerequisites to guarantee a temporally optimised care for multiple injured patients. Differences between the three centers concerning the logistic sequence and the radiologic examination techniques used are mainly due to variable emphasis put on CT in the initial phase of patient care. (orig.) [de

Trauma Studies: prospettive e problemi

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Rachele Branchini

2013-12-01

Full Text Available The trauma paradigm pervades contemporary life. In newspapers, on television, on the web, even in ordinary conversation, experiences of every kind (both figurative and positive ones are described as “traumatic”. Thus the very meaning of the term is often overturned. This article seeks to reshape the limits of the concept of trauma by tracing its evolution from the psychological debate of the early nineteenth century to the recent setting up of the specific discipline of Trauma Studies.

The Relationship of Visual Evoked Potential Asymmetries to the Performance of Sonar Operators

Science.gov (United States)

1981-08-11

also been related to EP variability. Schizophrenic adults and patients with Korsakoff’s Syndrome have shown higher evoked potential variability than...average evoked response in Korsakoff patients. J. Psychiatry Res. 6: 253-260, 1969. Santoro, T. and D. Fender. Rules for the perception of

Investigation into the Effect of Acoustic Radiation Force and Acoustic Streaming on Particle Patterning in Acoustic Standing Wave Fields

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Shilei Liu

2017-07-01

Full Text Available Acoustic standing waves have been widely used in trapping, patterning, and manipulating particles, whereas one barrier remains: the lack of understanding of force conditions on particles which mainly include acoustic radiation force (ARF and acoustic streaming (AS. In this paper, force conditions on micrometer size polystyrene microspheres in acoustic standing wave fields were investigated. The COMSOL® Mutiphysics particle tracing module was used to numerically simulate force conditions on various particles as a function of time. The velocity of particle movement was experimentally measured using particle imaging velocimetry (PIV. Through experimental and numerical simulation, the functions of ARF and AS in trapping and patterning were analyzed. It is shown that ARF is dominant in trapping and patterning large particles while the impact of AS increases rapidly with decreasing particle size. The combination of using both ARF and AS for medium size particles can obtain different patterns with only using ARF. Findings of the present study will aid the design of acoustic-driven microfluidic devices to increase the diversity of particle patterning.

Investigation into the Effect of Acoustic Radiation Force and Acoustic Streaming on Particle Patterning in Acoustic Standing Wave Fields

Science.gov (United States)

Yang, Yanye; Ni, Zhengyang; Guo, Xiasheng; Luo, Linjiao; Tu, Juan; Zhang, Dong

2017-01-01

Acoustic standing waves have been widely used in trapping, patterning, and manipulating particles, whereas one barrier remains: the lack of understanding of force conditions on particles which mainly include acoustic radiation force (ARF) and acoustic streaming (AS). In this paper, force conditions on micrometer size polystyrene microspheres in acoustic standing wave fields were investigated. The COMSOL® Mutiphysics particle tracing module was used to numerically simulate force conditions on various particles as a function of time. The velocity of particle movement was experimentally measured using particle imaging velocimetry (PIV). Through experimental and numerical simulation, the functions of ARF and AS in trapping and patterning were analyzed. It is shown that ARF is dominant in trapping and patterning large particles while the impact of AS increases rapidly with decreasing particle size. The combination of using both ARF and AS for medium size particles can obtain different patterns with only using ARF. Findings of the present study will aid the design of acoustic-driven microfluidic devices to increase the diversity of particle patterning. PMID:28753955

Ballistic trauma

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Parvathi Devi Munishwar

2016-01-01

Full Text Available Gunshot injuries are rather serious but uncommon type of trauma in India. Radiologists can contribute substantially in the evaluation and treatment of patients with gunshot wounds. Foreign bodies that enter a patient as a result of trauma are contaminated and produce a range of symptoms. Oral and maxillofacial gunshot injuries are usually fatal due to close proximity with vital structures. Here, we report a case in which radiographic evidence of foreign bodies in the right orofacial region exposed a history of a gunshot injury. The patient did not have any major complaints except for reduced mouth opening. These foreign bodies were clinically silent for approximately 12 years.

CT evaluation of abdominal trauma

International Nuclear Information System (INIS)

Huang Ruiting

2004-01-01

Objective: An evaluation of CT diagnosis of abdominal trauma. Methods: CT appearance of abdominal trauma was analyzed retrospectively in 95 cases. thirty-three patients were cured by operation, and the other 59 patients received conservative treatment. Fifty-one patients out of 59 were seen healed or improved by a follow up CT scan after the conservative treatment. Results: The study included: 31 cases of splenic contusion, accompanying with hemoperitoneum in 25 cases; 3 cases of hepatic laceration; 33 cases of liver and spleen compound trauma accompanying with hemoperitoneum; 18 cases of renal contusion, with subcapsular hemorrhage in 12 cases; 4 cases of midriff colic; 3 cases of mesentery breach; 3 cases of digestive tract perforation. Conclusion: CT is sensitive and precise in evaluating abdominal trauma, providing important information for treatment. (author)

Radiology of trauma to kidney and lower urinary tract

Energy Technology Data Exchange (ETDEWEB)

Dorph, S [Herlev University Hospital, Copenhagen (Denmark). Dept. of Radiology

1996-12-31

The contents are trauma to kidney, imaging of kidney trauma, management of renal trauma, delayed complications, trauma to the lower urinary tract, trauma to urinary bladder, radiologic diagnosis, ethiology of blunt bladder injury, urethal injury (6 refs.).

Radiology of trauma to kidney and lower urinary tract

International Nuclear Information System (INIS)

Dorph, S.

1995-01-01

The contents are trauma to kidney, imaging of kidney trauma, management of renal trauma, delayed complications, trauma to the lower urinary tract, trauma to urinary bladder, radiologic diagnosis, ethiology of blunt bladder injury, urethal injury (6 refs.)

Obesity in pediatric trauma.

Science.gov (United States)

Witt, Cordelie E; Arbabi, Saman; Nathens, Avery B; Vavilala, Monica S; Rivara, Frederick P

2017-04-01

The implications of childhood obesity on pediatric trauma outcomes are not clearly established. Anthropomorphic data were recently added to the National Trauma Data Bank (NTDB) Research Datasets, enabling a large, multicenter evaluation of the effect of obesity on pediatric trauma patients. Children ages 2 to 19years who required hospitalization for traumatic injury were identified in the 2013-2014 NTDB Research Datasets. Age and gender-specific body mass indices (BMI) were calculated. Outcomes included injury patterns, operative procedures, complications, and hospital utilization parameters. Data from 149,817 pediatric patients were analyzed; higher BMI percentiles were associated with significantly more extremity injuries, and fewer injuries to the head, abdomen, thorax and spine (p values Obese children also had significantly longer lengths of stay and more frequent ventilator requirement. Among children admitted after trauma, increased BMI percentile is associated with increased risk of death and potentially preventable complications. These findings suggest that obese children may require different management than nonobese counterparts to prevent complications. Level III; prognosis study. Copyright © 2017 Elsevier Inc. All rights reserved.

Variability in interhospital trauma data coding and scoring: A challenge to the accuracy of aggregated trauma registries.

Science.gov (United States)

Arabian, Sandra S; Marcus, Michael; Captain, Kevin; Pomphrey, Michelle; Breeze, Janis; Wolfe, Jennefer; Bugaev, Nikolay; Rabinovici, Reuven

2015-09-01

Analyses of data aggregated in state and national trauma registries provide the platform for clinical, research, development, and quality improvement efforts in trauma systems. However, the interhospital variability and accuracy in data abstraction and coding have not yet been directly evaluated. This multi-institutional, Web-based, anonymous study examines interhospital variability and accuracy in data coding and scoring by registrars. Eighty-two American College of Surgeons (ACS)/state-verified Level I and II trauma centers were invited to determine different data elements including diagnostic, procedure, and Abbreviated Injury Scale (AIS) coding as well as selected National Trauma Data Bank definitions for the same fictitious case. Variability and accuracy in data entries were assessed by the maximal percent agreement among the registrars for the tested data elements, and 95% confidence intervals were computed to compare this level of agreement to the ideal value of 100%. Variability and accuracy in all elements were compared (χ testing) based on Trauma Quality Improvement Program (TQIP) membership, level of trauma center, ACS verification, and registrar's certifications. Fifty registrars (61%) completed the survey. The overall accuracy for all tested elements was 64%. Variability was noted in all examined parameters except for the place of occurrence code in all groups and the lower extremity AIS code in Level II trauma centers and in the Certified Specialist in Trauma Registry- and Certified Abbreviated Injury Scale Specialist-certified registrar groups. No differences in variability were noted when groups were compared based on TQIP membership, level of center, ACS verification, and registrar's certifications, except for prehospital Glasgow Coma Scale (GCS), where TQIP respondents agreed more than non-TQIP centers (p = 0.004). There is variability and inaccuracy in interhospital data coding and scoring of injury information. This finding casts doubt on the

Deep Water Acoustics

Science.gov (United States)

2016-06-28

the Deep Water project and participate in the NPAL Workshops, including Art Baggeroer (MIT), J. Beron- Vera (UMiami), M. Brown (UMiami), T...Kathleen E . Wage. The North Pacific Acoustic Laboratory deep-water acoustic propagation experiments in the Philippine Sea. J. Acoust. Soc. Am., 134(4...estimate of the angle α during PhilSea09, made from ADCP measurements at the site of the DVLA. Sim. A B1 B2 B3 C D E F Prof. # 0 4 4 4 5 10 16 20 α

Acoustic Levitation With Less Equipment

Science.gov (United States)

Barmatz, M. B.; Jacobi, N.

1983-01-01

Certain chamber shapes require fewer than three acoustic drivers. Levitation at center of spherical chamber attained using only one acoustic driver. Exitation of lowest spherical mode produces asymmetric acoustic potential well.

TRAUMA

African Journals Online (AJOL)

2017-11-04

Nov 4, 2017 ... unit in Durban, and to correlate it with injury severity, length of hospital stay ... and via a password protected mobile application program within 6 ..... usage and costs performed in larger numbers on major trauma patients will ...

Anisotropy of acoustic properties in paratellurite

International Nuclear Information System (INIS)

Parygin, Vladimir N.

1996-01-01

One of the peculiarities of the TeO 2 crystal consists of its strong acoustic anisotropy. This anisotropy demonstrates itself by acoustic energy walk-off and anisotropic distortion of an acoustic beam. Four constants completely characterise the acoustic anisotropy of the medium. In this paper these constants are calculated for various directions of the acoustic beam in crystal. (authors)

Variable-Position Acoustic Levitation

Science.gov (United States)

Barmatz, M. B.; Stoneburner, J. D.; Jacobi, N.; Wang, T. G.

1983-01-01

Method of acoustic levitation supports objects at positions other than acoustic nodes. Acoustic force is varied so it balances gravitational (or other) force, thereby maintaining object at any position within equilibrium range. Levitation method applicable to containerless processing. Such objects as table-tennis balls, hollow plastic spheres, and balsa-wood spheres levitated in laboratory by new method.

Photo-acoustic and video-acoustic methods for sensing distant sound sources

Science.gov (United States)

Slater, Dan; Kozacik, Stephen; Kelmelis, Eric

2017-05-01

Long range telescopic video imagery of distant terrestrial scenes, aircraft, rockets and other aerospace vehicles can be a powerful observational tool. But what about the associated acoustic activity? A new technology, Remote Acoustic Sensing (RAS), may provide a method to remotely listen to the acoustic activity near these distant objects. Local acoustic activity sometimes weakly modulates the ambient illumination in a way that can be remotely sensed. RAS is a new type of microphone that separates an acoustic transducer into two spatially separated components: 1) a naturally formed in situ acousto-optic modulator (AOM) located within the distant scene and 2) a remote sensing readout device that recovers the distant audio. These two elements are passively coupled over long distances at the speed of light by naturally occurring ambient light energy or other electromagnetic fields. Stereophonic, multichannel and acoustic beam forming are all possible using RAS techniques and when combined with high-definition video imagery it can help to provide a more cinema like immersive viewing experience. A practical implementation of a remote acousto-optic readout device can be a challenging engineering problem. The acoustic influence on the optical signal is generally weak and often with a strong bias term. The optical signal is further degraded by atmospheric seeing turbulence. In this paper, we consider two fundamentally different optical readout approaches: 1) a low pixel count photodiode based RAS photoreceiver and 2) audio extraction directly from a video stream. Most of our RAS experiments to date have used the first method for reasons of performance and simplicity. But there are potential advantages to extracting audio directly from a video stream. These advantages include the straight forward ability to work with multiple AOMs (useful for acoustic beam forming), simpler optical configurations, and a potential ability to use certain preexisting video recordings. However

Conduction velocity of the human spinothalamic tract as assessed by laser evoked potentials

DEFF Research Database (Denmark)

Cruccu, G.; Iannetti, G. D.; Agostino, R.

2000-01-01

To study the conduction velocity of the spinothalamic tract (STT) we delivered CO2 laser pulses, evoking pinprick sensations, to the skin overlying the vertebral spinous processes at different spinal levels from C5 to T10 and recorded evoked potentials (LEPs) in 15 healthy human subjects...

Outcome of severely injured trauma patients at a designated trauma centre in the Hong Kong Special Administrative Region.

Science.gov (United States)

Leung, Ka Kit Gilberto; Ho, Wendy; Tong, King Hung Daniel; Yuen, Wai Key

2010-05-20

The Hong Kong Special Administrative Region (HKSAR) of the People's Republic of China (PRC) has seen significant changes in its trauma service over the last ten years including the implementation of a regional trauma system. The author's institution is one of the five trauma centres designated in 2003. This article reports our initial clinical experience. A prospective single-centre trauma registry from January 2004 to December 2008 was reviewed. The primary clinical outcome measure was hospital mortality. The Trauma and Injury Severity Score (TRISS) methodology was used for bench-marking with the North America Major Trauma Outcome Study (MTOS) database. There were 1451 patients. The majority (83.9%) suffered from blunt injury. The overall mortality rate was 7.8%. Severe injury, defined as the Injury Severity Score > 15, occurred in 22.5% of patients, and was associated with a mortality rate of 31.6%. A trend of progressive improvement was noted. The M-statistic was 0.99, indicating comparable case-mix with the MTOS. The Z- and W-statistics of each individual year revealed fewer, but not significantly so, number of survivors than expected. Trauma centre designation was feasible in the HKSAR and was associated with a gradual improvement in patient care. Trauma system implementation may be considered in regions equipped with the necessary socio-economic and organizational set-up.

Non-trauma-associated additional findings in whole-body CT examinations in patients with multiple trauma

International Nuclear Information System (INIS)

Hoffstetter, P.; Herold, T.; Daneschnejad, M.; Zorger, N.; Jung, E.M.; Feuerbach, S.; Schreyer, A.G.

2008-01-01

Purpose: whole-body CT scans for patients with multiple trauma represent an increasingly accepted first diagnostic tool. The multidetector approach in particular provides appropriate diagnostic algorithms for detecting nearly all relevant traumatic findings in a short time with a high grade of sensitivity and specificity. Non-trauma-associated additional findings are commonly depicted based on these CT examinations. The aim of this study is to evaluate the number and quality of these additional findings in consecutive patients with multiple trauma. Materials and methods: between 3/04 and 8/06 we scanned 304 patients according to our dedicated multiple trauma protocol. The examination protocol includes a head scan without intravenous contrast followed by a whole-body scan including the neck, thorax and abdomen acquired by a 16-row CT Scanner (Siemens, Sensation 16). The CT scans were retrospectively analyzed by two radiologists with respect to non-trauma-associated findings. Lesions were assessed according to their clinical relevance (highly relevant, moderately relevant, not relevant). For patients with highly relevant findings, additional follow-up research was performed. Results: The average age was 43 years (range 3 - 92). 236 of the patients were male (77.6%), 68 female (22.4%). 153 patients (50.3%) had additional non-trauma-associated findings. In 20 cases (6.6%) lesions with high clinical relevance were detected (e.g. carcinoma of the kidney or the ovary). In 71 patients (23.4%) findings with moderate relevance were described. In 63 patients (20.7%) additional findings without major relevance were diagnosed. Conclusion: Whole-body CT scans of patients randomized by a trauma show a considerable number of non-trauma-associated additional findings. In about 30% of cases, these findings are clinically relevant because further diagnostic workup or treatment in the short or medium-term is needed. The results of these analyses emphasize the diagnostic value of CT

Magnetic field induced random pulse trains of magnetic and acoustic noises in martensitic single-crystal Ni2MnGa

Science.gov (United States)

Daróczi, Lajos; Piros, Eszter; Tóth, László Z.; Beke, Dezső L.

2017-07-01

Jerky magnetic and acoustic noises were evoked in a single variant martensitic Ni2MnGa single crystal (produced by uniaxial compression) by application of an external magnetic field along the hard magnetization direction. It is shown that after reaching the detwinning threshold, spontaneous reorientation of martensite variants (twins) leads not only to acoustic emission but magnetic two-directional noises as well. At small magnetic fields, below the above threshold, unidirectional magnetic emission is also observed and attributed to a Barkhausen-type noise due to magnetic domain wall motions during magnetization along the hard direction. After the above first run, in cycles of decreasing and increasing magnetic field, at low-field values, weak, unidirectional Barkhausen noise is detected and attributed to the discontinuous motion of domain walls during magnetization along the easy magnetization direction. The magnetic noise is also measured by constraining the sample in the same initial variant state along the hard direction and, after the unidirectional noise (as obtained also in the first run), a two-directional noise package is developed and it is attributed to domain rotations. From the statistical analysis of the above noises, the critical exponents, characterizing the power-law behavior, are calculated and compared with each other and with the literature data. Time correlations within the magnetic as well as acoustic signals lead to a common scaled power function (with β =-1.25 exponent) for both types of signals.

Splenic trauma: Is splenectomy redundant?

Directory of Open Access Journals (Sweden)

S Tandon

2013-01-01

Full Text Available 41 year old male, serving air warrior sustained blunt abdominal trauma, CECT revealed grade III splenic injury. He was managed conservatively with good clinical outcome. Conservatism is the new approach to splenic trauma.

Evidence that 5-hydroxytryptamine3 receptors mediate cytotoxic drug and radiation-evoked emesis

International Nuclear Information System (INIS)

Miner, W.D.; Sanger, G.J.; Turner, D.H.

1987-01-01

The involvement of 5-hydroxytryptamine (5-HT) 5-HT 3 receptors in the mechanisms of severe emesis evoked by cytotoxic drugs or by total body irradiation have been studied in ferrets. Anti-emetic compounds tested were domperidone (a dopamine antagonist), metoclopramide (a gastric motility stimulant and dopamine antagonist at conventional doses, a 5-HT 3 receptor antagonist at higher doses) and BRL 24924 (a potent gastric motility stimulant and a 5-HT 3 receptor antagonist). Domperidone or metoclopramide prevented apomorphine-evoked emesis, whereas BRL 24924 did not. Similar doses of domperidone did not prevent emesis evoked by cis-platin or by total body irradiation, whereas metoclopramide or BRL 24924 greatly reduced or prevented these types of emesis. Metoclopramide and BRL 24924 also prevented emesis evoked by a combination of doxorubicin and cyclophosphamide. These results are discussed in terms of a fundamental role for 5-HT 3 receptors in the mechanisms mediating severely emetogenic cancer treatment therapies. (author)

The Dental Trauma Internet Calculator

DEFF Research Database (Denmark)

Gerds, Thomas Alexander; Lauridsen, Eva Fejerskov; Christensen, Søren Steno Ahrensburg

2012-01-01

Background/Aim Prediction tools are increasingly used to inform patients about the future dental health outcome. Advanced statistical methods are required to arrive at unbiased predictions based on follow-up studies. Material and Methods The Internet risk calculator at the Dental Trauma Guide...... provides prognoses for teeth with traumatic injuries based on the Copenhagen trauma database: http://www.dentaltraumaguide.org The database includes 2191 traumatized permanent teeth from 1282 patients that were treated at the dental trauma unit at the University Hospital in Copenhagen (Denmark...

Psychic trauma as cause of death.

Science.gov (United States)

Terranova, C; Snenghi, R; Thiene, G; Ferrara, S D

2011-01-01

of study Psychic trauma is described as the action of 'an emotionally overwhelming factor' capable of causing neurovegetative alterations leading to transitory or persisting bodily changes. The medico-legal concept of psychic trauma and its definition as a cause in penal cases is debated. The authors present three cases of death after psychic trauma, and discuss the definition of cause within the penal ambit of identified 'emotionally overwhelming factors'. The methodological approach to ascertainment and criterion-based assessment in each case involved the following phases: (1) examination of circumstantial evidence, clinical records and documentation; (2) autopsy; (3) ascertainment of cause of death; and (4) ascertainment of psychic trauma, and its coexisting relationship with the cause of death. The results and assessment of each of the three cases are discussed from the viewpoint of the causal connotation of psychic trauma. In the cases presented, psychic trauma caused death, as deduced from assessment of the type of externally caused emotional insult, the subjects' personal characteristics and the circumstances of the event causing death. In cases of death due to psychic trauma, careful methodological ascertainment is essential, with the double aim of defining 'emotionally overwhelming factors' as a significant cause of death from the penal point of view, and of identifying the responsibility of third parties involved in the death event and associated dynamics of homicide.

Interhemispheric Asymmetries in Visual Evoked Potential Amplitude

Science.gov (United States)

1980-06-12

Layne, 1965) and of patients with Korsakoff’s syndrome (Malerstein and Callaway, 1969) . In the schizophrenics, the high variability is related to poor...communication. Malerstein, A. J., Callaway, E. Two-tone average evoked response in Korsakoff patients. J. Psychiatr. Res. 6: 253-260, 1969. Marsh, G

Magnetoactive Acoustic Metamaterials.

Science.gov (United States)

Yu, Kunhao; Fang, Nicholas X; Huang, Guoliang; Wang, Qiming

2018-04-11

Acoustic metamaterials with negative constitutive parameters (modulus and/or mass density) have shown great potential in diverse applications ranging from sonic cloaking, abnormal refraction and superlensing, to noise canceling. In conventional acoustic metamaterials, the negative constitutive parameters are engineered via tailored structures with fixed geometries; therefore, the relationships between constitutive parameters and acoustic frequencies are typically fixed to form a 2D phase space once the structures are fabricated. Here, by means of a model system of magnetoactive lattice structures, stimuli-responsive acoustic metamaterials are demonstrated to be able to extend the 2D phase space to 3D through rapidly and repeatedly switching signs of constitutive parameters with remote magnetic fields. It is shown for the first time that effective modulus can be reversibly switched between positive and negative within controlled frequency regimes through lattice buckling modulated by theoretically predicted magnetic fields. The magnetically triggered negative-modulus and cavity-induced negative density are integrated to achieve flexible switching between single-negative and double-negative. This strategy opens promising avenues for remote, rapid, and reversible modulation of acoustic transportation, refraction, imaging, and focusing in subwavelength regimes. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Electron/electron acoustic instability

International Nuclear Information System (INIS)

Gary, S.P.

1987-01-01

The electron acoustic wave becomes a normal mode of an unmagnetized collisionless plasma in the presence of two electron components with similar densities, but strongly disparate temperatures. The characteristic frequency of this mode is the plasma frequency of the cooler electron component. If these two electron components have a relative drift speed several times the thermal speed of the cooler component, the electron/electron acoustic instability may arise. This paper describes the parametric dependences of the threshold drift speed and maximum growth rate of this instability, and compares these with the same properties of the electron/ion acoustic instability. Under the condition of zero current, the electron/ion acoustic instability typically has the lower threshold drift speed, so that observation of the electron/electron acoustic instability is a strong indication of the presence of an electrical current in the plasma

Acoustic imaging system

Science.gov (United States)

Smith, Richard W.

1979-01-01

An acoustic imaging system for displaying an object viewed by a moving array of transducers as the array is pivoted about a fixed point within a given plane. A plurality of transducers are fixedly positioned and equally spaced within a laterally extending array and operatively directed to transmit and receive acoustic signals along substantially parallel transmission paths. The transducers are sequentially activated along the array to transmit and receive acoustic signals according to a preestablished sequence. Means are provided for generating output voltages for each reception of an acoustic signal, corresponding to the coordinate position of the object viewed as the array is pivoted. Receptions from each of the transducers are presented on the same display at coordinates corresponding to the actual position of the object viewed to form a plane view of the object scanned.

Blunt chest trauma.

Science.gov (United States)

Stewart, Daphne J

2014-01-01

Blunt chest trauma is associated with a wide range of injuries, many of which are life threatening. This article is a case study demonstrating a variety of traumatic chest injuries, including pathophysiology, diagnosis, and treatment. Literature on the diagnosis and treatment was reviewed, including both theoretical and research literature, from a variety of disciplines. The role of the advance practice nurse in trauma is also discussed as it relates to assessment, diagnosis, and treatment of patients with traumatic chest injuries.

Chest trauma in children, single center experience.

Science.gov (United States)

Ismail, Mohamed Fouad; al-Refaie, Reda Ibrahim

2012-10-01

Trauma is the leading cause of mortality in children over one year of age in industrialized countries. In this retrospective study we reviewed all chest trauma in pediatric patients admitted to Mansoura University Emergency Hospital from January 1997 to January 2007. Our hospital received 472 patients under the age of 18. Male patients were 374 with a mean age of 9.2±4.9 years. Causes were penetrating trauma (2.1%) and blunt trauma (97.9%). The trauma was pedestrian injuries (38.3%), motor vehicle (28.1%), motorcycle crash (19.9%), falling from height (6.7%), animal trauma (2.9%), and sports injury (1.2%). Type of injury was pulmonary contusions (27.1%) and lacerations (6.9%), rib fractures (23.9%), flail chest (2.5%), hemothorax (18%), hemopneumothorax (11.8%), pneumothorax (23.7%), surgical emphysema (6.1%), tracheobronchial injury (5.3%), and diaphragm injury (2.1%). Associated lesions were head injuries (38.9%), bone fractures (33.5%), and abdominal injuries (16.7%). Management was conservative (29.9%), tube thoracostomy (58.1%), and thoracotomy (12.1%). Mortality rate was 7.2% and multiple trauma was the main cause of death (82.3%) (Ptrauma is the most common cause of pediatric chest trauma and often due to pedestrian injuries. Rib fractures and pulmonary contusions are the most frequent injuries. Delay in diagnosis and multiple trauma are associated with high incidence of mortality. Copyright © 2011 SEPAR. Published by Elsevier España, S.L. All rights reserved.

Perspective: Acoustic metamaterials in transition

KAUST Repository

Wu, Ying

2017-12-15

Acoustic metamaterials derive their novel characteristics from the interaction between acoustic waves with designed structures. Since its inception seventeen years ago, the field has been driven by fundamental geometric and physical principles that guide the structure design rules as well as provide the basis for wave functionalities. Recent examples include resonance-based acoustic metasurfaces that offer flexible control of acoustic wave propagation such as focusing and re-direction; parity-time (PT)-symmetric acoustics that utilizes the general concept of pairing loss and gain to achieve perfect absorption at a single frequency; and topological phononics that can provide one-way edge state propagation. However, such novel functionalities are not without constraints. Metasurface elements rely on resonances to enhance their coupling to the incident wave; hence, its functionality is limited to a narrow frequency band. Topological phononics is the result of the special lattice symmetry that must be fixed at the fabrication stage. Overcoming such constraints naturally forms the basis for further developments. We identify two emergent directions: Integration of acoustic metamaterial elements for achieving broadband characteristics as well as acoustic wave manipulation tasks more complex than the single demonstrative functionality; and active acoustic metamaterials that can adapt to environment as well as to go beyond the constraints on the passive acoustic metamaterials. Examples of a successful recent integration of multi-resonators in achieving broadband sound absorption can be found in optimal sound-absorbing structures, which utilize causality constraint as a design tool in realizing the target-set absorption spectrum with a minimal sample thickness. Active acoustic metamaterials have also demonstrated the capability to tune bandgaps as well as to alter property of resonances in real time through stiffening of the spring constants, in addition to the PT symmetric

Visual cortical somatosensory and brainstem auditory evoked potentials following incidental irradiation of the rhombencephalon

Energy Technology Data Exchange (ETDEWEB)

Nightingale, S. (Royal Victoria Infirmary, Newcastle upon Tyne (UK)); Schofield, I.S.; Dawes, P.J.D.K. (Newcastle upon Tyne Univ. (UK). Newcastle General Hospital)

1984-01-01

Visual, cortical somatosensory and brainstem auditory evoked potentials were recorded before incidental irradiation of the rhombencephalon during radiotherapy in and around the middle ear, and at 11 weeks and eight months after completion of treatment. No patient experienced neurological symptoms during this period. No consistent changes in evoked potentials were found. The failure to demonstrate subclinical radiation-induced demyelination suggests either that the syndrome of early-delayed radiation rhombencephalopathy occurs in an idiosyncratic manner, or that any subclinical lesions are not detectable by serial evoked potential recordings.

Canada Basin Acoustic Propagation Experiment (CANAPE)

Science.gov (United States)

2015-09-30

acoustic communications, acoustic navigation, or acoustic remote sensing of the ocean interior . RELATED PROJECTS The 2015 CANAPE pilot study was a...1 DISTRIBUTION STATEMENT A. Approved for public release; distribution is unlimited. Canada Basin Acoustic Propagation Experiment (CANAPE...ocean structure. Changes in sea ice and the water column affect both acoustic propagation and ambient noise. This implies that what was learned