WorldWideScience

Sample records for hemorraagiline tbi ehk

  1. Viromarketing ehk Eesti Asja salaturundus / Jaana Liigand

    Index Scriptorium Estoniae

    Liigand, Jaana

    2004-01-01

    Marketingifirma SoulKool poolt korraldatud Türi Vodka varjatud viinakampaaniast. Viromarketingist ehk viirusturundusest. Vt. samas: USA kolledzhiõpilaste uus kultusjook; Mis teevad ühest naistekast tõelise naisteka? Aga loomulikult kingad!

  2. TBI Endpoints Development

    Science.gov (United States)

    2015-10-01

    and serum samples that include TBI of different severities, and the inclusion of non-TBI trauma controls and normal controls for standardization and... Trauma Patient-Centered Outcomes Research Combine the expertise physicians/surgeons in critical care facilities, along with computational... psychosocial risk factors (such as physical activity, diet, depression, social support) on cognitive function and 5-year change at mid-life with

  3. Opioid use after TBI

    Science.gov (United States)

    2012-07-01

    with reward/risk circuitry including the nucleus accumbens, amygdala, hippocampus , and prefrontal-parietal white matter tracts ACUTELY after TBI in...Five days prior to injury, animals underwent surgical implantation of a chronic indwelling venous catheter under isoflurane anesthesia with morphine ...the nucleus accumbens, amygdala, hippocampus , and prefrontal-parietal white matter tracts after TBI in rats o Obtain and optimize protocols for the

  4. Opioid Abuse after TBI

    Science.gov (United States)

    2014-07-01

    AD_________________ Award Number: W81XWH-11-1-0373 TITLE: " Opioid Abuse after TBI...2014 2. REPORT TYPE Annual 3. DATES COVERED 1 July 2013 - 30 June 2014 4. TITLE AND SUBTITLE " Opioid Abuse after TBI" 5a. CONTRACT NUMBER 5b...the brain’s reward circuitry which may make an injured brain more susceptible to the rewarding effects of opioids . We are currently conducting

  5. TBI-ROC Part Nine: Diagnosing TBI and Psychiatric Disorders

    Science.gov (United States)

    Elias, Eileen; Weider, Katie; Mustafa, Ruman

    2011-01-01

    This article is the ninth of a multi-part series on traumatic brain injury (TBI). It focuses on the process of diagnosing TBI and psychiatric disorders. Diagnosing traumatic brain injury can be challenging. It can be difficult differentiating TBI and psychiatric symptoms, as both have similar symptoms (e.g., memory problems, emotional outbursts,…

  6. TBI-ROC Part Six: Lifelong Living after TBI

    Science.gov (United States)

    Boeing, Marianne; Barton, Barbara; Zinsmeister, Paula; Brouwers, Lynn; Trudel, Tina M.; Elias, Eileen; Weider, Katie

    2010-01-01

    This article is the sixth of a multi-part series on traumatic brain injury (TBI) and discusses lifelong living after TBI. Following TBI, lifelong outcomes vary depending on the individual affected, treatment provided and severity of injury. Fortunately, many individuals who experience mild concussions common to childhood have no lasting symptoms.…

  7. Opioid Abuse after TBI

    Science.gov (United States)

    2015-09-01

    VCU We continued our examination of neuronal cell death in the dentate gyrus of the hippocampus of animals in the various experimental group. An...the side of the brain contralateral to the injury. However, in the dentate gyrus ipsilateral to the injury, we saw a significant reduction in the...found no significant differences in the number of neurons in the dentate gyrus of rats from the Sham or TBI group, regardless of oxycodone

  8. Traumatic Brain Injury Registry (TBI)

    Data.gov (United States)

    Department of Veterans Affairs — As the number of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Traumatic Brain Injury (TBI) patients has grown, so has the need to track and monitor...

  9. TBI Symptoms, Diagnosis, Treatment, Prevention

    Science.gov (United States)

    ... Past Issues Cover Story: Traumatic Brain Injury TBI Symptoms, Diagnosis, Treatment, Prevention Past Issues / Fall 2008 Table of ... turn Javascript on. Photo courtesy of ABC News Symptoms Mild: Person may remain conscious or be briefly ...

  10. Tietoturvauhat ja niiden ehkäiseminen Android-sovelluksissa

    OpenAIRE

    Sallanko, Janita

    2017-01-01

    Kandidaatintutkielma käsittelee Android-sovellusten tietoturvauhkia ja näiden ehkäisemistä. Tutkielma rajautuu älypuhelimien tarkasteluun kaikkien Android-laitteiden sijasta. Kyberrikollisuuden lisääntymisen myötä on sovellusten turvallisuuden varmistamisen merkitys noussut. Kandidaatintutkielma käsittelee tietoturvaa ensisijaisesti sovelluksen ohjelmoitsijan näkökulmasta.

  11. Kätega ravimine ehk me kõik oleme energia / Kerttu Soans

    Index Scriptorium Estoniae

    Soans, Kerttu, 1961-

    2011-01-01

    Erinevatest energia vahendamisel põhinevatest psühhotehnikatest ja ravimeetoditest: reiki, Silva ultra, maagiline maatriks ehk MM, elektromagnetvälja tasakaalustamise tehnika EMF, kvantpuudutus, bioenergeetika

  12. What Are Common Traumatic Brain Injury (TBI) Symptoms?

    Science.gov (United States)

    ... Trials Resources and Publications What are common TBI symptoms? Skip sharing on social media links Share this: ... is not always a sign of severe TBI. Symptoms of Mild TBI A person with a mild ...

  13. Traumatic Brain Injury (TBI) in Kids

    Science.gov (United States)

    ... Research Information Clinical Trials Resources and Publications Traumatic Brain Injury (TBI): Condition Information Skip sharing on social ... external force that affects the functioning of the brain. It can be caused by a bump or ...

  14. Genetics and outcomes after traumatic brain injury (TBI): what do we know about pediatric TBI?

    Science.gov (United States)

    Kurowski, Brad; Martin, Lisa J; Wade, Shari L

    2012-01-01

    Human genetic association studies in individuals with traumatic brain injury (TBI) have increased rapidly over the past few years. Recently, several review articles evaluated the association of genetics with outcomes after TBI. However, almost all of the articles discussed in these reviews focused on adult TBI. The primary objective of this review is to gain a better understanding of which genes and/or genetic polymorphisms have been evaluated in pediatric TBI. Our initial search identified 113 articles. After review of these articles only 5 genetic association studies specific to pediatric TBI were identified. All five of these studies evaluated the apolipoprotein (APOE) gene. The study design and methods of these identified papers will be discussed. An additional search was then performed to evaluate genes beyond APOE that have been evaluated in adult TBI; findings from these studies are highlighted. Larger genetic studies will need to be performed in the future to better elucidate the association of APOE and other genes with outcomes after TBI in children. There is great potential to utilized genetic information to inform prognosis and management after TBI in children; however, we have much work ahead of us to reach the goal of individualized management.

  15. Eesti album ehk elu läheb edasi / Igor Kotjuh

    Index Scriptorium Estoniae

    Kotjuh, Igor, 1978-

    2005-01-01

    Arvustus: Semenenko, Svetlan. Estonski albom, ili, Jeshtsho ne vsjo poterjano = Eesti album, ehk, Mitte kõik ei ole veel kaotatud = Estonian album, or, Not everything is lost yet. Tallinn : Ilo, 2004

  16. Ajast ja arust ehk tempusest ja teadvusest eesti komplementlauses / Märt Väljataga

    Index Scriptorium Estoniae

    Väljataga, Märt, 1965-

    2016-01-01

    Mitmeosalisena mõeldud käsitluse esimeses osas vaadeldakse komplementlausete grammatikat ehk uuritakse, millest sõltub eesti keeles minevikulisele pealausele alistatud komplementlause tempus, kui kujutatakse pealause verbiga samaaegset sündmust

  17. Ajast ja arust ehk tempusest ja teadvusest eesti komplementlauses / Märt Väljataga

    Index Scriptorium Estoniae

    Väljataga, Märt, 1965-

    2016-01-01

    Mitmeosalisena mõeldud käsitluse esimeses osas vaadeldakse komplementausete grammatikat ehk uuritakse, millest sõltub eesti keeles minevikulisele pealausele alistatud komplementlause tempus, kui kujutatakse pealause verbiga samaaegset sündmust

  18. Globaalpohmeluse lokaalravitsus ehk viiul insenerina läbikukkunud inimkonnale / Mihkel Kunnus

    Index Scriptorium Estoniae

    Kunnus, Mihkel, 1982-

    2016-01-01

    Arvustus: Mikita, Valdur. Metsik lingvistika : sosinaid kartulikummardajate külast. Tallinn : Grenader, 2008 ; Mikita, Valdur. Lingvistiline mets : tsibihärblase paradigma. Teadvuse kiirendi. Tallinn : Grenader, 2013 ; Mikita, Valdur. Lindvistika, ehk, Metsa see lingvistika. Vara : [HM], 2015

  19. Globaalpohmeluse lokaalravitsus ehk viiul insenerina läbikukkunud inimkonnale / Mihkel Kunnus

    Index Scriptorium Estoniae

    Kunnus, Mihkel, 1982-

    2016-01-01

    Arvustus: Mikita, Valdur. Metsik lingvistika : sosinaid kartulikummardajate külast. Tallinn : Grenader, 2008 ; Mikita, Valdur. Lingvistiline mets : tsibihärblase paradigma. Teadvuse kiirendi. Tallinn : Grenader, 2013 ; Mikita, Valdur. Lindvistika, ehk, Metsa see lingvistika. Vara : [HM], 2015

  20. Ajast ja arust ehk tempusest ja teadvusest eesti komplementlauses / Märt Väljataga

    Index Scriptorium Estoniae

    Väljataga, Märt, 1965-

    2016-01-01

    Mitmeosalisena mõeldud käsitluse esimeses osas vaadeldakse komplementlausete grammatikat ehk uuritakse, millest sõltub eesti keeles minevikulisele pealausele alistatud komplementlause tempus, kui kujutatakse pealause verbiga samaaegset sündmust

  1. Altered Mitochondrial Dynamics and TBI Pathophysiology

    Directory of Open Access Journals (Sweden)

    Tara Diane Fischer

    2016-03-01

    Full Text Available Mitochondrial function is intimately linked to cellular survival, growth, and death. Mitochondria not only generate ATP from oxidative phosphorylation, but also mediate intracellular calcium buffering, generation of reactive oxygen species (ROS, and apoptosis. Electron leakage from the electron transport chain, especially from damaged or depolarized mitochondria, can generate excess free radicals that damage cellular proteins, DNA, and lipids. Furthermore, mitochondrial damage releases pro-apoptotic factors to initiate cell death. Previous studies have reported that traumatic brain injury (TBI reduces mitochondrial respiration, enhances production of ROS, and triggers apoptotic cell death, suggesting a prominent role of mitochondria in TBI pathophysiology. Mitochondria maintain cellular energy homeostasis and health via balanced processes of fusion and fission, continuously dividing and fusing to form an interconnected network throughout the cell. An imbalance of these processes, particularly an excess of fission, can be detrimental to mitochondrial function, causing decreased respiration, ROS production, and apoptosis. Mitochondrial fission is regulated by the cytosolic GTPase, dynamin-related protein 1 (Drp1, which translocates to the mitochondrial outer membrane to initiate fission. Aberrant Drp1 activity has been linked to excessive mitochondrial fission and neurodegeneration. Measurement of Drp1 levels in purified hippocampal mitochondria showed an increase in TBI animals as compared to sham controls. Analysis of cryo-electron micrographs of these mitochondria also showed that TBI caused an initial increase in the length of hippocampal mitochondria at 24 hours post-injury, followed by a significant decrease in length at 72 hours. Post-TBI administration of Mdivi-1, a pharmacological inhibitor of Drp1, prevented this decrease in mitochondria length. Mdivi-1 treatment also reduced the loss of newborn neurons in the hippocampus and improved

  2. Altered Mitochondrial Dynamics and TBI Pathophysiology.

    Science.gov (United States)

    Fischer, Tara D; Hylin, Michael J; Zhao, Jing; Moore, Anthony N; Waxham, M Neal; Dash, Pramod K

    2016-01-01

    Mitochondrial function is intimately linked to cellular survival, growth, and death. Mitochondria not only generate ATP from oxidative phosphorylation, but also mediate intracellular calcium buffering, generation of reactive oxygen species (ROS), and apoptosis. Electron leakage from the electron transport chain, especially from damaged or depolarized mitochondria, can generate excess free radicals that damage cellular proteins, DNA, and lipids. Furthermore, mitochondrial damage releases pro-apoptotic factors to initiate cell death. Previous studies have reported that traumatic brain injury (TBI) reduces mitochondrial respiration, enhances production of ROS, and triggers apoptotic cell death, suggesting a prominent role of mitochondria in TBI pathophysiology. Mitochondria maintain cellular energy homeostasis and health via balanced processes of fusion and fission, continuously dividing and fusing to form an interconnected network throughout the cell. An imbalance of these processes, particularly an excess of fission, can be detrimental to mitochondrial function, causing decreased respiration, ROS production, and apoptosis. Mitochondrial fission is regulated by the cytosolic GTPase, dynamin-related protein 1 (Drp1), which translocates to the mitochondrial outer membrane (MOM) to initiate fission. Aberrant Drp1 activity has been linked to excessive mitochondrial fission and neurodegeneration. Measurement of Drp1 levels in purified hippocampal mitochondria showed an increase in TBI animals as compared to sham controls. Analysis of cryo-electron micrographs of these mitochondria also showed that TBI caused an initial increase in the length of hippocampal mitochondria at 24 h post-injury, followed by a significant decrease in length at 72 h. Post-TBI administration of Mitochondrial division inhibitor-1 (Mdivi-1), a pharmacological inhibitor of Drp1, prevented this decrease in mitochondria length. Mdivi-1 treatment also reduced the loss of newborn neurons in the

  3. Mission Connect Mild TBI Translational Research Consortium

    Science.gov (United States)

    2010-08-31

    TBI Translational Research Consortium Executive Committee Steering Committee Model of Injury Working Group Neuroprotection Working Group Regeneration ...Report, Holcomb Page 22 Specific aim #3.1: To study neuroprotection and enhanced neurological recovery with erythropoietin ( Epo ) and Epo ...derivatives after MTBI. - #3.1.1 To study the effects of Epo and Epo derivatives on neurogenesis, angiogenesis, and outcome after experimental MTBI

  4. Mapping the Vasculome for Biomarkers in TBI

    Science.gov (United States)

    2014-12-01

    various times after TBI, ranging from initial injury (minutes to hrs) to delayed recovery (weeks). Total RNA is prepared and analyzed on the...model. Note that the experiments were performed by different lab members, and analysis was performed in two separate batches of micro -arrays. Our studies

  5. Preventing Older Adult Falls and TBI

    Centers for Disease Control (CDC) Podcasts

    2008-03-05

    This podcast provides tips on how older adults can prevent falls and related injuries, such as traumatic brain injuries (TBI).  Created: 3/5/2008 by National Center for Injury Prevention and Control (NCIPC).   Date Released: 3/7/2008.

  6. Cerebrovascular Pressure Reactivity in Children with TBI

    Directory of Open Access Journals (Sweden)

    Laurence Ducharme-Crevier

    2015-11-01

    Full Text Available Investigators from University of Melbourne, Australia, studied Pressure-Reactivity Index (PRx and optimal Cerebral Perfusion Pressure (CPP in 36 children aged between 6 months and 16 years treated for traumatic brain injury (TBI at the Royal Children's Hospital, Melbourne, from 2007 to 2013.

  7. Traumatic Brain Injury (TBI) Studies at Grady Memorial Hospital

    Science.gov (United States)

    2010-09-01

    management of adult, blunt-mechanism traumatic brain injury ( TBI ) patients and assess the overall mortality of this cohort at Grady...this study is to determine the current compliance with widely accepted guidelines for the management of severe traumatic brain injury ( TBI ) patients...AD_________________ Award Number: W81XWH-09-2-0145 Study Title: Traumatic Brain Injury ( TBI

  8. TBI-the most complex disease in the most complex organ: the CENTER-TBI trial-a commentary.

    Science.gov (United States)

    Wheble, Joanna L C; Menon, D K

    2016-04-01

    Each year, approximately 2.5 million people experience some form of traumatic brain injury (TBI) in Europe. One million of these are admitted to hospital and 75 000 will die. TBI represents a major cause of death and disability, particularly among those of working age. Substantial investments have been made in an effort to improve diagnosis, management and survival in TBI, but with little success. The Collaborative European Neuro-Trauma Effectiveness Research in TBI (CENTER-TBI) study promises to use the natural variability seen in the management of TBI across Europe with the application of Comparative Effectiveness Research (CER). It will generate repositories of baseline and comprehensive TBI patient data, neuroimaging, neurogenetics and biomarkers, which aim to improve the diagnosis, stratification, management and prognostication of patients with TBI.

  9. Advanced MRI in Acute Military TBI

    Science.gov (United States)

    2013-09-01

    clinical data for comparison. In addition, we were unable to get good measures of sleep disorders using approaches such as actigraphy due to limited...connectivity at the follow-ups do not necessarilymean complete restoration of bTBI pa- tients’ network architectures to baseline. Marginally perturbed within...scanners, medications between the time of the ini- tial and follow-up scans and sleep deprivation at the time of the initial scans prevented us from

  10. Mission Connect Mild TBI Translational Research Consortium

    Science.gov (United States)

    2010-08-01

    increased chronic inflammation we saw increased IBA 1 and ATF3 with decreased BDNF . Figure 10. Vimentin, like GFAP, appears upregulated in astrocytes...moderate TBI and/or stroke ) we also assessed the presence of blood borne proteins in brain at 18 days post-trauma. When we stained for albumin and...Yi and Hazell. 2004. J. Stroke Cerebrovasc. Dis. 13:129-137. Appendices None

  11. Update on TBI and Cognitive Impairment in Military Veterans.

    Science.gov (United States)

    Elder, Gregory A

    2015-10-01

    Traumatic brain injury (TBI) is a common cause of morbidity and mortality in military life. Interest in military TBI has increased recently due to the conflicts in Iraq and Afghanistan. Certain types of TBI are relatively unique to the military, the most prominent being blast-related TBI. Blast-related mild TBI has been of particular concern in veterans from the most recent conflicts although controversy remains concerning its separation from post-traumatic stress disorder. TBI is also a risk factor for the later development of neurodegenerative diseases in which cognitive impairment is prominent putting veterans at risk for disorders including Alzheimer's disease and chronic traumatic encephalopathy. Recent evidence associating TBI with chronic cognitive impairment is reviewed in the context of its relevance to military veterans.

  12. Advanced MRI in Blast-related TBI

    Science.gov (United States)

    2012-07-01

    Education (years) PT SD S ev er ity : C A PS T ot al S co re Figure 7: Inverse correlation between self-reported years of formal education and PSTD ... Suicide Vehicle Born IED Rocket: 6 Grenade: 4 1 2 3 4 5 6 7 8 10 11 9 43 Subjects Total TBI has been called the signature injury of both...Explosive Forced Propulsive HME: 3 Home Made Explosive 600-2000lb VBIED/SVBIED : 6 Vehicle Born IED - Suicide Vehicle Born IED Rocket: 6 Grenade

  13. Diffusion Tensor Imaging of TBI: Potentials and Challenges.

    Science.gov (United States)

    Douglas, David B; Iv, Michael; Douglas, Pamela K; Anderson, Ariana; Vos, Sjoerd B; Bammer, Roland; Zeineh, Michael; Wintermark, Max

    2015-10-01

    Neuroimaging plays a critical role in the setting in traumatic brain injury (TBI). Diffusion tensor imaging (DTI) is an advanced magnetic resonance imaging technique that is capable of providing rich information on the brain's neuroanatomic connectome. The purpose of this article is to systematically review the role of DTI and advanced diffusion techniques in the setting of TBI, including diffusion kurtosis imaging (DKI), neurite orientation dispersion and density imaging, diffusion spectrum imaging, and q-ball imaging. We discuss clinical applications of DTI and review the DTI literature as it pertains to TBI. Despite the continued advancements in DTI and related diffusion techniques over the past 20 years, DTI techniques are sensitive for TBI at the group level only and there is insufficient evidence that DTI plays a role at the individual level. We conclude by discussing future directions in DTI research in TBI including the role of machine learning in the pattern classification of TBI.

  14. Neuroimaging biomarkers in mild traumatic brain injury (mTBI).

    Science.gov (United States)

    Bigler, Erin D

    2013-09-01

    Reviewed herein are contemporary neuroimaging methods that detect abnormalities associated with mild traumatic brain injury (mTBI). Despite advances in demonstrating underlying neuropathology in a subset of individuals who sustain mTBI, considerable disagreement persists in neuropsychology about mTBI outcome and metrics for evaluation. This review outlines a thesis for the select use of sensitive neuroimaging methods as potential biomarkers of brain injury recognizing that the majority of individuals who sustain an mTBI recover without neuroimaging signs or neuropsychological sequelae detected with methods currently applied. Magnetic resonance imaging (MRI) provides several measures that could serve as mTBI biomarkers including the detection of hemosiderin and white matter abnormalities, assessment of white matter integrity derived from diffusion tensor imaging (DTI), and quantitative measures that directly assess neuroanatomy. Improved prediction of neuropsychological outcomes in mTBI may be achieved with the use of targeted neuroimaging markers.

  15. Miski on mäda, ehk kõik valed Hamletist / Aet Süvari

    Index Scriptorium Estoniae

    Süvari, Aet, 1977-

    2000-01-01

    Autor võtteplatsil toimuvat jälgimas : Ilmar Raag väntab Saaremaal Hamleti-teemalist ingliskeelset mängufilmi inglise näitlejatega esialgse pealkirjaga "Miski on riigis mäda ehk Kogu vale Hamletist" ("Something is Rotten or All the Lie About Hamlet"). Filmi operaator on Madis Mihkelsoo ja kunstnik Liina Unt

  16. Miski on mäda, ehk kõik valed Hamletist / Aet Süvari

    Index Scriptorium Estoniae

    Süvari, Aet, 1977-

    2000-01-01

    Autor võtteplatsil toimuvat jälgimas : Ilmar Raag väntab Saaremaal Hamleti-teemalist ingliskeelset mängufilmi inglise näitlejatega esialgse pealkirjaga "Miski on riigis mäda ehk Kogu vale Hamletist" ("Something is Rotten or All the Lie About Hamlet"). Filmi operaator on Madis Mihkelsoo ja kunstnik Liina Unt

  17. Nora ehk elu võimalikkusest naisena perekonnas, teatris ja kapitalismis / Anneli Saro

    Index Scriptorium Estoniae

    Saro, Anneli, 1968-

    2008-01-01

    Naistegelasest teatrist järgnevate lavastuste põhjal: Helen Rekkori lavastusest "Nora/Maja" Henrik Ibseni "Nukumaja" järgi Ugala teatris ja Elfriede Jelineki "Mis juhtus pärast seda, kui Nora oma mehe maha oli jätnud ehk Ühiskondade toed" Von Krahli Teatris, lavastaja Rainer Sarnet

  18. Nora ehk elu võimalikkusest naisena perekonnas, teatris ja kapitalismis / Anneli Saro

    Index Scriptorium Estoniae

    Saro, Anneli, 1968-

    2008-01-01

    Naistegelasest teatrist järgnevate lavastuste põhjal: Helen Rekkori lavastusest "Nora/Maja" Henrik Ibseni "Nukumaja" järgi Ugala teatris ja Elfriede Jelineki "Mis juhtus pärast seda, kui Nora oma mehe maha oli jätnud ehk Ühiskondade toed" Von Krahli Teatris, lavastaja Rainer Sarnet

  19. TBI Assessment of Readiness Using a Gait Evaluation Test (TARGET): Development of a Portable mTBI Screening Device

    Science.gov (United States)

    2016-05-01

    Evaluation Test (TARGET): Development of a Portable mTBI Screening Device 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-15-1-0094 5c. PROGRAM ...determine the validity and reliability of an Android device-based mTBI (mild traumatic brain injury) screening test app for assessing motor function. The...deployment. This study seeks to determine the validity and reliability of an Android device-based mTBI (mild traumatic brain injury) screening test app

  20. Pain pathoetiology after TBI: neural and nonneural mechanisms.

    Science.gov (United States)

    Walker, William C

    2004-01-01

    Individuals recovering from traumatic brain injury (TBI) frequently experience acute and chronic pain. Their pain experience is the net effect of many interacting and very complex physiologic, biochemical, and psychological mechanisms involving both the peripheral and central nervous system. This article reviews the basics of neural mechanisms and pathways of pain after TBI, and discusses clinical implications. Numerous intracranial and extracranial tissues must be considered in the evaluation of pain after TBI, with the specific mechanism of trauma influencing the anatomic distribution of injuries. The differential diagnosis usually falls into one of the following pathoetiologic classifications: primary or secondary musculoskeletal, vascular, visceral, and neural pain syndromes.

  1. Leveraging Game Consoles for the Delivery of TBI Rehabilitation

    Science.gov (United States)

    Super, Taryn; Mastaglio, Thomas; Shen, Yuzhong; Walker, Robert

    2011-01-01

    Military personnel are at a greater risk for traumatic brain injury (TBI) than the civilian population. In addition, the increase in exposure to explosives, i.e. , improvised explosive devices, in the Afghanistan and Iraq wars, along with more effective body armor, has resulted in far more surviving casualties suffering from TBI than in previous wars. This effort presents the results of a feasibility study and early prototype of a brain injury rehabilitation delivery system (BIRDS). BIRDS is designed to provide medical personnel treating TBI with a capability to prescribe game activities for patients to execute using a commercially available game console, either in a clinical setting or in their homes. These therapeutic activities will contribute to recovery or remediation of the patients' cognitive dysfunctions. Solutions such as this that provide new applications for existing platforms have significant potential to address the growing incidence of TBI today.

  2. Statistical Issues in TBI Clinical Studies

    Directory of Open Access Journals (Sweden)

    Paul eRapp

    2013-11-01

    Full Text Available The identification and longitudinal assessment of traumatic brain injury presents several challenges. Because these injuries can have subtle effects, efforts to find quantitative physiological measures that can be used to characterize traumatic brain injury are receiving increased attention. The results of this research must be considered with care. Six reasons for cautious assessment are outlined in this paper. None of the issues raised here are new. They are standard elements in the technical literature that describes the mathematical analysis of clinical data. The purpose of this paper is to draw attention to these issues because they need to be considered when clinicians evaluate the usefulness of this research. In some instances these points are demonstrated by simulation studies of diagnostic processes. We take as an additional objective the explicit presentation of the mathematical methods used to reach these conclusions. This material is in the appendices. The following points are made:1. A statistically significant separation of a clinical population from a control population does not ensure a successful diagnostic procedure.2. Adding more variables to a diagnostic discrimination can, in some instances, actually reduce classification accuracy.3. A high sensitivity and specificity in a TBI versus control population classification does not ensure diagnostic successes when the method is applied in a more general neuropsychiatric population. 4. Evaluation of treatment effectiveness must recognize that high variability is a pronounced characteristic of an injured central nervous system and that results can be confounded by either disease progression or spontaneous recovery. A large pre-treatment versus post-treatment effect size does not, of itself, establish a successful treatment.5. A procedure for discriminating between treatment responders and nonresponders requires, minimally, a two phase investigation. This procedure must include a

  3. Family needs and TBI caregiver mental health in Guadalajara, Mexico.

    Science.gov (United States)

    Leibach, Gillian G; Trapp, Stephen K; Perrin, Paul B; Everhart, Robin S; Cabrera, Teresita Villaseñor; Jimenez-Maldonado, Miriam; Arango-Lasprilla, Juan Carlos

    2014-01-01

    Traumatic brain injury (TBI) is a leading cause of death in Mexico, and Mexican TBI caregivers have been shown to experience significant mental health problems and high levels of family needs. This study investigated the associations between family needs and Mexican TBI caregiver mental health. Ninety TBI caregivers from Guadalajara, Mexico completed measures assessing their own mental health (depression, anxiety, burden, satisfaction with life, and self-esteem) and family needs (physical health, informational, financial, social support, and household). Family health needs were uniquely associated with all indices of caregiver mental health, and household needs were uniquely associated with caregiver depression, burden, and anxiety. Additionally, social support needs were related to caregiver satisfaction with life, informational needs to burden, and financial needs to self-esteem. Interventions for TBI caregivers in Mexico-and likely in other global regions with high levels of familism-should include an emphasis on overall family health, the delineation of family roles regarding household responsibilities, the improvement of social support networks and the social presence of family members, and the provision of complete and relevant information regarding TBI. When these needs are more comprehensively met, caregiver mental health will likely improve.

  4. Validating Multidimensional Outcome Assessment Using the TBI Common Data Elements: An Analysis of the TRACK-TBI Pilot Sample.

    Science.gov (United States)

    Nelson, Lindsay D; Ranson, Jana; Ferguson, Adam R; Giacino, Joseph; Okonkwo, David O; Valadka, Alex; Manley, Geoffrey; McCrea, Michael

    2017-06-08

    The Glasgow Outcome Scale-Extended (GOSE) is often the primary outcome measure in clinical trials for traumatic brain injury (TBI). Although the GOSE's capture of global function outcome has several strengths, concerns have been raised about its limited ability to identify mild disability and failure to capture the full scope of problems patients exhibit after TBI. This analysis examined the convergence of disability ratings across a multidimensional set of outcome domains in the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Pilot study. The study collected measures recommended by the TBI Common Data Elements (CDE) Workgroup. Patients presenting to 3 emergency departments with a TBI of any severity enrolled in TRACK-TBI prospectively after injury; outcome measures were collected at 3 and six months postinjury. Analyses examined frequency of impairment and overlap between impairment status across the CDE outcome domains of Global Level of Functioning (GOSE), Neuropsychological (cognitive) Impairment, Psychological Status, TBI Symptoms, and Quality of Life. GOSE score correlated in the expected direction with other outcomes (M Spearman's rho = .21 and .49 with neurocognitive and self-report outcomes, respectively). The subsample in the Upper Good Recovery (GOSE 8) category appeared quite healthy across most other outcomes, although 19.0% had impaired executive functioning (Trail Making Test Part B). A significant minority of participants in the Lower Good Recovery subgroup (GOSE 7) met criteria for impairment across numerous other outcome measures. The findings highlight the multidimensional nature of TBI recovery and the limitations of applying only a single outcome measure.

  5. Similar Survival for Patients Undergoing Reduced-Intensity Total Body Irradiation (TBI) Versus Myeloablative TBI as Conditioning for Allogeneic Transplant in Acute Leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Mikell, John L., E-mail: jmikell@emory.edu [Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Waller, Edmund K. [Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Switchenko, Jeffrey M. [Department of Biostatistics and Bioinformatics, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Rangaraju, Sravanti; Ali, Zahir; Graiser, Michael [Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Hall, William A. [Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Langston, Amelia A. [Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Esiashvili, Natia [Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Khoury, H. Jean [Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Khan, Mohammad K. [Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States)

    2014-06-01

    Purpose: Hematopoietic stem cell transplantation (HSCT) is the mainstay of treatment for adults with acute leukemia. Total body irradiation (TBI) remains an important part of the conditioning regimen for HCST. For those patients unable to tolerate myeloablative TBI (mTBI), reduced intensity TBI (riTBI) is commonly used. In this study we compared outcomes of patients undergoing mTBI with those of patients undergoing riTBI in our institution. Methods and Materials: We performed a retrospective review of all patients with acute leukemia who underwent TBI-based conditioning, using a prospectively acquired database of HSCT patients treated at our institution. Patient data including details of the transplantation procedure, disease status, Karnofsky performance status (KPS), response rates, toxicity, survival time, and time to progression were extracted. Patient outcomes for various radiation therapy regimens were examined. Descriptive statistical analysis was performed. Results: Between June 1985 and July 2012, 226 patients with acute leukemia underwent TBI as conditioning for HSCT. Of those patients, 180 had full radiation therapy data available; 83 had acute lymphoblastic leukemia and 94 had acute myelogenous leukemia; 45 patients received riTBI, and 135 received mTBI. Median overall survival (OS) was 13.7 months. Median relapse-free survival (RFS) for all patients was 10.2 months. Controlling for age, sex, KPS, disease status, and diagnosis, there were no significant differences in OS or RFS between patients who underwent riTBI and those who underwent mTBI (P=.402, P=.499, respectively). Median length of hospital stay was shorter for patients who received riTBI than for those who received mTBI (16 days vs 23 days, respectively; P<.001), and intensive care unit admissions were less frequent following riTBI than mTBI (2.22% vs 12.69%, respectively, P=.043). Nonrelapse survival rates were also similar (P=.186). Conclusions: No differences in OS or RFS were seen between

  6. Closed-Head TBI Model of Multiple Morbidity.

    Science.gov (United States)

    Thompson, Floyd J; Hou, Jiamei; Bose, Prodip K

    2016-01-01

    Successful therapy for TBI disabilities awaits refinement in the understanding of TBI neurobiology, quantitative measurement of treatment-induced incremental changes in recovery trajectories, and effective translation to human TBI using quantitative methods and protocols that were effective to monitor recovery in preclinical models. Details of the specific neurobiology that underlies these injuries and effective quantitation of treatment-induced changes are beginning to emerge utilizing a variety of preclinical and clinical models (for reviews see (Morales et al., Neuroscience 136:971-989, 2005; Fujimoto et al., Neurosci Biobehav Rev 28:365-378, 2004; Cernak, NeuroRx 2:410-422, 2005; Smith et al., J Neurotrauma 22:1485-1502, 2005; Bose et al., J Neurotrauma 30:1177-1191, 2013; Xiong et al., Nat Rev Neurosci 14:128-142, 2013; Xiong et al., Expert Opin Emerg Drugs 14:67-84, 2009; Johnson et al., Handb Clin Neurol 127:115-128, 2015; Bose et al., Brain neurotrauma: molecular, neuropsychological, and rehabilitation aspects, CRC Press/Taylor & Francis, Boca Raton, 2015)). Preclinical models of TBI, essential for the efficient study of TBI neurobiology, benefit from the setting of controlled injury and optimal opportunities for biometric quantitation of injury and treatment-induced changes in the trajectories of disability. Several preclinical models are currently used, and each offer opportunities for study of different aspects of TBI primary and secondary injuries (for review see (Morales et al., Neuroscience 136:971-989, 2005; Xiong et al., Nat Rev Neurosci 14:128-142, 2013; Xiong et al., Expert Opin Emerg Drugs 14:67-84, 2009; Johnson et al., Handb Clin Neurol 127:115-128, 2015; Dixon et al., J Neurotrauma 5:91-104, 1988)). The closed-head, impact-acceleration model of TBI designed by Marmarou et al., 1994 (J Neurosurg 80:291-300, 1994), when used to produce mild to moderate TBI, produces diffuse axonal injuries without significant additional focal injuries of the

  7. Sleep Disturbances, TBI and PTSD: Implications for Treatment and Recovery

    Science.gov (United States)

    Gilbert, Karina Stavitsky; Kark, Sarah M.; Gehrman, Philip; Bogdanova, Yelena

    2015-01-01

    Post-Traumatic Stress Disorder (PTSD), traumatic brain injury (TBI), and sleep problems significantly affect recovery and functional status in military personnel and Veterans returning from combat. Despite recent attention, sleep is understudied in the Veteran population. Few treatments and rehabilitation protocols target sleep, although poor sleep remains at clinical levels and continues to adversely impact functioning even after the resolution of PTSD or mild TBI symptoms. Recent developments in non-pharmacologic sleep treatments have proven efficacious as stand-alone interventions and have potential to improve treatment outcomes by augmenting traditional behavioral and cognitive therapies. This review discusses the extensive scope of work in the area of sleep as it relates to TBI and PTSD, including pathophysiology and neurobiology of sleep; existing and emerging treatment options; as well as methodological issues in sleep measurements for TBI and PTSD. Understanding sleep problems and their role in the development and maintenance of PTSD and TBI symptoms may lead to improvement in overall treatment outcomes while offering a non-stigmatizing entry in mental health services and make current treatments more comprehensive by helping to address a broader spectrum of difficulties. PMID:26164549

  8. Sleep disturbances, TBI and PTSD: Implications for treatment and recovery.

    Science.gov (United States)

    Gilbert, Karina Stavitsky; Kark, Sarah M; Gehrman, Philip; Bogdanova, Yelena

    2015-08-01

    Post-Traumatic Stress Disorder (PTSD), traumatic brain injury (TBI), and sleep problems significantly affect recovery and functional status in military personnel and Veterans returning from combat. Despite recent attention, sleep is understudied in the Veteran population. Few treatments and rehabilitation protocols target sleep, although poor sleep remains at clinical levels and continues to adversely impact functioning even after the resolution of PTSD or mild TBI symptoms. Recent developments in non-pharmacologic sleep treatments have proven efficacious as stand-alone interventions and have potential to improve treatment outcomes by augmenting traditional behavioral and cognitive therapies. This review discusses the extensive scope of work in the area of sleep as it relates to TBI and PTSD, including pathophysiology and neurobiology of sleep; existing and emerging treatment options; as well as methodological issues in sleep measurements for TBI and PTSD. Understanding sleep problems and their role in the development and maintenance of PTSD and TBI symptoms may lead to improvement in overall treatment outcomes while offering a non-stigmatizing entry in mental health services and make current treatments more comprehensive by helping to address a broader spectrum of difficulties.

  9. The impact of previous traumatic brain injury on health and functioning: a TRACK-TBI study.

    Science.gov (United States)

    Dams-O'Connor, Kristen; Spielman, Lisa; Singh, Ayushi; Gordon, Wayne A; Lingsma, Hester F; Maas, Andrew I R; Manley, Geoffrey T; Mukherjee, Pratik; Okonkwo, David O; Puccio, Ava M; Schnyer, David M; Valadka, Alex B; Yue, John K; Yuh, Esther L

    2013-12-15

    The idea that multiple traumatic brain injury (TBI) can have a cumulative detrimental effect on functioning is widely accepted. Most research supporting this idea comes from athlete samples, and it is not known whether remote history of previous TBI affects functioning after subsequent TBI in community-based samples. This study investigates whether a previous history of TBI with loss of consciousness (LOC) is associated with worse health and functioning in a sample of individuals who require emergency department care for current TBI. Twenty-three percent of the 586 individuals with current TBI in the Transforming Research and Clinical Knowledge in Traumatic Brain Injury study reported having sustained a previous TBI with LOC. Individuals with previous TBI were more likely to be unemployed (χ(2)=17.86; p=0.000), report a variety of chronic medical and psychiatric conditions (4.75≤χ(2)≥24.16; pTBI history. Those with a previous TBI had less-severe acute injuries, but experienced worse outcomes at 6-month follow-up. Results of a series of regression analyses controlling for demographics and acute injury severity indicated that individuals with previous TBI reported more mood symptoms, more postconcussive symptoms, lower life satisfaction, and had slower processing speed and poorer verbal learning, compared to those with no previous TBI history. These findings suggest that history of TBI with LOC may have important implications for health and psychological functioning after TBI in community-based samples.

  10. Distance perception in mild traumatic brain injury (mTBI).

    Science.gov (United States)

    Ciuffreda, Kenneth J; Yadav, Naveen K; Han, Esther; Ludlam, Diana P; Peddle, Angela; Hulse, Paul; Walter, Suzanne; Han, Jennifer

    2012-04-30

    The purpose of this study was to assess monocular and binocular distance perception, and stereoacuity, in individuals with mild traumatic brain injury (mTBI) who reported the symptom of "poor depth perception"; Ten patients with mTBI were tested and compared with ten visually-normal asymptomatic individuals in the following areas: perceived distance, stereoacuity at distance (3 meters) and near (40 cm), and a 9-item 5-point rating-scale questionnaire related to distance perception. Distance perception was assessed under monocular and binocular viewing conditions in both clustered and isolated static environments. Magnitude estimation was used to obtain the distance perception response function of physical versus perceived distance using common objects positioned at distances of 0.77 to 12.84 meters. The mean distance perception response function slopes were not significantly different in the two groups for any of the test conditions. Stereoacuity (sec arc) was slightly reduced at both near and distance in the individuals with mTBI (36 ± 24.58 and 84 ± 68.34, respectively) as compared with the normal subjects (20 ± 0 and 51 ± 9.93, respectively). The mTBI group mean symptom score was 3.24 ± 0.26 indicating a moderate problematic level; Similarity of the mean distance response functions in the mTBI group under monocular and binocular viewing conditions suggested that their misperception of distance was not due to a "binocular vergence" problem. Similarly, the slightly reduced stereoacuity in the mTBI group was not sufficient to explain their symptom of "poor depth perception." Thus, it is speculated that this problem reflects a higher-level cortical perceptual phenomenon related to diffuse brain damage in areas dealing with visuo-spatial mapping. American Optometric Association.

  11. Catecholaminergic based therapies for functional recovery after TBI.

    Science.gov (United States)

    Osier, Nicole D; Dixon, C Edward

    2016-06-01

    Among the many pathophysiologic consequences of traumatic brain injury are changes in catecholamines, including dopamine, epinephrine, and norepinephrine. In the context of TBI, dopamine is the one most extensively studied, though some research exploring epinephrine and norepinephrine have also been published. The purpose of this review is to summarize the evidence surrounding use of drugs that target the catecholaminergic system on pathophysiological and functional outcomes of TBI using published evidence from pre-clinical and clinical brain injury studies. Evidence of the effects of specific drugs that target catecholamines as agonists or antagonists will be discussed. Taken together, available evidence suggests that therapies targeting the catecholaminergic system may attenuate functional deficits after TBI. Notably, it is fairly common for TBI patients to be treated with catecholamine agonists for either physiological symptoms of TBI (e.g. altered cerebral perfusion pressures) or a co-occuring condition (e.g. shock), or cognitive symptoms (e.g. attentional and arousal deficits). Previous clinical trials are limited by methodological limitations, failure to replicate findings, challenges translating therapies to clinical practice, the complexity or lack of specificity of catecholamine receptors, as well as potentially counfounding effects of personal and genetic factors. Overall, there is a need for additional research evidence, along with a need for systematic dissemination of important study details and results as outlined in the common data elements published by the National Institute of Neurological Diseases and Stroke. Ultimately, a better understanding of catecholamines in the context of TBI may lead to therapeutic advancements. This article is part of a Special Issue entitled SI:Brain injury and recovery.

  12. Prospective memory rehabilitation using smartphones in patients with TBI

    DEFF Research Database (Denmark)

    Evald, Lars

    2015-01-01

    with the use of low-cost, off-the-shelf, unmodified smartphones combined with Internet calendars as a compensatory memory strategy. Thirteen community-dwelling patients with traumatic brain injury (TBI) received a 6-week group-based instruction in the systematic use of a smartphone as a memory compensatory aid...... with TBI and smartphones come with features that are advantageous to other compensatory strategies. However, some benefits come hand-in-hand with drawbacks, such as the feeling of dependency. These aspects should be taken into account when choosing assistive technology as a memory compensatory strategy....

  13. Hallist müürist ehk Praktik ütleb : "Teoreetikutest on praktilist kasu" / interv. Andres Keil

    Index Scriptorium Estoniae

    2002-01-01

    J. Unduski "Goodbye, Vienna ehk Gertrud" Tartu Teatrilaboris, lavastus valmis T. Lensmendi käe all ja koostöös Tartu Ülikooli teatriteaduse õppetooliga. Vestlusring on salvestatud mõni päev pärast esimest läbimängu

  14. Millest nad kirjutavad ehk Näidendivõistluse tänavusügisene saak / Triin Sinissaar

    Index Scriptorium Estoniae

    Sinissaar, Triin

    2003-01-01

    I preemia: Urmas Lennuk, "Boob teab"ja Jaan Undusk, "Quevedo"; II preemia: Anu Allas, "Lendav rõdu ehk Nagu nad tahtsid" ja Raivo Kütt, "Papa" ("Sõtse ja venna"); III preemia Jakob Karu, "Asjade seis" ja Hans Nordberg, "aaron : juuni"; ergutuspreemia: Urmas Lennuk, "Kadunud kindapood", Urmas Vadi, "Kadunud kosmoses" ja Jaan Võõramaa, "Mamma"

  15. Millest nad kirjutavad ehk Näidendivõistluse tänavusügisene saak / Triin Sinissaar

    Index Scriptorium Estoniae

    Sinissaar, Triin

    2003-01-01

    I preemia: Urmas Lennuk, "Boob teab"ja Jaan Undusk, "Quevedo"; II preemia: Anu Allas, "Lendav rõdu ehk Nagu nad tahtsid" ja Raivo Kütt, "Papa" ("Sõtse ja venna"); III preemia Jakob Karu, "Asjade seis" ja Hans Nordberg, "aaron : juuni"; ergutuspreemia: Urmas Lennuk, "Kadunud kindapood", Urmas Vadi, "Kadunud kosmoses" ja Jaan Võõramaa, "Mamma"

  16. Combined SCI and TBI: recovery of forelimb function after unilateral cervical spinal cord injury (SCI) is retarded by contralateral traumatic brain injury (TBI), and ipsilateral TBI balances the effects of SCI on paw placement.

    Science.gov (United States)

    Inoue, Tomoo; Lin, Amity; Ma, Xiaokui; McKenna, Stephen L; Creasey, Graham H; Manley, Geoffrey T; Ferguson, Adam R; Bresnahan, Jacqueline C; Beattie, Michael S

    2013-10-01

    A significant proportion (estimates range from 16 to 74%) of patients with spinal cord injury (SCI) have concomitant traumatic brain injury (TBI), and the combination often produces difficulties in planning and implementing rehabilitation strategies and drug therapies. For example, many of the drugs used to treat SCI may interfere with cognitive rehabilitation, and conversely drugs that are used to control seizures in TBI patients may undermine locomotor recovery after SCI. The current paper presents an experimental animal model for combined SCI and TBI to help drive mechanistic studies of dual diagnosis. Rats received a unilateral SCI (75 kdyn) at C5 vertebral level, a unilateral TBI (2.0 mm depth, 4.0 m/s velocity impact on the forelimb sensori-motor cortex), or both SCI+TBI. TBI was placed either contralateral or ipsilateral to the SCI. Behavioral recovery was examined using paw placement in a cylinder, grooming, open field locomotion, and the IBB cereal eating test. Over 6weeks, in the paw placement test, SCI+contralateral TBI produced a profound deficit that failed to recover, but SCI+ipsilateral TBI increased the relative use of the paw on the SCI side. In the grooming test, SCI+contralateral TBI produced worse recovery than either lesion alone even though contralateral TBI alone produced no observable deficit. In the IBB forelimb test, SCI+contralateral TBI revealed a severe deficit that recovered in 3 weeks. For open field locomotion, SCI alone or in combination with TBI resulted in an initial deficit that recovered in 2 weeks. Thus, TBI and SCI affected forelimb function differently depending upon the test, reflecting different neural substrates underlying, for example, exploratory paw placement and stereotyped grooming. Concurrent SCI and TBI had significantly different effects on outcomes and recovery, depending upon laterality of the two lesions. Recovery of function after cervical SCI was retarded by the addition of a moderate TBI in the contralateral

  17. Impact of conditioning intensity and TBI on acute GVHD after hematopoietic cell transplantation.

    Science.gov (United States)

    Nakasone, H; Fukuda, T; Kanda, J; Mori, T; Yano, S; Kobayashi, T; Miyamura, K; Eto, T; Kanamori, H; Iwato, K; Uchida, N; Mori, S; Nagamura-Inoue, T; Ichinohe, T; Atsuta, Y; Teshima, T; Murata, M

    2015-04-01

    The impact of the conditioning intensity and TBI on acute GVHD (aGVHD) is still a matter of debate. We analyzed 6848 adult recipients who received allogeneic hematopoietic cell transplants (HCT) between 2006 and 2011 in Japan. The subjects were divided into groups who had received myeloablative conditioning (MAC) or reduced-intensity conditioning (RIC), either with or without TBI. There was a significant difference in the incidence of aGVHD 2-4 among the different conditioning types: 39% in TBI-MAC, 35% in TBI-RIC and 32% in both no-TBI MAC and no-TBI-RIC (PTBI-MAC, but not no-TBI MAC, was significantly associated with an increased risk of aGVHD 2-4 (hazard ratio (HR) 1.33, PTBI-RIC was associated with an increased risk of GVHD 3-4 (HR 1.36, P=0.048). TBI-MAC and TBI-RIC were significantly associated with skin and gastrointestinal aGVHD. Subgroup analyses demonstrated that not only TBI-MAC, but also TBI-RIC, was significantly associated with aGVHD 2-4 in older patients. Furthermore, high-dose TBI only had an adverse impact on aGVHD 2-4 in HLA-matched HCT. Impacts of intensity and TBI on aGVHD differ by patient backgrounds, and this difference should be considered to establish a risk-adapted strategy for the prevention of aGVHD.

  18. Telerehabilitation for Veterans with Combat Related TBI/PTSD

    Science.gov (United States)

    2011-04-01

    signed by a proxy. Veterans and/or care givers must also possess basic computer literacy such as being able to access a web page and making entrees in...with Combat Related TBI/PTSD RTO-MP-HFM-205 15 - 7 or intervention ( diabetes , CHF, dementia etc), our cohort exhibits a very diverse population in

  19. Historical Review of the Fluid Percussion TBI Model

    Directory of Open Access Journals (Sweden)

    Bruce G Lyeth

    2016-12-01

    Full Text Available Abstract:Traumatic brain injury (TBI is a major health concern worldwide. Laboratory studies utilizing animal models of TBI are essential for addressing pathological mechanisms of brain injury and development of innovative treatments. Over the past 75 years, pioneering head injury researchers have devised and tested a number of fluid percussive methods to reproduce in animals the concussive clinical syndrome. The fluid percussion brain injury technique has evolved from early investigations that applied a generalized loading of the brain to more recent computer controlled systems. Of the many pre-clinical TBI models, the fluid percussion technique is one of the most extensively characterized and widely used models. Some of the most important advances involved the development of the Stalhammer device to produce concussion in cats and the later characterization of this device for application in rodents. The goal of this historical review is to provide readers with an appreciation for the time and effort expended by the pioneering researchers that have led to today’s state of the art fluid percussion animal models of TBI.

  20. Psychological Outcome in Young Survivors of Severe TBI

    DEFF Research Database (Denmark)

    Doser, Karoline; Poulsen, Ingrid; Norup, Anne

    2015-01-01

    Objective. To investigate the psychological outcome and the agreement between self-ratings and proxy-ratings in young individuals after severe traumatic brain injury (TBI). Methods. Twenty pairs of former patients who sustained a severe TBI in their adolescence or early adulthood and their signif......Objective. To investigate the psychological outcome and the agreement between self-ratings and proxy-ratings in young individuals after severe traumatic brain injury (TBI). Methods. Twenty pairs of former patients who sustained a severe TBI in their adolescence or early adulthood...... and their significant others (SOs) were contacted around 66 months after injury to complete a measure of psychological and behavioral problems. The Adult Self-Report 18-59 and the Adult Behavior Checklist 18-59 were used. Results. Results showed significant differences compared to the normative sample in the domains...... such as anxiety and depression, withdrawal, thought and attention problems, and personal strength. Conclusion. The findings show that young patients experience psychological dysfunction. Our study suggests that the use of either a self-rating or a proxy-rating would be appropriate for evaluating overt domains...

  1. Harnessing Neuroplasticity to Promote Rehabilitation: CI Therapy for TBI

    Science.gov (United States)

    2015-10-01

    medical record system for the contact information of veterans with diagnostic and procedural codes reflecting a history of TBI and motor impairment of...of treatment response in patients with new onset schizophrenia and untreated psychosis. This is a new project. There is no overlap. Participation in

  2. Rates of TBI-related Deaths by Age Group — United States, 2001–2010

    Data.gov (United States)

    U.S. Department of Health & Human Services — Changes in the rates of TBI-related deaths vary depending on age. For persons 44 years of age and younger, TBI-related deaths decreased between the periods of...

  3. Common biochemical defects linkage between post-traumatic stress disorders, mild traumatic brain injury (TBI) and penetrating TBI.

    Science.gov (United States)

    Prasad, Kedar N; Bondy, Stephen C

    2015-03-02

    Post-traumatic stress disorder (PTSD) is a complex mental disorder with psychological and emotional components, caused by exposure to single or repeated extreme traumatic events found in war, terrorist attacks, natural or man-caused disasters, and by violent personal assaults and accidents. Mild traumatic brain injury (TBI) occurs when the brain is violently rocked back and forth within the skull following a blow to the head or neck as in contact sports, or when in close proximity to a blast pressure wave following detonation of explosives in the battlefield. Penetrating TBI occurs when an object penetrates the skull and damages the brain, and is caused by vehicle crashes, gunshot wound to the head, and exposure to solid fragments in the proximity of explosions, and other combat-related head injuries. Despite clinical studies and improved understanding of the mechanisms of cellular damage, prevention and treatment strategies for patients with PTSD and TBI remain unsatisfactory. To develop an improved plan for treating and impeding progression of PTSD and TBI, it is important to identify underlying biochemical changes that may play key role in the initiation and progression of these disorders. This review identifies three common biochemical events, namely oxidative stress, chronic inflammation and excitotoxicity that participate in the initiation and progression of these conditions. While these features are separately discussed, in many instances, they overlap. This review also addresses the goal of developing novel treatments and drug regimens, aimed at combating this triad of events common to, and underlying, injury to the brain.

  4. Vagus Nerve Stimulation (VNS) and Rehabilitation in the Treatment of TBI

    Science.gov (United States)

    2009-04-01

    traumatic brain injury ( TBI ). The main limitation to these earlier results is that VNS treatment was initiated at either 2 hr or 24 hr after TBI ...the potential utility of VNS as a clinical treatment for human TBI . 15. SUBJECT TERMS Vagus nerve stimulation, recovery of function, brain injury ... TBI induced by Controlled Cortical Impact. A brain injury was induced over the left hemisphere at the following coordinates: Epicenter: Midpoint

  5. Blood Biomarker Profile of TBI Associated Cognitive Impairment Among Old and Young Veterans

    Science.gov (United States)

    2016-10-01

    distinguishable from AD and normal aging. Specifically, we hypothesize that: 1) patients with TBI associated CI will have higher phospho- tau/total tau...at both sites. As of 30-SEP- 2016, data from 134 participants has been collected (65 TBI, 48 controls, and 21 with AD and no TBI). Once data...treatment for CI and its prevention. 15. SUBJECT TERMS Traumatic brain injury (TBI), dementia , chronic traumatic encephalopathy (CTE), blood biomarkers

  6. Traumatic brain injury: Age at injury influences dementia risk after TBI

    OpenAIRE

    Johnson, Victoria E.; Stewart, William

    2015-01-01

    Traumatic brain injury (TBI) is increasingly recognized as a risk factor for dementia. New data provide further support for this association and demonstrate the influence of age at injury and injury severity on dementia risk after TBI, revealing that even mild TBI increases dementia risk in those aged ≥65 years.

  7. TBI-ROC Part One: Understanding Traumatic Brain Injury--An Introduction

    Science.gov (United States)

    Trudel, Tina M.; Scherer, Marcia J.; Elias, Eileen

    2011-01-01

    This article is the first of a multi-part series on traumatic brain injury (TBI). Historically, TBI has received very limited national public policy attention and support. However since it has become the signature injury of the military conflicts in Iraq and Afghanistan, TBI has gained the attention of elected officials, military leaders,…

  8. Enhanced Cognitive Rehabilitation to Treat Comorbid TBI and PTSD

    Science.gov (United States)

    2016-10-01

    Ph.D. CONTRACTING ORGANIZATION: Veterans Medical Research Foundation San Diego, CA 92161 REPORT DATE: Oct 2016 TYPE OF REPORT: Annual PREPARED...YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE Oct 2016 2. REPORT TYPE Annual 3. DATES COVERED 15 Sep 2015 – 14 Sep 2016 4. TITLE AND SUBTITLE...to accommodate the difficulties with attention, memory , and problem solving that patients with TBI may have. Therefore, this study integrates

  9. Mechanistic Links Between PARP, NAD, and Brain Inflammation After TBI

    Science.gov (United States)

    2015-10-01

    1 AWARD NUMBER: W81XWH-13-2-0091 TITLE: Mechanistic Links Between PARP, NAD, and Brain Inflammation After TBI PRINCIPAL INVESTIGATOR ...Raymond A. Swanson, M.D CONTRACTING ORGANIZATION: Northern California Institute for Research & Education San Francisco, CA 94121 REPORT DATE: October 2015...STATEMENT Approved for Public Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT This project is a pre-clinical evaluation of the

  10. Defining the Pathophysiological Role of Tau in Experimental TBI

    Science.gov (United States)

    2015-10-01

    AWARD NUMBER: W81XWH-14-1-0275 TITLE: Defining the Pathophysiological Role of Tau in Experimental TBI PRINCIPAL INVESTIGATOR: Dr. Robert...No. 0704-0188 Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing...information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this

  11. Automated Comprehensive Evaluation of mTBI Visual Dysfunction

    Science.gov (United States)

    2016-10-01

    Unlimited 13. SUPPLEMENTARY NOTES mild traumatic brain injury, mTBI, objective biomarkers, Neuro -Ophthalmic Device, NODe 14. ABSTRACT The purpose...of this study is to validate the Neuro -Ophthalmic Device (NODe) test battery that provides the highest sensitivity and specificity for the detection...matched controls. 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF RESPONSIBLE

  12. Illusiooni võitlus igavusega ehk Kes teatris ei käi, see ise on / Andrus Laansalu, Margus Kasterpalu

    Index Scriptorium Estoniae

    Laansalu, Andrus

    1996-01-01

    Dialoog. Draamateatri külalisetendused Tartus: Oskar Lutsu - Toomas Kalli 'Tagahoovis' (lav. Eino Baskin); William Shakespeare'i 'Eksituste komöödia' (lav. Evald Hermaküla); Pierre Corneille' 'Näitaja näitab ja vaataja vaatab ehk Illusioon' (lav. Mati Unt); Arthur Milleri 'Vaade sillalt' (Mikk Mikiver); Peter Shafferi 'Leekrüübe' (Priit Pedajas) ja 'Amadeus' (Kalju Komissarov); Alan Ayckbourni 'Intiimsed tehingud' ja Noel Cowardi 'Heinapalavik' (mõlemad Ivo Eensalu)

  13. Kahetsükliline kõrgharidus ehk 3+2 süsteem / Annika Tina

    Index Scriptorium Estoniae

    Tina, Annika

    Bologna protsessi üheks esmaseks tegevuseks oli pika õppetsükli lahutamine bakalaureuse- ja magistriõppeks ehk 3+2 süsteemiks. 2007. aastal oli 82% Euroopa kõrgkoolidest valinud Bologna protsessi eesmaärkidele vastava õppekavade süsteemi, Eesti läks üle 3+2 süsteemile 2002/2003 õppeaastal, tänaseks õpib Eestis uutel õppekavadel 90% kõrgkoolidest

  14. Kahetsükliline kõrgharidus ehk 3+2 süsteem / Annika Tina

    Index Scriptorium Estoniae

    Tina, Annika

    Bologna protsessi üheks esmaseks tegevuseks oli pika õppetsükli lahutamine bakalaureuse- ja magistriõppeks ehk 3+2 süsteemiks. 2007. aastal oli 82% Euroopa kõrgkoolidest valinud Bologna protsessi eesmaärkidele vastava õppekavade süsteemi, Eesti läks üle 3+2 süsteemile 2002/2003 õppeaastal, tänaseks õpib Eestis uutel õppekavadel 90% kõrgkoolidest

  15. Fludarabine and 2-Gy TBI is superior to 2 Gy TBI as conditioning for HLA-matched related hematopoietic cell transplantation: a phase III randomized trial.

    Science.gov (United States)

    Kornblit, Brian; Maloney, David G; Storb, Rainer; Storek, Jan; Hari, Parameswaran; Vucinic, Vladan; Maziarz, Richard T; Chauncey, Thomas R; Pulsipher, Michael A; Bruno, Benedetto; Petersen, Finn B; Bethge, Wolfgang A; Hübel, Kai; Bouvier, Michelle E; Fukuda, Takahiro; Storer, Barry E; Sandmaier, Brenda M

    2013-09-01

    The risks and benefits of adding fludarabine to a 2-Gy total body irradiation (TBI) nonmyeloablative regimen are unknown. For this reason, we conducted a prospective randomized trial comparing 2-Gy TBI alone, or in combination with 90 mg/m(2) fludarabine (FLU/TBI), before transplantation of peripheral blood stem cells from HLA-matched related donors. Eighty-five patients with hematological malignancies were randomized to be conditioned with TBI alone (n = 44) or FLU/TBI (n = 41). All patients had initial engraftment. Two graft rejections were observed, both in the TBI group. Infection rates, nonrelapse mortality, and graft-versus-host disease (GVHD) were similar between groups. Three-year overall survival was lower in the TBI group (54% versus 65%; hazard ratio [HR], .57; P = .09), with higher incidences of relapse/progression (55% versus 40%; HR, .55; P = .06), relapse-related mortality (37% versus 28%; HR, .53; P = .09), and a lower progression-free survival (36% versus 53%; HR, .56; P = .05). Median donor T cell chimerism levels were significantly lower in the TBI group at days 28 (61% versus 90%; P < .0001) and 84 (68% versus 92%; P < .0001), as was NK cell chimerism on day 28 (75% versus 96%; P = .0005). In conclusion, this randomized trial demonstrates the importance of fludarabine in augmenting the graft-versus-tumor effect by ensuring prompt and durable high-level donor engraftment early after transplantation.

  16. The Neurological Outcome Scale for Traumatic Brain Injury (NOS-TBI): II. Reliability and convergent validity.

    Science.gov (United States)

    McCauley, Stephen R; Wilde, Elisabeth A; Kelly, Tara M; Weyand, Annie M; Yallampalli, Ragini; Waldron, Eric J; Pedroza, Claudia; Schnelle, Kathleen P; Boake, Corwin; Levin, Harvey S; Moretti, Paolo

    2010-06-01

    A standardized measure of neurological dysfunction specifically designed for TBI currently does not exist and the lack of assessment of this domain represents a substantial gap. To address this, the Neurological Outcome Scale for Traumatic Brain Injury (NOS-TBI) was developed for TBI outcomes research through the addition to and modification of items specifically relevant to patients with TBI, based on the National Institutes of Health Stroke Scale. In a sample of 50 participants (mean age = 33.3 years, SD = 12.9) TBI, internal consistency of the NOS-TBI was high (Cronbach's alpha = 0.942). Test-retest reliability also was high (rho = 0.97, p TBI total score was excellent (W = 0.995). Convergent validity was demonstrated through significant Spearman rank-order correlations between the NOS-TBI and the concurrently administered Disability Rating Scale (rho = 0.75, p TBI is a reliable and valid measure of neurological functioning in patients with moderate to severe TBI.

  17. Harnessing Neuroplasticity to Promote Rehabilitation: CI Therapy for TBI

    Science.gov (United States)

    2016-10-01

    risk-to- benefit ratio of the study has not changed. The Data & Safety Monitor for this project recommended a minor change in our telephone screening...As noted, our recruitment activities have the benefit of increasing public awareness about the effects 16 of TBI on motor function of the upper...function WMS  digit span Wechsler Memory Scale Digit Span working memory WMS  logical memory WMS  recall of details of a short narrative narrative memory

  18. Preclinical care of children with traumatic brain injury (TBI

    Directory of Open Access Journals (Sweden)

    Sefrin, Peter

    2004-03-01

    Full Text Available The fact that injuries caused by accidents are the most common cause of death in children and adolescents in Germany gave rise to the study, which mainly deals with traffic accidents in this group. 200,221 records of emergency-service physicians in Bavaria which cover the period 1995-1999 were analysed with respect to the importance of traumatic brain injury (TBI in children and adolescents (n = 721 - representing 45.8% of traffic injuries in this age group. The highest incidence of TBI was in summer (34.3% and in the evening between 16.00 and 18.00 (23.7%. The time taken between accident and arrival of the emergency services was 8.8 ± 3.1 minutes. The preclinical phase lasted 19.3 ± 5.8 minutes. The probability of having an accident with TBI increases with age, the maximum being in the age-range 7 - 14 years (61.6%. Boys (63.2% were almost twice as susceptible to injury as girls. 36.8% of all cases had no noticeable neurological disorder, 71.1% resulted in a Glasgow Coma Scale (GCS score of 15. Only 6.3% had most severe neurological disorders, resulting in a GCS score of 3 - 5. Circulation parameters in the form of adapted hypotension were abnormal in only 3.4%, 21.9% of the children had a bradycardia and in 12.3% the blood oxygen saturation fell below 94%. The most frequent intervention was the laying of an i.v. line for infusions. 8.6% of the patients were intubated to allow for ventilation with oxygen. Analgesics were given in 16.7% of the cases. In 84.7% of all cases, the condition was stable and in only 3.3% was a severe deterioration to be observed. The assessments were made using both the National Advisory Committee for Aeronautics (NACA and Glasgow Coma Scales (GCS. Discrepancies occurred, as a NACA scale of I - III and a GCS score of < 9 was reported in 4.9% of cases. In contrast a NACA scale of IV - VI was reported with a GCS score of 15 in 30% of all cases. TBI symptoms in children are less obvious than in adults, which leads to an

  19. Pupillometry and Saccades as Objective mTBI Biomarker

    Science.gov (United States)

    2016-10-01

    identifying military personnel with mTBI. 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a...St. Pete Beach, August 2010, J. Neurotrauma 28 (4) (2011) 517–526, http://dx.doi.org/10.1089/ neu .2010.1638 (PubMed PMID: 21265587). [16] S. Moster...http://dx.doi.org/10.1227/01. NEU .0000280001.03578.FF (PubMed PMID: 17762746) discussion 44. [23] V.E. DC, Organization of visual areas in macaque and

  20. Targeting Epigenetic Mechanisms in Pain due to Trauma and Traumatic Brain Injury(TBI)

    Science.gov (United States)

    2016-10-01

    AD AWARD NUMBER: W81XWH-14-1-0579 TITLE: Targeting Epigenetic Mechanisms in Pain due to Trauma and Traumatic Brain Injury (TBI) PRINCIPAL...TITLE AND SUBTITLE Targeting Epigenetic Mechanisms in Pain due to Trauma and Traumatic Brain Injury (TBI) 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c... brain or peripheral trauma may support chronic pain. Our work to-date has established a rodent model of TBI in combination with injury to a limb as a

  1. Blood Biomarker Profile of TBI-Associated Cognitive Impairment Among Old and Young Veterans

    Science.gov (United States)

    2015-10-01

    distinguishable from AD and normal aging. Specifically, we hypothesize that: 1) patients with TBI associated CI will have higher phospho-tau/total tau ratio than...sites. As of 30-SEP-2015, data from 31 participants with TBI and 30 controls has been collected. Once data collection is complete, we will examine the...SUBJECT TERMS Traumatic brain injury (TBI), dementia , chronic traumatic encephalopathy (CTE), blood biomarkers, aging, cognitive impairment (CI

  2. SU-E-T-812: Volumetric Modulated Arc Therapy-Total Body Irradiation (VMAT-TBI) V.s. Conventional Extended SSD-TBI (cTBI): A Dosimetric Comparisom

    Energy Technology Data Exchange (ETDEWEB)

    Ouyang, L; Folkerts, M; Lee, H; Ramirez, E; Timmerman, R; Abdulrahman, R; Jiang, S; Gu, X [UT Southwestern Medical Center, Dallas, TX (United States)

    2015-06-15

    Purpose: To perform a dosimetric evaluation on a new developed volumetric modulated arc therapy based total body irradiation (VMAT-TBI). Methods: Three patients were CT scanned with an indexed rotatable body frame to get whole body CT images. Concatenated CT images were imported in Pinnacle treatment planning system and whole body and lung were contoured as PTV and organ at risk, respectively. Treatment plans were generated by matching multiple isocenter volumetric modulated arc (VMAT) fields of the upper body and multiple isocenter parallel-opposed fields of the lower body. For each plan, 1200 cGy in 8 fractions was prescribed to the whole body volume and the lung dose was constrained to a mean dose of 750 cGy. Such a two-level dose plan was achieved by inverse planning of the torso VMAT fields. For comparison, conventional standing TBI (cTBI) plans were generated on the same whole body CT images at an extended SSD (550cm).The shape of compensators and lung blocks are simulated using body segments and lung contours Compensation was calculated based on the patient CT images, in mimic of the standing TBI treatment. The whole body dose distribution of cTBI plans were calculated with a home-developed GPU Monte Carlo dose engine. Calculated cTBI dose distribution was prescribed to the mid-body point at umbilical level. Results: The VMAT-TBI treatment plans of three patients’ plans achieved 80.2%±5.0% coverage of the total body volume within ±10% of the prescription dose, while cTBI treatment plans achieved 72.2%±4.0% coverage of the total body volume. The averaged mean lung dose of all three patients is lower for VMAT-TBI (7.48 cGy) than for cTBI (8.96 cGy). Conclusion: The proposed patient comfort-oriented VMAT-TBI technique provides for a uniform dose distribution within the total body while reducing the dose to the lungs.

  3. [Late-onset Neurodegenerative Diseases Following Traumatic Brain Injury: Chronic Traumatic Encephalopathy (CTE) and Alzheimer's Disease Secondary to TBI (AD-TBI)].

    Science.gov (United States)

    Takahata, Keisuke; Tabuchi, Hajime; Mimura, Masaru

    2016-07-01

    Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease, which is associated with mild repetitive traumatic brain injury (TBI). This long-term and progressive symptom due to TBI was initially called punch-drunk syndrome or dementia pugilistica, since it was believed to be associated with boxing. However, serial neuropathological studies of mild repetitive TBI in the last decade have revealed that CTE occurs not only in boxers but also in a wider population including American football players, wrestlers, and military personnel. CTE has gained large public interest owing to dramatic cases involving retired professional athletes wherein serious behavioral problems and tragic incidents were reported. Unlike mild repetitive TBI, a single episode of severe TBI can cause another type of late-onset neuropsychiatric disease including Alzheimer's disease (AD). Several epidemiological studies have shown that a single episode of severe TBI is one of the major risk factors of AD. Pathologically, both AD and CTE are characterized by abnormal accumulations of hyperphosphorylated tau proteins. However, recent neuropathological studies revealed that CTE demonstrates a unique pattern of tau pathology in neurons and astrocytes, and accumulation of other misfolded proteins such as TDP-43. Currently, no reliable biomarkers of late-onset neurodegenerative diseases following TBI are available, and a definitive diagnosis can be made only via postmortem neuropathological examination. Development in neuroimaging techniques such as tau and amyloid positron emission tomography imaging might not only enable early diagnosis of CTE, but also contribute to the interventions for prevention of late-onset neurodegenerative diseases following TBI. Further studies are necessary to elucidate the mechanisms of neurodegeneration in the living brain of patients with TBI.

  4. Blast Loading Experiments of Surrogate Models for Tbi Scenarios

    Science.gov (United States)

    Alley, M. D.; Son, S. F.

    2009-12-01

    This study aims to characterize the interaction of explosive blast waves through simulated anatomical models. We have developed physical models and a systematic approach for testing traumatic brain injury (TBI) mechanisms and occurrences. A simplified series of models consisting of spherical PMMA shells housing synthetic gelatins as brain simulants have been utilized. A series of experiments was conducted to compare the sensitivity of the system response to mechanical properties of the simulants under high strain-rate explosive blasts. Small explosive charges were directed at the models to produce a realistic blast wave in a scaled laboratory test cell setting. Blast profiles were measured and analyzed to compare system response severity. High-speed shadowgraph imaging captured blast wave interaction with the head model while particle tracking captured internal response for displacement and strain correlation. The results suggest amplification of shock waves inside the head near material interfaces due to impedance mismatches. In addition, significant relative displacement was observed between the interacting materials suggesting large strain values of nearly 5%. Further quantitative results were obtained through shadowgraph imaging of the blasts confirming a separation of time scales between blast interaction and bulk movement. These results lead to the conclusion that primary blast effects could cause TBI occurrences.

  5. Dosimetry with phantom for total body irradiation (TBI)

    Energy Technology Data Exchange (ETDEWEB)

    Tezuka, Takako; Sakakura, Noriyuki; Obata, Yasunori; Tabushi, Katuyoshi; Kondou, Satoru [Nagoya Univ. (Japan). School of Health Sciences; Koyama, Syuuji; Aoyama, Yuuichi; Shimohira, Akiyo [Nagoya Univ. (Japan). Hospital

    2002-04-01

    Total body irradiation (TBI) is being used as a method of preparation for bone marrow transplantation (BMT). In TBI, the dose calculation is based on dosimetry using a phantom. We measured the basic dose with a phantom using a 10 MV X-rays. We confirmed the accuracy of the dose calculation performed in our facilities and investigated a method of more accurate dosimetry. We measured the variation in dose according to the size of the phantom and the depth using a tough water phantom, and examined the difference in TMR according to SCD, field size, and size of the phantom. Consequently, the dose has been changed regardless of the size of the phantom at larger than 80 x 30 x 30 cm{sup 3}, and it is about 1% larger than 30 x 30 x 30 cm{sup 3}. Also TMR has changed according to various conditions, including the size of the phantom, field size, and SCD. Therefore, it was found that dosimetry using the 30 x 30 x 30 cm{sup 3} phantom leads to underestimation in dose calculation, and there is no difference in dose between the field size of 151.5 x 160 cm{sup 2} and 151.5 x 80 cm{sup 2}. It is also necessary to consider the effect of the vertical size of the phantom. (author)

  6. Sexual Functioning, Desire, and Satisfaction in Women with TBI and Healthy Controls.

    Science.gov (United States)

    Strizzi, Jenna; Olabarrieta Landa, Laiene; Pappadis, Monique; Olivera, Silvia Leonor; Valdivia Tangarife, Edgar Ricardo; Fernandez Agis, Inmaculada; Perrin, Paul B; Arango-Lasprilla, Juan Carlos

    2015-01-01

    Traumatic brain injury (TBI) can substantially alter many areas of a person's life and there has been little research published regarding sexual functioning in women with TBI. Methods. A total of 58 women (29 with TBI and 29 healthy controls) from Neiva, Colombia, participated. There were no statistically significant differences between groups in sociodemographic characteristics. All 58 women completed the Sexual Quality of Life Questionnaire (SQoL), Female Sexual Functioning Index (FSFI), Sexual Desire Inventory (SDI), and the Sexual Satisfaction Index (ISS). Results. Women with TBI scored statistically significantly lower on the SQoL (p lubrication (p programs.

  7. The Neurological Outcome Scale for Traumatic Brain Injury (NOS-TBI): I. Construct validity.

    Science.gov (United States)

    Wilde, Elisabeth A; McCauley, Stephen R; Kelly, Tara M; Weyand, Annie M; Pedroza, Claudia; Levin, Harvey S; Clifton, Guy L; Schnelle, Kathleen P; Shah, Monika V; Moretti, Paolo

    2010-06-01

    The Neurological Outcome Scale for Traumatic Brain Injury (NOS-TBI) is a measure adapted from the National Institutes of Health Stroke Scale (NIHSS), and is intended to capture essential neurological deficits impacting individuals with traumatic brain injury (TBI) (see Wilde et al., 2010 ). In the present study we evaluate the measure's construct validity via comparison with a quantified neurological examination performed by a neurologist. Spearman rank-order correlation between the NOS-TBI and the neurological examination was rho = 0.76, p TBI compared favorably to the neurological examination items, with correlations ranging from 0.60 to 0.99 (all p TBI, and on the NOS-TBI neurological impairment was evident in all but one participant. This study documents the presence of measurable neurological sequelae in a sample of patients with TBI in a post-acute rehabilitation setting, underscoring the need for formal measurement of the frequency and severity of neurological deficits in this population. The results suggest that the NOS-TBI is a valid measure of neurological functioning in patients with TBI.

  8. Halstead-Reitan characteristics of nonimpact and impact mTBI litigants and insurance claimants.

    Science.gov (United States)

    Sweeney, James Ernest; Johnson, Andrew M

    2017-08-29

    The purpose of this study was to investigate possible neuropsychological differences in Halstead-Reitan characteristics between motor vehicle accident litigants and insurance claimants that sustained uncomplicated mild traumatic brain injury (mTBI) and did or did not sustain direct impact to the head (i.e., Impact vs. Nonimpact mTBI), and to compare these clinical groups with a control group that did not suffer mTBI (No mTBI). The Tactile Form Recognition Test (TFR) was the only level of performance test in the Halstead-Reitan Battery (HRB) that generated statistically significant differences. The TFR resembles a complex reaction time test. TFR response time was significantly longer for Nonimpact mTBI patients than for Impact mTBI and No mTBI participants. Frequency comparisons of abnormal score patterns demonstrated that Nonimpact patients produced significantly more aberrant Impairment Index vs. FSIQ score patterns than Impact and No mTBI participants. Given the components of the score pattern, this finding suggests that Nonimpact patients may experience less recovery from neuropsychological deficits than Impact participants. Complex perceptual reaction times and score patterns comparing sensitive and "hold" test results may represent heuristic avenues of future research in the study of compensation-seeking Nonimpact and Impact mTBI patients.

  9. Hyvät käytänteet ehkäistä kunniaväkivaltaa : integroiva kirjallisuuskatsaus

    OpenAIRE

    Kempe, Jenni; Reunama, Miisa

    2016-01-01

    Opinnäytetyön aiheena ovat hyvät käytänteet ehkäistä kunniaväkivaltaa. Kunniaväkivalta on yksi naisiin kohdistuvan väkivallan monista muodoista. Sillä tarkoitetaan yhteisön tai kulttuurin asettamia seksuaalimoraaliin liittyviä käytöstapoja ja niihin liittyvää yhteisöllistä kunnia-ajattelua. Tavoitteena on tuottaa näyttöön perustuvaa tietoa kunniaväkivallasta ja sen ehkäisystä. Tutkimuskysymykset ovat 1) Miten kunniaväkivalta ilmenee? 2) Mitkä ovat hyviä käytänteitä ehkäistä kunniaväkivaltaa? ...

  10. Sheep Collisions: the Good, the Bad, and the TBI

    CERN Document Server

    Courtney, Michael

    2007-01-01

    The title page of Chapter 9 in Fundamentals of Physics (Halliday, Resnick, and Walker, 8th Edition, p. 201) shows a dramatic photograph of two Big Horn sheep butting heads and promises to explain how sheep survive such violent clashes without serious injury. However, the answer presented in sample problem 9-4 (p. 213) errs in presuming an interaction time of 0.27 s which results in an unrealistically long stopping distance of 0.62 m. Furthermore, the assertion that the horns provide necessary cushioning of the blow is inconsistent with the absence of concussions in domestic breeds of hornless sheep. Results from traumatic brain injury (TBI) research allow acceleration tolerance of sheep to be estimated as 450 g facilitating an analysis of sheep collisions that is more consistent with available observations (stopping distance less than 1 cm, impact time of roughly 2 ms).

  11. Prospective memory rehabilitation using smartphones in patients with TBI

    DEFF Research Database (Denmark)

    Evald, Lars

    2015-01-01

    with the use of low-cost, off-the-shelf, unmodified smartphones combined with Internet calendars as a compensatory memory strategy. Thirteen community-dwelling patients with traumatic brain injury (TBI) received a 6-week group-based instruction in the systematic use of a smartphone as a memory compensatory aid...... followed by a brief structured open-ended interview regarding satisfaction with and advantages and disadvantages of the compensatory strategy. Ten of 13 participants continued to use a smartphone as their primary compensatory strategy. Audible and visual reminders were the most frequently mentioned...... advantages of the smartphone, and, second, the capability as an all-in-one memory device. In contrast, battery life was the most often mentioned disadvantage, followed by concerns about loss or failure of the device. Use of a smartphone seems to be a satisfactory compensatory memory strategy to many patients...

  12. When Injury Clouds Understanding of Others: Theory of Mind after Mild TBI in Preschool Children.

    Science.gov (United States)

    Bellerose, Jenny; Bernier, Annie; Beaudoin, Cindy; Gravel, Jocelyn; Beauchamp, Miriam H

    2015-08-01

    There is evidence to suggest that social skills, such as the ability to understand the perspective of others (theory of mind), may be affected by childhood traumatic brain injuries; however, studies to date have only considered moderate and severe traumatic brain injury (TBI). This study aimed to assess theory of mind after early, mild TBI (mTBI). Fifty-one children who sustained mTBI between 18 and 60 months were evaluated 6 months post-injury on emotion and desires reasoning and false-belief understanding tasks. Their results were compared to that of 50 typically developing children. The two groups did not differ on baseline characteristics, except for pre- and post-injury externalizing behavior. The mTBI group obtained poorer scores relative to controls on both the emotion and desires task and the false-belief understanding task, even after controlling for pre-injury externalizing behavior. No correlations were found between TBI injury characteristics and theory of mind. This is the first evidence that mTBI in preschool children is associated with theory of mind difficulties. Reduced perspective taking abilities could be linked with the social impairments that have been shown to arise following TBI.

  13. TBI-ROC Part Seven: Traumatic Brain Injury--Technologies to Support Memory and Cognition

    Science.gov (United States)

    Scherer, Marcia; Elias, Eileen; Weider, Katie

    2010-01-01

    This article is the seventh of a multi-part series on traumatic brain injury (TBI). The six earlier articles in this series have discussed the individualized nature of TBI and its consequences, the rehabilitation continuum, and interventions at various points along the continuum. As noted throughout the articles, many individuals with TBI…

  14. Individual neuropsychological support and group sessions for relatives to TBI patients

    DEFF Research Database (Denmark)

    Siert, Lars

    TITLE: Individual neuropsychological support and group sessions for relatives to TBI patients. OBJECTIVE: To describe how the neuropsychologist work with early and ongoing individual support and group sessions for relatives to adult TBI patients in the acute and sub acute phase and after discharge...

  15. fNIRS-based investigation of the Stroop task after TBI.

    Science.gov (United States)

    Plenger, Patrick; Krishnan, Kamini; Cloud, Matthew; Bosworth, Chris; Qualls, Devin; Marquez de la Plata, Carlos

    2016-06-01

    To evaluate neural changes during a Stroop task among individuals with TBI using functional near-infrared spectroscopy (fNIRS). Thirteen healthy controls and 14 patients with moderate to severe TBI were included in this study. Oxygenated hemoglobin (HbO) was recorded every tenth of a second using a 52-channel fNIRS unit. Data were acquired using a block design during a Stroop task (i.e., Condition A = Dot Color Naming, Condition B = Incongruent Condition). Visual stimuli were presented on a computer monitor. Behaviorally, response accuracy was similar between groups for condition A, but the TBI group made more errors than the control group during condition B. During condition A, the patient group demonstrated significant increases in HbO within bilateral frontal regions compared to controls (p TBI group (p TBI group performed as accurately as controls on the simpler dot color naming condition of the Stroop task, neural activity was greater within the frontal lobes during this relatively simple task among the TBI group suggesting neural inefficiency. Furthermore, the spatial distribution of neural activity related to the interference effect was not different among patients, suggesting the neural demand for the simpler task was comparable to that of the more cognitive demanding task among the TBI sample. The results suggest that fNIRS can identify frontal lobe inefficiency in TBI commonly observed with fMRI.

  16. TBI-ROC Part Seven: Traumatic Brain Injury--Technologies to Support Memory and Cognition

    Science.gov (United States)

    Scherer, Marcia; Elias, Eileen; Weider, Katie

    2010-01-01

    This article is the seventh of a multi-part series on traumatic brain injury (TBI). The six earlier articles in this series have discussed the individualized nature of TBI and its consequences, the rehabilitation continuum, and interventions at various points along the continuum. As noted throughout the articles, many individuals with TBI…

  17. Electropalatographic (EPG) Assessment of Tongue-to-Palate Contacts in Dysarthric Speakers Following TBI

    Science.gov (United States)

    Kuruvilla, Mili S.; Murdoch, Bruce E.; Goozee, Justine V.

    2008-01-01

    The aim of the investigation was to compare EPG-derived spatial and timing measures between a group of 11 dysarthric individuals post-severe TBI and 10 age- and sex-matched neurologically non-impaired individuals. Participants of the TBI group were diagnosed with dysarthria ranging from mild-to-moderate-severe dysarthria. Each participant from the…

  18. The Power of Cross-Disciplinary Teams for Developing First Responder Training in TBI

    Science.gov (United States)

    Shackelford, Jo L.; Cappiccie, Amy

    2016-01-01

    Misunderstanding of the symptoms of traumatic brain injury (TBI) often leaves first responders ill-equipped to handle encounters involving subjects with brain injury. This paper details a cross-disciplinary project to develop and disseminate a training curriculum designed to increase first responders' knowledge of and skills with TBI survivors.…

  19. The Power of Cross-Disciplinary Teams for Developing First Responder Training in TBI

    Science.gov (United States)

    Shackelford, Jo L.; Cappiccie, Amy

    2016-01-01

    Misunderstanding of the symptoms of traumatic brain injury (TBI) often leaves first responders ill-equipped to handle encounters involving subjects with brain injury. This paper details a cross-disciplinary project to develop and disseminate a training curriculum designed to increase first responders' knowledge of and skills with TBI survivors.…

  20. Clinical caveats on medical assessment and treatment of pain after TBI.

    Science.gov (United States)

    Ivanhoe, Cindy B; Hartman, Eric T

    2004-01-01

    The diagnosis and management of pain in the patient with traumatic brain injury (TBI) can be difficult in light of the limitations imposed by the cognitive, language, and behavioral deficits. With patients in the acute rehabilitation setting, one must be vigilant for the often subtle signs and symptoms of pain. Causes more commonly seen in the population with TBI as a consequence of the injury itself include dysautonomia, neuropathic pain, spasticity, and heterotopic ossification. Headaches may be a consequence of TBI or associated with it for other reasons. Sources of pain associated with TBI include deep venous thrombosis and others. The reader is reminded that patients with TBI are subject to all the causes of pain that affect the general population.

  1. Clarifying the Robust Foundation for and Appropriate Use of DTI in mTBI Patients.

    Science.gov (United States)

    Lipton, Michael L; Bigler, Erin D

    2014-01-01

    As clinicians and scientists, we believe scientific evidence and prudent clinical practice form the proper basis for determining the utility of diagnostic measures, which should subsequently inform forensic use. The misleading and often entirely unsubstantiated opinions and positions of Wortzel et al., in opposition to DTI as a useful measure in mTBI, are at odds with the clear consensus of the scientific literature regarding mTBI, its clinical assessment and natural history. The authors' critique contains numerous errors. We will focus on four areas: (1) the clinical reality of mTBI (2) the true substance of the scientific evidence supporting use of DTI in mTBI, (3) the authors' erroneous and off-target opinions regarding DTI analysis and (4) critical appraisal and integration of clinical information for diagnosis of mTBI.

  2. Rates of TBI-related Emergency Department Visits, Hospitalizations, and Deaths by Sex — United States, 2001–2010

    Data.gov (United States)

    U.S. Department of Health & Human Services — Overall rates of TBI climbed slowly from 2001 through 2007, then spiked sharply in 2008 and continued to climb through 2010. The increase in TBI rates in 2008 was...

  3. Neuropsychological effects of self-reported deployment-related mild TBI and current PTSD in OIF/OEF veterans.

    Science.gov (United States)

    Shandera-Ochsner, Anne L; Berry, David T R; Harp, Jordan P; Edmundson, Maryanne; Graue, Lili O; Roach, Abbey; High, Walter M

    2013-01-01

    Current combat veterans are exposed to many incidents that may result in mild traumatic brain injury (mTBI) and/or posttraumatic stress disorder (PTSD). While there is literature on the neuropsychological consequences of PTSD only (PTSD-o) and mTBI alone (mTBI-o), less has been done to explore their combined (mTBI+PTSD) effect. The goal of this study was to determine whether Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) veterans with mTBI+PTSD have poorer cognitive and psychological outcomes than veterans with PTSD-o, mTBI-o, or combat exposure-only. The final sample included 20 OIF/OEF veterans with histories of self-reported deployment mTBI (mTBI-o), 19 with current PTSD (PTSD-o), 21 with PTSD and self-reported mTBI (mTBI+PTSD), and 21 combat controls (CC) (no PTSD and no reported mTBI). Groups were formed using structured interviews for mTBI and PTSD. All participants underwent comprehensive neuropsychological testing, including neurocognitive and psychiatric feigning tests. Results of cognitive tests revealed significant differences in performance in the mTBI+PTSD and PTSD-o groups relative to mTBI-o and CC. Consistent with previous PTSD literature, significant differences were found on executive (switching) tasks, verbal fluency, and verbal memory. Effect sizes tended to be large in both groups with PTSD. Thus, PTSD seems to be an important variable affecting neuropsychological profiles in the post-deployment time period. Consistent with literature on civilian mTBI, the current study did not find evidence that combat-related mTBI in and of itself contributes to objective cognitive impairment in the late stage of injury.

  4. Kiusaaminen ja sen ehkäisy päiväkodissa: työntekijöiden ja 5-7-vuotiaiden lasten näkemyksiä

    OpenAIRE

    Minkkinen, Laura

    2013-01-01

    Opinnäytetyöni aiheena oli kiusaaminen ja sen ehkäisy päiväkodissa. Valitsin aiheen, koska se on mielestäni kiinnostava ja ajankohtainen: tutkimusten mukaan kiusaaminen on jatkuvasti lisääntynyt, eikä sen ehkäisemiseksi ole löydetty tehokkaita menetelmiä. Kiusaamista on tutkittu paljon, mutta vasta viime vuosina on nostettu esiin pienten lasten kiusaaminen. Näin ajankohtaiseksi on myös noussut kiusaamisen ehkäiseminen, joka voidaan aloittaa jo varhaiskasvatuksessa tulevaisuuden asenteiden ...

  5. [J. Tapio. Suljetut vaunut, eli, Kadonnutta aikaa etsimässä ; Jukka Kostiainen. Kinnises tõllas, ehk, Kadunud aega otsimas ; Tatu Vaaskivi. Maarjamaa] / Hannu Oittinen

    Index Scriptorium Estoniae

    Oittinen, Hannu, 1959-

    2013-01-01

    Arvustus: Tapio, J. Suljetut vaunut, eli, Kadonnutta aikaa etsimässä. Porvoo : J. Kostiainen, 2012 ; Kostiainen, Jukka. Kinnises tõllas, ehk, Kadunud aega otsimas / tõlkinud Ants Paikre. Tartu : Atlex, 2013 ; Vaaskivi, Tatu. Maarjamaa / tõlkinud Ants Paikre. Tallinn : Kultuurileht, 2013. (Loomingu raamatukogu)

  6. Tartu füüsikud põrgatavad ilmapalli ehk Õhupallid koolifüüsikas / Piia Post, Kristel Uiboupin

    Index Scriptorium Estoniae

    Post, Piia, 1963-

    2016-01-01

    Möödunud aastal tähistati 150 aasta möödumist professionaalse ilmavaatluse algusest Eestis. Selle tähistamiseks avati uus ilmajaam Tartu ülikooli füüsikahoone ehk Physicumi katusel. Selle heeliumiga täidetud õhupalliga võeti osa rahvusvahelisest õhupallide lennutamise võistlusest „Global Space Balloon Challenge”

  7. Tartu füüsikud põrgatavad ilmapalli ehk Õhupallid koolifüüsikas / Piia Post, Kristel Uiboupin

    Index Scriptorium Estoniae

    Post, Piia, 1963-

    2016-01-01

    Möödunud aastal tähistati 150 aasta möödumist professionaalse ilmavaatluse algusest Eestis. Selle tähistamiseks avati uus ilmajaam Tartu ülikooli füüsikahoone ehk Physicumi katusel. Selle heeliumiga täidetud õhupalliga võeti osa rahvusvahelisest õhupallide lennutamise võistlusest „Global Space Balloon Challenge”

  8. [J. Tapio. Suljetut vaunut, eli, Kadonnutta aikaa etsimässä ; Jukka Kostiainen. Kinnises tõllas, ehk, Kadunud aega otsimas ; Tatu Vaaskivi. Maarjamaa] / Hannu Oittinen

    Index Scriptorium Estoniae

    Oittinen, Hannu, 1959-

    2013-01-01

    Arvustus: Tapio, J. Suljetut vaunut, eli, Kadonnutta aikaa etsimässä. Porvoo : J. Kostiainen, 2012 ; Kostiainen, Jukka. Kinnises tõllas, ehk, Kadunud aega otsimas / tõlkinud Ants Paikre. Tartu : Atlex, 2013 ; Vaaskivi, Tatu. Maarjamaa / tõlkinud Ants Paikre. Tallinn : Kultuurileht, 2013. (Loomingu raamatukogu)

  9. Edukas outsourcing ehk iga keti tugevuse määrab tema nõrgim lüli / Riho Sarv

    Index Scriptorium Estoniae

    Sarv, Riho

    2007-01-01

    Tänapäeva ettevõtete edukuse aluseks on spetsialiseerumine ühele kindlale tegevusalale. Outsourcing ehk väljasttellimine on ettevõtte põhitegevust toetavate teenuste sisseostmine maksimaalse tulemuse saavutamiseks, konkreetne töölõik või projekt delegeeritakse teenuse pakkujale. Lisa: Olulisemad väljasttellimise kasutamise eelised

  10. Edukas outsourcing ehk iga keti tugevuse määrab tema nõrgim lüli / Riho Sarv

    Index Scriptorium Estoniae

    Sarv, Riho

    2007-01-01

    Tänapäeva ettevõtete edukuse aluseks on spetsialiseerumine ühele kindlale tegevusalale. Outsourcing ehk väljasttellimine on ettevõtte põhitegevust toetavate teenuste sisseostmine maksimaalse tulemuse saavutamiseks, konkreetne töölõik või projekt delegeeritakse teenuse pakkujale. Lisa: Olulisemad väljasttellimise kasutamise eelised

  11. Subjective Executive funtioning as a predictor of coping styl in patients with TBI at all levels of severity

    NARCIS (Netherlands)

    Rakers, Sandra; Scheenen, Myrthe; Evers, Herma; Keizer, Annemarie; Spikman, Jacoba

    2016-01-01

    Objectives: The majority of patients with traumatic braininjury (TBI) sustain a mild TBI, of which the prognosis isgenerally favourable. However, patients with moderate-to-severe TBI can experience long-lasting cognitive, emotionaland behavioural deficits that interfere with functioning in dailylife

  12. Sexual Functioning, Desire, and Satisfaction in Women with TBI and Healthy Controls

    Directory of Open Access Journals (Sweden)

    Jenna Strizzi

    2015-01-01

    Full Text Available Traumatic brain injury (TBI can substantially alter many areas of a person’s life and there has been little research published regarding sexual functioning in women with TBI. Methods. A total of 58 women (29 with TBI and 29 healthy controls from Neiva, Colombia, participated. There were no statistically significant differences between groups in sociodemographic characteristics. All 58 women completed the Sexual Quality of Life Questionnaire (SQoL, Female Sexual Functioning Index (FSFI, Sexual Desire Inventory (SDI, and the Sexual Satisfaction Index (ISS. Results. Women with TBI scored statistically significantly lower on the SQoL (p<0.001, FSFI subscales of desire (p<0.05, arousal (p<0.05, lubrication (p<0.05, orgasm (p<0.05, and satisfaction (p<0.05, and the ISS (p<0.001 than healthy controls. Multiple linear regressions revealed that age was negatively associated with some sexuality measures, while months since the TBI incident were positively associated with these variables. Conclusion. These results disclose that women with TBI do not fare as well as controls in these measures of sexual functioning and were less sexually satisfied. Future research is required to further understand the impact of TBI on sexual function and satisfaction to inform for rehabilitation programs.

  13. Quality of Life (QoL in patients with Traumatic Brain Injury (TBI: A Literature Review

    Directory of Open Access Journals (Sweden)

    Nury Sukraeny

    2014-01-01

    Full Text Available Purpose: To describe the definition of quality of life (QoL and identify the most appropriate tool for QoL assessment used in patients with TBI.Method: Searching was conducted from PubMed, CINAHL, EBSCO, and ProQuest during 2000-2011. A total of 33 studies were analyzed for this review consisting of 9 review studies, 2 intervention studies, and 22 descriptive studies.Result: Two important definitions of QoL were used in studies related to TBI namely achievement and subjective well-being. Although varieties of generic measurements have been used to measure QoL in TBI patients, there was a lack of TBI-specific Health-related Quality of Life (HRQoL instrument. Despite the different approach and time measured either short or long outcomes, appropriate domains of QoL tool seem essential particularly among those with moderate and severe TBI.Conclusion: QoL is a wide concept which can be defined in several dimensions. The QOLIBRI as a new disease-specific QoL measurement in TBI seems a feasible and valid approach for the assessment of QoL in TBI. However, the application across cultural remains a challenge and needs a validation.

  14. The influence of genetic variants on striatal dopamine transporter and D2 receptor binding after TBI.

    Science.gov (United States)

    Wagner, Amy K; Scanlon, Joelle M; Becker, Carl R; Ritter, Anne C; Niyonkuru, Christian; Dixon, Clifton E; Conley, Yvette P; Price, Julie C

    2014-08-01

    Dopamine (DA) neurotransmission influences cognition and recovery after traumatic brain injury (TBI). We explored whether functional genetic variants affecting the DA transporter (DAT) and D2 receptor (DRD2) impacted in vivo dopaminergic binding with positron emission tomography (PET) using [(11)C]βCFT and [(11)C]raclopride. We examined subjects with moderate/severe TBI (N=12) ∼1 year post injury and similarly matched healthy controls (N=13). The variable number of tandem repeat polymorphism within the DAT gene and the TaqI restriction fragment length polymorphism near the DRD2 gene were assessed. TBI subjects had age-adjusted DAT-binding reductions in the caudate, putamen, and ventral striatum, and modestly increased D2 binding in ventral striatum versus controls. Despite small sample sizes, multivariate analysis showed lower caudate and putamen DAT binding among DAT 9-allele carriers and DRD2 A2/A2 homozygotes with TBI versus controls with the same genotype. Among TBI subjects, 9-allele carriers had lower caudate and putamen binding than 10/10 homozygotes. This PET study suggests a hypodopaminergic environment and altered DRD2 autoreceptor DAT interactions that may influence DA transmission after TBI. Future work will relate these findings to cognitive performance; future studies are required to determine how DRD2/DAT1 genotype and DA-ligand binding are associated with neurostimulant response and TBI recovery.

  15. Personality and neuroimaging measures differentiate PTSD from mTBI in veterans.

    Science.gov (United States)

    Davenport, Nicholas D; Lim, Kelvin O; Sponheim, Scott R

    2015-09-01

    Mild traumatic brain injury (mTBI) is common among recent veterans and often is associated with chronic post-concussive symptoms (PCS). Elevated PCS may also be a consequence of post-traumatic stress disorder (PTSD) which shares symptoms with PCS. Identification of personality, biological, and psychopathology factors that contribute to the relationship between mTBI and PCS could help isolate the sources of chronic post concussive syndrome in veterans. Clinician rated diagnoses (PTSD, Major Depression, Alcohol Dependence), personality characteristics (Multidimensional Personality Questionnaire [MPQ] subscales), white matter brain imaging measures (Mean Diffusivity, Generalized Fractional Anisotropy), and diagnoses of mTBI were collected from 125 American military veterans of Iraq or Afghanistan. Linear and logistic regression models were tested to determine contributions to PCS and whether there were similar contributors to PTSD and mTBI. PCS score was associated with personality characteristics of high Stress Reaction and Traditionalism and low Control as well as mTBI. A diagnosis of PTSD was associated with low Social Closeness, PCS, Alcohol Dependence, and abnormal white matter mean diffusivity. Diagnosis of mTBI was associated with fewer white matter mean diffusivity abnormalities, PCS, and number of deployments. As commonly observed clinically, both PTSD and mTBI were associated with higher rates of PCS, though the contribution of PTSD appears to be secondary to personality traits, particularly Stress Reaction. Furthermore, the observation of factors that are uniquely associated with Blast mTBI (number of deployments) or with PTSD (Lifetime Alcohol Dependence and low Social Closeness), as well as a factor (region of abnormal MD) that had opposite effects on the likelihood of each diagnosis, indicates that the complex relationships between personality, psychopathology, and nature of mTBI need to be considered when interpreting chronic post-concussive symptoms.

  16. Functional neuroimaging with default mode network regions distinguishes PTSD from TBI in a military veteran population.

    Science.gov (United States)

    Raji, Cyrus A; Willeumier, Kristen; Taylor, Derek; Tarzwell, Robert; Newberg, Andrew; Henderson, Theodore A; Amen, Daniel G

    2015-09-01

    PTSD and TBI are two common conditions in veteran populations that can be difficult to distinguish clinically. The default mode network (DMN) is abnormal in a multitude of neurological and psychiatric disorders. We hypothesize that brain perfusion SPECT can be applied to diagnostically separate PTSD from TBI reliably in a veteran cohort using DMN regions. A group of 196 veterans (36 with PTSD, 115 with TBI, 45 with PTSD/TBI) were selected from a large multi-site population cohort of individuals with psychiatric disease. Inclusion criteria were peacetime or wartime veterans regardless of branch of service and included those for whom the traumatic brain injury was not service related. SPECT imaging was performed on this group both at rest and during a concentration task. These measures, as well as the baseline-concentration difference, were then inputted from DMN regions into separate binary logistic regression models controlling for age, gender, race, clinic site, co-morbid psychiatric diseases, TBI severity, whether or not the TBI was service related, and branch of armed service. Predicted probabilities were then inputted into a receiver operating characteristic analysis to compute sensitivity, specificity, and accuracy. Compared to PSTD, persons with TBI were older, male, and had higher rates of bipolar and major depressive disorder (p TBI in the veterans with 92 % sensitivity, 85 % specificity, and 94 % accuracy. With concentration scans, there was 85 % sensitivity, 83 % specificity and 89 % accuracy. Baseline-concentration (the difference metric between the two scans) scans were 85 % sensitivity, 80 % specificity, and 87 % accuracy. In separating TBI from PTSD/TBI visual readings of baseline scans had 85 % sensitivity, 81 % specificity, and 83 % accuracy. Concentration scans had 80 % sensitivity, 65 % specificity, and 79 % accuracy. Baseline-concentration scans had 82 % sensitivity, 69 % specificity, and 81 % accuracy. For separating PTSD

  17. Normalized power transmission between ABP and ICP in TBI.

    Science.gov (United States)

    Shahsavari, S; Hallen, T; McKelvey, T; Ritzen, C; Rydenhag, B

    2009-01-01

    A new approach to study the pulse transmission between the cerebrovascular bed and the intracranial space is presented. In the proposed approach, the normalized power transmission between ABP and ICP has got the main attention rather than the actual power transmission. Evaluating the gain of the proposed transfer function at any single frequency can reveal how the percentage of contribution of that specific frequency component has been changed through the cerebrospinal system. The gain of the new transfer function at the fundamental cardiac frequency was utilized to evaluate the state of the brain in three TBI patients. Results were assessed using the reference evaluations achieved by a novel CT scan-based scoring scheme. In all three study cases, the gain of the transfer function showed a good capability to follow the trend of the CT scores and describe the brain state. Comparing the new transfer function with the traditional one and also the index of compensatory reserve, the proposed transfer function was found more informative about the state of the brain in the patients under study.

  18. Blast Loading Experiments of Developed Surrogate Models for TBI Scenarios

    Science.gov (United States)

    Alley, Matthew; Son, Steven

    2009-06-01

    This study aims to characterize the interaction of explosive blast waves through simulated anatomical systems. We have developed physical models and a systematic approach for testing traumatic brain injury (TBI) mechanisms and occurrences. A simplified series of models consisting of spherical PMMA shells followed by SLA prototyped skulls housing synthetic gelatins as brain simulants have been utilized. A series of experiments was conducted with the simple geometries to compare the sensitivity of the system response to mechanical properties of the simulants under high strain-rate explosive blasts. Small explosive charges were directed at the models to produce a realistic blast wave in a scaled laboratory setting. Blast profiles were measured and analyzed to compare system response severity. High-speed shadowgraph imaging captured blast wave interaction with the head model while particle tracking captured internal response for displacement and strain correlation. The results suggest amplification of shock waves inside the head due to impedance mismatches. Results from the strain correlations added to the theory of internal shearing between tissues.

  19. SEGMENTATION OF SERIAL MRI OF TBI PATIENTS USING PERSONALIZED ATLAS CONSTRUCTION AND TOPOLOGICAL CHANGE ESTIMATION.

    Science.gov (United States)

    Wang, Bo; Prastawa, Marcel; Awate, Suyash P; Irimia, Andrei; Chambers, Micah C; Vespa, Paul M; van Horn, John D; Gerig, Guido

    2012-01-01

    Traumatic brain injury (TBI) due to falls, car accidents, and warfare affects millions of people annually. Determining personalized therapy and assessment of treatment efficacy can substantially benefit from longitudinal (4D) magnetic resonance imaging (MRI). In this paper, we propose a method for segmenting longitudinal brain MR images with TBI using personalized atlas construction. Longitudinal images with TBI typically present topological changes over time due to the effect of the impact force on tissue, skull, and blood vessels and the recovery process. We address this issue by defining a novel atlas construction scheme that explicitly models the effect of topological changes. Our method automatically estimates the probability of topological changes jointly with the personalized atlas. We demonstrate the effectiveness of this approach on MR images with TBI that also have been segmented by human raters, where our method that integrates 4D information yields improved validation measures compared to temporally independent segmentations.

  20. Monitoring Neurocognitive Performance and Electrophysiological Activity After Mild Traumatic Brain Injury (mTBI)

    Science.gov (United States)

    2014-03-01

    High versus Low PTSD Symptom Severity. National Capital Area TBI Research Symposium. 2014. Bethesda, Maryland. 5. DeGraba M, Merrifield W...Localized Correlated Spectroscopy. Alzheimer Research and Therapy. (In Press) 12. APPENDICES Nothing to report.

  1. Comparative Effectiveness of Family Problem-Solving Therapy (F-PST) for Adolescent TBI

    Science.gov (United States)

    2016-07-25

    Tbi; Intracranial Edema; Brain Edema; Craniocerebral Trauma; Head Injury; Brain Hemorrhage, Traumatic; Subdural Hematoma; Brain Concussion; Head Injuries, Closed; Epidural Hematoma; Cortical Contusion; Wounds and Injuries; Disorders of Environmental Origin; Trauma, Nervous System; Brain Injuries

  2. Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI)

    DEFF Research Database (Denmark)

    Maas, Andrew I R; Menon, David K; Steyerberg, Ewout W

    2015-01-01

    BACKGROUND: Current classification of traumatic brain injury (TBI) is suboptimal, and management is based on weak evidence, with little attempt to personalize treatment. A need exists for new precision medicine and stratified management approaches that incorporate emerging technologies. OBJECTIVE...

  3. Modeling distinct imaging hemodynamics early after TBI: the relationship between signal amplitude and connectivity.

    Science.gov (United States)

    Medaglia, John D; McAleavey, Andrew A; Rostami, Sohayla; Slocomb, Julia; Hillary, Frank G

    2015-06-01

    Over the past decade, fMRI studies of cognitive change following traumatic brain injury (TBI) have investigated blood oxygen level dependent (BOLD) activity during working memory (WM) performance in individuals in early and chronic phases of recovery. Recently, BOLD fMRI work has largely shifted to focus on WM and resting functional connectivity following TBI. However, fundamental questions in WM remain. Specifically, the effects of injury on the basic relationships between local and interregional functional neuroimaging signals during WM processing early following moderate to severe TBI have not been examined. This study employs a mixed effects model to examine prefrontal cortex and parietal lobe signal change during a WM task, the n-back, and whether there is covariance between regions of high amplitude signal change, (synchrony of elicited activity (SEA) very early following TBI. We also examined whether signal change and SEA differentially predict performance during WM. Overall, percent signal change in the right prefrontal cortex (rPFC) was and important predictor of both reaction time (RT) and SEA in early TBI and matched controls. Right prefrontal cortex (rPFC) percent signal change positively predicted SEA within and between persons regardless of injury status, suggesting that the link between these neurodynamic processes in WM-activated regions remains unaffected even very early after TBI. Additionally, rPFC activity was positively related to RT within and between persons in both groups. Right parietal (rPAR) activity was negatively related to RT within subjects in both groups. Thus, the local signal intensity of the rPFC in TBI appears to be a critical property of network functioning and performance in WM processing and may be a precursor to recruitment observed in chronic samples. The present results suggest that as much research moves toward large scale functional connectivity modeling, it will be essential to develop integrated models of how local and

  4. Role of Sertraline in insomnia associated with post traumatic brain injury (TBI depression

    Directory of Open Access Journals (Sweden)

    Ansari Ahmed

    2016-09-01

    Full Text Available Traumatic brain injury (TBI is a major cause of disability (1, 2. Sleep disturbances, such as insomnia, are very common following traumatic brain injury and have been reported in frequencies from 40% (3 to as high as 84% (4. Sleep disruption can be related to the TBI itself but may also be secondary to neuropsychiatric (e.g., depression or neuromuscular (e.g., pain conditions associated with TBI or to the pharmacological management of the injury and its consequences. Post-TBI insomnia has been associated with numerous negative outcomes including daytime fatigue, tiredness, difficulty functioning: impaired performance at work, memory problems, mood problems, greater functional disability, reduced participation in activities of daily living, less social and recreational activity, less employment potential, increased caregiver burden, greater sexual dysfunction, and also lower ratings of health, poor subjective wellbeing. These negative consequences can hamper the person’s reintegration into the community, adjustment after injury, and overall QOL. (5 The connection between depression and insomnia has not been investigated within the post TBI population to a great extent. For the general population, clinically significant insomnia is often associated with the presence of an emotional disorder (6. Fichtenberg et al. (2002 (7, in his study established that the strongest relationship with the diagnosis of insomnia belonged to depression. Given the high prevalence of depression during the first 2 years following TBI (8, a link between depression and insomnia among TBI patients makes innate sense. The present study aims at assessing role of sertralline in post TBI insomnia associated with depression.

  5. rTMS: A Treatment to Restore Function After Severe TBI

    Science.gov (United States)

    2015-10-01

    TBI related neurologic populations combined with our preliminary findings with severe TBI, indicate that rTMS merits investigation as a...30 treatment sessions. Determine long-term effects of Active APT III+ Active iTBS according to above measures, by computing change between baseline...pain of UCPPS. Specific Aims: Aim 1: Evaluate differential efficacy for UCPPS urological pain relief between placebo and DCS. Aim 2: Evaluate

  6. Growth impairment after TBI of leukemia survivors children: a model- based investigation

    OpenAIRE

    Galletto, Chiara; Gliozzi, Antonio; Nucera, Daniele; Bertorello, Nicoletta; Biasin, Eleonora; Corrias, Andrea; Chiabotto, Patrizia; Fagioli, Franca; Guiot, Caterina

    2014-01-01

    Background Children receiving Total Body Irradiation (TBI) in preparation for Hematopoietic Stem Cell Transplantation (HSCT) are at risk for Growth Hormone Deficiency (GHD), which sometimes severely compromises their Final Height (FH). To better represent the impact of such therapies on growth we apply a mathematical model, which accounts both for the gompertzian-like growth trend and the hormone-related ‘spurts’, and evaluate how the parameter values estimated on the children undergoing TBI ...

  7. Minimizing the effect of TBI-related physical sequelae on vocational return.

    Science.gov (United States)

    McNamee, Shane; Walker, William; Cifu, David X; Wehman, Paul H

    2009-01-01

    This article evaluated the common physical sequelae that affect return to work (RTW) after traumatic brain injury (TBI). We performed a Medline search and evaluation of current TBI rehabilitation texts. The information presented is a combination of published literature and clinical guidelines. The limitations faced by many patients with TBI can best be overcome through clever job search, job redesign, and community linkages with business and industry that are willing to partner in helping the patient with TBI regain employment. The physician plays a key role in communicating suggestions to the vocational specialist. The comorbidities described represent challenges to successful RTW. These problems are recurrent, long-term, and clearly affect job procurement, nature of job, level of required support, and likelihood of job retention. Conversely, these challenges should not be viewed as impenetrable obstacles. With appropriate supports such as compensatory strategies, job coaching, assistive technology, medical management, and job restructuring, successful RTW is viable option. Physicians must focus on employment outcomes in real jobs and not settle for volunteer work, sheltered work, or assessment and planning. Individuals should be placed in real work for real pay. Through close collaboration between the survivor of TBI, the physician, the vocational specialist, and community resources, successful employment for survivors of TBI is possible and must be prescribed a high value.

  8. Health-related quality of life and mental health outcomes in Mexican TBI caregivers.

    Science.gov (United States)

    Gulin, Shaina L; Perrin, Paul B; Stevens, Lillian F; Villaseñor-Cabrera, Teresita J; Jiménez-Maldonado, Miriam; Martínez-Cortes, Ma Luisa; Arango-Lasprilla, Juan Carlos

    2014-03-01

    Research has documented the deleterious effects on caregivers of providing care for an individual with traumatic brain injury (TBI). TBI caregivers in Mexico specifically have reduced health-related quality of life (HRQOL) across both physical and mental health domains. The purpose of the current study was to uncover the system of connections between Mexican TBI caregivers' HRQOL and their mental health. A cross-sectional survey was conducted at a public medical facility in Guadalajara, México. Ninety family caregivers of individuals with TBI completed measures of HRQOL, satisfaction with life, depression, and burden. A canonical correlation analysis revealed that the better the caregivers' HRQOL, the better their mental health was, with the effect reaching a large-sized effect. A distinct pattern emerged linking caregivers' higher energy levels and better social functioning to lower depression and greater satisfaction with life. A series of multiple regressions similarly uncovered that the most robust independent HRQOL predictors of caregiver mental health were vitality and social functioning. Especially for TBI caregivers with poor health, behavioral health interventions in Latin America that target the HRQOL domains of social functioning and vitality may significantly improve caregiver mental health, and as a result, informal care for TBI.

  9. EYE-TRAC: monitoring attention and utility for mTBI

    Science.gov (United States)

    Maruta, Jun; Tong, Jianliang; Lee, Stephanie W.; Iqbal, Zarah; Schonberger, Alison; Ghajar, Jamshid

    2012-06-01

    Attention is a core function in cognition and also the most prevalent cognitive deficit in mild traumatic brain injury (mTBI). Predictive timing is an essential element of attention functioning because sensory processing and execution of goal-oriented behavior are facilitated by temporally accurate prediction. It is hypothesized that impaired synchronization between prediction and external events accounts for the attention deficit in mTBI. Other cognitive and somatic or affective symptoms associated with mTBI may be explained as secondary consequences of impaired predictive timing. Eye-Tracking Rapid Attention Computation (EYE-TRAC) is the quantification of predictive timing with indices of dynamic visuo-motor synchronization (DVS) between the gaze and the target during continuous predictive visual tracking. Such quantification allows for cognitive performance monitoring in comparison to the overall population as well as within individuals over time. We report preliminary results of normative data and data collected from subjects with a history of mTBI within 2 weeks of injury and post-concussive symptoms at the time of recruitment. A substantial proportion of mTBI subjects demonstrated DVS scores worse than 95% of normal subjects. In addition, longitudinal monitoring of acute mTBI subjects showed that initially abnormal DVS scores were followed by improvement toward the normal range. In summary, EYE-TRAC provides fast and objective indices of DVS that allow comparison of attention performance to a normative standard and monitoring of within-individual changes.

  10. Mathematical outcomes and working memory in children with TBI and orthopedic injury.

    Science.gov (United States)

    Raghubar, Kimberly P; Barnes, Marcia A; Prasad, Mary; Johnson, Chad P; Ewing-Cobbs, Linda

    2013-03-01

    This study compared mathematical outcomes in children with predominantly moderate to severe traumatic brain injury (TBI; n550) or orthopedic injury (OI; n547) at 2 and 24 months post-injury. Working memory and its contribution to math outcomes at 24 months post-injury was also examined. Participants were administered an experimental cognitive addition task and standardized measures of calculation, math fluency, and applied problems; as well as experimental measures of verbal and visual-spatial working memory. Although children with TBI did not have deficits in foundational math fact retrieval, they performed more poorly than OIs on standardized measures of math. In the TBI group, performance on standardized measures was predicted by age at injury, socioeconomic status, and the duration of impaired consciousness. Children with TBI showed impairments on verbal, but not visual working memory relative to children with OI. Verbal working memory mediated group differences on math calculations and applied problems at 24 months post-injury. Children with TBI have difficulties in mathematics, but do not have deficits in math fact retrieval, a signature deficit of math disabilities. Results are discussed with reference to models of mathematical cognition and disability and the role of working memory in math learning and performance for children with TBI.

  11. The epidemiology of traumatic brain injuries (TBI – a literature review

    Directory of Open Access Journals (Sweden)

    S. R. Kalyan

    2007-02-01

    Full Text Available A search of the literature showed limited reported research on the epidemiology of TBI in South Africa. This prompted a search of literature on the epidemiology of TBI in the rest of the world. Traumatic brain injury (TBI is a leading cause of death and disability in most western countries. Motor vehicle accidents (MVA are the main cause of TBI, followed by gunshot wounds (GSW and falls. In South Africa, road accident fatalities are 27,3 per 100 000 of the population.  The causes of death and disability vary with age, race and gender groups. Improved medical emergency care has resulted in a decrease in the mortality rate following TBI, but has increased the morbidity rate. The increase in the number of people living with neurological impairments is a significant economic burden when taking into account hospitalization, rehabilitation, medication and the loss of working hours. The emotional burden is unknown. The purpose of this paper is to place in perspective, the epidemiology of TBI, by looking at the published literature in the rest of the world.  In the developing world it is projected that the burden of disease resulting from interpersonal violence will nearly double by 2020 unless preventive action is taken. Many more people survive acts of interpersonal violence than die from them.

  12. Intracranial pressure and cerebral perfusion pressure monitoring in non-TBI patients: special considerations.

    Science.gov (United States)

    Helbok, Raimund; Olson, DaiWai M; Le Roux, Peter D; Vespa, Paul

    2014-12-01

    The effect of intracranial pressure (ICP) and the role of ICP monitoring are best studied in traumatic brain injury (TBI). However, a variety of acute neurologic illnesses e.g., subarachnoid hemorrhage, intracerebral hemorrhage, ischemic stroke, meningitis/encephalitis, and select metabolic disorders, e.g., liver failure and malignant, brain tumors can affect ICP. The purpose of this paper is to review the literature about ICP monitoring in conditions other than TBI and to provide recommendations how the technique may be used in patient management. A PubMed search between 1980 and September 2013 identified 989 articles; 225 of which were reviewed in detail. The technique used to monitor ICP in non-TBI conditions is similar to that used in TBI; however, indications for ICP monitoring often are intertwined with the presence of obstructive hydrocephalus and hence the use of ventricular catheters is more frequent. Increased ICP can adversely affect outcome, particularly when it fails to respond to treatment. However, patients with elevated ICP can still have favorable outcomes. Although the influence of ICP-based care on outcome in non-TBI conditions appears less robust than in TBI, monitoring ICP and cerebral perfusion pressure can play a role in guiding therapy in select patients.

  13. The impact of pediatric traumatic brain injury (TBI) on family functioning: a systematic review.

    Science.gov (United States)

    Rashid, Marghalara; Goez, Helly R; Mabood, Neelam; Damanhoury, Samah; Yager, Jerome Y; Joyce, Anthony S; Newton, Amanda S

    2014-01-01

    To explore the impact moderate to severe traumatic brain injury (TBI) in a child has on family functioning. The search was conducted using 9 bibliographic databases for articles published between 1980 and 2013. Two reviewers independently screened for inclusion and assessed study quality. Two reviewers extracted study data and a third checked for completeness and accuracy. Findings are presented by three domains: injury-related burden and stress, family adaptability, and family cohesion. Nine observational studies were included. Across the studies, differences between study groups for family functioning varied, but there was a trend for more dysfunction in families whose child had a severe TBI as compared to families whose child had a moderate TBI or orthopedic injury. In three studies, injury-associated burden was persistent post-injury and was highest in families whose child had a severe TBI followed by families with a child who had a moderate TBI. One study found fathers reported more family dysfunction caused by their child's injury compared to mothers. Two studies found that mothers' adaptability depended on social support and stress levels while fathers' adaptability was independent of these factors and injury severity. Moderate to severe TBI has a significant, long-standing impact on family functioning. Factors associated with family adaptability vary by parental role.

  14. White matter involvement after TBI: Clues to axon and myelin repair capacity.

    Science.gov (United States)

    Armstrong, Regina C; Mierzwa, Amanda J; Marion, Christina M; Sullivan, Genevieve M

    2016-01-01

    Impact-acceleration forces to the head cause traumatic brain injury (TBI) with damage in white matter tracts comprised of long axons traversing the brain. White matter injury after TBI involves both traumatic axonal injury (TAI) and myelin pathology that evolves throughout the post-injury time course. The axon response to initial mechanical forces and secondary insults follows the process of Wallerian degeneration, which initiates as a potentially reversible phase of intra-axonal damage and proceeds to an irreversible phase of axon fragmentation. Distal to sites of axon disconnection, myelin sheaths remain for prolonged periods, which may activate neuroinflammation and inhibit axon regeneration. In addition to TAI, TBI can cause demyelination of intact axons. These evolving features of axon and myelin pathology also represent opportunities for repair. In experimental TBI, demyelinated axons exhibit remyelination, which can serve to both protect axons and facilitate recovery of function. Myelin remodeling may also contribute to neuroplasticity. Efficient clearance of myelin debris is a potential target to attenuate the progression of chronic pathology. During the early phase of Wallerian degeneration, interventions that prevent the transition from reversible damage to axon disconnection warrant the highest priority, based on the poor regenerative capacity of axons in the CNS. Clinical evaluation of TBI will need to address the challenge of accurately detecting the extent and stage of axon damage. Distinguishing the complex white matter changes associated with axons and myelin is necessary for interpreting advanced neuroimaging approaches and for identifying a broader range of therapeutic opportunities to improve outcome after TBI.

  15. Neuroprotective effects of SNX-185 in an in vitro model of TBI with a second insult.

    Science.gov (United States)

    Shahlaie, Kiarash; Gurkoff, Gene G; Lyeth, Bruce G; Muizelaar, J Paul; Berman, Robert F

    2013-01-01

    Second insults following traumatic brain injury (TBI), such as ischemia and hypoxia, significantly worsen outcome in patients and in experimental models of TBI. Following TBI there is a pathological increase in intracellular calcium, triggering cellular mechanisms of dysfunction and death. N-type specific voltage gated calcium channel (VGCC) blockers reduce cell death in both in vitro mechanical strain injury (MSI) and in vivo models of TBI, but they have not been previously explored in a model of TBI followed by a second insult. In the following studies, cortical neurons and astrocytes experienced MSI followed by incubation in 20% CO2. Cultures were treated with the N-type VGCC blocker, ω-conopeptide SNX-185 (1 μM), 5-minutes post-injury and intracellular calcium accumulation was assessed at 3, 6 and 24 h. Neuronal viability was assessed 24 h after MSI. Increasing incubator CO2 to 20% significantly increased calcium accumulation and cell death regardless of MSI severity. Treatment with 1 μM of SNX-185 significantly reduced the accumulation of calcium 3 hours following injury and increased the number of viable neurons 24 h post-injury and incubation in 20% CO2. In vitro models provide a critical tool for identifying roles of cell specific mechanisms involved in neuronal dysfunction and death following injury. These data demonstrate the potential of N-type VGCC blockers in reducing the damaging effects of TBI and second insults.

  16. Reliability of a computer and Internet survey (Computer User Profile) used by adults with and without traumatic brain injury (TBI).

    Science.gov (United States)

    Kilov, Andrea M; Togher, Leanne; Power, Emma

    2015-01-01

    To determine test-re-test reliability of the 'Computer User Profile' (CUP) in people with and without TBI. The CUP was administered on two occasions to people with and without TBI. The CUP investigated the nature and frequency of participants' computer and Internet use. Intra-class correlation coefficients and kappa coefficients were conducted to measure reliability of individual CUP items. Descriptive statistics were used to summarize content of responses. Sixteen adults with TBI and 40 adults without TBI were included in the study. All participants were reliable in reporting demographic information, frequency of social communication and leisure activities and computer/Internet habits and usage. Adults with TBI were reliable in 77% of their responses to survey items. Adults without TBI were reliable in 88% of their responses to survey items. The CUP was practical and valuable in capturing information about social, leisure, communication and computer/Internet habits of people with and without TBI. Adults without TBI scored more items with satisfactory reliability overall in their surveys. Future studies may include larger samples and could also include an exploration of how people with/without TBI use other digital communication technologies. This may provide further information on determining technology readiness for people with TBI in therapy programmes.

  17. ‘Hit & Run' model of closed-skull traumatic brain injury (TBI) reveals complex patterns of post-traumatic AQP4 dysregulation

    OpenAIRE

    Ren, Zeguang; Iliff, Jeffrey J.; Yang, LiJun; Yang, Jiankai; Chen, Xiaolin; Chen, Michael J.; Giese, Rebecca N; Wang, Baozhi; Shi, Xuefang; Nedergaard, Maiken

    2013-01-01

    Cerebral edema is a major contributor to morbidity associated with traumatic brain injury (TBI). The methods involved in most rodent models of TBI, including head fixation, opening of the skull, and prolonged anesthesia, likely alter TBI development and reduce secondary injury. We report the development of a closed-skull model of murine TBI, which minimizes time of anesthesia, allows the monitoring of intracranial pressure (ICP), and can be modulated to produce mild and moderate grade TBI. In...

  18. Flavonoid derivative 7,8-DHF attenuates TBI pathology via TrkB activation.

    Science.gov (United States)

    Agrawal, Rahul; Noble, Emily; Tyagi, Ethika; Zhuang, Yumei; Ying, Zhe; Gomez-Pinilla, Fernando

    2015-05-01

    Traumatic brain injury (TBI) is followed by a state of metabolic dysfunction, affecting the ability of neurons to use energy and support brain plasticity; there is no effective therapy to counteract the TBI pathology. Brain-derived neurotrophic factor (BDNF) has an exceptional capacity to support metabolism and plasticity, which highly contrasts with its poor pharmacological profile. We evaluated the action of a flavonoid derivative 7,8-dihydroxyflavone (7,8-DHF), a BDNF receptor (TrkB) agonist with the pharmacological profile congruent for potential human therapies. Treatment with 7,8-DHF (5mg/kg, ip, daily for 7 days) was effective to ameliorate the effects of TBI on plasticity markers (CREB phosphorylation, GAP-43 and syntaxin-3 levels) and memory function in Barnes maze test. Treatment with 7,8-DHF restored the decrease in protein and phenotypic expression of TrkB phosphorylation after TBI. In turn, intrahippocampal injections of K252a, a TrkB antagonist, counteracted the 7,8-DHF induced TrkB signaling activation and memory improvement in TBI, suggesting the pivotal role of TrkB signaling in cognitive performance after brain injury. A potential action of 7,8-DHF on cell energy homeostasis was corroborated by the normalization in levels of PGC-1α, TFAM, COII, AMPK and SIRT1 in animals subjected to TBI. Results suggest a potential mechanism by which 7,8-DHF counteracts TBI pathology via activation of the TrkB receptor and engaging the interplay between cell energy management and synaptic plasticity. Since metabolic dysfunction is an important risk factor for the development of neurological and psychiatric disorders, these results set a precedent for the therapeutic use of 7,8-DHF in a larger context.

  19. Acute CSF interleukin-6 trajectories after TBI: associations with neuroinflammation, polytrauma, and outcome.

    Science.gov (United States)

    Kumar, R G; Diamond, M L; Boles, J A; Berger, R P; Tisherman, S A; Kochanek, P M; Wagner, A K

    2015-03-01

    Traumatic brain injury (TBI) results in a significant inflammatory burden that perpetuates the production of inflammatory mediators and biomarkers. Interleukin-6 (IL-6) is a pro-inflammatory cytokine known to be elevated after trauma, and a major contributor to the inflammatory response following TBI. Previous studies have investigated associations between IL-6 and outcome following TBI, but to date, studies have been inconsistent in their conclusions. We hypothesized that cohort heterogeneity, temporal inflammatory profiles, and concurrent inflammatory marker associations are critical to characterize when targeting subpopulations for anti-inflammatory therapies. Toward this objective, we used serial cerebrospinal fluid (CSF) samples to generate temporal acute IL-6 trajectory (TRAJ) profiles in a prospective cohort of adults with severe TBI (n=114). We examined the impact of injury type on IL-6 profiles, and how IL-6 profiles impact sub-acute (2weeks-3months) serum inflammatory marker load and long-term global outcome 6-12months post-injury. There were two distinct acute CSF IL-6 profiles, a high and low TRAJ group. Individuals in the high TRAJ had increased odds of unfavorable Glasgow Outcome Scale (GOS) scores at 6months (adjusted OR=3.436, 95% CI: 1.259, 9.380). Individuals in the high TRAJ also had higher mean acute CSF inflammatory load compared to individuals in the low TRAJ (p⩽0.05). The two groups did not differ with respect acute serum profiles; however, individuals in the high CSF IL-6 TRAJ also had higher mean sub-acute serum IL-1β and IL-6 levels compared with the low TRAJ group (p⩽0.05). Lastly, injury type (isolated TBI vs. TBI+polytrauma) was associated with IL-6 TRAJ group (χ(2)=5.31, p=0.02). Specifically, there was 70% concordance between those with TBI+polytrauma and the low TRAJ; in contrast, isolated TBI was similarly distributed between TRAJ groups. These data provide evidence that sustained, elevated levels of CSF IL-6 are associated

  20. TBI lung dose comparisons using bilateral and anteroposterior delivery techniques and tissue density corrections.

    Science.gov (United States)

    Bailey, Daniel W; Wang, Iris Z; Lakeman, Tara; Hales, Lee D; Singh, Anurag K; Podgorsak, Matthew B

    2015-03-08

    This study compares lung dose distributions for two common techniques of total body photon irradiation (TBI) at extended source-to-surface distance calculated with, and without, tissue density correction (TDC). Lung dose correction factors as a function of lateral thorax separation are approximated for bilateral opposed TBI (supine), similar to those published for anteroposterior-posteroanterior (AP-PA) techniques in AAPM Report 17 (i.e., Task Group 29). 3D treatment plans were created retrospectively for 24 patients treated with bilateral TBI, and for whom CT data had been acquired from the head to the lower leg. These plans included bilateral opposed and AP-PA techniques- each with and without - TDC, using source-to-axis distance of 377 cm and largest possible field size. On average, bilateral TBI requires 40% more monitor units than AP-PA TBI due to increased separation (26% more for 23 MV). Calculation of midline thorax dose without TDC leads to dose underestimation of 17% on average (standard deviation, 4%) for bilateral 6 MV TBI, and 11% on average (standard deviation, 3%) for 23 MV. Lung dose correction factors (CF) are calculated as the ratio of midlung dose (with TDC) to midline thorax dose (without TDC). Bilateral CF generally increases with patient separation, though with high variability due to individual uniqueness of anatomy. Bilateral CF are 5% (standard deviation, 4%) higher than the same corrections calculated for AP-PA TBI in the 6 MV case, and 4% higher (standard deviation, 2%) for 23 MV. The maximum lung dose is much higher with bilateral TBI (up to 40% higher than prescribed, depending on patient anatomy) due to the absence of arm tissue blocking the anterior chest. Dose calculations for bilateral TBI without TDC are incorrect by up to 24% in the thorax for 6 MV and up to 16% for 23 MV. Bilateral lung CF may be calculated as 1.05 times the values published in Table 6 of AAPM Report 17, though a larger patient pool is necessary to better

  1. Head Stabilization Measurements As a Potential Evaluation Tool for Comparison of Persons with TBI and Vestibular Dysfunction with Healthy Controls

    Science.gov (United States)

    2015-03-01

    Persons with TBI and Vestibular Dysfunction with Healty Controls 5a. Contract Number: 5b. Grant Number: R116 5c. Program Element Number: 5d...large percentage of persons with traumatic brain injury ( TBI ) incur some type of vestibular dysfunction requiring vestibular physical therapy. These...the group having a TBI did not show the same patterned motion as the control group but over time and with training, more closely resembled that of the

  2. Adolescent TBI-induced hypopituitarism causes sexual dysfunction in adult male rats.

    Science.gov (United States)

    Greco, Tiffany; Hovda, David A; Prins, Mayumi L

    2015-02-01

    Adolescents are at greatest risk for traumatic brain injury (TBI) and repeat TBI (RTBI). TBI-induced hypopituitarism has been documented in both adults and juveniles and despite the necessity of pituitary function for normal physical and brain development, it is still unrecognized and untreated in adolescents following TBI. TBI induced hormonal dysfunction during a critical developmental window has the potential to cause long-term cognitive and behavioral deficits and the topic currently remains unaddressed. The purpose of this study was to determine if four mild TBIs delivered to adolescent male rats disrupts testosterone production and adult behavioral outcomes. Plasma testosterone was quantified from 72 hrs preinjury to 3 months postinjury and pubertal onset, reproductive organ growth, erectile function and reproductive behaviors were assessed at 1 and 2 months postinjury. RTBI resulted in both acute and chronic decreases in testosterone production and delayed onset of puberty. Significant deficits were observed in reproductive organ growth, erectile function and reproductive behaviors in adult rats at both 1 and 2 months postinjury. These data suggest adolescent RTBI-induced hypopituitarism underlies abnormal behavioral changes observed during adulthood. The impact of undiagnosed hypopituitarism following RTBI in adolescence has significance not only for growth and puberty, but also for brain development and neurobehavioral function as adults.

  3. Challenging the Paradigms of Experimental TBI Models: From Preclinical to Clinical Practice.

    Science.gov (United States)

    Tortella, Frank C

    2016-01-01

    Despite prodigious advances in TBI neurobiology research and a broad arsenal of animal models mimicking different aspects of human brain injury, this field has repeatedly experienced collective failures to translate from animals to humans, particularly in the area of therapeutics. This lack of success stems from variability and inconsistent standardization across models and laboratories, as well as insufficient objective and quantifiable diagnostic measures (biomarkers, high-resolution imaging), understanding of the vast clinical heterogeneity, and clinically centered conception of the TBI animal models. Significant progress has been made by establishing well-defined standards for reporting animal studies with "preclinical common data elements" (CDE), and for the reliability and reproducibility in preclinical TBI therapeutic research with the Operation Brain Trauma Therapy (OBTT) consortium. However, to break the chain of failures and achieve a therapeutic breakthrough in TBI will probably require the use of higher species models, specific mechanism-based injury models by which to theranostically targeted treatment portfolios are tested, more creative concepts of therapy intervention including combination therapy and regeneration neurobiology strategies, and the adoption of dosing regimens based upon pharmacokinetic-pharmacodynamic (PK-PD) studies and guided by the injury severity and TBI recovery process.

  4. TBI ADAPTER: traumatic brain injury assessment diagnosis advocacy prevention and treatment from the emergency room--a prospective observational study.

    Science.gov (United States)

    Ganti, Latha; Daneshvar, Yasamin; Bodhit, Aakash; Ayala, Sarah; Patel, Pratik S; Lottenberg, Lawrence L; York, Donna; Counsell, Colleen; Peters, Keith R

    2015-04-01

    There is no standard treatment algorithm for patients who present to the emergency department (ED) with acute traumatic brain injury (TBI). This is in part because of the heterogeneity of the injury pattern and the patient profile, and the lack of evidence-based guidelines, especially for mild TBI in adults. As TBI is seen more and more frequently in the ED, a standardized assessment would be beneficial in terms of efficiency. The authors present their ED approach to mild TBI evaluation in the ED, along with results to date. These data represent a prospective observational cohort study, where each patient provided individual, written informed consent.

  5. Neurotrauma and Repair Research: Traumatic Brain Injury (TBI) and its Treatments.

    Science.gov (United States)

    Algattas, Hanna; Huang, Jason H

    2013-01-01

    Traumatic brain injury (TBI) affects a growing portion of the population and continues to take national spotlight with advances in imaging technology and understanding of long-term effects. However, there is large variance in TBI treatment protocols due to injury variability and lack of both mechanistic understanding and strong treatment recommendations. Recent practice suggests three disparate treatment approaches, all which aim at promoting neuroprotection after TBI, show promise: immediate hypothermia, hyperbaric oxygen, and progesterone supplementation. The research is controversial at times, yet there are abundant opportunities to develop the technology behind hypothermia and hyperbaric oxygen treatments which would surely aid in aligning the current data. Additionally, while progesterone has already been packaged in nanoparticle form it may benefit from continued formulation and administration research. The treatments and the avenues for improvement are reviewed in the present paper.

  6. Complementary and alternative medicine (CAM) following traumatic brain injury (TBI): Opportunities and challenges.

    Science.gov (United States)

    Hernández, Theresa D; Brenner, Lisa A; Walter, Kristen H; Bormann, Jill E; Johansson, Birgitta

    2016-06-01

    Traumatic brain injury (TBI) is highly prevalent and occurs in a variety of populations. Because of the complexity of its sequelae, treatment strategies pose a challenge. Given this complexity, TBI provides a unique target of opportunity for complementary and alternative medicine (CAM) treatments. The present review describes and discusses current opportunitites and challenges associated with CAM research and clinical applications in civilian, veteran and military service populations. In addition to a brief overview of CAM, the translational capacity from basic to clinical research to clinical practice will be described. Finally, a systematic approach to developing an adoptable evidence base, with proof of effectiveness based on the literature will be discussed. Inherent in this discussion will be the methodological and ethical challenges associated with CAM research in those with TBI and associated comorbidities, specifically in terms of how these challenges relate to practice and policy issues, implementation and dissemination. This article is part of a Special Issue entitled SI:Brain injury and recovery.

  7. Versional eye tracking in mild traumatic brain injury (mTBI): effects of oculomotor training (OMT).

    Science.gov (United States)

    Thiagarajan, Preethi; Ciuffreda, Kenneth J

    2014-01-01

    To evaluate a range of objective measures of versional eye movements before and after oculomotor training (OMT) in individuals with mTBI. The results were compared with placebo (P) training. Twelve individuals with mTBI (mean age = 29 ± 3 years) having oculomotor-based near-vision symptoms participated in the study. Versional eye movements were recorded objectively before and after OMT (fixation, predictable saccades, simulated reading) and P training (6 weeks each, two sessions/week, 45 minutes/session). Following OMT, there was a significant (p OMT had a significant, positive effect on most aspects of versional tracking. These findings are suggestive of improved rhythmicity, accuracy and sequencing of saccades following OMT in mTBI as a result of oculomotor learning.

  8. Statistical machine learning to identify traumatic brain injury (TBI) from structural disconnections of white matter networks.

    Science.gov (United States)

    Mitra, Jhimli; Shen, Kai-kai; Ghose, Soumya; Bourgeat, Pierrick; Fripp, Jurgen; Salvado, Olivier; Pannek, Kerstin; Taylor, D Jamie; Mathias, Jane L; Rose, Stephen

    2016-04-01

    Identifying diffuse axonal injury (DAI) in patients with traumatic brain injury (TBI) presenting with normal appearing radiological MRI presents a significant challenge. Neuroimaging methods such as diffusion MRI and probabilistic tractography, which probe the connectivity of neural networks, show significant promise. We present a machine learning approach to classify TBI participants primarily with mild traumatic brain injury (mTBI) based on altered structural connectivity patterns derived through the network based statistical analysis of structural connectomes generated from TBI and age-matched control groups. In this approach, higher order diffusion models were used to map white matter connections between 116 cortical and subcortical regions. Tracts between these regions were generated using probabilistic tracking and mean fractional anisotropy (FA) measures along these connections were encoded in the connectivity matrices. Network-based statistical analysis of the connectivity matrices was performed to identify the network differences between a representative subset of the two groups. The affected network connections provided the feature vectors for principal component analysis and subsequent classification by random forest. The validity of the approach was tested using data acquired from a total of 179 TBI patients and 146 controls participants. The analysis revealed altered connectivity within a number of intra- and inter-hemispheric white matter pathways associated with DAI, in consensus with existing literature. A mean classification accuracy of 68.16%±1.81% and mean sensitivity of 80.0%±2.36% were achieved in correctly classifying the TBI patients evaluated on the subset of the participants that was not used for the statistical analysis, in a 10-fold cross-validation framework. These results highlight the potential for statistical machine learning approaches applied to structural connectomes to identify patients with diffusive axonal injury.

  9. Retrospective, monocentric analysis of late effects after total body irradiation (TBI) in adults

    Energy Technology Data Exchange (ETDEWEB)

    Boelling, Tobias [Universitaetsklinikum Muenster (Germany). Dept. of Radiotherapy; Paracelsus Clinic Osnabrueck (Germany). Dept. of Radiotherapy; Kreuziger, David Christoph; Ernst, Iris; Elsayed, Hassan; Willich, Normann [Universitaetsklinikum Muenster (Germany). Dept. of Radiotherapy

    2011-05-15

    Purpose: Total body irradiation (TBI) is a standard treatment modality within the multidisciplinary approach for allogeneous stem cell or bone marrow transplantation. However, surviving patients are at risk for developing a variety of late sequelae. This analysis aimed to retrospectively characterize late effects after TBI in adults treated in a single center. Patients and Methods: Patients {>=} 18 years treated with fractionated TBI (4-12 Gy) between 1996 and 2008 were included in this study. Treatment data were collected retrospectively from the treating departments. Late effects were evaluated using the clinic charts and/or were obtained from the general practitioners using a standardized questionnaire. Analyses were performed by calculation of the cumulative incidences using the Kaplan-Meier method and the log rank test. Results: A total of 308 patients {>=} 18 years were treated including a TBI of whom 78 patients were excluded from further analysis due to death within less than 1 year after TBI. Patients suffered from leukemia in most cases. Late toxicity follow-up was available in 120 patients (mean age 46.1 years; range, 18-70 years) after a mean follow-up of 23 months (range, 12-96 months). The cumulative incidences (CI) at 3 years were 28% for pulmonary event, 8% for pulmonary toxicity, 25% for kidney toxicity, 8% for cataract, 17% for bone toxicity, and 10% for secondary malignancy. The CI of bone toxicity was higher in female than in male patients (p = 0.019). Conclusion: Late effects after TBI in the context of allogeneous stem cell or bone marrow transplantation can frequently be observed. Regular follow-up examinations are advised for the early registration and treatment of adverse effects. (orig.)

  10. NIR light propagation in a digital head model for traumatic brain injury (TBI).

    Science.gov (United States)

    Francis, Robert; Khan, Bilal; Alexandrakis, George; Florence, James; MacFarlane, Duncan

    2015-09-01

    Near infrared spectroscopy (NIRS) is capable of detecting and monitoring acute changes in cerebral blood volume and oxygenation associated with traumatic brain injury (TBI). Wavelength selection, source-detector separation, optode density, and detector sensitivity are key design parameters that determine the imaging depth, chromophore separability, and, ultimately, clinical usefulness of a NIRS instrument. We present simulation results of NIR light propagation in a digital head model as it relates to the ability to detect intracranial hematomas and monitor the peri-hematomal tissue viability. These results inform NIRS instrument design specific to TBI diagnosis and monitoring.

  11. Targeting Epigenetic Mechanisms in Pain Due to Trauma and Traumatic Brain Injury (TBI)

    Science.gov (United States)

    2015-10-01

    Pain  ( nociceptive ) sensitization was followed using the von Frey method. Those measures were continued until  the resolution of sensitization. We...AWARD NUMBER: W81XWH-14-1-0579 TITLE: Targeting Epigenetic Mechanisms in Pain due to Trauma and Traumatic Brain Injury (TBI) PRINCIPAL...SUBTITLE Targeting Epigenetic Mechanisms in Pain due to Trauma and Traumatic Brain Injury (TBI) 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-14-1-0579 5c

  12. Neurologic Functional and Quality of Life Outcomes after TBI: Clinic Attendees versus Non-Attendees.

    Science.gov (United States)

    Patel, Mayur B; Wilson, Laura D; Bregman, Jana A; Leath, Taylor C; Humble, Stephen S; Davidson, Mario A; de Riesthal, Michael R; Guillamondegui, Oscar D

    2015-07-01

    This investigation describes the relationship between TBI patient demographics, quality of life outcome, and functional status outcome among clinic attendees and non-attendees. Of adult TBI survivors with intracranial hemorrhage, 63 attended our TBI clinic and 167 did not attend. All were telephone surveyed using the Extended-Glasgow Outcome Scale (GOSE), the Quality of Life after Brain Injury (QOLIBRI) scale, and a post-discharge therapy questionnaire. To determine risk factors for GOSE and QOLIBRI outcomes, we created multivariable regression models employing covariates of age, injury characteristics, clinic attendance, insurance status, post-discharge rehabilitation, and time from injury. Compared with those with severe TBI, higher GOSE scores were identified in individuals with both mild (odds ratio [OR]=2.0; 95% confidence interval [CI]: 1.1-3.6) and moderate (OR=4.7; 95% CI: 1.6-14.1) TBIs. In addition, survivors with private insurance had higher GOSE scores, compared with those with public insurance (OR=2.0; 95% CI: 1.1-3.6), workers' compensation (OR=8.4; 95% CI: 2.6-26.9), and no insurance (OR=3.1; 95% CI: 1.6-6.2). Compared with those with severe TBI, QOLIBRI scores were 11.7 points (95% CI: 3.7-19.7) higher in survivors with mild TBI and 17.3 points (95% CI: 3.2-31.5) higher in survivors with moderate TBI. In addition, survivors who received post-discharge rehabilitation had higher QOLIBRI scores by 11.4 points (95% CI: 3.7-19.1) than those who did not. Survivors with private insurance had QOLIBRI scores that were 25.5 points higher (95% CI: 11.3-39.7) than those with workers' compensation and 16.8 points higher (95% CI: 7.4-26.2) than those without insurance. Because neurologic injury severity, insurance status, and receipt of rehabilitation or therapy are independent risk factors for functional and quality of life outcomes, future directions will include improving earlier access to post-TBI rehabilitation, social work services, affordable insurance

  13. The effect of moderate to severe traumatic brain injury (TBI) on different aspects of memory: a selective review.

    Science.gov (United States)

    Vakil, Eli

    2005-11-01

    Deficient learning and memory are frequently reported as a consequence of traumatic brain injury (TBI). Because of the diffuse nature of the injury, patients with TBI are not the ideal group for studying brain-behavior relations. Nevertheless, characterization of the memory breakdown following TBI could contribute to the assessment and rehabilitation of this patient population. It is well documented that memory is not a unitary system. Accordingly, in this article I review studies that have investigated the long-term effect of moderate to severe TBI on different memory aspects, including explicit and implicit tests of memory. This review demonstrates that TBI affects a large range of memory aspects. One of the conclusions is that the memory impairment observed in TBI patients could be viewed, at least to some degree, as a consequence of a more general cognitive deficit. Thus, unlike patients suffering from global amnesia, memory in patients with TBI is not selectively impaired. Nevertheless, it is possible to detect a subgroup of patients that do meet the criteria of amnesia. However, the most common vulnerable memory processes following TBI very much resemble the memory deficits reported in patients following frontal lobe damage, e.g., difficulties in applying active or effortful strategy in the learning or retrieval process. The suggested similarity between patients with TBI and those suffering from frontal lobe injury should be viewed cautiously; considering the nature of TBI, patients suffering from such injuries are not a homogeneous group. In view of this limitation, the future challenge in this field will be to identify subgroups of patients, either a priori according to a range of factors such as severity of injury, or a posteriori based on their specific memory deficit characteristics. Such a research approach has the potential of explaining much of the variability in findings reported in the literature on the effect of TBI on memory.

  14. Effect of c-mpl ligands after total body irradiation (TBI) with and without allogeneic hematopoietic stem cell transplantation: low-dose TBI does not prevent sensitization.

    Science.gov (United States)

    Nash, Richard A; Takatu, Alessandra; Feng, Ziding; Slichter, Sherrill; Abrams, Kraig; Espino, German; Gass, M John; Georges, George E; McSweeney, Peter A; Shulman, Howard M; Storb, Rainer

    2002-01-01

    This study investigates the potential role of the recombinant c-mpl ligands (recombinant human thrombopoietin [rhTPO] and pegylated recombinant human megakaryocyte growth and development factor [PEG-rhMGDF]) on the recovery of platelet counts after TBI with and without allogeneic hematopoietic stem cell transplantation (HSCT) in an established canine model. Initially, 3 cohorts, each with 2 nonirradiated dogs, received increasing doses of rhTPO (5 microg/kg per day; 10 microg/kg per day; 20 microg/kg per day) for 7 days to determine the optimal dose. The dose of 10 microg/kg per day of rhTPO was selected for subsequent studies. Ten dogs then received either rhTPO or placebo for 28 days after 200 cGy TBI without HSCT. The rhTPO group had fewer days with platelet counts RhTPO-specific antibodies developed in 2 dogs, which caused a significant but transient decrease of the platelet counts. Retreatment of these sensitized dogs with rhTPO resulted in profound transient decreases in platelet counts. In the next study, 20 dogs received either PEG-rhMGDF or placebo for 21 days after 920 cGy TBI and allogeneic HSCT. The median time to platelet recovery (>20,000/microL) for the PEG-rhMGDF group (n = 10) was 14.0 days compared to 15.5 days for the control group (n = 10; log rank, P = .35). There were no significant differences in the total time to platelet counts 500/microL. The effects of rhTPO on recovery of platelet and granulocyte counts after sublethal TBI were modest, and no effects of PEG-rhMGDF were observed on hematopoietic recovery after high-dose TBI and allogeneic HSCT. The significant effect that rhTPO-specific antibodies had on the platelet counts may limit the clinical role of recombinant c-mpl ligands unless sensitization can be prevented.

  15. Reliability of the NINDS common data elements cranial tomography (CT) rating variables for traumatic brain injury (TBI)

    NARCIS (Netherlands)

    Harburg, Leah; McCormack, Erin; Kenney, Kimbra; Moore, Carol; Yang, Kelly; Vos, Pieter; Jacobs, Bram; Madden, Christopher J; Diaz-Arrastia, Ramon; Bogoslovsky, Tanya

    2016-01-01

    BACKGROUND: Non-contrast head computer tomography (CT) is widely used to evaluate eligibility of patients after acute traumatic brain injury (TBI) for clinical trials. The NINDS Common Data Elements (CDEs) TBI were developed to standardize collection of CT variables. The objectives of this study wer

  16. Health-related quality of life after TBI: a systematic review of study design, instruments, measurement properties, and outcome.

    Science.gov (United States)

    Polinder, Suzanne; Haagsma, Juanita A; van Klaveren, David; Steyerberg, Ewout W; van Beeck, Ed F

    2015-01-01

    Measurement of health-related quality of life (HRQL) is essential to quantify the subjective burden of traumatic brain injury (TBI) in survivors. We performed a systematic review of HRQL studies in TBI to evaluate study design, instruments used, methodological quality, and outcome. Fifty-eight studies were included, showing large variation in HRQL instruments and assessment time points used. The Short Form-36 (SF-36) was most frequently used. A high prevalence of health problems during and after the first year of TBI was a common finding of the studies included. In the long term, patients with a TBI still showed large deficits from full recovery compared to population norms. Positive results for internal consistency and interpretability of the SF-36 were reported in validity studies. The Quality of Life after Brain Injury instrument (QOLIBRI), European Brain Injury Questionnaire (EBIQ), Child Health Questionnaire (CHQ), and the World Health Organization Quality of Life short version (WHOQOL-BREF) showed positive results, but evidence was limited. Meta-analysis of SF-36 showed that TBI outcome is heterogeneous, encompassing a broad spectrum of HRQL, with most problems reported in the physical, emotional, and social functioning domain. The use of SF-36 in combination with a TBI-specific instrument, i.e., QOLIBRI, seems promising. Consensus on preferred methodologies of HRQL measurement in TBI would facilitate comparability across studies, resulting in improved insights in recovery patterns and better estimates of the burden of TBI.

  17. Reliability of the NINDS common data elements cranial tomography (CT) rating variables for traumatic brain injury (TBI)

    NARCIS (Netherlands)

    Harburg, Leah; McCormack, Erin; Kenney, Kimbra; Moore, Carol; Yang, Kelly; Vos, Pieter; Jacobs, Bram; Madden, Christopher J; Diaz-Arrastia, Ramon R; Bogoslovsky, Tanya

    2017-01-01

    Background: Non-contrast head computer tomography (CT) is widely used to evaluate eligibility of patients after acute traumatic brain injury (TBI) for clinical trials. The NINDS Common Data Elements (CDEs) TBI were developed to standardize collection of CT variables. The objectives of this study

  18. Chapter 1 Common Data Elements and Federal Interagency Traumatic Brain Injury Research Informatics System for TBI Research.

    Science.gov (United States)

    Thompson, Hilaire J; Vavilala, Monica S; Rivara, Frederick P

    2015-01-01

    Despite increased attention to traumatic brain injury (TBI), there remains no specific treatment and available interventions focus rather on the prevention of secondary injury. One of the reasons posited for the lack of a successful therapy is the amalgamation of various types of injuries under the same severity category in clinical trials. Informatics approaches have been suggested as a means to develop an improved classification system for TBI. As a result of federal interagency efforts, common data elements (CDEs) for TBI have now been developed. Further, the Federal Interagency Traumatic Brain Injury Research Informatics System (FITBIR) has been created and is now available for TBI researchers to both add and retrieve data. This chapter will discuss the goals, development, and evolution of the CDEs and FITBIR and discuss how these tools can be used to support TBI research. A specific exemplar using the CDEs and lessons learned from working with the CDEs and FITBIR are included to aid future researchers.

  19. The consequence of spatial visual processing dysfunction caused by traumatic brain injury (TBI).

    Science.gov (United States)

    Padula, William V; Capo-Aponte, Jose E; Padula, William V; Singman, Eric L; Jenness, Jonathan

    2017-01-01

    A bi-modal visual processing model is supported by research to affect dysfunction following a traumatic brain injury (TBI). TBI causes dysfunction of visual processing affecting binocularity, spatial orientation, posture and balance. Research demonstrates that prescription of prisms influence the plasticity between spatial visual processing and motor-sensory systems improving visual processing and reducing symptoms following a TBI. The rationale demonstrates that visual processing underlies the functional aspects of binocularity, balance and posture. The bi-modal visual process maintains plasticity for efficiency. Compromise causes Post Trauma Vision Syndrome (PTVS) and Visual Midline Shift Syndrome (VMSS). Rehabilitation through use of lenses, prisms and sectoral occlusion has inter-professional implications in rehabilitation affecting the plasticity of the bi-modal visual process, thereby improving binocularity, spatial orientation, posture and balance Main outcomes: This review provides an opportunity to create a new perspective of the consequences of TBI on visual processing and the symptoms that are often caused by trauma. It also serves to provide a perspective of visual processing dysfunction that has potential for developing new approaches of rehabilitation. Understanding vision as a bi-modal process facilitates a new perspective of visual processing and the potentials for rehabilitation following a concussion, brain injury or other neurological events.

  20. Patient Characterization Protocols for Psychophysiological Studies of Traumatic Brain Injury and Post-TBI Psychiatric Disorders.

    Science.gov (United States)

    Rapp, Paul E; Rosenberg, Brenna M; Keyser, David O; Nathan, Dominic; Toruno, Kevin M; Cellucci, Christopher J; Albano, Alfonso M; Wylie, Scott A; Gibson, Douglas; Gilpin, Adele M K; Bashore, Theodore R

    2013-01-01

    Psychophysiological investigations of traumatic brain injury (TBI) are being conducted for several reasons, including the objective of learning more about the underlying physiological mechanisms of the pathological processes that can be initiated by a head injury. Additional goals include the development of objective physiologically based measures that can be used to monitor the response to treatment and to identify minimally symptomatic individuals who are at risk of delayed-onset neuropsychiatric disorders following injury. Research programs studying TBI search for relationships between psychophysiological measures, particularly ERP (event-related potential) component properties (e.g., timing, amplitude, scalp distribution), and a participant's clinical condition. Moreover, the complex relationships between brain injury and psychiatric disorders are receiving increased research attention, and ERP technologies are making contributions to this effort. This review has two objectives supporting such research efforts. The first is to review evidence indicating that TBI is a significant risk factor for post-injury neuropsychiatric disorders. The second objective is to introduce ERP researchers who are not familiar with neuropsychiatric assessment to the instruments that are available for characterizing TBI, post-concussion syndrome, and psychiatric disorders. Specific recommendations within this very large literature are made. We have proceeded on the assumption that, as is typically the case in an ERP laboratory, the investigators are not clinically qualified and that they will not have access to participant medical records.

  1. Microglia in the TBI brain: The good, the bad, and the dysregulated.

    Science.gov (United States)

    Loane, David J; Kumar, Alok

    2016-01-01

    As the major cellular component of the innate immune system in the central nervous system (CNS) and the first line of defense whenever injury or disease occurs, microglia play a critical role in neuroinflammation following a traumatic brain injury (TBI). In the injured brain microglia can produce neuroprotective factors, clear cellular debris and orchestrate neurorestorative processes that are beneficial for neurological recovery after TBI. However, microglia can also become dysregulated and can produce high levels of pro-inflammatory and cytotoxic mediators that hinder CNS repair and contribute to neuronal dysfunction and cell death. The dual role of microglial activation in promoting beneficial and detrimental effects on neurons may be accounted for by their polarization state and functional responses after injury. In this review article we discuss emerging research on microglial activation phenotypes in the context of acute brain injury, and the potential role of microglia in phenotype-specific neurorestorative processes such as neurogenesis, angiogenesis, oligodendrogenesis and regeneration. We also describe some of the known molecular mechanisms that regulate phenotype switching, and highlight new therapeutic approaches that alter microglial activation state balance to enhance long-term functional recovery after TBI. An improved understanding of the regulatory mechanisms that control microglial phenotypic shifts may advance our knowledge of post-injury recovery and repair, and provide opportunities for the development of novel therapeutic strategies for TBI.

  2. Role of APOE Isforms in the Pathogenesis of TBI Induced Alzheimer’s Disease

    Science.gov (United States)

    2014-10-01

    the inheritance of APOe4 is the only proven genetic risk factor for sporadic Alzheimer disease (AD). Importantly, TBI is a risk factor for the...mediated through ABCA1. 2 Keywords Traumatic brain injury, APOE isoforms, ABCA1, Alzheimer disease, APPmice, amyloid beta, axonal injury, inflamma

  3. A simplified technique for delivering total body irradiation (TBI) with improved dose homogeneity

    Energy Technology Data Exchange (ETDEWEB)

    Yao Rui; Bernard, Damian; Turian, Julius; Abrams, Ross A.; Sensakovic, William; Fung, Henry C.; Chu, James C. H. [Department of Radiation Oncology, Rush University Medical Center, 500 South Paulina Street, Chicago, Illinois 60612 (United States); Sections of Hematology and Stem Cell Transplantation, Division of Hematology/Oncology, Rush University Medical Center, 500 South Paulina Street, Chicago, Illinois 60612 (United States); Department of Radiation Oncology, Rush University Medical Center, 500 South Paulina Street, Chicago, Illinois 60612 (United States)

    2012-04-15

    Purpose: Total body irradiation (TBI) with megavoltage photon beams has been accepted as an important component of management for a number of hematologic malignancies, generally as part of bone marrow conditioning regimens. The purpose of this paper is to present and discuss the authors' TBI technique, which both simplifies the treatment process and improves the treatment quality. Methods: An AP/PA TBI treatment technique to produce uniform dose distributions using sequential collimator reductions during each fraction was implemented, and a sample calculation worksheet is presented. Using this methodology, the dosimetric characteristics of both 6 and 18 MV photon beams, including lung dose under cerrobend blocks was investigated. A method of estimating midplane lung doses based on measured entrance and exit doses was proposed, and the estimated results were compared with measurements. Results: Whole body midplane dose uniformity of {+-}10% was achieved with no more than two collimator-based beam modulations. The proposed model predicted midplane lung doses 5% to 10% higher than the measured doses for 6 and 18 MV beams. The estimated total midplane doses were within {+-}5% of the prescribed midplane dose on average except for the lungs where the doses were 6% to 10% lower than the prescribed dose on average. Conclusions: The proposed TBI technique can achieve dose uniformity within {+-}10%. This technique is easy to implement and does not require complicated dosimetry and/or compensators.

  4. Physics of shock tube simulated IED blast for mTBI research

    NARCIS (Netherlands)

    Mediavilla Varas, J.; Philippens, M.M.G.M.; Meijer, S.R.

    2010-01-01

    The objective of this research is to understand the blast propagation into the human skull and brain causing mTBI and use this knowledge for enabling design of effective protection measures against them. A shock tube including sensor system was optimized to simulate realistic IED blast profiles obta

  5. Linac-based total body irradiation (TBI) with volumetric modulated arc therapy (VMAT)

    Science.gov (United States)

    Tas, B.; Durmus, I. F.; Okumus, A.; Uzel, O. E.

    2017-02-01

    To evaluate dose distribution of Volumetric modulated arc therapy (VMAT) planning tecnique using Versa HD® lineer accelerator to deliver Total Body Irradiation (TBI) on the coach. Eight TBI patient's Treatment Planning System (TPS) were performed with dual arc VMAT for each patient. The VMAT-TBI consisted of three isocentres and three dual overlapping arcs. The prescribed dose was 12 Gy. Mean dose to lung and kidney were restricted less than 10 Gy and max. dose to lens were restricted less than 6 Gy. The plans were verified using 2D array and ion chamber. The comparison between calculation and measurement were made by γ-index analysis and absolute dose. An average total delivery time was determined 923±34 seconds and an average MU was determined 2614±228 MUs for dual arc VMAT. Mean dose to lungs was 9.7±0.2 Gy, mean dose to kidneys was 8.8±0.3 Gy, max. dose to lens was 5.5±0.3 Gy and max. dose was 14.6±0.3 Gy, HI of PTV was 1.13±0.2, mean dose to PTV was 12.6±1.5 Gy and mean γ-index pass rate was %97.1±1.9. The results show that the tecnique for TBI using VMAT on the treatment coach is feasible.

  6. Altered Effective Connectivity of Hippocampus-Dependent Episodic Memory Network in mTBI Survivors

    Science.gov (United States)

    2016-01-01

    Traumatic brain injuries (TBIs) are generally recognized to affect episodic memory. However, less is known regarding how external force altered the way functionally connected brain structures of the episodic memory system interact. To address this issue, we adopted an effective connectivity based analysis, namely, multivariate Granger causality approach, to explore causal interactions within the brain network of interest. Results presented that TBI induced increased bilateral and decreased ipsilateral effective connectivity in the episodic memory network in comparison with that of normal controls. Moreover, the left anterior superior temporal gyrus (aSTG, the concept forming hub), left hippocampus (the personal experience binding hub), and left parahippocampal gyrus (the contextual association hub) were no longer network hubs in TBI survivors, who compensated for hippocampal deficits by relying more on the right hippocampus (underlying perceptual memory) and the right medial frontal gyrus (MeFG) in the anterior prefrontal cortex (PFC). We postulated that the overrecruitment of the right anterior PFC caused dysfunction of the strategic component of episodic memory, which caused deteriorating episodic memory in mTBI survivors. Our findings also suggested that the pattern of brain network changes in TBI survivors presented similar functional consequences to normal aging. PMID:28074162

  7. Altered Effective Connectivity of Hippocampus-Dependent Episodic Memory Network in mTBI Survivors

    Directory of Open Access Journals (Sweden)

    Hao Yan

    2016-01-01

    Full Text Available Traumatic brain injuries (TBIs are generally recognized to affect episodic memory. However, less is known regarding how external force altered the way functionally connected brain structures of the episodic memory system interact. To address this issue, we adopted an effective connectivity based analysis, namely, multivariate Granger causality approach, to explore causal interactions within the brain network of interest. Results presented that TBI induced increased bilateral and decreased ipsilateral effective connectivity in the episodic memory network in comparison with that of normal controls. Moreover, the left anterior superior temporal gyrus (aSTG, the concept forming hub, left hippocampus (the personal experience binding hub, and left parahippocampal gyrus (the contextual association hub were no longer network hubs in TBI survivors, who compensated for hippocampal deficits by relying more on the right hippocampus (underlying perceptual memory and the right medial frontal gyrus (MeFG in the anterior prefrontal cortex (PFC. We postulated that the overrecruitment of the right anterior PFC caused dysfunction of the strategic component of episodic memory, which caused deteriorating episodic memory in mTBI survivors. Our findings also suggested that the pattern of brain network changes in TBI survivors presented similar functional consequences to normal aging.

  8. Using pattern analysis matching to differentiate TBI and PTSD in a military sample.

    Science.gov (United States)

    Meyers, John E; Miller, Ronald M; Tuita, Alexa R R

    2014-01-01

    Distinguishing between traumatic brain injury (TBI) residuals and the effects of posttraumatic stress disorder (PTSD) during neuropsychological evaluation can be difficult because of significant overlap of symptom presentation. Using a standardized battery of tests, an artificial neural network was used to create an algorithm to perform pattern analysis matching (PAM) functions that can be used to assist with diagnosis. PAM analyzes a patient's neuropsychological data and provides a best fit classification, according to one of four groups: TBI, PTSD, malingering/invalid data, or "other" (depressed/anxious/postconcussion syndrome/normal). The original PAM was modeled on civilian data; the current study was undertaken using a database of 100 active-duty army service personnel who were referred for neuropsychological assessment in a military TBI clinic. The PAM classifications showed 90% overall accuracy when compared with clinicians' diagnoses. The PAM function is able to classify detailed neuropsychological profiles from a military population with a high degree of accuracy and is able to distinguish between TBI, PTSD, malingering/invalid data, or "other." PAM is a useful tool to help with clinical decision-making.

  9. Physics of shock tube simulated IED blast for mTBI research

    NARCIS (Netherlands)

    Mediavilla Varas, J.; Philippens, M.M.G.M.; Meijer, S.R.

    2010-01-01

    The objective of this research is to understand the blast propagation into the human skull and brain causing mTBI and use this knowledge for enabling design of effective protection measures against them. A shock tube including sensor system was optimized to simulate realistic IED blast profiles

  10. TBI server: a web server for predicting ion effects in RNA folding.

    Directory of Open Access Journals (Sweden)

    Yuhong Zhu

    Full Text Available Metal ions play a critical role in the stabilization of RNA structures. Therefore, accurate prediction of the ion effects in RNA folding can have a far-reaching impact on our understanding of RNA structure and function. Multivalent ions, especially Mg²⁺, are essential for RNA tertiary structure formation. These ions can possibly become strongly correlated in the close vicinity of RNA surface. Most of the currently available software packages, which have widespread success in predicting ion effects in biomolecular systems, however, do not explicitly account for the ion correlation effect. Therefore, it is important to develop a software package/web server for the prediction of ion electrostatics in RNA folding by including ion correlation effects.The TBI web server http://rna.physics.missouri.edu/tbi_index.html provides predictions for the total electrostatic free energy, the different free energy components, and the mean number and the most probable distributions of the bound ions. A novel feature of the TBI server is its ability to account for ion correlation and ion distribution fluctuation effects.By accounting for the ion correlation and fluctuation effects, the TBI server is a unique online tool for computing ion-mediated electrostatic properties for given RNA structures. The results can provide important data for in-depth analysis for ion effects in RNA folding including the ion-dependence of folding stability, ion uptake in the folding process, and the interplay between the different energetic components.

  11. Cognitive ability predicts motor learning on a virtual reality game in patients with TBI.

    Science.gov (United States)

    O'Neil, Rochelle L; Skeel, Reid L; Ustinova, Ksenia I

    2013-01-01

    Virtual reality games and simulations have been utilized successfully for motor rehabilitation of individuals with traumatic brain injury (TBI). Little is known, however, how TBI-related cognitive decline affects learning of motor tasks in virtual environments. To fill this gap, we examined learning within a virtual reality game involving various reaching motions in 14 patients with TBI and 15 healthy individuals with different cognitive abilities. All participants practiced ten 90-second gaming trials to assess various aspects of motor learning. Cognitive abilities were assessed with a battery of tests including measures of memory, executive functioning, and visuospatial ability. Overall, participants with TBI showed both reduced performance and a slower learning rate in the virtual reality game compared to healthy individuals. Numerous correlations between overall performance and several of the cognitive ability domains were revealed for both the patient and control groups, with the best predictor being overall cognitive ability. The results may provide a starting point for rehabilitation programs regarding which cognitive domains interact with motor learning.

  12. Neuronal damage and functional deficits are ameliorated by inhibition of aquaporin and HIF1α after traumatic brain injury (TBI).

    Science.gov (United States)

    Shenaq, Mohammed; Kassem, Hassan; Peng, Changya; Schafer, Steven; Ding, Jamie Y; Fredrickson, Vance; Guthikonda, Murali; Kreipke, Christian W; Rafols, José A; Ding, Yuchuan

    2012-12-15

    The present study, using a rodent model of closed-head diffuse traumatic brain injury (TBI), investigated the role of dysregulated aquaporins (AQP) 4 and 9, as well as hypoxia inducible factor -1α(HIF-1α) on brain edema formation, neuronal injury, and functional deficits. TBI was induced in adult (400-425 g), male Sprague-Dawley rats using a modified Marmarou's head impact-acceleration device (450 g weight dropped from 2m height). Animals in each treatment group were administered intravenous anti-AQP4 or -AQP9 antibodies or 2-Methoxyestradiol (2ME2, an inhibitor of HIF-1α) 30 min after injury. At 24h post-TBI, animals (n=6 each group) were sacrificed to examine the extent of brain edema by water content, as well as protein expression of AQP and HIF-1α by Western immune-blotting. At 48-hours post-TBI, neuronal injury (n=8 each group) was assessed by FluoroJade (FJ) histochemistry. Spatial learning and memory deficits were evaluated by radial arm maze (n=8 each group) up to 21 days post-TBI. Compared to non-injured controls, significant (pTBI was associated with increases (p TBI animals, AQP or HIF-1α inhibition significantly (pTBI. Taken together, the present data supports a causal relation between HIF-AQP mediated cerebral edema, secondary neuronal injury, and tertiary behavioral deficits post-TBI. The data further suggests that upstream modulation of the molecular patho-trajectory effectively ameliorates both neuronal injury and behavioral deficits post-TBI.

  13. Symptomatology and functional outcome in mild traumatic brain injury: results from the prospective TRACK-TBI study.

    Science.gov (United States)

    McMahon, Paul; Hricik, Allison; Yue, John K; Puccio, Ava M; Inoue, Tomoo; Lingsma, Hester F; Beers, Sue R; Gordon, Wayne A; Valadka, Alex B; Manley, Geoffrey T; Okonkwo, David O

    2014-01-01

    Mild Traumatic Brain Injury (mTBI), or concussion, is a major public health concern. There is controversy in the literature regarding the true incidence of postconcussion syndrome (PCS), with the constellation of physical, cognitive, emotional, and sleep symptoms after mTBI. In the current study, we report on the incidence and evolution of PCS symptoms and patient outcomes after mTBI at 3, 6, and 12 months in a large, prospective cohort of mTBI patients. Participants were identified as part of the prospective, multi-center Transforming Research and Clinical Knowledge in Traumatic Brain Injury Study. The study population was mTBI patients (Glasgow Coma Scale score of 13-15) presenting to the emergency department, including patients with a negative head computed tomography discharged to home without admission to hospital; 375 mTBI subjects were included in the analysis. At both 6 and 12 months after mTBI, 82% (n=250 of 305 and n=163 of 199, respectively) of patients reported at least one PCS symptom. Further, 44.5 and 40.3% of patients had significantly reduced Satisfaction With Life scores at 6 and 12 months, respectively. At 3 months after injury, 33% of the mTBI subjects were functionally impaired (Glasgow Outcome Scale-Extended score ≤6); 22.4% of the mTBI subjects available for follow-up were still below full functional status at 1 year after injury. The term "mild" continues to be a misnomer for this patient population and underscores the critical need for evolving classification strategies for TBI for targeted therapy.

  14. Greater neurobehavioral deficits occur in adult mice after repeated, as compared to single, mild traumatic brain injury (mTBI).

    Science.gov (United States)

    Nichols, Jessica N; Deshane, Alok S; Niedzielko, Tracy L; Smith, Cory D; Floyd, Candace L

    2016-02-01

    Mild traumatic brain injury (mTBI) accounts for the majority of all brain injuries and affected individuals typically experience some extent of cognitive and/or neuropsychiatric deficits. Given that repeated mTBIs often result in worsened prognosis, the cumulative effect of repeated mTBIs is an area of clinical concern and on-going pre-clinical research. Animal models are critical in elucidating the underlying mechanisms of single and repeated mTBI-associated deficits, but the neurobehavioral sequelae produced by these models have not been well characterized. Thus, we sought to evaluate the behavioral changes incurred after single and repeated mTBIs in mice utilizing a modified impact-acceleration model. Mice in the mTBI group received 1 impact while the repeated mTBI group received 3 impacts with an inter-injury interval of 24h. Classic behavior evaluations included the Morris water maze (MWM) to assess learning and memory, elevated plus maze (EPM) for anxiety, and forced swim test (FST) for depression/helplessness. Additionally, species-typical behaviors were evaluated with the marble-burying and nestlet shredding tests to determine motivation and apathy. Non-invasive vibration platforms were used to examine sleep patterns post-mTBI. We found that the repeated mTBI mice demonstrated deficits in MWM testing and poorer performance on species-typical behaviors. While neither single nor repeated mTBI affected behavior in the EPM or FST, sleep disturbances were observed after both single and repeated mTBI. Here, we conclude that behavioral alterations shown after repeated mTBI resemble several of the deficits or disturbances reported by patients, thus demonstrating the relevance of this murine model to study repeated mTBIs.

  15. Robust training attenuates TBI-induced deficits in reference and working memory on the radial 8-arm maze

    Directory of Open Access Journals (Sweden)

    Veronica eSebastian

    2013-05-01

    Full Text Available Globally, it is estimated that nearly 10 million people sustain severe brain injuries leading to hospitalization and/or death every year. Amongst survivors, traumatic brain injury (TBI results in a wide variety of physical, emotional and cognitive deficits. The most common cognitive deficit associated with TBI is memory loss, involving impairments in spatial reference and working memory. However, the majority of research thus far has characterized the deficits associated with TBI on either reference or working memory systems separately, without investigating how they interact within in a single task. Thus we examined the effects of TBI on short-term working and long-term reference memory using the radial 8-arm maze (RAM with a sequence of 4 baited and 4 unbaited arms. Subjects were given 10 daily trials for 6 days followed by a memory retrieval test two weeks after training. Multiple training trials not only provide robust training, but also test the subjects’ ability to frequently update short-term memory while learning the reference rules of the task. Our results show that TBI significantly impaired short-term working memory function on previously acquired spatial information but has little effect on long-term reference memory. Additionally, TBI significantly increased working memory errors during acquisition and reference memory errors during retention testing two weeks later. With a longer recovery period after TBI, the robust RAM training mitigated the reference memory deficit in retention but not the short-term working memory deficit during acquisition. These results identify the resiliency and vulnerabilities of short-term working and long-term reference memory to TBI in the context of robust training. The data highlight the role of cognitive training and other behavioral remediation strategies implicated in attenuating deficits associated with TBI.

  16. Fracture of a HTR-PMI cranioplastic implant after severe TBI.

    Science.gov (United States)

    López González, Antonio; Pérez Borredá, Pedro; Conde Sardón, Rebeca

    2015-02-01

    A 13-year-old girl with a large left fronto-parietal hard-tissue replacement patient-matched implant (HTR®-PMI) cranioplasty-since she suffered from a traumatic brain injury (TBI) 6 years ago-had a new severe TBI that detached and fractured the implant as well as caused a left subdural hematoma and a large frontal contusion. The hematoma and contusion were removed and the implant was substituted by a provisional titanium mesh. To the best of our knowledge, this is the first case reported about an HTR®-PMI fracture. It is theorized that the bone ingrowth into the macroporous implants, like those of hydroxyapatite, gives strength and resistance to the implant. But in the case we describe, no macroscopic bone ingrowth was detected 6 years after implantation and the traumatic force that impacted over the cranioplasty exceeded its properties.

  17. The ESPARR cohort: the future of the serious injured aged 16 years and over (MAIS3=) with a traumatic brain injury (TBI) three years after the crash.

    OpenAIRE

    Tournier, Charlène; CHARNAY, Pierrette; LUAUTE, Jacques; Hours, Martine

    2014-01-01

    Introduction Few longitudinal studies investigated the long-term future of road accident victims. The ESPARR cohort has been followed for five years after the crash occurred. Objective To study the future of serious injured with TBI three years after their road accident. Methods The ESPARR cohort comprises 324 serious injured including 72 mild TBI (AIS2) and 70 moderate/severe TBI (AIS3+). 51 TBI2 and 49 TBI3+ responded to the questionnaire at three years. They are compared to 131 serious in...

  18. Development of Posiphen, an Inhibitor of Phosphorylated Tau Expression, as a Treatment of TBI

    Science.gov (United States)

    2015-09-01

    cognitive deficits in the Y maze alternation, the novel object recognition task and the Morris water maze. A 4 weeks treatment with Posiphen (2.5, 5, and...Posiphen mitigated neurodegenerative consequences of mild TBI on the nigrostriatal pathway, which is affected in Parkinson’s disease, without improving ...showed diarrhea and bloody stools in the course of the study. At autopsy the animals injected with the highest doses (40 and 50 mg/kg Posiphen) for 21

  19. Cavitation Induced Structural and Neural Damage in Live Brain Tissue Slices: Relevance to TBI

    Science.gov (United States)

    2014-09-29

    the value of this experimental platform to investigate the single bubble cavitation- induced damage in a biological tissue is illustrated with an...Lei Wu, Malisa Sarntinoranont, Huikai Xie1. Refractive index measurement of acute rat brain tissue slices using optical coherence tomography, Optics...b-TBI, i.e. what is “broken”, in the brain during exposure to shock loading is currently unknown. While blast waves are well known to have negative

  20. The Separate and Cumulative Effects of TBI and PTSD on Cognitive Function and Emotional Control

    Science.gov (United States)

    2010-04-01

    sustained a traumatic brain injury ( TBI ) can show impairments in behavioral and cognitive control and increases in impulsivity. In addition, many... Traumatic Stress Disorder and Traumatic Brain Injury . Military Health Research Forum, Kansas City. 11 August 18, 2009: Neurobehavioral Brown Bag...veterans with post- traumatic stress disorder and mild traumatic brain injury . Related Publication - This work was funded by the PI’s VA Merit grant and

  1. Mechanism and Therapy for the Shared Susceptibility to Migraine and Epilepsy after Brain Injury (TBI)

    Science.gov (United States)

    2015-12-01

    headache, post-traumatic epilepsy, migraine, epilepsy. 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF...the stage for epilepsy or chronic migraine Major Task 1. Acute/subacute experiments after controlled cortical impact (CCI) TBI (Brennan, Dudek...mice9 to compare with our wild type animals. A mutation in CK1d was identified in two families having sleep phase syndrome and typical migraine with

  2. Neural Markers and Rehabilitation of Executive Functioning in Veterans with TBI and PTSD

    Science.gov (United States)

    2016-10-01

    multiple domains of living and reduce emotional dysregulation and disinhibition associated with the co-occurring disorders . 15 Specific...Posttraumatic Stress Disorder (PTSD). TBI and PTSD are both characterized by deficits in multiple cognitive domains, including attention, executive function...provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently

  3. Integrated Eye Tracking and Neural Monitoring for Enhanced Assessment of Mild TBI

    Science.gov (United States)

    2017-06-01

    Data analysis for USU primary study continues. Despite administrative and technical delays during Year 4, MRI data collection was initiated during...include saccadic latency, saccadic duration, saccadic reaction time, manual reaction time, pupillary response, and several EEG/ERP components. At the end...behavioral ( manual and saccadic) performance and psychophysiological responses (EEG/ERP and pupillometry) between-groups (Controls, Mild TBI, and

  4. Blue and Red Light-Evoked Pupil Responses in Photophobic Subjects with TBI.

    Science.gov (United States)

    Yuhas, Phillip T; Shorter, Patrick D; McDaniel, Catherine E; Earley, Michael J; Hartwick, Andrew T E

    2017-01-01

    Photophobia is a common symptom in individuals suffering from traumatic brain injury (TBI). Recent evidence has implicated blue light-sensitive intrinsically photosensitive retinal ganglion cells (ipRGCs) in contributing to the neural circuitry mediating photophobia in migraine sufferers. The goal of this work is to test the hypothesis that ipRGC function is altered in TBI patients with photophobia by assessing pupillary responses to blue and red light. Twenty-four case participants (mean age 43.3; 58% female), with mild TBI and self-reported photophobia, and 12 control participants (mean age 42.6; 58% female) were in this study. After 10 minutes of dark adaptation, blue (470 nm, 1 × 10 phots/s/cm) and red (625 nm, 7 × 10 phots/s/cm) flashing (0.1 Hz) light stimuli were delivered for 30 seconds to the dilated left eye while the right pupil was recorded. The amplitude of normalized pupil fluctuation (constriction and dilation) was quantified using Fourier fast transforms. In both case and control participants, the amplitude of pupil fluctuation was significantly less for the blue light stimuli as compared to the red light stimuli, consistent with a contribution of ipRGCs to these pupil responses. There was no significant difference in the mean pupil fluctuation amplitudes between the two participant groups, but case participants displayed greater variability in their pupil responses to the blue stimulus. Case and control participants showed robust ipRGC-mediated components in their pupil responses to blue light. The results did not support the hypothesis that ipRGCs are "hypersensitive" to light in TBI participants with photophobia. However, greater pupil response variability in the case subjects suggests that ipRGC function may be more heterogeneous in this group.

  5. Neural Markers and Rehabilitation of Executive Functioning in Veterans with TBI and PTSD

    Science.gov (United States)

    2015-10-01

    retention of motor function.  Timeline. This paper was published in the Journal of Head Trauma Rehabilitation last year, it is attached to this...the neurobiology and neuropsychology associated with an evidence-based cognitive rehabilitation intervention will allow us to identify Veterans with...both TBI and PTSD who are predisposed to positive treatment outcomes. To our knowledge, this will be the first attempt to integrate neurobiological

  6. Primary Blast Injury Criteria for Animal/Human TBI Models using Field Validated Shock Tubes

    Science.gov (United States)

    2016-09-01

    differential equations for the conservation of momentum, mass and energy along with the material constitutive equations and the equations defining the initial...BOP. Using logistic regression model, predicted mortality rate (PMR) function was calculated, and used to establish TBI severities. We determined a...helped identify loading pathways through which blast overpressure ‘leaks’ into the brain leading to differential loading of the tissue in various

  7. Neuromodulation and Neurorehabilitation for Treatment of Functional Deficits after mTBI plus PTSD

    Science.gov (United States)

    2016-10-01

    PRINCIPAL INVESTIGATOR: Theresa Pape, DrPH CONTRACTING ORGANIZATION: Chicago Association for Research and Education in Science Hines, IL 60141 REPORT...TBI. Specific Aims: Aim I will determine presence, direction and sustainability of rTMS-induced neurobehavioral effects measured with the Disability...Rating Scale. Aim II will determine the presence, direction and sustainability of rTMS- induced changes in functional neural activation and whether or

  8. Pressure Autoregulation Measurement Techniques in Adult TBI, Part II: A Scoping Review of Continuous Methods.

    Science.gov (United States)

    Zeiler, Frederick Adam; Donnelly, Joseph; Calviello, Leanne; Smieleweski, Peter; Menon, David; Czosnyka, Marek

    2017-07-12

    To perform systematically a scoping review of the literature on commonly described continuous autoregulation measurement techniques in adult TBI. The goal was to provide an overview of methodology and comprehensive reference library of the available literature for each technique. Five separate small systematic reviews were conducted for each of the continuous techniques: pressure reactivity index (PRx), laser Doppler flowmetry (LDF), near infrared spectroscopy (NIRS) techniques, brain tissue oxygen tension (PbtO2), and thermal diffusion (TD) techniques. Articles from MEDLINE, BIOSIS, EMBASE, Global Health, Scopus, Cochrane Library (inception to December 2016) and reference lists of relevant articles were searched. A two-tier filter of references was conducted. The literature base identified from the individual searches was limited, except for PRx. The total number of articles utilizing each of the 5 searched techniques for continuous autoregulation in adult TBI were: PRx (28), LDF (4), NIRS (9), PbtO2 (10), and TD (8). All continuous techniques described in adult TBI are based on moving correlation coefficients. The premise behind the calculation of these moving correlation coefficients focuses on the impact of slow fluctuations in either MAP or CPP on some indirect measure of CBF, such as: intracranial pressure (ICP), LDF, NIRS signals, PbtO2 or TD CBF. The thought is the correlation between a hemodynamic driving factor, such as MAP or CPP, and a surrogate for CBF or cerebral perfusion sheds insight on the state of cerebral autoregulation. Both PRx and NIRS indices were validated experimentally against 'golden standard' static autoregulatory curve (Lassen curve) at least around lower threshold of autoregulation. PRx has the largest literature base supporting the association with patient outcome. Various methods of continuous autoregulation assessment are described within the adult TBI literature. Many studies exist on these various indices, suggesting an

  9. SU-E-T-485: In Vivo Dosimetry with EBT3 Radiochromic Films for TBI Treatments

    Energy Technology Data Exchange (ETDEWEB)

    Lozares, S; Gracia, M; Olasolo, J; Gallardo, N; Fuentemilla, N; Pellejero, S; Miquelez, S; Maneru, F; Martin, M; Bragado, L; Rubio, A [Complejo Hospitalario de Navarra, Pamplona, Navarra (Spain)

    2015-06-15

    Purpose: Total body irradiation (TBI) is a technique that requires special equipment to control “in vivo” the dose to the patient because it is a complex technique performed in extraordinary conditions. There are several devices to perform this task (diodes, TLDs, ionization chambers, MOSFET). In this paper we study the possibility of performing these measurements with radiochromic films EBT3 properly calibrated. This method has been compared to the PTW diodes system for TBI. Methods: Once made the TC to the patients, we measured different thicknesses of the relevant areas of the body (head, neck, chest with or without arms, umbilicus area, knees and ankles); for each of these thicknesses we measured dose rate (cGy / UM) in RW3 phantom, in TBI conditions, with ionization chamber in the center; in turn, the input diode and the output of each configuration is placed to assign dose to each set of diodes. Movie calibration is performed according to manufacturer’s recommendations but TBI conditions. The dose at the center of each thickness compared to a linear interpolation of the dose at the entrance and exit, resulting in an adequate approximation. Finally in each session for each patient put a piece of film (2×2 cm2) at the entrance and another at the exit in each area, obtaining these readings and interpolating the estimated center dose, as with the diodes. Results: These results show a greater homogeneity in the distribution for use with film and validate the use of the same for this task and, if necessary, to avoid purchasing diode group if they have not. Conclusion: By using radiochromic films for this technique gives us a proper calculation of the dose received by the patient in the absence of other methods, or gives us a second additional track that already used normally.

  10. Retrospective Study: Sleep, Mental Disorders, and TBI in Deployed Military Members

    Science.gov (United States)

    2014-12-06

    Wilk, J. E., Thomas, J. L., McGurk, D. M., Riviere, L. A., Castro, C. A., & Hoge, C. W. (2010). Mild traumatic brain injury ( concussion ) during...multiple cells . Comorbid substance use and adjustment disorders occurred the most frequently (18.2%), followed by substance use and mood disorders (16.3...sleep disorders had more comorbid anxiety disorders. Traumatic Brain Injury The first identified TBI diagnosis for each participant was used

  11. Toward Development of a Field-Deployable Imaging Device for TBI

    Science.gov (United States)

    2015-06-01

    for many years to detect tissue stiffness and is growing in importance for breast cancer diagnoses.5 One elastographic method evaluates tissue stiffness ...treatment of prostate cancer [12]. An advantage to Vibro-acoustic images is that they do not exhibit the speckle noise traditionally associated with B-mode...reasons it is reasonable to expect that changes in the stiffness of brain accompany TBI, and that ultrasound-based ‘sonoelastic’ imaging modalities

  12. The Expression of NP847 and Sox2 after TBI and Its Influence on NSCs

    Science.gov (United States)

    Gu, Jun; Bao, Yifeng; Chen, Jian; Huang, Chuanjun; Zhang, Xinghua; Jiang, Rui; Liu, Qianqian; Liu, Yonghua; Xu, Xide; Shi, Wei

    2016-01-01

    The proliferation and differentiation of neural stem cells (NSCs) is important for neural regeneration after cerebral injury. Here, for the first time, we show that phosphorylated (p)-ser847-nNOS (NP847), rather than nNOS, may play a major role in NSC proliferation after traumatic brain injury (TBI). Western blot results demonstrated that the expression of NP847 and Sox2 in the hippocampus is up-regulated after TBI, and they both peak 3 days after brain injury. In addition, an immunofluorescence experiment indicated that NP847 and Sox2 partly co-localize in the nuclei of NSCs after TBI. Further immunoprecipitation experiments found that NP847 and Sox2 can directly interact with each other in NSCs. Moreover, in an OGD model of NSCs, NP847 expression is decreased, which is followed by the down-regulation of Sox2. Interestingly, in this study, we did not observe changes in the expression of nNOS in the OGD model. Further research data suggest that the NP847-Sox2 complex may play a major role in NSCs through the Shh/Gli signaling pathway in a CaMKII-dependent manner after brain injury. PMID:28066182

  13. [New three-dimensional compensating filter for TBI using compu-former associated with RT LAN].

    Science.gov (United States)

    Fujiwara, Masayuki; Kamikonya, Norihiko; Tsuboi, Keita; Irie, Miwa; Misawa, Mahito; Hara, Hiroshi; Kai, Syunrou; Nakao, Norio

    2003-09-01

    To shorten the TBI process, we developed a new device for making the three-dimensional (3D) compensating filter that improves dose distribution. The dose distributions in the phantom and manufacturing time were compared between the new device and the previous one. Clinical evaluations included dose distribution in patients and the clinical rate of interstitial pneumonitis (IP). Our 3D compensating filter is made of polystyrene resin and gypsum. The filter was made after performing two procedures as follows. Patient data were measured by CT, and the 3D dose-distribution data and 3D compensating-filter data were obtained from the CT data by the 3D radiation planning system. We were able to produce the new 3D compensating filter within about 4 hours, including all procedures. The average dose distribution to each site when the 3D compensating filter was used was 92.7% to the head, 102.1% to the thorax, 106.4% to the pelvis, 90.2% to the knee, and 93.8% to the ankle joint, when the scheduled dose was taken as 100%. Dose distribution was improved. IP occurred in 6 of 32 patients (18.8%). There was no significant difference between the TBI and non-TBI groups in the frequency of IP (p = 0.27).

  14. Measuring executive function in control subjects and TBI patients with question completion time (QCT

    Directory of Open Access Journals (Sweden)

    David L Woods

    2015-05-01

    Full Text Available Questionnaire completion is a complex task that places demands on cognitive functions subserving reading, introspective memory, decision-making, and motor control. Although computerized questionnaires and surveys are used with increasing frequency in clinical practice, few studies have examined question completion time (QCT, the time required to complete each question. Here, we analyzed QCTs in 172 control subjects and 31 patients with traumatic brain injury (TBI who completed two computerized questionnaires, the 17-question Post-Traumatic Stress Disorder (PTSD Checklist (PCL and the 25-question Cognitive Failures Questionnaire (CFQ. In control subjects, robust correlations were found between self-paced QCTs on the PCL and CFQ (r = 0.82. QCTs on individual questions correlated strongly with the number of words in the question, indicating the critical role of reading speed. QCTs increased significantly with age, and were reduced in females and in subjects with increased education and computer experience. QCT z-scores, corrected for age, education, computer use, and sex, correlated more strongly with each other than with the results of other cognitive tests. Patients with a history of severe TBI showed significantly delayed QCTs, but QCTs fell within the normal range in patients with a history of mild TBI. When questionnaires are used to gather relevant patient information, simultaneous QCT measures provide reliable and clinically sensitive measures of processing speed and executive function.

  15. Mathematical models of blast induced TBI: current status, challenges and prospects

    Directory of Open Access Journals (Sweden)

    Raj K Gupta

    2013-05-01

    Full Text Available Blast induced traumatic brain injury (TBI has become a signature wound of recent military activities and is the leading cause of death and long-term disability among U.S. soldiers. The current limited understanding of brain injury mechanisms impedes the development of protection, diagnostic and treatment strategies. We believe mathematical models of blast wave brain injury biomechanics and neurobiology, complemented with in vitro and in vivo experimental studies, will enable a better understanding of injury mechanisms and accelerate the development of both protective and treatment strategies. The goal of this paper is to review the current state of the art in mathematical and computational modeling of blast induced TBI, identify research gaps and recommend future developments. A brief overview of blast wave physics, injury biomechanics and the neurobiology of brain injury is used as a foundation for a more detailed discussion of multiscale mathematical models of primary biomechanics and secondary injury and repair mechanisms. The paper also presents a discussion of model development strategies, experimental approaches to generate benchmark data for model validation and potential applications of the model for prevention and protection against blast wave TBI.

  16. An examination of the Wechsler Adult Intelligence Scales, Fourth Edition (WAIS-IV) in individuals with complicated mild, moderate and Severe traumatic brain injury (TBI).

    Science.gov (United States)

    Carlozzi, Noelle E; Kirsch, Ned L; Kisala, Pamela A; Tulsky, David S

    2015-01-01

    This study examined the clinical utility of the Wechsler Adult Intelligence Scales-Fourth Edition (WAIS-IV) in individuals with complicated mild, moderate or severe TBI. One hundred individuals with TBI (n = 35 complicated mild or moderate TBI; n = 65 severe TBI) and 100 control participants matched on key demographic variables from the WAIS-IV normative dataset completed the WAIS-IV. Univariate analyses indicated that participants with severe TBI had poorer performance than matched controls on all index scores and subtests (except Matrix Reasoning). Individuals with complicated mild/moderate TBI performed more poorly than controls on the Working Memory Index (WMI), Processing Speed Index (PSI), and Full Scale IQ (FSIQ), and on four subtests: the two processing speed subtests (SS, CD), two working memory subtests (AR, LN), and a perceptual reasoning subtest (BD). Participants with severe TBI had significantly lower scores than the complicated mild/moderate TBI on PSI, and on three subtests: the two processing speed subtests (SS and CD), and the new visual puzzles test. Effect sizes for index and subtest scores were generally small-to-moderate for the group with complicated mild/moderate and moderate-to-large for the group with severe TBI. PSI also showed good sensitivity and specificity for classifying individuals with severe TBI versus controls. Findings provide support for the clinical utility of the WAIS-IV in individuals with complicated mild, moderate, and severe TBI.

  17. The Effects of Lactobacillus acidophilus on the Intestinal Smooth Muscle Contraction through PKC/MLCK/MLC Signaling Pathway in TBI Mouse Model.

    Directory of Open Access Journals (Sweden)

    Bo Sun

    Full Text Available Clinical studies have shown that probiotics influence gastrointestinal motility. However, the molecular mechanisms by which probiotic Lactobacillus modulates intestinal motility in traumatic brain injury (TBI mouse model have not been explored. In the present study, we provided evidence showing that treatment of TBI mice with Lactobacillus acidophilus significantly improved the terminal ileum villus morphology, restored the impaired interstitial cells of Cajal (ICC and the disrupted ICC networks after TBI, and prevented TBI-mediated inhibition of contractile activity in intestinal smooth muscle. Mechanistically, the decreased concentration of MLCK, phospho-MLC20 and phospho-MYPT1 and increased concentration of MLCP and PKC were observed after TBI, and these events mediated by TBI were efficiently prevented by Lactobacillus acidophilus application. These findings may provide a novel mechanistic basis for the application of Lactobacillus acidophilus in the treatment of TBI.

  18. The Effects of Lactobacillus acidophilus on the Intestinal Smooth Muscle Contraction through PKC/MLCK/MLC Signaling Pathway in TBI Mouse Model.

    Science.gov (United States)

    Sun, Bo; Hu, Chen; Fang, Huan; Zhu, Lina; Gao, Ning; Zhu, Jingci

    2015-01-01

    Clinical studies have shown that probiotics influence gastrointestinal motility. However, the molecular mechanisms by which probiotic Lactobacillus modulates intestinal motility in traumatic brain injury (TBI) mouse model have not been explored. In the present study, we provided evidence showing that treatment of TBI mice with Lactobacillus acidophilus significantly improved the terminal ileum villus morphology, restored the impaired interstitial cells of Cajal (ICC) and the disrupted ICC networks after TBI, and prevented TBI-mediated inhibition of contractile activity in intestinal smooth muscle. Mechanistically, the decreased concentration of MLCK, phospho-MLC20 and phospho-MYPT1 and increased concentration of MLCP and PKC were observed after TBI, and these events mediated by TBI were efficiently prevented by Lactobacillus acidophilus application. These findings may provide a novel mechanistic basis for the application of Lactobacillus acidophilus in the treatment of TBI.

  19. Collaborative European Neuro Trauma Effectiveness Research in traumatic brain injury (CENTER-TBI) : a prospective longitudinal observational study

    NARCIS (Netherlands)

    van der Naalt, Joukje; Maas, Alex; Menon, David K; Steyerberg, E.W.; Citerio, Giuseppe; Lecky, F.; Manley, G.T.; Hill, S; Legrand, Victor; Sorgner, A.

    BACKGROUND: Current classification of traumatic brain injury (TBI) is suboptimal, and management is based on weak evidence, with little attempt to personalize treatment. A need exists for new precision medicine and stratified management approaches that incorporate emerging technologies. OBJECTIVE:

  20. Rates of TBI-related Emergency Department Visits, Hospitalizations, and Deaths — United States, 2001–2010

    Data.gov (United States)

    U.S. Department of Health & Human Services — In general, total combined rates for traumatic brain injury (TBI)-related emergency department (ED) visits, hospitalizations and deaths have increased over the past...

  1. Efficiency of high-dose cytarabine added to CY/TBI in cord blood transplantation for myeloid malignancy.

    Science.gov (United States)

    Arai, Yasuyuki; Takeda, June; Aoki, Kazunari; Kondo, Tadakazu; Takahashi, Satoshi; Onishi, Yasushi; Ozawa, Yukiyasu; Aotsuka, Nobuyuki; Kouzai, Yasuji; Nakamae, Hirohisa; Ota, Shuichi; Nakaseko, Chiaki; Yamaguchi, Hiroki; Kato, Koji; Atsuta, Yoshiko; Takami, Akiyoshi

    2015-07-16

    Cord blood transplantation (CBT) is an effective therapeutic option for adults with acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS) after the conventional cyclophosphamide and total body irradiation (CY/TBI) regimen, but posttransplant relapse is still of high importance. High-dose cytarabine (HDCA) can be added to CY/TBI for an intensified regimen; however, its additional effects have not yet been completely elucidated. Therefore, we conducted a cohort study to compare the prognosis of HDCA/CY/TBI (n = 617) and CY/TBI (n = 312) in CBT for AML/MDS, using a Japanese transplant registry database. The median age was 40 years, and 86.2% of the patients had AML; high-risk disease was observed in 56.2% of the patients. The median follow-up period after CBT was approximately 3.5 years. Overall survival was significantly superior in the HDCA/CY/TBI group (adjusted hazard ratio [HR], 0.56; 95% confidence interval [CI], 0.45-0.69; P TBI group (HR, 1.33 and 2.30, respectively), but not grade III to IV aGVHD. Incidence of infectious episodes showed no significant difference. Nonrelapse mortality was not increased by the addition of HDCA. Higher-dose CA (12 rather than 8 g/m(2)) was more effective, particularly in patients at high-risk for disease. This study is the first to show the superiority of HDCA/CY/TBI to CY/TBI in CBT for AML/MDS. A large-scale prospective study is warranted to establish new conditioning regimens including HDCA administration.

  2. 'Hit & Run' model of closed-skull traumatic brain injury (TBI) reveals complex patterns of post-traumatic AQP4 dysregulation.

    Science.gov (United States)

    Ren, Zeguang; Iliff, Jeffrey J; Yang, Lijun; Yang, Jiankai; Chen, Xiaolin; Chen, Michael J; Giese, Rebecca N; Wang, Baozhi; Shi, Xuefang; Nedergaard, Maiken

    2013-06-01

    Cerebral edema is a major contributor to morbidity associated with traumatic brain injury (TBI). The methods involved in most rodent models of TBI, including head fixation, opening of the skull, and prolonged anesthesia, likely alter TBI development and reduce secondary injury. We report the development of a closed-skull model of murine TBI, which minimizes time of anesthesia, allows the monitoring of intracranial pressure (ICP), and can be modulated to produce mild and moderate grade TBI. In this model, we characterized changes in aquaporin-4 (AQP4) expression and localization after mild and moderate TBI. We found that global AQP4 expression after TBI was generally increased; however, analysis of AQP4 localization revealed that the most prominent effect of TBI on AQP4 was the loss of polarized localization at endfoot processes of reactive astrocytes. This AQP4 dysregulation peaked at 7 days after injury and was largely indistinguishable between mild and moderate grade TBI for the first 2 weeks after injury. Within the same model, blood-brain barrieranalysis of variance permeability, cerebral edema, and ICP largely normalized within 7 days after moderate TBI. These findings suggest that changes in AQP4 expression and localization may not contribute to cerebral edema formation, but rather may represent a compensatory mechanism to facilitate its resolution.

  3. Disconnection and hyper-connectivity underlie reorganization after TBI: A rodent functional connectomic analysis.

    Science.gov (United States)

    Harris, N G; Verley, D R; Gutman, B A; Thompson, P M; Yeh, H J; Brown, J A

    2016-03-01

    While past neuroimaging methods have contributed greatly to our understanding of brain function after traumatic brain injury (TBI), resting state functional MRI (rsfMRI) connectivity methods have more recently provided a far more unbiased approach with which to monitor brain circuitry compared to task-based approaches. However, current knowledge on the physiologic underpinnings of the correlated blood oxygen level dependent signal, and how changes in functional connectivity relate to reorganizational processes that occur following injury is limited. The degree and extent of this relationship remain to be determined in order that rsfMRI methods can be fully adapted for determining the optimal timing and type of rehabilitative interventions that can be used post-TBI to achieve the best outcome. Very few rsfMRI studies exist after experimental TBI and therefore we chose to acquire rsfMRI data before and at 7, 14 and 28 days after experimental TBI using a well-known, clinically-relevant, unilateral controlled cortical impact injury (CCI) adult rat model of TBI. This model was chosen since it has widespread axonal injury, a well-defined time-course of reorganization including spine, dendrite, axonal and cortical map changes, as well as spontaneous recovery of sensorimotor function by 28 d post-injury from which to interpret alterations in functional connectivity. Data were co-registered to a parcellated rat template to generate adjacency matrices for network analysis by graph theory. Making no assumptions about direction of change, we used two-tailed statistical analysis over multiple brain regions in a data-driven approach to access global and regional changes in network topology in order to assess brain connectivity in an unbiased way. Our main hypothesis was that deficits in functional connectivity would become apparent in regions known to be structurally altered or deficient in axonal connectivity in this model. The data show the loss of functional connectivity

  4. Longitudinal outcome and recovery of social problems after pediatric traumatic brain injury (TBI): Contribution of brain insult and family environment.

    Science.gov (United States)

    Ryan, Nicholas P; van Bijnen, Loeka; Catroppa, Cathy; Beauchamp, Miriam H; Crossley, Louise; Hearps, Stephen; Anderson, Vicki

    2016-04-01

    Pediatric traumatic brain injury (TBI) can result in a range of social impairments, however longitudinal recovery is not well characterized, and clinicians are poorly equipped to identify children at risk for persisting difficulties. Using a longitudinal prospective design, this study aimed to evaluate the contribution of injury and non-injury related risk and resilience factors to longitudinal outcome and recovery of social problems from 12- to 24-months post-TBI. 78 children with TBI (injury age: 5.0-15.0 years) and 40 age and gender-matched typically developing (TD) children underwent magnetic resonance imaging including a susceptibility-weighted imaging (SWI) sequence 2-8 weeks post-injury (M=39.25, SD=27.64 days). At 12 and 24-months post- injury, parents completed questionnaires rating their child's social functioning, and environmental factors including socioeconomic status, caregiver mental health and family functioning. Results revealed that longitudinal recovery profiles differed as a function of injury severity, such that among children with severe TBI, social problems significantly increased from 12- to 24-months post-injury, and were found to be significantly worse than TD controls and children with mild and moderate TBI. In contrast, children with mild and moderate injuries showed few problems at 12-months post-injury and little change over time. Pre-injury environment and SWI did not significantly contribute to outcome at 24-months, however concurrent caregiver mental health and family functioning explained a large and significant proportion of variance in these outcomes. Overall, this study shows that longitudinal recovery profiles differ as a function of injury severity, with evidence for late-emerging social problems among children with severe TBI. Poorer long-term social outcomes were associated with family dysfunction and poorer caregiver mental health at 24-months post injury, suggesting that efforts to optimize the child's environment and

  5. Primary blast causes mild, moderate, severe and lethal TBI with increasing blast overpressures: Experimental rat injury model

    Science.gov (United States)

    Mishra, Vikas; Skotak, Maciej; Schuetz, Heather; Heller, Abi; Haorah, James; Chandra, Namas

    2016-06-01

    Injury severity in blast induced Traumatic Brain Injury (bTBI) increases with blast overpressure (BOP) and impulse in dose-dependent manner. Pure primary blast waves were simulated in compressed gas shock-tubes in discrete increments. Present work demonstrates 24 hour survival of rats in 0–450 kPa (0–800 Pa•s impulse) range at 10 discrete levels (60, 100, 130, 160, 190, 230, 250, 290, 350 and 420 kPa) and determines the mortality rate as a non-linear function of BOP. Using logistic regression model, predicted mortality rate (PMR) function was calculated, and used to establish TBI severities. We determined a BOP of 145 kPa as upper mild TBI threshold (5% PMR). Also we determined 146–220 kPa and 221–290 kPa levels as moderate and severe TBI based on 35%, and 70% PMR, respectively, while BOP above 290 kPa is lethal. Since there are no standards for animal bTBI injury severity, these thresholds need further refinements using histopathology, immunohistochemistry and behavior. Further, we specifically investigated mild TBI range (0–145 kPa) using physiological (heart rate), pathological (lung injury), immuno-histochemical (oxidative/nitrosative and blood-brain barrier markers) as well as blood borne biomarkers. With these additional data, we conclude that mild bTBI occurs in rats when the BOP is in the range of 85–145 kPa.

  6. Acute upregulation of neuronal mitochondrial type-1 cannabinoid receptor and it's role in metabolic defects and neuronal apoptosis after TBI.

    Science.gov (United States)

    Xu, Zhen; Lv, Xiao-Ai; Dai, Qun; Ge, Yu-Qing; Xu, Jie

    2016-08-02

    Metabolic defects and neuronal apoptosis initiated by traumatic brain injury (TBI) contribute to subsequent neurodegeneration. They are all regulated by mechanisms centered around mitochondrion. Type-1 cannabinoid receptor (CB1) is a G-protein coupled receptor (GPCR) enriched on neuronal plasma membrane. Recent evidences point to the substantial presence of CB1 receptors on neuronal mitochondrial outer membranes (mtCB1) and the activation of mtCB1 influences aerobic respiration via inhibiting mitochondrial cyclic adenosine monophosphate (cAMP)/protein kinase A (PKA)/complex I pathway. The expression and role of neuronal mtCB1 under TBI are unknown. Using TBI models of cultured neurons, wild type and CB1 knockout mice, we found mtCB1 quickly upregulated after TBI. Activation of mtCB1 promoted metabolic defects accompanied with ATP shortage but protected neurons from apoptosis. Selective activation of plasma membrane CB1 showed no effects on neuronal metabolism and apoptosis. Activation of mtCB1 receptors inhibited mitochondrial cAMP/PKA/complex I and resulted in exacerbated metabolic defects accompanied with a higher ratio of ATP reduction to oxygen consumption decrease as well as neuronal apoptosis. Further research found the remarkable accumulation of protein kinase B (AKT) on neuronal mitochondria following TBI and the activation of mtCB1 upregulated mitochondrial AKT/complex V activity. Upregulation of mitochondrial AKT/complex V activity showed anti-apoptosis effects and alleviated ATP shortage in metabolic defects. Taken together, we have identified mtCB1 quickly upregulate after TBI and a dual role the mtCB1 might play in metabolic defects and neuronal apoptosis initiated by TBI: the inhibition of mitochondrial cAMP/PKA/complex I aggravates metabolic defects, energy insufficiency as well as neuronal apoptosis, but the coactivation of mitochondrial AKT/complex V mitigates energy insufficiency and neuronal apoptosis.

  7. Effect Size as the Essential Statistic in Developing Methods for mTBI Diagnosis.

    Science.gov (United States)

    Gibson, Douglas Brandt

    2015-01-01

    The descriptive statistic known as "effect size" measures the distinguishability of two sets of data. Distingishability is at the core of diagnosis. This article is intended to point out the importance of effect size in the development of effective diagnostics for mild traumatic brain injury and to point out the applicability of the effect size statistic in comparing diagnostic efficiency across the main proposed TBI diagnostic methods: psychological, physiological, biochemical, and radiologic. Comparing diagnostic approaches is difficult because different researcher in different fields have different approaches to measuring efficacy. Converting diverse measures to effect sizes, as is done in meta-analysis, is a relatively easy way to make studies comparable.

  8. Consultation Dilemma Catatonia in a Patient with Prior TBI: MentaI or Medical Disorder?

    Science.gov (United States)

    Khalafian, Andrey; Dukes, Charles; Tucker, Phebe

    2015-08-01

    Mr. R, a 27 year old Hispanic male with history of traumatic brain injury (TBI) over ten years prior but no psychiatric history, presents to the psychiatric consultation service with recent onset of mutism, psychotic behavior and new diagnosis of epilepsy. The differential diagnosis is broad and includes both medical and psychiatric causes: post-ictal state, non-convulsive status epilepticus, delirium due to metabolic conditions, drugs, catatonia, conversion disorder, major depression with psychotic features, new onset schizophrenia or a combination of these possible diagnoses. We explore different medical causes that can present with symptoms of catatonia, as it is crucial to rule out a possible treatable medical cause.

  9. Deficits in comprehension of speech acts after TBI: The role of theory of mind and executive function.

    Science.gov (United States)

    Honan, Cynthia A; McDonald, Skye; Gowland, Alison; Fisher, Alana; Randall, Rebekah K

    2015-11-01

    Theory of mind (ToM) is critical to effective communication following traumatic brain injury (TBI) however, whether impairments are specific to social cognition, or reflective of executive demands is unclear. This study examined whether ToM impairments are predicted by executive function difficulties using everyday conversation tasks. Twenty-five individuals with severe-TBI were compared to 25 healthy controls on low- and high-ToM tasks across four conditions: (1) low cognitive load, (2) high flexibility, (3) high working memory (WM) and (4) high inhibition. TBI individuals were impaired on high-ToM tasks in the WM condition. When the WM demands of the task were controlled, the impairments were no longer apparent. TBI individuals were not impaired on high-ToM tasks in the inhibition and flexibility conditions, suggesting these tasks may not have been sufficiently demanding of ToM abilities. The results suggest that ToM impairments in everyday communication may arise due to WM demands, in individuals with TBI. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. TBI during BM and SCT: review of the past, discussion of the present and consideration of future directions.

    Science.gov (United States)

    Hill-Kayser, C E; Plastaras, J P; Tochner, Z; Glatstein, E

    2011-04-01

    TBI has been used widely in the setting of BMT over the past 3 decades. Early research demonstrated feasibility and efficacy in the myeloablative setting, in preparation first for allogenic BMT and later for autologous stem cell rescue. As experience with TBI increased, its dual roles of myeloablation and immunosuppression came to be recognized. Toxicity associated with myeloablative TBI remains significant, and this treatment is generally reserved for younger patients with excellent performance status. Reduced intensity conditioning regimens may be useful to provide immunosuppression for patients who are not candidates for myeloablative treatment. Efforts to reduce toxicity through protection of normal tissue using methods of normal tissue blocking and use of TLI, rather than TBI, continue. In the future, modalities such as helical tomotherapy, proton radiotherapy and radioimmunotherapy, may have roles in delivery of radiation to the BM and lymphoid structures with reduced normal tissue toxicity. With further investigation, these efforts may expand the therapeutic ratio associated with TBI, allowing safer delivery to a broader range of patients.

  11. To Fear Is to Gain? The Role of Fear Recognition in Risky Decision Making in TBI Patients and Healthy Controls

    Science.gov (United States)

    Visser-Keizer, Annemarie C.; Westerhof-Evers, Herma J.; Gerritsen, Marleen J. J.; van der Naalt, Joukje; Spikman, Jacoba M.

    2016-01-01

    Fear is an important emotional reaction that guides decision making in situations of ambiguity or uncertainty. Both recognition of facial expressions of fear and decision making ability can be impaired after traumatic brain injury (TBI), in particular when the frontal lobe is damaged. So far, it has not been investigated how recognition of fear influences risk behavior in healthy subjects and TBI patients. The ability to recognize fear is thought to be related to the ability to experience fear and to use it as a warning signal to guide decision making. We hypothesized that a better ability to recognize fear would be related to a better regulation of risk behavior, with healthy controls outperforming TBI patients. To investigate this, 59 healthy subjects and 49 TBI patients were assessed with a test for emotion recognition (Facial Expression of Emotion: Stimuli and Tests) and a gambling task (Iowa Gambling Task (IGT)). The results showed that, regardless of post traumatic amnesia duration or the presence of frontal lesions, patients were more impaired than healthy controls on both fear recognition and decision making. In both groups, a significant relationship was found between better fear recognition, the development of an advantageous strategy across the IGT and less risk behavior in the last blocks of the IGT. Educational level moderated this relationship in the final block of the IGT. This study has important clinical implications, indicating that impaired decision making and risk behavior after TBI can be preceded by deficits in the processing of fear. PMID:27870900

  12. Modeling, planning and XiO R CMS validation of TBI treatment (extended SSD 400 cm); Modelacion, planificacion y validacion del XiO CMS para tratamientos TBI (SSD extendida de 400 cm)

    Energy Technology Data Exchange (ETDEWEB)

    Teijeiro, A.; Pereira, L.; Moral, F. del; Vazquez, J.; Lopez Medina, A.; Meal, A.; Andrade Alvarez, B.; Salgado Fernandez, M.; Munoz, V.

    2011-07-01

    The whole body irradiation (TBI) is a radiotherapy technique previously used a bone marrow transplant and for certain blood diseases, in which a patient is irradiated to extended distance (SSD from 350 to 400). The aim of the TBI is to kill tumor cells in the receiver and prevent rejection of transplanted bone marrow. The dose is prescribed at the midpoint of the abdomen around the navel wing. The most planners not permit the treatment of patients with a much higher SSD to 100 cm, also using the table TBI with spoiler to increase skin dose should be taken into account This requires measurements and checks ad hoc if you use a planner, because modeling is not optimized a priori for an SSD of 400 cm.

  13. Patient Characterization Protocols for Psychophysiological Studies of Traumatic Brain Injury and Post-TBI Psychiatric Disorders

    Directory of Open Access Journals (Sweden)

    Paul E. Rapp

    2013-07-01

    Full Text Available Psychophysiological investigations of traumatic brain injury (TBI are being conducted for several reasons, including the objective of learning more about the underlying physiological mechanisms of the pathological processes that can be initiated by a head injury. Additional goals include the development of objective physiologically based measures that can be used to monitor the response to treatment and to identify minimally symptomatic individuals who are at risk of delayed onset neuropsychiatric disorders following injury. Research programs studying TBI search for relationships between psychophysiological measures, particularly ERP component properties (e.g. timing, amplitude, scalp distribution, and a participant’s clinical condition. Moreover, the complex relationships between brain injury and psychiatric disorders are receiving increased research attention, and ERP technologies are making contributions to this effort. This review has two objectives supporting such research efforts. The first is to review evidence indicating that traumatic brain injury is a significant risk factor for post-injury neuropsychiatric disorders. The second objective is to introduce ERP researchers who are not familiar with neuropsychiatric assessment to the instruments that are available for characterizing traumatic brain injury, post-concussion syndrome, and psychiatric disorders. Specific recommendations within this very large literature are made. We have proceeded on the assumption that, as is typically the case in an ERP laboratory, the investigators are not clinically qualified and that they will not have access to participant medical records.

  14. Characterizing the spatial distribution of microhemorrhages resulting from Traumatic Brain Injury (TBI)

    Science.gov (United States)

    Li, Ningzhi; Chou, Yi-Yu; Shiee, Navid; Chan, Leighton; Pham, Dzung L.; Butman, John A.

    2014-03-01

    This study examines the spatial distribution of microhemorrhages defined using susceptibility weighted images (SWI) in 46 patients with Traumatic Brain Injury (TBI) and applying region of interest (ROI) analysis using a brain atlas. SWI and 3D T1-weighted images were acquired on a 3T clinical Siemens scanner. A neuroradiologist reviewed all SWI images and manually labeled all identified microhemorrhages. To characterize the spatial distribution of microhemorrhages in standard Montreal Neurological Institute (MNI) space, the T1-weighted images were nonlinearly registered to the MNI template. This transformation was then applied to the co-registered SWI images and to the microhemorrhage coordinates. The frequencies of microhemorrhages were determined in major structures from ROIs defined in the digital Talairach brain atlas and in white matter tracts defined using a diffusion tensor imaging atlas. A total of 629 microhemorrhages were found with an average of 22±42 (range=1-179) in the 24 positive TBI patients. Microhemorrhages mostly congregated around the periphery of the brain and were fairly symmetrically distributed, although a number were found in the corpus callosum. From Talairach ROI analysis, microhemorrhages were most prevalent in the frontal lobes (65.1%). Restricting the analysis to WM tracts, microhemorrhages were primarily found in the corpus callosum (56.9%).

  15. Prospective memory rehabilitation using smartphones in patients with TBI: What do participants report?

    Science.gov (United States)

    Evald, Lars

    2015-01-01

    Use of assistive devices has been shown to be beneficial as a compensatory memory strategy among brain injury survivors, but little is known about possible advantages and disadvantages of the technology. As part of an intervention study participants were interviewed about their experiences with the use of low-cost, off-the-shelf, unmodified smartphones combined with Internet calendars as a compensatory memory strategy. Thirteen community-dwelling patients with traumatic brain injury (TBI) received a 6-week group-based instruction in the systematic use of a smartphone as a memory compensatory aid followed by a brief structured open-ended interview regarding satisfaction with and advantages and disadvantages of the compensatory strategy. Ten of 13 participants continued to use a smartphone as their primary compensatory strategy. Audible and visual reminders were the most frequently mentioned advantages of the smartphone, and, second, the capability as an all-in-one memory device. In contrast, battery life was the most often mentioned disadvantage, followed by concerns about loss or failure of the device. Use of a smartphone seems to be a satisfactory compensatory memory strategy to many patients with TBI and smartphones come with features that are advantageous to other compensatory strategies. However, some benefits come hand-in-hand with drawbacks, such as the feeling of dependency. These aspects should be taken into account when choosing assistive technology as a memory compensatory strategy.

  16. Parvalbumin immunoreactivity and expression of GABAA receptor subunits in the thalamus after experimental TBI.

    Science.gov (United States)

    Huusko, N; Pitkänen, A

    2014-05-16

    Traumatic brain injury (TBI) causes 10-20% of acquired epilepsy in humans, resulting in an ictogenic region that is often located in the cerebral cortex. The thalamus provides heavy projections to the cortex and the activity of thalamocortical pathways is controlled by GABAergic afferents from the reticular nucleus of the thalamus (RT). As rats with TBI induced by lateral fluid-percussion injury (FPI) undergo epileptogenesis, we hypothesized that damage to the parvalbumin (PARV)-immunoreactive (ir) neurons in the RT is associated with seizure susceptibility after lateral FPI. To address this hypothesis, adult Sprague-Dawley rats (n=13) were injured with lateral FPI. At 6months post-TBI, each animal underwent a pentylenetetrazol (PTZ) seizure susceptibility test and 2weeks of continuous video-electroencephalography (EEG) monitoring for detection of the occurrence of spontaneous seizures. Thereafter, the brain was processed for PARV immunohistochemistry. We (a) estimated the total number of PARV-ir neurons in the RT using unbiased stereology, (b) measured the volume of the ventroposteromedial (VPM) and ventroposterolateral (VPL) nuclei of the thalamus, which receive PARV-ir inputs from the RT and project to the perilesional cortex, (c) quantified the density of PARV-ir terminals in the VPM-VPL, and (d) studied the expression of GABAA receptor subunits in a separate group of rats using laser-dissection of the thalamus followed by Real-Time polymerase chain reaction (RT-PCR) array studies. At 6months post-TBI, only 64% of PARV-ir neurons were remaining in the RT ipsilaterally (p0.05). Also, the volume of the VPM-VPL was only 51% of that in controls ipsilaterally (p<0.001) and 91% contralaterally (p<0.05). The density of PARV-ir axonal labeling was remarkably increased in the lateral aspects of the VPM and VPL (both p<0.001). Expression of the ε- and θ-subunits of the GABAA receptor was down-regulated (0.152, p<0.01 and 0.302, p<0.05, respectively), which could relate

  17. Early Cerebral Circulation Disturbance in Patients Suffering from Severe Traumatic Brain Injury (TBI): A Xenon CT and Perfusion CT Study

    Science.gov (United States)

    HONDA, Mitsuru; ICHIBAYASHI, Ryo; YOKOMURO, Hiroki; YOSHIHARA, Katsunori; MASUDA, Hiroyuki; HAGA, Daisuke; SEIKI, Yoshikatsu; KUDOH, Chiaki; KISHI, Taichi

    2016-01-01

    Traumatic brain injury (TBI) is widely known to cause dynamic changes in cerebral blood flow (CBF). Ischemia is a common and deleterious secondary injury following TBI. Detecting early ischemia in TBI patients is important to prevent further advancement and deterioration of the brain tissue. The purpose of this study was to clarify the cerebral circulatory disturbance during the early phase and whether it can be used to predict patient outcome. A total of 90 patients with TBI underwent a xenon-computed tomography (Xe-CT) and subsequently perfusion CT to evaluate the cerebral circulation on days 1–3. We measured CBF using Xe-CT and mean transit time (MTT: the width between two inflection points [maximum upward slope and maximum downward slope from inflow to outflow of the contrast agent]) using perfusion CT and calculated the cerebral blood volume (CBV) using the AZ-7000W98 computer system. The relationships of the hemodynamic parameters CBF, MTT, and CBV to the Glasgow Coma Scale (GCS) score and the Glasgow Outcome Scale (GOS) score were examined. There were no significant differences in CBF, MTT, and CBV among GCS3–4, GCS5–6, and GCS7–8 groups. The patients with a favorable outcome (GR and MD) had significantly higher CBF and lower MTT than those with an unfavorable one (SD, VS, or D). The discriminant analysis of these parameters could predict patient outcome with a probability of 70.6%. During the early phase, CBF reduction and MTT prolongation might influence the clinical outcome of TBI. These parameters are helpful for evaluating the severity of cerebral circulatory disturbance and predicting the outcome of TBI patients. PMID:27356957

  18. Effect of chromatic filters on visual performance in individuals with mild traumatic brain injury (mTBI): A pilot study.

    Science.gov (United States)

    Fimreite, Vanessa; Willeford, Kevin T; Ciuffreda, Kenneth J

    2016-01-01

    Spectral filters have been used clinically in patients with mild traumatic brain injury (mTBI). However, they have not been formally assessed using objective techniques in this population. Thus, the aim of the present pilot study was to determine the effect of spectral filters on reading performance and visuo-cortical responsivity in adults with mTBI. 12 adults with mTBI/concussion were tested. All reported photosensitivity and reading problems. They were compared to 12 visually-normal, asymptomatic adults. There were several test conditions: three luminance-matched control filters (gray neutral density, blue, and red), the patient-selected 'precision tint lens' that provided the most comfort and clarity of text using the Intuitive Colorimeter System, and baseline without any filters. The Visagraph was used to assess reading eye movements and reading speed objectively with each filter. In addition, both the amplitude and latency of the visual-evoked potential (VEP) were assessed with the same filters. There were few significant group differences in either the reading-related parameters or VEP latency for any of the test filter conditions. Subjective improvements were noted in most with mTBI (11/12). The majority of patients with mTBI chose a tinted filter that resulted in increased visual comfort. While significant findings based on the objective testing were found for some conditions, the subjective results suggest that precision tints should be considered as an adjunctive treatment in patients with mTBI and photosensitivity. Copyright © 2016 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

  19. Early Cerebral Circulation Disturbance in Patients Suffering from Severe Traumatic Brain Injury (TBI): A Xenon CT and Perfusion CT Study.

    Science.gov (United States)

    Honda, Mitsuru; Ichibayashi, Ryo; Yokomuro, Hiroki; Yoshihara, Katsunori; Masuda, Hiroyuki; Haga, Daisuke; Seiki, Yoshikatsu; Kudoh, Chiaki; Kishi, Taichi

    2016-08-15

    Traumatic brain injury (TBI) is widely known to cause dynamic changes in cerebral blood flow (CBF). Ischemia is a common and deleterious secondary injury following TBI. Detecting early ischemia in TBI patients is important to prevent further advancement and deterioration of the brain tissue. The purpose of this study was to clarify the cerebral circulatory disturbance during the early phase and whether it can be used to predict patient outcome. A total of 90 patients with TBI underwent a xenon-computed tomography (Xe-CT) and subsequently perfusion CT to evaluate the cerebral circulation on days 1-3. We measured CBF using Xe-CT and mean transit time (MTT: the width between two inflection points [maximum upward slope and maximum downward slope from inflow to outflow of the contrast agent]) using perfusion CT and calculated the cerebral blood volume (CBV) using the AZ-7000W98 computer system. The relationships of the hemodynamic parameters CBF, MTT, and CBV to the Glasgow Coma Scale (GCS) score and the Glasgow Outcome Scale (GOS) score were examined. There were no significant differences in CBF, MTT, and CBV among GCS3-4, GCS5-6, and GCS7-8 groups. The patients with a favorable outcome (GR and MD) had significantly higher CBF and lower MTT than those with an unfavorable one (SD, VS, or D). The discriminant analysis of these parameters could predict patient outcome with a probability of 70.6%. During the early phase, CBF reduction and MTT prolongation might influence the clinical outcome of TBI. These parameters are helpful for evaluating the severity of cerebral circulatory disturbance and predicting the outcome of TBI patients.

  20. Outcome prediction after mild and complicated mild traumatic brain injury: external validation of existing models and identification of new predictors using the TRACK-TBI pilot study.

    Science.gov (United States)

    Lingsma, Hester F; Yue, John K; Maas, Andrew I R; Steyerberg, Ewout W; Manley, Geoffrey T

    2015-01-15

    Although the majority of patients with mild traumatic brain injury (mTBI) recover completely, some still suffer from disabling ailments at 3 or 6 months. We validated existing prognostic models for mTBI and explored predictors of poor outcome after mTBI. We selected patients with mTBI from TRACK-TBI Pilot, an unselected observational cohort of TBI patients from three centers in the United States. We validated two prognostic models for the Glasgow Outcome Scale Extended (GOS-E) at 6 months after injury. One model was based on the CRASH study data and another from Nijmegen, The Netherlands. Possible predictors of 3- and 6-month GOS-E were analyzed with univariate and multi-variable proportional odds regression models. Of the 386 of 485 patients included in the study (median age, 44 years; interquartile range, 27-58), 75% (n=290) presented with a Glasgow Coma Score (GCS) of 15. In this mTBI population, both previously developed models had a poor performance (area under the receiver operating characteristic curve, 0.49-0.56). In multivariable analyses, the strongest predictors of lower 3- and 6-month GOS-E were older age, pre-existing psychiatric conditions, and lower education. Injury caused by assault, extracranial injuries, and lower GCS were also predictive of lower GOS-E. Existing models for mTBI performed unsatisfactorily. Our study shows that, for mTBI, different predictors are relevant as for moderate and severe TBI. These include age, pre-existing psychiatric conditions, and lower education. Development of a valid prediction model for mTBI patients requires further research efforts.

  1. Outcome Prediction after Mild and Complicated Mild Traumatic Brain Injury: External Validation of Existing Models and Identification of New Predictors Using the TRACK-TBI Pilot Study

    Science.gov (United States)

    Lingsma, Hester F.; Yue, John K.; Maas, Andrew I.R.; Steyerberg, Ewout W.; Cooper, Shelly R.; Dams-O'Connor, Kristen; Gordon, Wayne A.; Menon, David K.; Mukherjee, Pratik; Okonkwo, David O.; Puccio, Ava M.; Schnyer, David M.; Valadka, Alex B.; Vassar, Mary J.; Yuh, Esther L.

    2015-01-01

    Abstract Although the majority of patients with mild traumatic brain injury (mTBI) recover completely, some still suffer from disabling ailments at 3 or 6 months. We validated existing prognostic models for mTBI and explored predictors of poor outcome after mTBI. We selected patients with mTBI from TRACK-TBI Pilot, an unselected observational cohort of TBI patients from three centers in the United States. We validated two prognostic models for the Glasgow Outcome Scale Extended (GOS-E) at 6 months after injury. One model was based on the CRASH study data and another from Nijmegen, The Netherlands. Possible predictors of 3- and 6-month GOS-E were analyzed with univariate and multi-variable proportional odds regression models. Of the 386 of 485 patients included in the study (median age, 44 years; interquartile range, 27–58), 75% (n=290) presented with a Glasgow Coma Score (GCS) of 15. In this mTBI population, both previously developed models had a poor performance (area under the receiver operating characteristic curve, 0.49–0.56). In multivariable analyses, the strongest predictors of lower 3- and 6-month GOS-E were older age, pre-existing psychiatric conditions, and lower education. Injury caused by assault, extracranial injuries, and lower GCS were also predictive of lower GOS-E. Existing models for mTBI performed unsatisfactorily. Our study shows that, for mTBI, different predictors are relevant as for moderate and severe TBI. These include age, pre-existing psychiatric conditions, and lower education. Development of a valid prediction model for mTBI patients requires further research efforts. PMID:25025611

  2. Diffusion tensor imaging for outcome prediction in mild traumatic brain injury: a TRACK-TBI study.

    Science.gov (United States)

    Yuh, Esther L; Cooper, Shelly R; Mukherjee, Pratik; Yue, John K; Lingsma, Hester F; Gordon, Wayne A; Valadka, Alex B; Okonkwo, David O; Schnyer, David M; Vassar, Mary J; Maas, Andrew I R; Manley, Geoffrey T

    2014-09-01

    We evaluated 3T diffusion tensor imaging (DTI) for white matter injury in 76 adult mild traumatic brain injury (mTBI) patients at the semiacute stage (11.2±3.3 days), employing both whole-brain voxel-wise and region-of-interest (ROI) approaches. The subgroup of 32 patients with any traumatic intracranial lesion on either day-of-injury computed tomography (CT) or semiacute magnetic resonance imaging (MRI) demonstrated reduced fractional anisotropy (FA) in numerous white matter tracts, compared to 50 control subjects. In contrast, 44 CT/MRI-negative mTBI patients demonstrated no significant difference in any DTI parameter, compared to controls. To determine the clinical relevance of DTI, we evaluated correlations between 3- and 6-month outcome and imaging, demographic/socioeconomic, and clinical predictors. Statistically significant univariable predictors of 3-month Glasgow Outcome Scale-Extended (GOS-E) included MRI evidence for contusion (odds ratio [OR] 4.9 per unit decrease in GOS-E; p=0.01), ≥1 ROI with severely reduced FA (OR, 3.9; p=0.005), neuropsychiatric history (OR, 3.3; p=0.02), age (OR, 1.07/year; p=0.002), and years of education (OR, 0.79/year; p=0.01). Significant predictors of 6-month GOS-E included ≥1 ROI with severely reduced FA (OR, 2.7; p=0.048), neuropsychiatric history (OR, 3.7; p=0.01), and years of education (OR, 0.82/year; p=0.03). For the subset of 37 patients lacking neuropsychiatric and substance abuse history, MRI surpassed all other predictors for both 3- and 6-month outcome prediction. This is the first study to compare DTI in individual mTBI patients to conventional imaging, clinical, and demographic/socioeconomic characteristics for outcome prediction. DTI demonstrated utility in an inclusive group of patients with heterogeneous backgrounds, as well as in a subset of patients without neuropsychiatric or substance abuse history.

  3. Diffusion Tensor Imaging for Outcome Prediction in Mild Traumatic Brain Injury: A TRACK-TBI Study

    Science.gov (United States)

    Yuh, Esther L.; Cooper, Shelly R.; Mukherjee, Pratik; Yue, John K.; Lingsma, Hester F.; Gordon, Wayne A.; Valadka, Alex B.; Okonkwo, David O.; Schnyer, David M.; Vassar, Mary J.; Maas, Andrew I.R.; Casey, Scott S.; Cheong, Maxwell; Dams-O'Connor, Kristen; Hricik, Allison J.; Inoue, Tomoo; Menon, David K.; Morabito, Diane J.; Pacheco, Jennifer L.; Puccio, Ava M.; Sinha, Tuhin K.

    2014-01-01

    Abstract We evaluated 3T diffusion tensor imaging (DTI) for white matter injury in 76 adult mild traumatic brain injury (mTBI) patients at the semiacute stage (11.2±3.3 days), employing both whole-brain voxel-wise and region-of-interest (ROI) approaches. The subgroup of 32 patients with any traumatic intracranial lesion on either day-of-injury computed tomography (CT) or semiacute magnetic resonance imaging (MRI) demonstrated reduced fractional anisotropy (FA) in numerous white matter tracts, compared to 50 control subjects. In contrast, 44 CT/MRI-negative mTBI patients demonstrated no significant difference in any DTI parameter, compared to controls. To determine the clinical relevance of DTI, we evaluated correlations between 3- and 6-month outcome and imaging, demographic/socioeconomic, and clinical predictors. Statistically significant univariable predictors of 3-month Glasgow Outcome Scale-Extended (GOS-E) included MRI evidence for contusion (odds ratio [OR] 4.9 per unit decrease in GOS-E; p=0.01), ≥1 ROI with severely reduced FA (OR, 3.9; p=0.005), neuropsychiatric history (OR, 3.3; p=0.02), age (OR, 1.07/year; p=0.002), and years of education (OR, 0.79/year; p=0.01). Significant predictors of 6-month GOS-E included ≥1 ROI with severely reduced FA (OR, 2.7; p=0.048), neuropsychiatric history (OR, 3.7; p=0.01), and years of education (OR, 0.82/year; p=0.03). For the subset of 37 patients lacking neuropsychiatric and substance abuse history, MRI surpassed all other predictors for both 3- and 6-month outcome prediction. This is the first study to compare DTI in individual mTBI patients to conventional imaging, clinical, and demographic/socioeconomic characteristics for outcome prediction. DTI demonstrated utility in an inclusive group of patients with heterogeneous backgrounds, as well as in a subset of patients without neuropsychiatric or substance abuse history. PMID:24742275

  4. Variation in structure and process of care in traumatic brain injury: Provider profiles of European Neurotrauma Centers participating in the CENTER-TBI study

    NARCIS (Netherlands)

    M.C. Cnossen (Maryse); S. Polinder (Suzanne); Lingsma, H.F. (Hester F.); A.I.R. Maas (Andrew); D.K. Menon (David ); E.W. Steyerberg (Ewout); Adams, H. (Hadie); Alessandro, M. (Masala); J. Allanson (Judith); Amrein, K. (Krisztina); Andaluz, N. (Norberto); N. Andelic (Nada); Andrea, N. (Nanni); L. Andreassen (Lasse); Anke, A. (Audny); Antoni, A. (Anna); Ardon, H. (Hilko); G. Audibert (Gérard); Auslands, K. (Kaspars); Azouvi, P. (Philippe); Baciu, C. (Camelia); Bacon, A. (Andrew); Badenes, R. (Rafael); Baglin, T. (Trevor); Bartels, R. (Ronald); Barzó, P. (Pál); Bauerfeind, U. (Ursula); R. Beer (Ronny); Belda, F.J. (Francisco Javier); B.-M. Bellander (Bo-Michael); A. Belli (Antonio); Bellier, R. (Rémy); H. Benali (Habib); Benard, T. (Thierry); M. Berardino (Maurizio); Beretta, L. (Luigi); Beynon, C. (Christopher); Bilotta, F. (Federico); H. Binder (Harald); Biqiri, E. (Erta); Blaabjerg, M. (Morten); Borgen, L.S. (Lund Stine); Bouzat, P. (Pierre); Bragge, P. (Peter); A. Brazinova (Alexandra); F. Brehar (Felix); Brorsson, C. (Camilla); Buki, A. (Andras); M. Bullinger (Monika); Bučková, V. (Veronika); Calappi, E. (Emiliana); P. Cameron (Peter); Carbayo, L.G. (Lozano Guillermo); Carise, E. (Elsa); Carpenter, C.; Castaño-León, A.M. (Ana M.); Causin, F. (Francesco); Chevallard, G. (Giorgio); A. Chieregato (Arturo); G. Citerio (Giuseppe); M. Coburn (Mark); J.P. Coles (Jonathan P.); Cooper, J.D. (Jamie D.); Correia, M. (Marta); A. Covic (Amra); N. Curry (Nicola); E. Czeiter (Endre); M. Czosnyka (Marek); Dahyot-Fizelier, C. (Claire); F. Damas (François); P. Damas (Pierre); H. Dawes (Helen); De Keyser, V. (Véronique); F. Della Corte (Francesco); B. Depreitere (Bart); Ding, S. (Shenghao); D.W.J. Dippel (Diederik); K. Dizdarevic (Kemal); Dulière, G.-L. (Guy-Loup); Dzeko, A. (Adelaida); G. Eapen (George); Engemann, H. (Heiko); A. Ercole (Ari); P. Esser (Patrick); Ezer, E. (Erzsébet); M. Fabricius (Martin); V.L. Feigin (V.); Feng, J. (Junfeng); Foks, K. (Kelly); F. Fossi (Francesca); Francony, G. (Gilles); J. Frantzén (Janek); Freo, U. (Ulderico); S.K. Frisvold (Shirin Kordasti); Furmanov, A. (Alex); P. Gagliardo (Pablo); D. Galanaud (Damien); G. Gao (Guoyi); K. Geleijns (Karin); A. Ghuysen (Alexandre); Giraud, B. (Benoit); Glocker, B. (Ben); Gomez, P.A. (Pedro A.); Grossi, F. (Francesca); R.L. Gruen (Russell); Gupta, D. (Deepak); J.A. Haagsma (Juanita); E. Hadzic (Ermin); I. Haitsma (Iain); J.A. Hartings (Jed); R. Helbok (Raimund); E. Helseth (Eirik); Hertle, D. (Daniel); S. Hill (Sean); Hoedemaekers, A. (Astrid); S. Hoefer (Stefan); P.J. Hutchinson (Peter J.); Håberg, A.K. (Asta Kristine); B.C. Jacobs (Bart); Janciak, I. (Ivan); K. Janssens (Koen); J.-Y. Jiang (Ji-Yao); Jones, K. (Kelly); Kalala, J.-P. (Jean-Pierre); Kamnitsas, K. (Konstantinos); Karan, M. (Mladen); Karau, J. (Jana); A. Katila (Ari); M. Kaukonen (Maija); Keeling, D. (David); Kerforne, T. (Thomas); N. Ketharanathan (Naomi); J. Kettunen (Johannes); Kivisaari, R. (Riku); A.G. Kolias (Angelos G.); Kolumbán, B. (Bálint); E.J.O. Kompanje (Erwin); D. Kondziella (Daniel); L.-O. Koskinen (Lars-Owe); Kovács, N. (Noémi); F. Kalovits (Ferenc); A. Lagares (Alfonso); L. Lanyon (Linda); S. Laureys (Steven); Lauritzen, M. (Martin); F.E. Lecky (Fiona); C. Ledig (Christian); R. Lefering; V. Legrand (Valerie); Lei, J. (Jin); L. Levi (Leon); R. Lightfoot (Roger); H.F. Lingsma (Hester); D. Loeckx (Dirk); Lozano, A. (Angels); Luddington, R. (Roger); Luijten-Arts, C. (Chantal); A.I.R. Maas (Andrew I.R.); MacDonald, S. (Stephen); MacFayden, C. (Charles); M. Maegele; M. Majdan (Marek); Major, S. (Sebastian); A. Manara (Alex); Manhes, P. (Pauline); G. Manley (Geoffrey); Martin, D. (Didier); C. Martino (Costanza); Maruenda, A. (Armando); H. Maréchal (Hugues); Mastelova, D. (Dagmara); Mattern, J. (Julia); C. McMahon (Catherine); Melegh, B. (Béla); T. Menovsky (Tomas); C. Morganti-Kossmann (Cristina); Mulazzi, D. (Davide); Mutschler, M. (Manuel); H. Mühlan (Holger); Negru, A. (Ancuta); D. Nelson (David); E. Neugebauer (Eddy); V.F. Newcombe (Virginia F.); Noirhomme, Q. (Quentin); Nyirádi, J. (József); M. Oddo (Mauro); Oldenbeuving, A. (Annemarie); M. Oresic (Matej); Ortolano, F. (Fabrizio); A. Palotie (Aarno); P.M. Parizel; Patruno, A. (Adriana); J.-F. Payen (Jean-François); Perera, N. (Natascha); V. Perlbarg (Vincent); Persona, P. (Paolo); W.C. Peul (Wilco); N. Pichon (Nicolas); Piilgaard, H. (Henning); A. Piippo (Anna); Pili, F.S. (Floury Sébastien); M. Pirinen (Matti); H. Ples (Horia); Pomposo, I. (Inigo); M. Psota (Marek); P. Pullens (Pim); L. Puybasset (Louis); A. Ragauskas (Arminas); Raj, R. (Rahul); Rambadagalla, M. (Malinka); Rehorčíková, V. (Veronika); J.K.J. Rhodes (Jonathan K.J.); S. Richardson (Sylvia); S. Ripatti (Samuli); S. Rocka (Saulius); Rodier, N. (Nicolas); Roe, C. (Cecilie); Roise, O. (Olav); Roks, G. (Gerwin); Romegoux, P. (Pauline); J. Rosand (Jonathan); Rosenfeld, J. (Jeffrey); C. Rosenlund (Christina); G. Rosenthal (Guy); R. Rossaint (Rolf); S. Rossi (Sandra); Rostalski, T. (Tim); Rueckert, D.L. (Danie L.); Ruiz De Arcaute, F. (Felix); M. Rusnák (Martin); Sacchi, M. (Marco); Sahakian, B. (Barbara); J. Sahuquillo (Juan); O. Sakowitz (Oliver); Sala, F. (Francesca); Sanchez-Pena, P. (Paola); Sanchez-Porras, R. (Renan); Sandor, J. (Janos); Santos, E. (Edgar); N. Sasse (Nadine); Sasu, L. (Luminita); Savo, D. (Davide); I.B. Schipper (Inger); Schlößer, B. (Barbara); S. Schmidt (Silke); Schneider, A. (Annette); H. Schoechl (Herbert); G.G. Schoonman; R. Schou (Rico); E. Schwendenwein (Elisabeth); Schöll, M. (Michael); Sir, O. (Özcan); T. Skandsen (Toril); Smakman, L. (Lidwien); D. Smeets (Dirk); Smielewski, P. (Peter); Sorinola, A. (Abayomi); Stamatakis, E.L. (Emmanue L.); S. Stanworth (Simon); Stegemann, K. (Katrin); Steinbüchel, N. (Nicole); R. Stevens (Robert); W. Stewart (William); N. Stocchetti (Nino); Sundström, N. (Nina); Synnot, A. (Anneliese); J. Szabó (József); J. Söderberg (Jeannette); F.S. Taccone (Fabio); Tamás, V. (Viktória); Tanskanen, P. (Päivi); A. Tascu (Alexandru); Taylor, M.S. (Mark Steven); Te Ao, B. (Braden); O. Tenovuo (Olli); Teodorani, G. (Guido); A. Theadom (Alice); Thomas, M. (Matt); D. Tibboel (Dick); C.M. Tolias (Christos M.); Tshibanda, J.-F.L. (Jean-Flory Luaba); Tudora, C.M. (Cristina Maria); P. Vajkoczy (Peter); Valeinis, E. (Egils); W. van Hecke (Wim); D. Van Praag (Dominique); D. Van Roost (Dirk); Van Vlierberghe, E. (Eline); Vande Vyvere, T. (Thijs); Vanhaudenhuyse, A. (Audrey); A. Vargiolu (Alessia); E. Vega (Emmanuel); J. Verheyden (Jan); P.M. Vespa (Paul M.); A. Vik (Anne); R. Vilcinis (Rimantas); Vizzino, G. (Giacinta); C.L.A.M. Vleggeert-Lankamp (Carmen); V. Volovici (Victor); P. Vulekovic (Peter); Vámos, Z. (Zoltán); Wade, D. (Derick); Wang, K.K.W. (Kevin K.W.); Wang, L. (Lei); Wildschut, E. (Eno); G. Williams (Guy); Willumsen, L. (Lisette); Wilson, A. (Adam); L. Wilson (Lindsay); Winkler, M.K.L. (Maren K. L.); P. Ylén (Peter); Younsi, A. (Alexander); M. Zaaroor (Menashe); Zhang, Z. (Zhiqun); Zheng, Z. (Zelong); Zumbo, F. (Fabrizio); De Lange, S. (Stefanie); G.C.W. De Ruiter (Godard C.W.); Den Boogert, H. (Hugo); Van Dijck, J. (Jeroen); T.A. van Essen (T.); C.M. van Heugten (Caroline M.); M. van der Jagt (Mathieu); J. van der Naalt (Joukje)

    2016-01-01

    textabstractIntroduction: The strength of evidence underpinning care and treatment recommendations in traumatic brain injury (TBI) is low. Comparative effectiveness research (CER) has been proposed as a framework to provide evidence for optimal care for TBI patients. The first step in CER is to map

  5. Variation in structure and process of care in traumatic brain injury: Provider profiles of European Neurotrauma Centers participating in the CENTER-TBI study

    NARCIS (Netherlands)

    M.C. Cnossen; S. Polinder (Suzanne); Lingsma, H.F. (Hester F.); A.I.R. Maas (Andrew); D.K. Menon (David ); E.W. Steyerberg (Ewout); Adams, H. (Hadie); Alessandro, M. (Masala); J. Allanson (Judith); Amrein, K. (Krisztina); Andaluz, N. (Norberto); N. Andelic (Nada); Andrea, N. (Nanni); L. Andreassen (Lasse); Anke, A. (Audny); Antoni, A. (Anna); Ardon, H. (Hilko); G. Audibert (Gérard); Auslands, K. (Kaspars); Azouvi, P. (Philippe); Baciu, C. (Camelia); Bacon, A. (Andrew); Badenes, R. (Rafael); Baglin, T. (Trevor); Bartels, R. (Ronald); Barzó, P. (Pál); Bauerfeind, U. (Ursula); R. Beer (Ronny); Belda, F.J. (Francisco Javier); B.-M. Bellander (Bo-Michael); A. Belli (Antonio); Bellier, R. (Rémy); H. Benali (Habib); Benard, T. (Thierry); M. Berardino (Maurizio); Beretta, L. (Luigi); Beynon, C. (Christopher); Bilotta, F. (Federico); H. Binder (Harald); Biqiri, E. (Erta); Blaabjerg, M. (Morten); Borgen, L.S. (Lund Stine); Bouzat, P. (Pierre); Bragge, P. (Peter); A. Brazinova (Alexandra); F. Brehar (Felix); Brorsson, C. (Camilla); Buki, A. (Andras); M. Bullinger (Monika); Bučková, V. (Veronika); Calappi, E. (Emiliana); P. Cameron (Peter); Carbayo, L.G. (Lozano Guillermo); Carise, E. (Elsa); Carpenter, C.; Castaño-León, A.M. (Ana M.); Causin, F. (Francesco); Chevallard, G. (Giorgio); A. Chieregato (Arturo); G. Citerio (Giuseppe); M. Coburn (Mark); J.P. Coles (Jonathan P.); Cooper, J.D. (Jamie D.); Correia, M. (Marta); A. Covic (Amra); N. Curry (Nicola); E. Czeiter (Endre); M. Czosnyka (Marek); Dahyot-Fizelier, C. (Claire); F. Damas (François); P. Damas (Pierre); H. Dawes (Helen); De Keyser, V. (Véronique); F. Della Corte (Francesco); B. Depreitere (Bart); Ding, S. (Shenghao); D.W.J. Dippel (Diederik); K. Dizdarevic (Kemal); Dulière, G.-L. (Guy-Loup); Dzeko, A. (Adelaida); G. Eapen (George); Engemann, H. (Heiko); A. Ercole (Ari); P. Esser (Patrick); Ezer, E. (Erzsébet); M. Fabricius (Martin); V.L. Feigin (V.); Feng, J. (Junfeng); Foks, K. (Kelly); F. Fossi (Francesca); Francony, G. (Gilles); J. Frantzén (Janek); Freo, U. (Ulderico); S.K. Frisvold (Shirin Kordasti); Furmanov, A. (Alex); P. Gagliardo (Pablo); D. Galanaud (Damien); G. Gao (Guoyi); K. Geleijns (Karin); A. Ghuysen (Alexandre); Giraud, B. (Benoit); Glocker, B. (Ben); Gomez, P.A. (Pedro A.); Grossi, F. (Francesca); R.L. Gruen (Russell); Gupta, D. (Deepak); J.A. Haagsma (Juanita); E. Hadzic (Ermin); I. Haitsma (Iain); J.A. Hartings (Jed); R. Helbok (Raimund); E. Helseth (Eirik); Hertle, D. (Daniel); S. Hill (Sean); Hoedemaekers, A. (Astrid); S. Hoefer (Stefan); P.J. Hutchinson (Peter J.); Håberg, A.K. (Asta Kristine); B.C. Jacobs (Bart); Janciak, I. (Ivan); K. Janssens (Koen); J.-Y. Jiang (Ji-Yao); Jones, K. (Kelly); Kalala, J.-P. (Jean-Pierre); Kamnitsas, K. (Konstantinos); Karan, M. (Mladen); Karau, J. (Jana); A. Katila (Ari); M. Kaukonen (Maija); Keeling, D. (David); Kerforne, T. (Thomas); N. Ketharanathan (Naomi); J. Kettunen (Johannes); Kivisaari, R. (Riku); A.G. Kolias (Angelos G.); Kolumbán, B. (Bálint); E.J.O. Kompanje (Erwin); D. Kondziella (Daniel); L.-O. Koskinen (Lars-Owe); Kovács, N. (Noémi); F. Kalovits (Ferenc); A. Lagares (Alfonso); L. Lanyon (Linda); S. Laureys (Steven); Lauritzen, M. (Martin); F.E. Lecky (Fiona); C. Ledig (Christian); R. Lefering; V. Legrand (Valerie); Lei, J. (Jin); L. Levi (Leon); R. Lightfoot (Roger); H.F. Lingsma (Hester); D. Loeckx (Dirk); Lozano, A. (Angels); Luddington, R. (Roger); Luijten-Arts, C. (Chantal); A.I.R. Maas (Andrew I.R.); MacDonald, S. (Stephen); MacFayden, C. (Charles); M. Maegele; M. Majdan (Marek); Major, S. (Sebastian); A. Manara (Alex); Manhes, P. (Pauline); G. Manley (Geoffrey); Martin, D. (Didier); C. Martino (Costanza); Maruenda, A. (Armando); H. Maréchal (Hugues); Mastelova, D. (Dagmara); Mattern, J. (Julia); C. McMahon (Catherine); Melegh, B. (Béla); T. Menovsky (Tomas); C. Morganti-Kossmann (Cristina); Mulazzi, D. (Davide); Mutschler, M. (Manuel); H. Mühlan (Holger); Negru, A. (Ancuta); D. Nelson (David); E. Neugebauer (Eddy); V.F. Newcombe (Virginia F.); Noirhomme, Q. (Quentin); Nyirádi, J. (József); M. Oddo (Mauro); Oldenbeuving, A. (Annemarie); M. Oresic (Matej); Ortolano, F. (Fabrizio); A. Palotie (Aarno); P.M. Parizel; Patruno, A. (Adriana); J.-F. Payen (Jean-François); Perera, N. (Natascha); V. Perlbarg (Vincent); Persona, P. (Paolo); W.C. Peul (Wilco); N. Pichon (Nicolas); Piilgaard, H. (Henning); A. Piippo (Anna); Pili, F.S. (Floury Sébastien); M. Pirinen (Matti); H. Ples (Horia); Pomposo, I. (Inigo); M. Psota (Marek); P. Pullens (Pim); L. Puybasset (Louis); A. Ragauskas (Arminas); Raj, R. (Rahul); Rambadagalla, M. (Malinka); Rehorčíková, V. (Veronika); J.K.J. Rhodes (Jonathan K.J.); S. Richardson (Sylvia); S. Ripatti (Samuli); S. Rocka (Saulius); Rodier, N. (Nicolas); Roe, C. (Cecilie); Roise, O. (Olav); Roks, G. (Gerwin); Romegoux, P. (Pauline); J. Rosand (Jonathan); Rosenfeld, J. (Jeffrey); C. Rosenlund (Christina); G. Rosenthal (Guy); R. Rossaint (Rolf); S. Rossi (Sandra); Rostalski, T. (Tim); Rueckert, D.L. (Danie L.); Ruiz De Arcaute, F. (Felix); M. Rusnák (Martin); Sacchi, M. (Marco); Sahakian, B. (Barbara); J. Sahuquillo (Juan); O. Sakowitz (Oliver); Sala, F. (Francesca); Sanchez-Pena, P. (Paola); Sanchez-Porras, R. (Renan); Sandor, J. (Janos); Santos, E. (Edgar); N. Sasse (Nadine); Sasu, L. (Luminita); Savo, D. (Davide); I.B. Schipper (Inger); Schlößer, B. (Barbara); S. Schmidt (Silke); Schneider, A. (Annette); H. Schoechl (Herbert); G.G. Schoonman; R. Schou (Rico); E. Schwendenwein (Elisabeth); Schöll, M. (Michael); Sir, O. (Özcan); T. Skandsen (Toril); Smakman, L. (Lidwien); D. Smeets (Dirk); Smielewski, P. (Peter); Sorinola, A. (Abayomi); Stamatakis, E.L. (Emmanue L.); S. Stanworth (Simon); Stegemann, K. (Katrin); Steinbüchel, N. (Nicole); R. Stevens (Robert); W. Stewart (William); N. Stocchetti (Nino); Sundström, N. (Nina); Synnot, A. (Anneliese); J. Szabó (József); J. Söderberg (Jeannette); F.S. Taccone (Fabio); Tamás, V. (Viktória); Tanskanen, P. (Päivi); A. Tascu (Alexandru); Taylor, M.S. (Mark Steven); Te Ao, B. (Braden); O. Tenovuo (Olli); Teodorani, G. (Guido); A. Theadom (Alice); Thomas, M. (Matt); D. Tibboel (Dick); C.M. Tolias (Christos M.); Tshibanda, J.-F.L. (Jean-Flory Luaba); Tudora, C.M. (Cristina Maria); P. Vajkoczy (Peter); Valeinis, E. (Egils); W. van Hecke (Wim); D. Van Praag (Dominique); D. Van Roost (Dirk); Van Vlierberghe, E. (Eline); Vande Vyvere, T. (Thijs); Vanhaudenhuyse, A. (Audrey); A. Vargiolu (Alessia); E. Vega (Emmanuel); J. Verheyden (Jan); P.M. Vespa (Paul M.); A. Vik (Anne); R. Vilcinis (Rimantas); Vizzino, G. (Giacinta); C.L.A.M. Vleggeert-Lankamp (Carmen); V. Volovici (Victor); P. Vulekovic (Peter); Vámos, Z. (Zoltán); Wade, D. (Derick); Wang, K.K.W. (Kevin K.W.); Wang, L. (Lei); Wildschut, E. (Eno); G. Williams (Guy); Willumsen, L. (Lisette); Wilson, A. (Adam); L. Wilson (Lindsay); Winkler, M.K.L. (Maren K. L.); P. Ylén (Peter); Younsi, A. (Alexander); M. Zaaroor (Menashe); Zhang, Z. (Zhiqun); Zheng, Z. (Zelong); Zumbo, F. (Fabrizio); De Lange, S. (Stefanie); G.C.W. De Ruiter (Godard C.W.); Den Boogert, H. (Hugo); Van Dijck, J. (Jeroen); T.A. van Essen (T.); C.M. van Heugten (Caroline M.); M. van der Jagt (Mathieu); J. van der Naalt (Joukje)

    2016-01-01

    textabstractIntroduction: The strength of evidence underpinning care and treatment recommendations in traumatic brain injury (TBI) is low. Comparative effectiveness research (CER) has been proposed as a framework to provide evidence for optimal care for TBI patients. The first step in CER is to map

  6. Meta-analytic methods and the importance of non-TBI factors related to outcome in mild traumatic brain injury: response to Bigler et al. (2013).

    Science.gov (United States)

    Larrabee, Glenn J; Binder, Laurence M; Rohling, Martin L; Ploetz, Danielle M

    2013-01-01

    Bigler et al. (2013, The Clinical Neuropsychologist) contend that weak methodology and poor quality of the studies comprising our recent meta-analysis led us to miss detecting a subgroup of mild traumatic brain injury (mTBI) characterized by persisting symptomatic complaint and positive biomarkers for neurological damage. Our computation of non-significant Q, tau(2), and I(2) statistics contradicts the existence of a subgroup of mTBI with poor outcome, or variation in effect size as a function of quality of research design. Consistent with this conclusion, the largest single contributor to our meta-analysis, Dikmen, Machamer, Winn, and Temkin (1995, Neuropsychology, 9, 80) yielded an effect size, -0.02, that was smaller than our overall effect size of -0.07 despite using the most liberal definition of mTBI: loss of consciousness less than 1 hour, with no exclusion of subjects who had positive CT scans. The evidence is weak for biomarkers of mTBI, such as diffusion tensor imaging and for demonstrable neuropathology in uncomplicated mTBI. Postconcussive symptoms, and reduced neuropsychological test scores are not specific to mTBI but can result from pre-existing psychosocial and psychiatric problems, expectancy effects and diagnosis threat. Moreover, neuropsychological impairment is seen in a variety of primary psychiatric disorders, which themselves are predictive of persistent complaints following mTBI. We urge use of prospective studies with orthopedic trauma controls in future investigations of mTBI to control for these confounding factors.

  7. ED disposition of the Glasgow Coma Scale 13 to 15 traumatic brain injury patient: Analysis of the Transforming Research and Clinical Knowledge in TBI study

    NARCIS (Netherlands)

    J.J. Ratcliff (Jonathan); O. Adeoye (Opeolu); D. Lindsell; K.W. Hart (Kimberly); A. Pancioli (Arthur); D.J. McMullan (Dominic); J.K. Yue (John); D.K. Nishijima (Daniel); W.A. Gordon (Wayne); A.B. Valadka (Alex); D. Okonkwo (David); H.F. Lingsma (Hester); A.I.R. Maas (Andrew); G. Manley (Geoffrey)

    2014-01-01

    textabstractObjective Mild traumatic brain injury (mTBI) patients are frequently admitted to high levels of care despite limited evidence suggesting benefit. Such decisions may contribute to the significant cost of caring for mTBI patients. Understanding the factors that drive disposition decision

  8. Intensive combined modality therapy including low-dose TBI in high-risk Ewing's sarcoma patients

    Energy Technology Data Exchange (ETDEWEB)

    Kinsella, T.J.; Glaubiger, D.; Diesseroth, A.; Makuch, R.; Waller, B.; Pizzo, P.; Glatstein, E.

    1983-12-01

    Twenty-four high-risk Ewing's sarcoma patients were treated on an intensive combined modality protocol including low-dose fractionated total body irradiaiton (TBI) and autologous bone marrow infusion (ABMI). Twenty patients (83%) achieved a complete clinical response to the primary and/or metastatic sites following induction therapy. The median disease-free interval was 18 months, and nine patients remain disease-free with a follow-up of 22 to 72 months. Local failure as a manifestation of initial relapse occurred in only three patients (15%), each having synchronous distant failure. Eight patients failed initially with only distant metastases, usually within 1-2 years following a complete clinical response. Two patterns of granulocyte recovery following consolidative therapy (including TBI and ABMI) were recognized. The time to platelet recovery was different for the groups with early and late granulocyte recovery. Patients with late recovery did not tolerate maintenance chemotherapy. However, there was no difference in disease-free and overall survival, when comparing the groups with early and late granulocyte recovery. It is concluded that these high-risk Ewing's sarcoma patients remain a poor-prognosis group in spite of intensive combined modality therapy including low-dose TBI. The control of microscopic systemic disease remains the major challenge to improving the cure rate. A new combined modality protocol with high-dose 'therapeutic' TBI (800 rad/2 fractions) is being used and the protocol design is outlined.

  9. The contribution of retrospective memory, attention and executive functions to the prospective and retrospective components of prospective memory following TBI.

    LENUS (Irish Health Repository)

    Clune-Ryberg, Melanie

    2011-01-01

    Despite the prevalence of prospective memory (PM) problems, relatively little is known about the processes underlying impairment following TBI. This study sought to examine PM performance, using a multiple-task, multiple-response video-based paradigm in which initial encoding of the cue-action associations was ensured (Video-Assessment of Prospective Memory; VAPM).

  10. Long-term renal toxicity in children following fractionated total-body irradiation (TBI) before allogeneic stem cell transplantation (SCT)

    Energy Technology Data Exchange (ETDEWEB)

    Gerstein, Johanna; Meyer, Andreas; Fruehauf, Joerg; Karstens, Johann H.; Bremer, Michael [Dept. of Radiation Oncology, Medical School Hannover (Germany); Sykora, Karl-Walter [Dept. of Pediatric Hematology and Oncology, Medical School Hannover (Germany)

    2009-11-15

    Purpose: to retrospectively assess the incidence and time course of renal dysfunction in children ({<=} 16 years) following total-body irradiation (TBI) before allogeneic stem cell transplantation (SCT). Patients and methods: between 1986 and 2003, 92 children (median age, 11 years; range, 3-16 years) underwent TBI before allogeneic SCT. 43 of them had a minimum follow-up of 12 months (median, 51 months; range, 12-186 months) and were included into this analysis. Conditioning regimen included chemotherapy and fractionated TBI with 12 Gy (n = 26) or 11.1 Gy (n = 17). In one patient, renal dose was limited to 10 Gy by customized renal shielding due to known nephropathy prior to SCt. Renal dysfunction was defined as an increase of serum creatinine > 1.25 times the upper limit of age-dependent normal. Results: twelve children (28%) experienced an episode of renal dysfunction after a median of 2 months (range, 1-10 months) following SCT. In all but one patient renal dysfunction was transient and resolved after a median of 8 months (range, 3-16 months). One single patient developed persistent renal dysfunction with onset at 10 months after SCT. None of these patients required dialysis. The actuarial 3-year freedom from persistent renal toxicity for children surviving > 12 months after SCt was 97.3%. Conclusion: the incidence of persistent renal dysfunction after fractionated TBI with total doses {<=} 12 Gy was very low in this analysis. (orig.)

  11. Assessment and rehabilitation of central sensory impairments for balance in mTBI using auditory biofeedback: a randomized clinical trial.

    Science.gov (United States)

    Fino, Peter C; Peterka, Robert J; Hullar, Timothy E; Murchison, Chad; Horak, Fay B; Chesnutt, James C; King, Laurie A

    2017-02-23

    Complaints of imbalance are common non-resolving signs in individuals with post-concussive syndrome. Yet, there is no consensus rehabilitation for non-resolving balance complaints following mild traumatic brain injury (mTBI). The heterogeneity of balance deficits and varied rates of recovery suggest varied etiologies and a need for interventions that address the underlying causes of poor balance function. Our central hypothesis is that most chronic balance deficits after mTBI result from impairments in central sensorimotor integration that may be helped by rehabilitation. Two studies are described to 1) characterize balance deficits in people with mTBI who have chronic, non-resolving balance deficits compared to healthy control subjects, and 2) determine the efficacy of an augmented vestibular rehabilitation program using auditory biofeedback to improve central sensorimotor integration, static and dynamic balance, and functional activity in patients with chronic mTBI. Two studies are described. Study 1 is a cross-sectional study to take place jointly at Oregon Health and Science University and the VA Portland Health Care System. The study participants will be individuals with non-resolving complaints of balance following mTBI and age- and gender-matched controls who meet all inclusion criteria. The primary outcome will be measures of central sensorimotor integration derived from a novel central sensorimotor integration test. Study 2 is a randomized controlled intervention to take place at Oregon Health & Science University. In this study, participants from Study 1 with mTBI and abnormal central sensorimotor integration will be randomized into two rehabilitation interventions. The interventions will be 6 weeks of vestibular rehabilitation 1) with or 2) without the use of an auditory biofeedback device. The primary outcome measure is the daily activity of the participants measured using an inertial sensor. The results of these two studies will improve our

  12. Comparison of neurite density measured by MRI and histology after TBI.

    Directory of Open Access Journals (Sweden)

    Shiyang Wang

    Full Text Available BACKGROUND: Functional recovery after brain injury in animals is improved by marrow stromal cells (MSC which stimulate neurite reorganization. However, MRI measurement of neurite density changes after injury has not been performed. In this study, we investigate the feasibility of MRI measurement of neurite density in an animal model of traumatic brain injury (TBI with and without MSC treatment. METHODS: Fifteen male Wistar rats, were treated with saline (n = 6 or MSCs (n = 9 and were sacrificed at 6 weeks after controlled cortical impact (CCI. Healthy non-CCI rats (n = 5, were also employed. Ex-vivo MRI scans were performed two days after the rats were sacrificed. Multiple-shell hybrid diffusion imaging encoding scheme and spherical harmonic expansion of a two-compartment water diffusion displacement model were used to extract neurite related parameters. Bielshowski and Luxol Fast blue was used for staining axons and myelin, respectively. Modified Morris water maze and neurological severity score (mNSS test were performed for functional evaluation. The treatment effects, the correlations between neurite densities measured by MRI and histology, and the correlations between MRI and functional variables were calculated by repeated measures analysis of variance, the regression correlation analysis tests, and spearman correlation coefficients. RESULTS: Neurite densities exhibited a significant correlation (R(2>0.80, p<1E-20 between MRI and immuno-histochemistry measurements with 95% lower bound of the intra-correlation coefficient (ICC as 0.86. The conventional fractional anisotropy (FA correlated moderately with histological neurite density (R(2 = 0.59, P<1E-5 with 95% lower bound of ICC as 0.76. MRI data revealed increased neurite reorganization with MSC treatment compared with saline treatment, confirmed by histological data from the same animals. mNSS were significantly correlated with MRI neurite density in the hippocampus region

  13. [Changes of EEG power spectrum in response to the emotional auditory stimuli in patients in acute and recovery stages of TBI (traumatic brain injury)].

    Science.gov (United States)

    2013-01-01

    We investigated variability of responses to emotionally important auditory stimulation in different groups of TBI (Traumatic Brain Injury) in acute state or recovery. The patients sampling consisted of three different groups: patients in coma or vegetative state, patients with Severe and Moderate TBI in recovery period. Subjects were stimulated with auditory stimuli containing important physiological sounds (coughing, vomiting), emotional sounds (laughing, crying), nature sounds (bird song, barking), unpleasant household sounds (nails scratching the glass), natural sounds (sea, rain, fire) and neutral sounds (white noise). The background encephalographic activity was registered during at least 7 minutes. EEG was recorded while using portable device "Entsefalan". Significant differences of power of the rhythmic activity registered during the presentation of different types of stimuli were analyzed using Mathlab and Statistica 6.0. Results showed that EEG-response to the emotional stimuli differed depending on consciousness level, stimuli type, severity of TBI. Most valuable changes in EEG spectrum power for a patient with TBI were found for unpleasant auditory stimulation. Responsiveness to the pleasant stimulation could be registered in later stages of coming out of coma than to unpleasant stimulation. Alpha-activity is reducing in patients with TBI: the alpha rhythm depression is most evident in the control group, less in group after moderate TBI, and even less in group after severe TBI. Patients in coma or vegetative state didn't show any response in rhythmic power in the frequency of alpha rhythm.

  14. Social communication mediates the relationship between emotion perception and externalizing behaviors in young adult survivors of pediatric traumatic brain injury (TBI).

    Science.gov (United States)

    Ryan, Nicholas P; Anderson, Vicki; Godfrey, Celia; Eren, Senem; Rosema, Stefanie; Taylor, Kaitlyn; Catroppa, Cathy

    2013-12-01

    Traumatic brain injury (TBI) is a common cause of childhood disability, and is associated with elevated risk for long-term social impairment. Though social (pragmatic) communication deficits may be among the most debilitating consequences of childhood TBI, few studies have examined very long-term communication outcomes as children with TBI make the transition to young adulthood. In addition, the extent to which reduced social function contributes to externalizing behaviors in survivors of childhood TBI remains poorly understood. The present study aimed to evaluate the extent of social communication difficulty among young adult survivors of childhood TBI (n=34, injury age: 1.0-7.0 years; M time since injury: 16.55 years) and examine relations among aspects of social function including emotion perception, social communication and externalizing behaviors rated by close-other proxies. Compared to controls the TBI group had significantly greater social communication difficulty, which was associated with more frequent externalizing behaviors and poorer emotion perception. Analyses demonstrated that reduced social communication mediated the association between poorer emotion perception and more frequent externalizing behaviors. Our findings indicate that socio-cognitive impairments may indirectly increase the risk for externalizing behaviors among young adult survivors of childhood TBI, and underscore the need for targeted social skills interventions delivered soon after injury, and into the very long-term. Copyright © 2013 ISDN. Published by Elsevier Ltd. All rights reserved.

  15. Fractal Analysis of Brain Blood Oxygenation Level Dependent (BOLD) Signals from Children with Mild Traumatic Brain Injury (mTBI)

    Science.gov (United States)

    Dona, Olga; DeMatteo, Carol; Connolly, John F.

    2017-01-01

    Background Conventional imaging techniques are unable to detect abnormalities in the brain following mild traumatic brain injury (mTBI). Yet patients with mTBI typically show delayed response on neuropsychological evaluation. Because fractal geometry represents complexity, we explored its utility in measuring temporal fluctuations of brain resting state blood oxygen level dependent (rs-BOLD) signal. We hypothesized that there could be a detectable difference in rs-BOLD signal complexity between healthy subjects and mTBI patients based on previous studies that associated reduction in signal complexity with disease. Methods Fifteen subjects (13.4 ± 2.3 y/o) and 56 age-matched (13.5 ± 2.34 y/o) healthy controls were scanned using a GE Discovery MR750 3T MRI and 32-channel RF-coil. Axial FSPGR-3D images were used to prescribe rs-BOLD (TE/TR = 35/2000ms), acquired over 6 minutes. Motion correction was performed and anatomical and functional images were aligned and spatially warped to the N27 standard atlas. Fractal analysis, performed on grey matter, was done by estimating the Hurst exponent using de-trended fluctuation analysis and signal summation conversion methods. Results and Conclusions Voxel-wise fractal dimension (FD) was calculated for every subject in the control group to generate mean and standard deviation maps for regional Z-score analysis. Voxel-wise validation of FD normality across controls was confirmed, and non-Gaussian voxels (3.05% over the brain) were eliminated from subsequent analysis. For each mTBI patient, regions where Z-score values were at least 2 standard deviations away from the mean (i.e. where |Z| > 2.0) were identified. In individual patients the frequently affected regions were amygdala (p = 0.02), vermis(p = 0.03), caudate head (p = 0.04), hippocampus(p = 0.03), and hypothalamus(p = 0.04), all previously reported as dysfunctional after mTBI, but based on group analysis. It is well known that the brain is best modeled as a complex

  16. Using the public health model to address unintentional injuries and TBI: A perspective from the Centers for Disease Control and Prevention (CDC).

    Science.gov (United States)

    Baldwin, Grant; Breiding, Matt; Sleet, David

    2016-06-30

    Traumatic brain injury (TBI) can have long term effects on mental and physical health, and can disrupt vocational, educational, and social functioning. TBIs can range from mild to severe and their effects can last many years after the initial injury. CDC seeks to reduce the burden of TBI from unintentional injuries through a focus on primary prevention, improved recognition and management, and intervening to improve health outcomes after TBI. CDC uses a 4-stage public health model to guide TBI prevention, moving from 1) surveillance of TBI, 2) identification of risk and protective factors for TBI, 3) development and testing of evidence-based interventions, to 4) bringing effective intervention to scale through widespread adoption. CDC's unintentional injury prevention activities focus on the prevention of sports-related concussions, motor vehicle crashes, and older adult falls. For concussion prevention, CDC developed Heads Up - an awareness initiative focusing on ways to prevent a concussion in sports, and identifying how to recognize and manage potential concussions. In motor vehicle injury prevention, CDC has developed a tool (MV PICCS) to calculate the expected number of injuries prevented and lives saved using various evidence-based motor vehicle crash prevention strategies. To help prevent TBI related to older adult falls, CDC has developed STEADI, an initiative to help primary care providers identify their patients' falls risk and provide effective interventions. In the future, CDC is focused on advancing our understanding of the public health burden of TBI through improved surveillance in order to produce more comprehensive estimates of the public health burden of TBI.

  17. Targeting the nNOS/peroxynitrite/calpain system to confer neuroprotection and aid functional recovery in a mouse model of TBI.

    Science.gov (United States)

    Khan, Mushfiquddin; Dhammu, Tajinder S; Matsuda, Fumiyo; Annamalai, Balasubramaniam; Dhindsa, Tejbir Singh; Singh, Inderjit; Singh, Avtar K

    2016-01-01

    Traumatic brain injury (TBI) derails nitric oxide (NO)-based anti-inflammatory and anti-excitotoxicity mechanisms. NO is consumed by superoxide to form peroxynitrite, leading to decreased NO bioavailability for S-nitrosoglutathione (GSNO) synthesis and regulation of neuroprotective pathways. Neuronal peroxynitrite is implicated in neuronal loss and functional deficits following TBI. Using a contusion mouse model of TBI, we investigated mechanisms for the opposed roles of GSNO versus peroxynitrite for neuroprotection and functional recovery. TBI was induced by controlled cortical impact (CCI) in adult male mice. GSNO treatment at 2h after CCI decreased the expression levels of phospho neuronal nitric oxide synthase (pnNOS), alpha II spectrin degraded products, and 3-NT, while also decreasing the activities of nNOS and calpains. Treatment of TBI with FeTPPS, a peroxynitrite scavenger, had effects similar to GSNO treatment. GSNO treatment of TBI also reduced neuronal degeneration and improved neurobehavioral function in a two-week TBI study. In a cell free system, SIN-1 (a peroxynitrite donor and 3-nitrotyrosinating agent) increased whereas GSNO (an S-nitrosylating agent) decreased calpain activity, and these activities were reversed by, respectively, FeTPPS and mercuric chloride, a cysteine-NO bond cleaving agent. These data indicate that peroxynitrite-mediated activation and GSNO-mediated inhibition of the deleterious nNOS/calpain system play critical roles in the pathobiology of neuronal protection and functional recovery in TBI disease. Given GSNO׳s safety record in other diseases, its neuroprotective efficacy and promotion of functional recovery in this TBI study make low-dose GSNO a potential candidate for preclinical evaluation.

  18. ACPSEM ROSG TBI working group recommendations for quality assurance in total body irradiation.

    Science.gov (United States)

    Nelligan, Raelene; Bailey, Michael; Tran, Thu; Baldwin, Zoë

    2015-06-01

    The Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM) radiation oncology specialty group (ROSG) formed a series of working groups in 2011 to develop recommendations for guidance of radiation oncology medical physics practice within the Australasian setting. These recommendations are intended to provide guidance for safe work practices and a suitable level of quality control without detailed work instructions. It is the responsibility of the medical physicist to ensure that locally available equipment and procedures are sufficiently sensitive to establish compliance to these recommendations. The recommendations are endorsed by the ROSG, and have been subject to independent expert reviews. For the Australian audience, these recommendations should be read in conjunction with the tripartite radiation oncology practice standards [1, 2]. This publication presents the recommendations of the ACPSEM total body irradiation working group (TBIWG) and has been developed in alignment with other international associations. However, these recommendations should be read in conjunction with relevant national, state or territory legislation and local requirements, which take precedence over the ACPSEM recommendations. It is hoped that the users of this and other ACPSEM recommendations will contribute to the development of future versions through the ROSG of the ACPSEM. This document serves as a guideline for calibration and quality assurance of equipment used for TBI in Australasia.

  19. Efficacy of memory rehabilitation therapy: a meta-analysis of TBI and stroke cognitive rehabilitation literature.

    Science.gov (United States)

    Elliott, Madison; Parente, Frederick

    2014-01-01

    To examine the efficacy of cognitive rehabilitation strategies specifically designed to improve memory after traumatic brain injury (TBI) and stroke vs. memory improvement with the passage of time. A meta-analysis was performed on 26 studies of memory retraining and recovery that were published between the years of 1985 and 2013. Effect sizes (ESs) from each study were calculated and converted to Pearson's r and then analysed to assess the overall effect size and the relationship among the ESs, patient demographics and treatment interventions. RESULTS indicated a significant average ES (r = 0.51) in the treatment intervention conditions, as well as a significant average ES (r = 0.31) in the control conditions, in which participants did not receive any treatment. The largest ESs occurred in studies of stroke patients and studies concerning working memory rehabilitation. RESULTS showed that memory rehabilitation was an effective therapeutic intervention, especially for stroke patients and for working memory as a treatment domain. However, the results also indicated that significant memory improvement occurred spontaneously over time.

  20. Interrelation between Neuroendocrine Disturbances and Medical Complications Encountered during Rehabilitation after TBI

    Directory of Open Access Journals (Sweden)

    Caroline I. E. Renner

    2015-09-01

    Full Text Available Traumatic brain injury is not a discrete event but an unfolding sequence of damage to the central nervous system. Not only the acute phase but also the subacute and chronic period after injury, i.e., during inpatient rehabilitation, is characterized by multiple neurotransmitter alterations, cellular dysfunction, and medical complications causing additional secondary injury. Neuroendocrine disturbances also influence neurological outcome and are easily overlooked as they often present with diffuse symptoms such as fatigue, depression, poor concentration, or a decline in overall cognitive function; these are also typical sequelae of traumatic brain injury. Furthermore, neurological complications such as hydrocephalus, epilepsy, fatigue, disorders of consciousness, paroxysmal sympathetic hyperactivity, or psychiatric-behavioural symptoms may mask and/or complicate the diagnosis of neuroendocrine disturbances, delay appropriate treatment and impede neurorehabilitation. The present review seeks to examine the interrelation between neuroendocrine disturbances with neurological complications frequently encountered after moderate to severe TBI during rehabilitation. Common neuroendocrine disturbances and medical complications and their clinical implications are discussed.

  1. Effect of Black Grape Juice against Heart Damage from Acute Gamma TBI in Rats

    Directory of Open Access Journals (Sweden)

    Edson Ramos de Andrade

    2013-09-01

    Full Text Available The aim of this study was to evaluate the potential positive effect of black grape juice (BGJ on lipid peroxidation considering Total Body Irradiation (TBI in Wistar rats. As a potential feasible means of evaluation in situ, blood serum lactate dehydrogenase (LDH levels were evaluated as a marker for heart damage from acute radiation syndrome (ARS. Twenty rats were divided into four groups, two of them being irradiated by gamma-rays from a Co-60 source. Animals were treated by gavage with 2 mL per day of BGJ or placebo for one week before and 4 days after 6 Gy whole body gamma-irradiation, when they were euthanasiated. LDH on serum and lipid peroxidation on heart tissue were evaluated. High concentration of metabolites from lipid peroxidation in heart, and high LDH level on serum were found only in gamma-irradiated group given placebo, mainly at the first 24 h after radiation. Phytochemical analysis of BGJ was performed by determining total phenolics, flavonoids, and tannins followed by a high-performance liquid chromatography (HPLC/DAD analysis, which showed resveratrol as the major constituent. Results suggest that BGJ is a good protective candidate compound against heart damage from ARS and its effects suggest its use as a radiomodifier.

  2. Music therapy for early cognitive rehabilitation post-childhood TBI: an intrinsic mixed methods case study.

    Science.gov (United States)

    Bower, Janeen; Catroppa, Cathy; Grocke, Denise; Shoemark, Helen

    2014-10-01

    The primary aim of this case study was to explore the behavioural changes of a paediatric patient in post-traumatic amnesia (PTA) during a music therapy session. A secondary objective was to measure the effect of the music therapy intervention on agitation. Video data from pre, during and post-music therapy sessions were collected and analysed using video micro-analysis and the Agitated Behaviour Scale. The participant displayed four discrete categories of behaviours: Neutral, Acceptance, Recruitment and Rejection. Further analysis revealed brief but consistent and repeated periods of awareness and responsiveness to the live singing of familiar songs, which were classified as Islands of Awareness. Song offered an Environment of Potential to maximise these periods of emerging consciousness. The quantitative data analysis yielded inconclusive results in determining if music therapy was effective in reducing agitation during and immediately post the music therapy sessions. The process of micro-analysis illuminated four discrete participant behaviours not apparent in the immediate clinical setting. The results of this case suggest that the use of familiar song as a music therapy intervention may harness early patient responsiveness to foster cognitive rehabilitation in the early acute phase post-TBI.

  3. Uncovering latent deficits due to mild traumatic brain injury (mTBI by using normobaric hypoxia stress

    Directory of Open Access Journals (Sweden)

    Leonard eTemme

    2013-04-01

    Full Text Available Memory deficits and other cognitive symptoms frequently associated with mTBI are commonly thought to resolve within 7 to 10 days. This generalization is based principally on observations made in individuals who are in the unstressed environmental conditions typical to a clinic and so does not consider the impact of physiologic, environmental or psychological stress. Normobaric Hypoxia (NH stress can be generated by mixing normal mean sea level air (MSL containing 21% oxygen (O2 with nitrogen, which is biologically inert, so that the resultant mixed gas has a partial pressure of O2 approximating that of specified altitudes. This technique was used to generate NH equivalents of 8,000, 12,000 and 14,000 feet above MSL in a group of 36 volunteers with an mTBI history and an equal number of controls matched on the basis of age, gender, weight, etc. Short term visual memory was tested using Matching to Sample (M2S subtest of the BrainCheckers analogue of the Automated Neuropsychological Assessment Metrics (ANAM. Although there were no significant differences in M2S performance between the two groups of subjects at MSL, with increased altitude, performance deteriorated in the mTBI group as predicted to be significantly worse than that of the controls. When the subjects were returned to MSL, the difference disappeared. This finding suggests that the hypoxic challenge paradigm developed here has potential clinical utility for assessing the effects of mTBI in individuals who appear asymptomatic under normal conditions.

  4. The Role of PP2A Methylation in Susceptibility and Resistance to TBI and AD-Induced Neurodegeneration

    Science.gov (United States)

    2014-10-01

    development and characterization in mice. J Neurotrauma 28, 2171-2183. Wood , G.W., Panzer, M.B., Yu, A.W., Rafaels, K.A., Matthews, K.A., Bass, C.R...INTRODUCTION: Neurodegeneration resulting from both traumatic brain injury (TBI) and Alzheimer’s disease (AD) is characterized by aggregates of...we are staining paraffin embedded sections with H&E stain to examine general anatomical and cellular morphology, and performing

  5. Quantitative Tractography and Volumetric MRI in Blast and Blunt Force TBI: Predictors of Neurocognitive and Behavioral Outcome

    Science.gov (United States)

    2015-10-01

    middle frontal and left inferior parietal regions, as well as with the left caudate and right lateral and medial orbital-frontal regions (Orff et al...within cortical and subcortical regions within the frontal and temporal lobes including prefrontal cortices, the anterior cingulate, the temporal cortex... lobe volumes. Initial efforts have proved that volumetric analyses are not as sensitive to the effects of TBI (at least in this subset of

  6. Project Career: Perceived benefits of iPad apps among college students with Traumatic Brain Injury (TBI).

    Science.gov (United States)

    Jacobs, K; Leopold, A; Hendricks, D J; Sampson, E; Nardone, A; Lopez, K B; Rumrill, P; Stauffer, C; Elias, E; Scherer, M; Dembe, J

    2017-09-14

    Project Career is an interprofessional five-year development project designed to improve academic and employment success of undergraduate students with a traumatic brain injury (TBI) at two- and four-year colleges and universities. Students receive technology in the form of iPad applications ("apps") to support them in and out of the classroom. To assess participants' perspectives on technology at baseline and perceived benefit of apps after 6 and 12 months of use. This article address a component of a larger study. Participants included 50 college-aged students with traumatic brain injuries. Statistical analysis included data from two Matching Person and Technology (MPT) assessment forms, including the Survey of Technology Use at baseline and the Assistive Technology Use Follow-Up Survey: Apps Currently Using, administered at 6- and 12-months re-evaluation. Analyses included frequencies and descriptives. Average scores at baseline indicated positive perspectives on technology. At 6 months, quality of life (67%) and academics (76%) improved moderately or more from the use of iPad apps. At 12 months, quality of life (65%) and academics (82%) improved moderately or more from the use of iPad apps. Students with a TBI have positive perspectives on technology use. The results on perceived benefit of apps indicated that students with a TBI (including civilians and veterans) report that the apps help them perform in daily life and academic settings.

  7. Variation in monitoring and treatment policies for intracranial hypertension in traumatic brain injury: A survey in 66 neurotrauma centers participating in the CENTER-TBI study

    NARCIS (Netherlands)

    M.C. Cnossen (Maryse); Huijben, J.A. (Jilske A.); van der Jagt, M. (Mathieu); Volovici, V. (Victor); van Essen, T. (Thomas); S. Polinder (Suzanne); D. Nelson (David); Ercole, A. (Ari); Stocchetti, N. (Nino); Citerio, G. (Giuseppe); W.C. Peul (Wilco); A.I.R. Maas (Andrew I.R.); D.K. Menon (David ); E.W. Steyerberg (Ewout W.); Lingsma, H.F. (Hester F.); Adams, H. (Hadie); Alessandro, M. (Masala); J. Allanson (Judith); Amrein, K. (Krisztina); Andaluz, N. (Norberto); N. Andelic (Nada); Andrea, N. (Nanni); L. Andreassen (Lasse); Anke, A. (Audny); Antoni, A. (Anna); Ardon, H. (Hilko); Audibert, G. (Gérard); Auslands, K. (Kaspars); Azouvi, P. (Philippe); Baciu, C. (Camelia); Bacon, A. (Andrew); Badenes, R. (Rafael); Baglin, T. (Trevor); R.H.M.A. Bartels (Ronald); P. Barzo (P.); Bauerfeind, U. (Ursula); R. Beer (Ronny); Belda, F.J. (Francisco Javier); B.-M. Bellander (Bo-Michael); A. Belli (Antonio); Bellier, R. (Rémy); H. Benali (Habib); Benard, T. (Thierry); M. Berardino (Maurizio); L. Beretta (Luigi); Beynon, C. (Christopher); Bilotta, F. (Federico); H. Binder (Harald); Biqiri, E. (Erta); Blaabjerg, M. (Morten); Lund, S.B. (Stine Borgen); Bouzat, P. (Pierre); Bragge, P. (Peter); Brazinova, A. (Alexandra); F. Brehar (Felix); Brorsson, C. (Camilla); Buki, A. (Andras); M. Bullinger (Monika); Bucková, V. (Veronika); Calappi, E. (Emiliana); P. Cameron (Peter); Carbayo, L.G. (Lozano Guillermo); Carise, E. (Elsa); K.L.H. Carpenter (Keri L.H.); Castaño-León, A.M. (Ana M.); Causin, F. (Francesco); Chevallard, G. (Giorgio); A. Chieregato (Arturo); G. Citerio (Giuseppe); Cnossen, M. (Maryse); M. Coburn (Mark); J.P. Coles (Jonathan P.); Cooper, J.D. (Jamie D.); Correia, M. (Marta); A. Covic (Amra); N. Curry (Nicola); E. Czeiter (Endre); M. Czosnyka (Marek); Dahyot-Fizelier, C. (Claire); F. Damas (François); P. Damas (Pierre); H. Dawes (Helen); De Keyser, V. (Véronique); F.D. Corte (Francesco); B. Depreitere (Bart); Ding, S. (Shenghao); D.W.J. Dippel (Diederik); K. Dizdarevic (Kemal); Dulière, G.-L. (Guy-Loup); Dzeko, A. (Adelaida); G. Eapen (George); Engemann, H. (Heiko); A. Ercole (Ari); P. Esser (Patrick); Ezer, E. (Erzsébet); M. Fabricius (Martin); V.L. Feigin (V.); Feng, J. (Junfeng); Foks, K. (Kelly); F. Fossi (Francesca); Francony, G. (Gilles); J. Frantzén (Janek); Freo, U. (Ulderico); S.K. Frisvold (Shirin Kordasti); Furmanov, A. (Alex); Gagliardo, P. (Pablo); D. Galanaud (Damien); G. Gao (Guoyi); K. Geleijns (Karin); A. Ghuysen (Alexandre); Giraud, B. (Benoit); Glocker, B. (Ben); Gomez, P.A. (Pedro A.); Grossi, F. (Francesca); R.L. Gruen (Russell); Gupta, D. (Deepak); J.A. Haagsma (Juanita); E. Hadzic (Ermin); I. Haitsma (Iain); J.A. Hartings (Jed); R. Helbok (Raimund); E. Helseth (Eirik); Hertle, D. (Daniel); S. Hill (Sean); Hoedemaekers, A. (Astrid); S. Hoefer (Stefan); P.J. Hutchinson (Peter J.); Håberg, K.A. (Kristine Asta); B.C. Jacobs (Bart); Janciak, I. (Ivan); K. Janssens (Koen); Jiang, J.-Y. (Ji-Yao); Jones, K. (Kelly); Kalala, J.-P. (Jean-Pierre); Kamnitsas, K. (Konstantinos); Karan, M. (Mladen); Karau, J. (Jana); A. Katila (Ari); M. Kaukonen (Maija); Keeling, D. (David); Kerforne, T. (Thomas); N. Ketharanathan (Naomi); Kettunen, J. (Johannes); Kivisaari, R. (Riku); A.G. Kolias (Angelos G.); Kolumbán, B. (Bálint); E.J.O. Kompanje (Erwin); D. Kondziella (Daniel); L.-O. Koskinen (Lars-Owe); Kovács, N. (Noémi); F. Kalovits (Ferenc); A. Lagares (Alfonso); L. Lanyon (Linda); S. Laureys (Steven); Lauritzen, M. (Martin); F.E. Lecky (Fiona); C. Ledig (Christian); R. Lefering; V. Legrand (Valerie); Lei, J. (Jin); L. Levi (Leon); R. Lightfoot (Roger); H.F. Lingsma (Hester); D. Loeckx (Dirk); Lozano, A. (Angels); Luddington, R. (Roger); Luijten-Arts, C. (Chantal); Maas, A.I.R. (Andrew I.R.); MacDonald, S. (Stephen); MacFayden, C. (Charles); M. Maegele; M. Majdan (Marek); Major, S. (Sebastian); A. Manara (Alex); Manhes, P. (Pauline); G. Manley (Geoffrey); Martin, D. (Didier); C. Martino (Costanza); Maruenda, A. (Armando); H. Maréchal (Hugues); Mastelova, D. (Dagmara); Mattern, J. (Julia); McMahon, C. (Catherine); Melegh, B. (Béla); Menon, D. (David); T. Menovsky (Tomas); Morganti-Kossmann, C. (Cristina); Mulazzi, D. (Davide); Mutschler, M. (Manuel); H. Mühlan (Holger); Negru, A. (Ancuta); Nelson, D. (David); E. Neugebauer (Eddy); V.F. Newcombe (Virginia F.); Noirhomme, Q. (Quentin); Nyirádi, J. (József); M. Oddo (Mauro); A.W. Oldenbeuving; M. Oresic (Matej); Ortolano, F. (Fabrizio); A. Palotie (Aarno); P.M. Parizel; Patruno, A. (Adriana); J.-F. Payen (Jean-François); Perera, N. (Natascha); V. Perlbarg (Vincent); Persona, P. (Paolo); Peul, W. (Wilco); N. Pichon (Nicolas); Piilgaard, H. (Henning); A. Piippo (Anna); S.P. Floury (Sébastien Pili); M. Pirinen (Matti); H. Ples (Horia); Polinder, S. (Suzanne); Pomposo, I. (Inigo); M. Psota (Marek); P. Pullens (Pim); L. Puybasset (Louis); A. Ragauskas (Arminas); R. Raj (Rahul); Rambadagalla, M. (Malinka); Rehorcíková, V. (Veronika); J.K.J. Rhodes (Jonathan K.J.); S. Richardson (Sylvia); S. Ripatti (Samuli); S. Rocka (Saulius); Rodier, N. (Nicolas); Roe, C. (Cecilie); Roise, O. (Olav); G. Roks (Gerwin); Romegoux, P. (Pauline); J. Rosand (Jonathan); Rosenfeld, J. (Jeffrey); C. Rosenlund (Christina); G. Rosenthal (Guy); R. Rossaint (Rolf); S. Rossi (Sandra); Rostalski, T. (Tim); D. Rueckert (Daniel); de Ruiz, A.F. (Arcaute Felix); M. Rusnák (Martin); Sacchi, M. (Marco); Sahakian, B. (Barbara); J. Sahuquillo (Juan); O. Sakowitz (Oliver); Sala, F. (Francesca); Sanchez-Pena, P. (Paola); Sanchez-Porras, R. (Renan); Sandor, J. (Janos); Santos, E. (Edgar); N. Sasse (Nadine); Sasu, L. (Luminita); Savo, D. (Davide); I.B. Schipper (Inger); Schlößer, B. (Barbara); S. Schmidt (Silke); Schneider, A. (Annette); H. Schoechl (Herbert); G.G. Schoonman; Rico, F.S. (Frederik Schou); E. Schwendenwein (Elisabeth); Schöll, M. (Michael); Sir, O. (özcan); T. Skandsen (Toril); Smakman, L. (Lidwien); D. Smeets (Dominique); Smielewski, P. (Peter); Sorinola, A. (Abayomi); E. Stamatakis (Emmanuel); S. Stanworth (Simon); Stegemann, K. (Katrin); Steinbüchel, N. (Nicole); R. Stevens (Robert); W. Stewart (William); E.W. Steyerberg (Ewout); N. Stocchetti (Nino); Sundström, N. (Nina); Synnot, A. (Anneliese); J. Szabó (József); J. Söderberg (Jeannette); F.S. Taccone (Fabio); Tamás, V. (Viktória); Tanskanen, P. (Päivi); A. Tascu (Alexandru); Taylor, M.S. (Mark Steven); Te, A.B. (Ao Braden); O. Tenovuo (Olli); Teodorani, G. (Guido); A. Theadom (Alice); Thomas, M. (Matt); D. Tibboel (Dick); C.M. Tolias (Christos M.); Tshibanda, J.-F.L. (Jean-Flory Luaba); Tudora, C.M. (Cristina Maria); P. Vajkoczy (Peter); Valeinis, E. (Egils); Hecke, W.V. (Wim Van); Praag, D.V. (Dominique Van); Dirk, V.R. (Van Roost); Vlierberghe, E.V. (Eline Van); Vyvere, T.V. (Thijs vande); Vanhaudenhuyse, A. (Audrey); A. Vargiolu (Alessia); E. Vega (Emmanuel); J. Verheyden (Jan); Vespa, P.M. (Paul M.); A. Vik (Anne); R. Vilcinis (Rimantas); Vizzino, G. (Giacinta); C.L.A.M. Vleggeert-Lankamp (Carmen); V. Volovici (Victor); P. Vulekovic (Peter); Vámos, Z. (Zoltán); Wade, D. (Derick); Wang, K.K.W. (Kevin K.W.); Wang, L. (Lei); E.D. Wildschut (Enno); G. Williams (Guy); Willumsen, L. (Lisette); Wilson, A. (Adam); Wilson, L. (Lindsay); Winkler, M.K.L. (Maren K.L.); P. Ylén (Peter); Younsi, A. (Alexander); M. Zaaroor (Menashe); Zhang, Z. (Zhiqun); Zheng, Z. (Zelong); Zumbo, F. (Fabrizio); de Lange, S. (Stefanie); G.C.W. De Ruiter (Godard C.W.); den Boogert, H. (Hugo); van Dijck, J. (Jeroen); T.A. van Essen (T.); C.M. van Heugten (Caroline M.); M. van der Jagt (Mathieu); J. van der Naalt (Joukje)

    2017-01-01

    textabstractBackground: No definitive evidence exists on how intracranial hypertension should be treated in patients with traumatic brain injury (TBI). It is therefore likely that centers and practitioners individually balance potential benefits and risks of different intracranial pressure (ICP)

  8. Pressure Autoregulation Measurement Techniques in Adult TBI, Part I: A Scoping Review of Intermittent/Semi-Intermittent Methods.

    Science.gov (United States)

    Zeiler, Frederick Adam; Donnelly, Joseph; Calviello, Leanne; Menon, David; Smieleweski, Peter; Czosnyka, Marek

    2017-06-24

    To perform a systematic, scoping review of commonly described intermittent/semi-intermittent autoregulation measurement techniques in adult TBI. Nine separate systematic reviews were conducted for each intermittent technique: Computed tomographic perfusion (CTP)/Xenon-CT (Xe-CT), positron emission tomography (PET), magnetic resonance imaging (MRI), arterio-venous difference in oxygen (AVDO2) technique, thigh cuff deflation technique (TCDT), transient hyperemic response test (THRT), orthostatic hypotension test (OHT), mean flow index (Mx) and transfer function ARI (TF-ARI). MEDLINE, BIOSIS, EMBASE, Global Health, Scopus, Cochrane Library (inception to December 2016) and reference lists of relevant articles were searched. A two-tier filter of references was conducted. The total number of articles utilizing each of the 9 searched techniques for intermittent/semi-intermittent autoregulation techniques in adult TBI were: CTP/Xe-CT (10), PET (6), MRI (0), AVDO2 (10), autoregulation index (ARI) based TCDT (9), THRT (6), OHT (3), Mx (17) and TF-ARI (6). The premise behind all of the intermittent techniques is manipulation of systemic blood pressure/blood volume via either chemical (such as vasopressors) or mechanical (such as thigh cuffs or carotid compression) means. Exceptionally, Mx and TF-ARI are based on spontaneous fluctuations of CPP or MAP. The method for assessing the cerebral circulation during these manipulations varies, with both imaging based techniques and TCD utilized. Despite the limited literature for intermittent/semi-intermittent techniques in adult TBI (minus Mx), it is important to acknowledge the availability of such tests. They have provided fundamental insight into human autoregulatory capacity, leading to the development of continuous and more commonly applied techniques in the ICU. Numerous methods of intermittent/semi-intermittent pressure autoregulation assessment in adult TBI exist, including: CTP/Xe-CT, PET, AVDO2 technique, TCDT based ARI

  9. Validity of the RIAS for assessing children with traumatic brain injury: sensitivity to TBI and comparability to the WISC-III and WISC-IV.

    Science.gov (United States)

    Allen, Daniel N; Stolberg, Paul C; Thaler, Nicholas S; Sutton, Griffin; Mayfield, Joan

    2014-01-01

    Intelligence tests are commonly administered to children following moderate-to-severe traumatic brain injury (TBI). The Reynolds Intellectual Assessment Scales (RIAS) is a recently developed measure of intellectual ability that has a number of appealing features for assessing individuals with brain damage, but as yet has little validity information when applied to children with TBI or other forms of brain injury. It is therefore unclear whether RIAS scores are sensitive to brain injury and how they compare to older more well-established tests such as the Wechsler scales. The current article reports two studies that examine these matters in youth with TBI. The first study examined sensitivity of the RIAS to TBI in 110 children. Results indicated the TBI sample performed significantly worse compared with the standardization sample on all RIAS index scores. The second study included 102 children who were administered either the RIAS, Wechsler Intelligence Scale for Children-Third Edition (WISC-III), or WISC-Fourth Edition (WISC-IV; 34 children in each group). Comparisons among the RIAS, WISC-III, and WISC-IV groups indicated no significant differences among the measures on verbal, nonverbal, and Composite Index/Full-Scale IQs. Results provide support for the sensitivity of the RIAS to TBI in children and also suggest that IQs produced by the RIAS, WISC-III, and WISC-IV do not significantly vary from one test to the other, which is particularly true of the verbal and Composite Index/Full-Scale IQs.

  10. Activation-induced spatiotemporal cerebral blood flow changes and behavioral deficit after developmental mTBI in rats can be favorably altered by facilitating mitochondrial calcium uptake

    Directory of Open Access Journals (Sweden)

    Madhuvika eMurugan

    2016-03-01

    Full Text Available Mild to moderate traumatic brain injury (mTBI leads to secondary neuronal loss via excitotoxic mechanisms, including mitochondrial Ca2+ overload. However in the surviving cellular population, mitochondrial Ca2+ influx and oxidative metabolism are diminished leading to suboptimal neuronal circuit activity and poor prognosis. Hence we tested the impact of boosting neuronal electrical activity and oxidative metabolism by facilitating mitochondrial Ca2+ uptake in a rat model of mTBI. In developing rats (P25-P26 sustaining an mTBI, we demonstrate post-traumatic changes in cerebral blood flow (CBF in the sensorimotor cortex in response to whisker stimulation compared to sham using functional Laser Doppler Imaging (fLDI at adulthood (P67-P73. Compared to sham, whisker stimulation-evoked positive CBF responses decreased while negative CBF responses increased in the mTBI animals. The spatiotemporal CBF changes representing underlying neuronal activity suggested profound changes to neurovascular activity after mTBI. Behavioral assessment of the same cohort of animals prior to fLDI showed that mTBI resulted in persistent contralateral sensorimotor behavioral deficit along with ipsilateral neuronal loss compared to sham. Treating mTBI rats with Kaempferol, a dietary flavonol compound that enhanced mitochondrial Ca2+ uptake, eliminated the inter-hemispheric asymmetry in the whisker stimulation-induced positive CBF responses and the ipsilateral negative CBF responses otherwise observed in the untreated and vehicle-treated mTBI animals in adulthood. Kaempferol also improved somatosensory behavioral measures compared to untreated and vehicle treated mTBI animals without augmenting post-injury neuronal loss. The results indicate that reduced mitochondrial Ca2+ uptake in the surviving populations affect post-traumatic neural activation leading to persistent behavioral deficits. Improvement in sensorimotor behavior and spatiotemporal neurovascular activity

  11. Diffusion tensor imaging (DTI) findings in adult civilian, military, and sport-related mild traumatic brain injury (mTBI): a systematic critical review.

    Science.gov (United States)

    Asken, Breton Michael; DeKosky, Steven T; Clugston, James R; Jaffee, Michael S; Bauer, Russell M

    2017-03-24

    This review seeks to summarize diffusion tensor imaging (DTI) studies that have evaluated structural changes attributed to the mechanisms of mild traumatic brain injury (mTBI) in adult civilian, military, and athlete populations. Articles from 2002 to 2016 were retrieved from PubMed/MEDLINE, EBSCOhost, and Google Scholar, using a Boolean search string containing the following terms: "diffusion tensor imaging", "diffusion imaging", "DTI", "white matter", "concussion", "mild traumatic brain injury", "mTBI", "traumatic brain injury", and "TBI". We added studies not identified by this method that were found via manually-searched reference lists. We identified 86 eligible studies from English-language journals using, adult, human samples. Studies were evaluated based on duration between injury and DTI assessment, categorized as acute, subacute/chronic, remote mTBI, and repetitive brain trauma considerations. Since changes in brain structure after mTBI can also be affected by other co-occurring medical and demographic factors, we also briefly review DTI studies that have addressed socioeconomic status factors (SES), major depressive disorder (MDD), and attention-deficit hyperactivity disorder (ADHD). The review describes population-specific risks and the complications of clinical versus pathophysiological outcomes of mTBI. We had anticipated that the distinct population groups (civilian, military, and athlete) would require separate consideration, and various aspects of the study characteristics supported this. In general, study results suggested widespread but inconsistent differences in white matter diffusion metrics (primarily fractional anisotropy [FA], mean diffusivity [MD], radial diffusivity [RD], and axial diffusivity [AD]) following mTBI/concussion. Inspection of study designs and results revealed potential explanations for discrepant DTI findings, such as control group variability, analytic techniques, the manner in which regional differences were reported, and

  12. Development of a 3D immersive videogame to improve arm-postural coordination in patients with TBI

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    Cassavaugh Nicholas D

    2011-10-01

    Full Text Available Abstract Background Traumatic brain injury (TBI disrupts the central and executive mechanisms of arm(s and postural (trunk and legs coordination. To address these issues, we developed a 3D immersive videogame-- Octopus. The game was developed using the basic principles of videogame design and previous experience of using videogames for rehabilitation of patients with acquired brain injuries. Unlike many other custom-designed virtual environments, Octopus included an actual gaming component with a system of multiple rewards, making the game challenging, competitive, motivating and fun. Effect of a short-term practice with the Octopus game on arm-postural coordination in patients with TBI was tested. Methods The game was developed using WorldViz Vizard software, integrated with the Qualysis system for motion analysis. Avatars of the participant's hands precisely reproducing the real-time kinematic patterns were synchronized with the simulated environment, presented in the first person 3D view on an 82-inch DLP screen. 13 individuals with mild-to-moderate manifestations of TBI participated in the study. While standing in front of the screen, the participants interacted with a computer-generated environment by popping bubbles blown by the Octopus. The bubbles followed a specific trajectory. Interception of the bubbles with the left or right hand avatar allowed flexible use of the postural segments for balance maintenance and arm transport. All participants practiced ten 90-s gaming trials during a single session, followed by a retention test. Arm-postural coordination was analysed using principal component analysis. Results As a result of the short-term practice, the participants improved in game performance, arm movement time, and precision. Improvements were achieved mostly by adapting efficient arm-postural coordination strategies. Of the 13 participants, 10 showed an immediate increase in arm forward reach and single-leg stance time. Conclusion

  13. Cognitive control of conscious error awareness: error awareness and error positivity (Pe) amplitude in moderate-to-severe traumatic brain injury (TBI).

    Science.gov (United States)

    Logan, Dustin M; Hill, Kyle R; Larson, Michael J

    2015-01-01

    Poor awareness has been linked to worse recovery and rehabilitation outcomes following moderate-to-severe traumatic brain injury (M/S TBI). The error positivity (Pe) component of the event-related potential (ERP) is linked to error awareness and cognitive control. Participants included 37 neurologically healthy controls and 24 individuals with M/S TBI who completed a brief neuropsychological battery and the error awareness task (EAT), a modified Stroop go/no-go task that elicits aware and unaware errors. Analyses compared between-group no-go accuracy (including accuracy between the first and second halves of the task to measure attention and fatigue), error awareness performance, and Pe amplitude by level of awareness. The M/S TBI group decreased in accuracy and maintained error awareness over time; control participants improved both accuracy and error awareness during the course of the task. Pe amplitude was larger for aware than unaware errors for both groups; however, consistent with previous research on the Pe and TBI, there were no significant between-group differences for Pe amplitudes. Findings suggest possible attention difficulties and low improvement of performance over time may influence specific aspects of error awareness in M/S TBI.

  14. WAIS-III processing speed index scores after TBI: the influence of working memory, psychomotor speed and perceptual processing.

    Science.gov (United States)

    Kennedy, Jan E; Clement, Pamelia F; Curtiss, Glenn

    2003-08-01

    This study investigates the extent to which working memory, motor speed and perceptual processing speed influence Wechsler Adult Intelligence Scale-III (WAIS-III) Processing Speed Index (PSI) scores. Sixty-eight adult outpatients with Traumatic Brain Injury (TBI) of varying severity and complete data on all outcome measures were identified. Two cases with outlying values on one outcome measure were omitted from the final sample. Working memory was measured by the Working Memory Index score from the WAIS-III. Motor speed was measured as score on the Halstead-Reitan Finger Oscillation Test (finger tapping) and perceptual processing as score on the Trail Making Test--Part B. In hierarchical multiple regression analyses, working memory accounted for 10% of the variance in PSI scores, whereas motor speed only accounted for 3%. An independent measure of perceptual processing, Trail Making Test--B, accounted for 26% of the variance in WAIS-III PSI scores. The total variance accounted for by the three factors was 56%. Findings confirm that the WAIS-III PSI scores of individuals who have received a TBI reflect perceptual processing speed, with an additional component attributable to working memory. Motor speed made only a small contribution to WAIS-III PSI scores in the present sample.

  15. Language and cognitive communication disorder during post-traumatic amnesia: Profiles of recovery after TBI from three cases.

    Science.gov (United States)

    Steel, Joanne; Ferguson, Alison; Spencer, Elizabeth; Togher, Leanne

    2017-09-25

    There has been limited empirical speech-language pathology (SLP) study of language and cognitive communication during post-traumatic amnesia (PTA) and the early stages after TBI. The purpose of the current research was to explore the potential means and utility of assessing cognitive communication during PTA and the post-acute recovery period. This research used a longitudinal mixed methods design to describe language and cognitive communication assessment and recovery profiles of three patients with TBI. Cognitive communication was assessed with repeated standardised and non-standardised methods during PTA (rated with Westmead PTA Scale) and at follow-up 3 months after PTA emergence. All participants demonstrated a profile of language and cognitive communication strengths and weaknesses during PTA and the post-acute period, also evident at follow-up. Improvement occurred gradually throughout PTA, although with individual fluctuation across test occasions. There was no marked change in communication function immediately before and after PTA emergence, indicating that cognitive communication ability and those functions measured on the Westmead PTA Scale (memory and orientation) did not recover at the same rate. It was feasible to assess language and cognitive communication throughout PTA and the post-acute period, and early assessment results were relevant to the patient's ongoing communicative function. It is suggested that early and repeated SLP assessment may contribute to the prediction of persisting cognitive communication issues.

  16. Predicting 14-day mortality after severe traumatic brain injury: application of the IMPACT models in the brain trauma foundation TBI-trac® New York State database.

    Science.gov (United States)

    Roozenbeek, Bob; Chiu, Ya-Lin; Lingsma, Hester F; Gerber, Linda M; Steyerberg, Ewout W; Ghajar, Jamshid; Maas, Andrew I R

    2012-05-01

    Prognostic models for outcome prediction in patients with traumatic brain injury (TBI) are important instruments in both clinical practice and research. To remain current a continuous process of model validation is necessary. We aimed to investigate the performance of the International Mission on Prognosis and Analysis of Clinical Trials in TBI (IMPACT) prognostic models in predicting mortality in a contemporary New York State TBI registry developed and maintained by the Brain Trauma Foundation. The Brain Trauma Foundation (BTF) TBI-trac® database contains data on 3125 patients who sustained severe TBI (Glasgow Coma Scale [GCS] score ≤ 8) in New York State between 2000 and 2009. The outcome measure was 14-day mortality. To predict 14-day mortality with admission data, we adapted the IMPACT Core and Extended models. Performance of the models was assessed by determining calibration (agreement between observed and predicted outcomes), and discrimination (separation of those patients who die from those who survive). Calibration was explored graphically with calibration plots. Discrimination was expressed by the area under the receiver operating characteristic (ROC) curve (AUC). A total of 2513 out of 3125 patients in the BTF database met the inclusion criteria. The 14-day mortality rate was 23%. The models showed excellent calibration. Mean predicted probabilities were 20% for the Core model and 24% for the Extended model. Both models showed good discrimination with AUCs of 0.79 (Core) and 0.83 (Extended). We conclude that the IMPACT models validly predict 14-day mortality in the BTF database, confirming generalizability of these models for outcome prediction in TBI patients.

  17. Evaluating a Novel Sleep-Focused Mind-body Rehabilitative Program for Veterans. Veterans with mTBI and Other Polytrauma Symptoms: An RCT Study

    Science.gov (United States)

    2013-09-01

    Veterans with mTBI and other “ polytrauma ” symptoms: An RCT study PRINCIPAL INVESTIGATOR: Yoshio Nakamura, Ph.D. CONTRACTING...Veterans with mTBI and other “ polytrauma ” symptoms: An RCT study 5a. CONTRACT NUMBER W81XWH-12-1-0385 5b. GRANT NUMBER W81XWH-12-1-0385...DoD HRPO and started planning study logistics and refined them by meeting with the Polytrauma clinic to inform their personnel about the study and

  18. Decreasing adrenergic or sympathetic hyperactivity after severe traumatic brain injury using propranolol and clonidine (DASH After TBI Study: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Patel Mayur B

    2012-09-01

    Full Text Available Abstract Background Severe TBI, defined as a Glasgow Coma Scale ≤ 8, increases intracranial pressure and activates the sympathetic nervous system. Sympathetic hyperactivity after TBI manifests as catecholamine excess, hypertension, abnormal heart rate variability, and agitation, and is associated with poor neuropsychological outcome. Propranolol and clonidine are centrally acting drugs that may decrease sympathetic outflow, brain edema, and agitation. However, there is no prospective randomized evidence available demonstrating the feasibility, outcome benefits, and safety for adrenergic blockade after TBI. Methods/Design The DASH after TBI study is an actively accruing, single-center, randomized, double-blinded, placebo-controlled, two-arm trial, where one group receives centrally acting sympatholytic drugs, propranolol (1 mg intravenously every 6 h for 7 days and clonidine (0.1 mg per tube every 12 h for 7 days, and the other group, double placebo, within 48 h of severe TBI. The study uses a weighted adaptive minimization randomization with categories of age and Marshall head CT classification. Feasibility will be assessed by ability to provide a neuroradiology read for randomization, by treatment contamination, and by treatment compliance. The primary endpoint is reduction in plasma norepinephrine level as measured on day 8. Secondary endpoints include comprehensive plasma and urine catecholamine levels, heart rate variability, arrhythmia occurrence, infections, agitation measures using the Richmond Agitation-Sedation Scale and Agitated Behavior scale, medication use (anti-hypertensive, sedative, analgesic, and antipsychotic, coma-free days, ventilator-free days, length of stay, and mortality. Neuropsychological outcomes will be measured at hospital discharge and at 3 and 12 months. The domains tested will include global executive function, memory, processing speed, visual-spatial, and behavior. Other assessments include

  19. Total body irradiation (TBI) in pediatric patients. A single-center experience after 30 years of low-dose rate irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Linsenmeier, Claudia; Thoennessen, Daniel; Negretti, Laura; Streller, Tino; Luetolf, Urs Martin [University Hospital Zurich (Switzerland). Dept. of Radiation-Oncology; Bourquin, Jean-Pierre [University Children' s Hospital Zurich (Switzerland). Dept. of Hemato-Oncology; Oertel, Susanne [University Hospital Zurich (Switzerland). Dept. of Radiation-Oncology; Heidelberg Univ. (Germany). Dept. of Radiation Oncology

    2010-11-15

    To retrospectively analyze patient characteristics, treatment, and treatment outcome of pediatric patients with hematologic diseases treated with total body irradiation (TBI) between 1978 and 2006. 32 pediatric patients were referred to the Department of Radiation-Oncology at the University of Zurich for TBI. Records of regular follow-up of 28 patients were available for review. Patient characteristics as well as treatment outcome regarding local control and overall survival were assessed. A total of 18 patients suffered from acute lymphoblastic leukemia (ALL), 5 from acute and 2 from chronic myelogenous leukemia, 1 from non-Hodgkin lymphoma, and 2 from anaplastic anemia. The cohort consisted of 15 patients referred after first remission and 13 patients with relapsed leukemia. Mean follow-up was 34 months (2-196 months) with 15 patients alive at the time of last follow-up. Eight patients died of recurrent disease, 1 of graft vs. host reaction, 2 of sepsis, and 2 patients died of a secondary malignancy. The 5-year overall survival rate (OS) was 60%. Overall survival was significantly inferior in patients treated after relapse compared to those treated for newly diagnosed leukemia (24% versus 74%; p=0.004). At the time of last follow-up, 11 patients survived for more than 36 months following TBI. Late effects (RTOG {>=}3) were pneumonitis in 1 patient, chronic bronchitis in 1 patient, cardiomyopathy in 2 patients, severe cataractogenesis in 1 patient (48 months after TBI with 10 Gy in a single dose) and secondary malignancies in 2 patients (36 and 190 months after TBI). Growth disturbances were observed in all patients treated prepubertally. In 2 patients with identical twins treated at ages 2 and 7, a loss of 8% in final height of the treated twin was observed. As severe late sequelae after TBI, we observed 2 secondary malignancies in 11 patients who survived in excess of 36 months. However, long-term morbidity is moderate following treatment with the fractionated

  20. The family experiences of in-hospital care questionnaire in severe traumatic brain injury (FECQ-TBI): a validation study.

    Science.gov (United States)

    Anke, Audny; Manskow, Unn Sollid; Friborg, Oddgeir; Røe, Cecilie; Arntzen, Cathrine

    2016-11-28

    Family members are important for support and care of their close relative after severe traumas, and their experiences are vital health care quality indicators. The objective was to describe the development of the Family Experiences of in-hospital Care Questionnaire for family members of patients with severe Traumatic Brain Injury (FECQ-TBI), and to evaluate its psychometric properties and validity. The design of the study is a Norwegian multicentre study inviting 171 family members. The questionnaire developmental process included a literature review, use of an existing instrument (the parent experience of paediatric care questionnaire), focus group with close family members, as well as expert group judgments. Items asking for family care experiences related to acute wards and rehabilitation were included. Several items of the paediatric care questionnaire were removed or the wording of the items was changed to comply with the present purpose. Questions covering experiences with the inpatient rehabilitation period, the discharge phase, the family experiences with hospital facilities, the transfer between departments and the economic needs of the family were added. The developed questionnaire was mailed to the participants. Exploratory factor analyses were used to examine scale structure, in addition to screening for data quality, and analyses of internal consistency and validity. The questionnaire was returned by 122 (71%) of family members. Principal component analysis extracted six dimensions (eigenvalues > 1.0): acute organization and information (10 items), rehabilitation organization (13 items), rehabilitation information (6 items), discharge (4 items), hospital facilities-patients (4 items) and hospital facilities-family (2 items). Items related to the acute phase were comparable to items in the two dimensions of rehabilitation: organization and information. All six subscales had high Cronbach's alpha coefficients >0.80. The construct validity was

  1. Molecular programs induced by heat acclimation confer neuroprotection against TBI and hypoxic insults via cross-tolerance mechanisms

    Directory of Open Access Journals (Sweden)

    Michal eHorowitz

    2015-07-01

    Full Text Available Neuroprotection following prolonged exposure to high ambient temperatures (heat acclimation HA develops via altered molecular programs such as cross-tolerance (Heat Acclimation -Neuroprotection Cross-Tolerance -HANCT. The mechanisms underlying cross-tolerance depend on enhanced on-demand protective pathways evolving during acclimation. The protection achieved is long lasting and limits the need for de novo recruitment of cytoprotective pathways upon exposure to novel stressors. Using mouse and rat acclimated phenotypes, we will focus on the impact of heat acclimation on Angiotensin II-AT2 receptors in neurogenesis and on HIF-1 as key mediators in spontaneous recovery and HANCT after traumatic brain injury (TBI. The neuroprotective consequences of heat acclimation on NMDA and AMPA receptors will be discussed using the global hypoxia model. A behavioral-molecular link will be crystallized. The differences between HANCT and consensus preconditioning will be reviewed.

  2. PENINGKATAN KETERAMPILAN BERBICARA BAHASA INGGRIS DENGAN METODE SUGGESTOPEDIA PADA MAHASISWA SEMESTER II-E TBI STAIN PAMEKASAN

    Directory of Open Access Journals (Sweden)

    Sumihatul Ummah

    2015-11-01

    Full Text Available There are two problems in the result of research that will be discussed in this article. They are (1 how are the steps of the implementation of suggestopedia method in learning speaking English at the second semester students of E class TBI STAIN Pamekasan and (2 How are the increasing of speaking English skill for the second semester students of E class TBI STAIN Pamekasan in learning speaking English by using the suggestopedia method. The research method is classroom action research by using research strategy of Kemmis and Mc Taggert Model which consist of four (4 steps, namely planning, acting, observing, and reflecting. The result of research provided that classically for the 1st, 2nd, and 3rd cycle indicated the increasing of students learning completeness scores, each of them are 38.23%, 67.54%, and 82.35%. While the students performance for each aspects are increasing from the 1st cycle up to 3rd cycle. The students performance of speaking English activities in the classroom from each aspects that more appear was grammar with score 85.2%. for the 2nd cycle was comprehensibility with score 88.2% and vocabulary with score 88.2%, and for the 3rd  cycle that more appear was fluency with score 91.2%.  Besides, for the frequency percentage of students performance from each cycles are more increasing, by the 1st  cycle 55% (enough, the 2nd cycle 70% (good, and the 3rd cycle 85% (very good. Finally, the suggestopedia method in learning speaking English can increase the result of students learning. In fact, the students look like be enthusiastic in learning speaking English. The students were active to joint with this subject from each cycle. By the good atmosphere, conducive situation of the classroom, and soft music made the students to be relax in learning the subject. It also was increase imagination, concentration, and liveliness for the students.

  3. TBI Patient, Injury, Therapy, and Ancillary Treatments Associated with Outcomes at Discharge and 9 Months Post-discharge

    Science.gov (United States)

    Horn, Susan D.; Corrigan, John D.; Beaulieu, Cynthia L.; Bogner, Jennifer; Barrett, Ryan S.; Giuffrida, Clare G.; Ryser, David K.; Cooper, Kelli; Carroll, Deborah M.; Deutscher, Daniel

    2015-01-01

    Objective To examine associations of patient and injury characteristics, inpatient rehabilitation therapy activities, and neurotropic medications with outcomes at discharge and 9 months post-discharge for patients with traumatic brain injury (TBI) Design Prospective, longitudinal observational study Setting 10 inpatient rehabilitation centers (9 US, 1 Canada) Participants Consecutive patients (n=2130) enrolled between 2008 and 2011, admitted for inpatient rehabilitation after an index TBI injury Interventions Not applicable Main Outcome Measures Rehabilitation length of stay, discharge to home, and Functional Independence Measure (FIM) at discharge and 9 months post-discharge Results The admission FIM Cognitive score was used to create 5 relatively homogeneous subgroups for subsequent analysis of treatment outcomes. Within each subgroup, significant associations were found between outcomes and patient and injury characteristics, time spent in therapy activities, and medications used. Patient and injury characteristics explained on average 35.7% of the variation in discharge outcomes and 22.3% in 9-month outcomes. Adding time spent and level of effort in therapy activities, as well as percent of stay using specific medications, explained approximately 20.0% more variation for discharge outcomes and 12.9% for 9-month outcomes. After patient, injury, and treatment characteristics were used to predict outcomes, center differences added only approximately 1.9% additional variance explained. Conclusions At discharge, greater effort during therapy sessions, time spent in more complex therapy activities, and use of specific medications were associated with better outcomes for patients in all admission FIM Cognitive subgroups. At 9 months post-discharge, similar but less pervasive associations were observed for therapy activities, but not classes of medications. Further research is warranted to examine more specific combinations of therapy activities and medications that

  4. Increased prognostic accuracy of TBI when a brain electrical activity biomarker is added to loss of consciousness (LOC).

    Science.gov (United States)

    Hack, Dallas; Huff, J Stephen; Curley, Kenneth; Naunheim, Roseanne; Ghosh Dastidar, Samanwoy; Prichep, Leslie S

    2017-07-01

    Extremely high accuracy for predicting CT+ traumatic brain injury (TBI) using a quantitative EEG (QEEG) based multivariate classification algorithm was demonstrated in an independent validation trial, in Emergency Department (ED) patients, using an easy to use handheld device. This study compares the predictive power using that algorithm (which includes LOC and amnesia), to the predictive power of LOC alone or LOC plus traumatic amnesia. ED patients 18-85years presenting within 72h of closed head injury, with GSC 12-15, were study candidates. 680 patients with known absence or presence of LOC were enrolled (145 CT+ and 535 CT- patients). 5-10min of eyes closed EEG was acquired using the Ahead 300 handheld device, from frontal and frontotemporal regions. The same classification algorithm methodology was used for both the EEG based and the LOC based algorithms. Predictive power was evaluated using area under the ROC curve (AUC) and odds ratios. The QEEG based classification algorithm demonstrated significant improvement in predictive power compared with LOC alone, both in improved AUC (83% improvement) and odds ratio (increase from 4.65 to 16.22). Adding RGA and/or PTA to LOC was not improved over LOC alone. Rapid triage of TBI relies on strong initial predictors. Addition of an electrophysiological based marker was shown to outperform report of LOC alone or LOC plus amnesia, in determining risk of an intracranial bleed. In addition, ease of use at point-of-care, non-invasive, and rapid result using such technology suggests significant value added to standard clinical prediction. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. ABI and TBI in diabetics%糖尿病病人的踝肱指数和趾肱指数

    Institute of Scientific and Technical Information of China (English)

    陈若飞; 罗文军; 唐博

    2006-01-01

    目的探讨踝肱指数(ABI)、趾肱指数(TBI)在2型糖尿病(T2DM)病人中的变化、影响因素.方法 142例2型糖尿病病人和40例非糖尿病病人对照进行ABI与TBI测量.记录病人高血压、血脂异常、吸烟、是否行胰岛素治疗等病史,检测血糖、血脂,测量血压.根据ABI和临床资料分组,进行统计学分析.结果 T2DM组TBI低于对照组TBI (P<0.01).ABI<1.3组与ABI≥1.3组间ABI比较,差异有统计学意义(P<0.01), TBI比较差异无统计学意义.T2DM组中,ABI和TBI在有和无高血压病史、有和无血脂异常及有和无吸烟病史比较差异均有统计学意义(P<0.01).在对照组和T2DM未合并下肢动脉疾病组,ABI与TBI相关系数r分别为0.44(P<0.05)、0.32(P<0.01).T2DM组中,ABI与TBI的一致性检验P<0.05.结论 2型糖尿病病人的TBI较正常人低,ABI与TBI受年龄、糖尿病病程、高血压、血脂异常、吸烟等因素影响.ABI与TBI的相关性不高.

  6. Clinical and diagnostic approach to patients with hypopituitarism due to traumatic brain injury (TBI), subarachnoid hemorrhage (SAH), and ischemic stroke (IS).

    Science.gov (United States)

    Karamouzis, Ioannis; Pagano, Loredana; Prodam, Flavia; Mele, Chiara; Zavattaro, Marco; Busti, Arianna; Marzullo, Paolo; Aimaretti, Gianluca

    2016-06-01

    The hypothalamic-pituitary dysfunction attributable to traumatic brain injury (TBI), aneurysmal subarachnoid hemorrhage (SAH), and ischemic stroke (IS) has been lately highlighted. The diagnosis of TBI-induced-hypopituitarism, defined as a deficient secretion of one or more pituitary hormones, is made similarly to the diagnosis of classical hypopituitarism because of hypothalamic/pituitary diseases. Hypopituitarism is believed to contribute to TBI-associated morbidity and to functional and cognitive final outcome, and quality-of-life impairment. Each pituitary hormone must be tested separately, since there is a variable pattern of hormone deficiency among patients with TBI-induced-hypopituitarism. Similarly, the SAH and IS may lead to pituitary dysfunction although the literature in this field is limited. The drive to diagnose hypopituitarism is the suspect that the secretion of one/more pituitary hormone may be subnormal. This suspicion can be based upon the knowledge that the patient has an appropriate clinical context in which hypopituitarism can be present, or a symptom known as caused by hypopituitarism. Hypopituitarism should be diagnosed as a combination of low peripheral and inappropriately normal/low pituitary hormones although their basal evaluation may be not distinctive due to pulsatile, circadian, or situational secretion of some hormones. Evaluation of the somatotroph and corticotroph axes require dynamic stimulation test (ITT for both axes, GHRH + arginine test for somatotroph axis) in order to clearly separate normal from deficient responses.

  7. Feasibility of TBI Assessment Measures in a Field Environment: A Pilot Study for the Environmental Sensors in Training (ESiT) Project

    Science.gov (United States)

    2016-12-22

    assigned to one of two conditions. Condition 1 included neurocognitive performance tests (Continuous Performance, Symbol Digit Coding, Stroop and Four-Part...22 1 Introduction Traumatic brain injury (TBI) has been labeled the “ signature injury” of...timely and accurate detection of head injury include the neuropsychological measures Continuous Performance, Symbol Digit Coding, Stroop, and Four

  8. Facial Emotion Recognition Deficits following Moderate-Severe Traumatic Brain Injury (TBI): Re-examining the Valence Effect and the Role of Emotion Intensity

    NARCIS (Netherlands)

    Rosenberg, H.; McDonald, S.; Dethier, M.; Kessels, R.P.C.; Westbrook, R.F.

    2014-01-01

    Many individuals who sustain moderate-severe traumatic brain injuries (TBI) are poor at recognizing emotional expressions, with a greater impairment in recognizing negative (e.g., fear, disgust, sadness, and anger) than positive emotions (e.g., happiness and surprise). It has been questioned whether

  9. Facial Emotion Recognition Deficits following Moderate-Severe Traumatic Brain Injury (TBI): Re-examining the Valence Effect and the Role of Emotion Intensity

    NARCIS (Netherlands)

    Rosenberg, H.; McDonald, S.; Dethier, M.; Kessels, R.P.C.; Westbrook, R.F.

    2014-01-01

    Many individuals who sustain moderate-severe traumatic brain injuries (TBI) are poor at recognizing emotional expressions, with a greater impairment in recognizing negative (e.g., fear, disgust, sadness, and anger) than positive emotions (e.g., happiness and surprise). It has been questioned whether

  10. Disainisurf : DIY ehk Do It Yourself ehk TSI ehk Tee Seda Ise / Aleksander Tsapov

    Index Scriptorium Estoniae

    Tsapov, Aleksander

    2006-01-01

    Kolm valikut disainerite ja disainibüroode objekte isetegemise eeskujuks. Efektiivne kasutamiselust: alumiiniumleht sisustuse vormimiseks; taaskasutus: raamatud ruumi liigendamise osana, tool-panipaik, "mumifitseeritud" tool, plastpudelitest nagi; lihtsus: rattaga pink, kaasaskantav, jalgadele asetatav lamp, valgustid, hoiukastid

  11. Synchronization between the anterior and posterior cortex determines consciousness level in patients with traumatic brain injury (TBI).

    Science.gov (United States)

    Leon-Carrion, Jose; Leon-Dominguez, Umberto; Pollonini, Luca; Wu, Meng-Hung; Frye, Richard E; Dominguez-Morales, Maria Rosario; Zouridakis, George

    2012-10-02

    Survivors of traumatic brain injury (TBI) often suffer disorders of consciousness as a result of a breakdown in cortical connectivity. However, little is known about the neural discharges and cortical areas working in synchrony to generate consciousness in these patients. In this study, we analyzed cortical connectivity in patients with severe neurocognitive disorder (SND) and in the minimally conscious state (MCS). We found two synchronized networks subserving consciousness; one retrolandic (cognitive network) and the other frontal (executive control network). The synchrony between these networks is severely disrupted in patients in the MCS as compared to those with better levels of consciousness and a preserved state of alertness (SND). The executive control network could facilitate the synchronization and coherence of large populations of distant cortical neurons using high frequency oscillations on a precise temporal scale. Consciousness is altered or disappears after losing synchrony and coherence. We suggest that the synchrony between anterior and retrolandic regions is essential to awareness, and that a functioning frontal lobe is a surrogate marker for preserved consciousness. This article is part of a Special Issue entitled: Brain Integration. Copyright © 2012 Elsevier B.V. All rights reserved.

  12. SU-C-213-04: Application of Depth Sensing and 3D-Printing Technique for Total Body Irradiation (TBI) Patient Measurement and Treatment Planning

    Energy Technology Data Exchange (ETDEWEB)

    Lee, M; Suh, T [Department of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Han, B; Xing, L [Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, CA (United States); Jenkins, C [Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, CA (United States); Department of Mechanical Engineering, Stanford University, Palo Alto, CA (United States)

    2015-06-15

    Purpose: To develop and validate an innovative method of using depth sensing cameras and 3D printing techniques for Total Body Irradiation (TBI) treatment planning and compensator fabrication. Methods: A tablet with motion tracking cameras and integrated depth sensing was used to scan a RANDOTM phantom arranged in a TBI treatment booth to detect and store the 3D surface in a point cloud (PC) format. The accuracy of the detected surface was evaluated by comparison to extracted measurements from CT scan images. The thickness, source to surface distance and off-axis distance of the phantom at different body section was measured for TBI treatment planning. A 2D map containing a detailed compensator design was calculated to achieve uniform dose distribution throughout the phantom. The compensator was fabricated using a 3D printer, silicone molding and tungsten powder. In vivo dosimetry measurements were performed using optically stimulated luminescent detectors (OSLDs). Results: The whole scan of the anthropomorphic phantom took approximately 30 seconds. The mean error for thickness measurements at each section of phantom compare to CT was 0.44 ± 0.268 cm. These errors resulted in approximately 2% dose error calculation and 0.4 mm tungsten thickness deviation for the compensator design. The accuracy of 3D compensator printing was within 0.2 mm. In vivo measurements for an end-to-end test showed the overall dose difference was within 3%. Conclusion: Motion cameras and depth sensing techniques proved to be an accurate and efficient tool for TBI patient measurement and treatment planning. 3D printing technique improved the efficiency and accuracy of the compensator production and ensured a more accurate treatment delivery.

  13. Evaluating a Novel Sleep-Focused Mind-Body Rehabilitative Program for Veterans with mTBI and Other Polytrauma Symptoms: An RCT Study

    Science.gov (United States)

    2015-09-01

    34 Polytrauma " Symptoms: An RCT Study PRINCIPAL INVESTIGATOR: Yoshio Nakamura, Ph.D. CONTRACTING ORGANIZATION: University of Utah , Salt Lake City, UT 84112...Rehabilitative Program for Veterans with mTBI and Other " Polytrauma " Symptoms: An RCT Study 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S...our recruiting effort. We screened the patient lists obtained from Polytrauma Clinic at VA, sent recruitment letters and made phone calls to follow

  14. SU-E-T-515: Field-In-Field Compensation Technique Using Multi-Leaf Collimator to Deliver Total Body Irradiation (TBI) Dose

    Energy Technology Data Exchange (ETDEWEB)

    Lakeman, T [The State University of New York at Buffalo (United States); Wang, IZ [The State University of New York at Buffalo (United States); Roswell Park Cancer Institute, Buffalo, NY (United States)

    2014-06-01

    Purpose: Total body irradiation (TBI) uses large parallel-opposed radiation fields to suppress the patient's immune system and eradicate the residual cancer cells in preparation of recipient for bone marrow transplant. The manual placement of lead compensators has been used conventionally to compensate for the varying thickness through the entire body in large-field TBI. The goal of this study is to pursue utilizing the modern field-in-field (FIF) technique with the multi-leaf collimator (MLC) to more accurately and efficiently deliver dose to patients in need of TBI. Method: Treatment plans utilizing the FIF technique to deliver a total body dose were created retrospectively for patients for whom CT data had been previously acquired. Treatment fields include one pair of opposed open large fields (collimator=45°) with a specific weighting and a succession of smaller fields (collimator=90°) each with their own weighting. The smaller fields are shaped by moving MLC to block the sections of the patient which have already received close to 100% of the prescribed dose. The weighting factors for each of these fields were calculated using the attenuation coefficient of the initial lead compensators and the separation of the patient in different positions in the axial plane. Results: Dose-volume histograms (DVH) were calculated for evaluating the FIF compensation technique. The maximum body doses calculated from the DVH were reduced from the non-compensated 179.3% to 148.2% in the FIF plans, indicating a more uniform dose with the FIF compensation. All calculated monitor units were well within clinically acceptable limits and exceeded those of the original lead compensation plan by less than 50 MU (only ~1.1% increase). Conclusion: MLC FIF technique for TBI will not significantly increase the beam on time while it can substantially reduce the compensator setup time and the potential risk of errors in manually placing lead compensators.

  15. ED disposition of the Glasgow Coma Scale 13 to 15 traumatic brain injury patient: analysis of the Transforming Research and Clinical Knowledge in TBI study☆,☆☆

    Science.gov (United States)

    Adeoye, Opeolu; Lindsell, Christopher J.; Hart, Kimberly W.; Pancioli, Arthur; McMullan, Jason T.; Yue, John K.; Nishijima, Daniel K.; Gordon, Wayne A.; Valadka, Alex B.; Okonkwo, David O.; Lingsma, Hester F.; Maas, Andrew I.R.

    2014-01-01

    Objective Mild traumatic brain injury (mTBI) patients are frequently admitted to high levels of care despite limited evidence suggesting benefit. Such decisions may contribute to the significant cost of caring for mTBI patients. Understanding the factors that drive disposition decision making and how disposition is associated with outcomes is necessary for developing an evidence-base supporting disposition decisions. We evaluated factors associated with emergency department triage of mTBI patients to 1 of 3 levels of care: home, inpatient floor, or intensive care unit (ICU). Methods This multicenter, prospective, cohort study included patients with isolated head trauma, a cranial computed tomography as part of routine care, and a Glasgow Coma Scale (GCS) score of 13 to 15. Data analysis was performed using multinomial logistic regression. Results Of the 304 patients included, 167 (55%) were discharged home, 76 (25%) were admitted to the inpatient floor, and 61 (20%) were admitted to the ICU. In the multivariable model, admission to the ICU, compared with floor admission, varied by study site, odds ratio (OR) 0.18 (95% confidence interval [CI], 0.06–0.57); antiplatelet/anticoagulation therapy, OR 7.46 (95% CI, 1.79–31.13); skull fracture, OR 7.60 (95% CI, 2.44–23.73); and lower GCS, OR 2.36 (95% CI, 1.05–5.30). No difference in outcome was observed between the 3 levels of care. Conclusion Clinical characteristics and local practice patterns contribute to mTBI disposition decisions. Level of care was not associated with outcomes. Intracranial hemorrhage, GCS 13 to 14, skull fracture, and current antiplatelet/anticoagulant therapy influenced disposition decisions. PMID:24857248

  16. The impact of self-awareness and depression on subjective reports of memory, quality-of-life and satisfaction with life following TBI.

    Science.gov (United States)

    Goverover, Yael; Chiaravalloti, Nancy

    2014-01-01

    To determine the relationship between self-awareness and depressive symptomatology with self-reports of memory, Quality-of-Life (QoL) and satisfaction with life in individuals with traumatic brain injury (TBI). Cross-sectional survey of 30 community dwelling adults, who sustained a TBI at least 1 year prior to study enrolment. Participants completed questionnaires to assess the constructs of depression, self-awareness, QoL, satisfaction with life and memory. Symptoms of depression were significantly associated with self-reports of poor memory abilities, lower QoL and lower satisfaction with life. Additionally, higher levels of self-awareness were associated with lower ratings of QoL and reduced memory abilities and better strategy use regarding memory. However, when examining the contribution of each construct individually, depressive symptomatology, and not self-awareness, was significantly associated with subjective self-reports of memory, QoL and satisfaction with life. This pattern of relationships illustrates that, when a person has a low level of depressive symptoms, his/her reports of QoL, memory and satisfaction with life will be more positive; however, he/she will demonstrate more difficulty with self-awareness. Thus, psychological aspects of recovery must, therefore, be taken into account when using self-reported measures in the evaluation of persons who have sustained TBI.

  17. Advanced Sensors for TBI

    Science.gov (United States)

    2016-12-01

    definition provides a variety of advantages to the overall process: • The cavity definition requires a plasma etch that is a challenging operation to perform...to this time is plasma etch to singulate the die. If a substitute for this process can be identified, no backside processing will be required of the...considered including laser dicing, sidewall polishing or reverting back to plasma etching . To determine whether this process would weaken or compromise

  18. Opioid Use after TBI

    Science.gov (United States)

    2013-07-01

    abused prescription pain medications is oxycodone, especially in its sustained release formulation OxyContin3. This pain medication and others in the...suggestive of increased impulsivity • No differences were detected between groups in baseline nociception or in response to the acute anti- nociceptive ...performance was stable ( 3 days >20% change) Assessment of nociception with warm water tail withdrawal: • Rats were habituated to the test apparatus

  19. Advanced Sensors for TBI

    Science.gov (United States)

    2011-07-01

    degrees C) in temperature within the biological range of 34-45 degrees C (Figure 14). REPORTABLE OUTCOMES: Lyeth B., Bonner D., Van K ...seizures, fever, and neurotrauma. Ann N Y Acad Sci. 1113:173-177. Bauman, R.A., Ling, G., Tong, L., Januszkiewicz , A., Agoston, D., Delanerolle, N., Kim

  20. Advanced Sensors for TBI

    Science.gov (United States)

    2015-07-01

    value) • Producing the reference volume cavity requires a hermetic seal that requires a high temperature operation that is difficult to perform later in... CMOS clean • Commercialization of the sensor is aided by this process as use of CMOS -clean commercial foundries will not be restricted Bench...proposed to use miniaturized, state-of-the-art pressure/ temperature sensors engineered at LLNL to measure the immediate increases in ICP combined

  1. Evidence of increased brain amyloid in severe TBI survivors at 1, 12, and 24 months after injury: report of 2 cases.

    Science.gov (United States)

    Gatson, Joshua W; Stebbins, Cari; Mathews, Dana; Harris, Thomas S; Madden, Christopher; Batjer, Hunt; Diaz-Arrastia, Ramon; Minei, Joseph P

    2016-06-01

    Traumatic brain injury (TBI) is a major risk factor for Alzheimer's disease. With respect to amyloid deposition, there are no published serial data regarding the deposition rate of amyloid throughout the brain after TBI. The authors conducted serial (18)F-AV-45 (florbetapir F18) positron emission tomography (PET) imaging in 2 patients with severe TBI at 1, 12, and 24 months after injury. A total of 12 brain regions were surveyed for changes in amyloid levels. Case 1 involved a 50-year-old man who experienced a severe TBI. Compared with the 1-month time point, of the 12 brain regions that were surveyed, a decrease in amyloid (as indicated by standard uptake value ratios) was only observed in the hippocampus (-16%, left; -12%, right) and caudate nucleus (-18%, left; -18%, right), suggesting that initial amyloid accumulation in the brain was cleared between time points 1 and 12 months after injury. Compared to the scan at 1 year, a greater increase in amyloid (+15%) was observed in the right hippocampus at the 24-month time point. The patient in Case 2 was a 37-year-old man who suffered severe trauma to the head and a subsequent stroke; he had poor cognitive/functional outcomes and underwent 1.5 years of rehabilitation. Due to a large infarct area on the injured side of the brain (right side), the authors focused primarily on brain regions affected within the left hemisphere. Compared with the 1-month scan, they only found an increase in brain amyloid within the left anterior putamen (+11%) at 12 months after injury. In contrast, decreased amyloid burden was detected in the left caudate nucleus (-48%), occipital cortex (-21%), and precuneus (-19%) brain regions at the 12-month time point, which is indicative of early accumulation and subsequent clearance. In comparison with 12-month values, more clearance was observed, since a reduction in amyloid was found at 24 months after trauma within the left anterior putamen (-12%) and occipital cortex (-15%). Also, by 24

  2. Stretch and/or oxygen glucose deprivation (OGD) in an in vitro traumatic brain injury (TBI) model induces calcium alteration and inflammatory cascade.

    Science.gov (United States)

    Salvador, Ellaine; Burek, Malgorzata; Förster, Carola Y

    2015-01-01

    The blood-brain barrier (BBB), made up of endothelial cells of capillaries in the brain, maintains the microenvironment of the central nervous system. During ischemia and traumatic brain injury (TBI), cellular disruption leading to mechanical insult results to the BBB being compromised. Oxygen glucose deprivation (OGD) is the most commonly used in vitro model for ischemia. On the other hand, stretch injury is currently being used to model TBI in vitro. In this paper, the two methods are used alone or in combination, to assess their effects on cerebrovascular endothelial cells cEND in the presence or absence of astrocytic factors. Applying severe stretch and/or OGD to cEND cells in our experiments resulted to cell swelling and distortion. Damage to the cells induced release of lactate dehydrogenase enzyme (LDH) and nitric oxide (NO) into the cell culture medium. In addition, mRNA expression of inflammatory markers interleukin (I L)-6, IL-1α, chemokine (C-C motif) ligand 2 (CCL2) and tumor necrosis factor (TNF)-α also increased. These events could lead to the opening of calcium ion channels resulting to excitotoxicity. This could be demonstrated by increased calcium level in OGD-subjected cEND cells incubated with astrocyte-conditioned medium. Furthermore, reduction of cell membrane integrity decreased tight junction proteins claudin-5 and occludin expression. In addition, permeability of the endothelial cell monolayer increased. Also, since cell damage requires an increased uptake of glucose, expression of glucose transporter glut1 was found to increase at the mRNA level after OGD. Overall, the effects of OGD on cEND cells appear to be more prominent than that of stretch with regards to TJ proteins, NO, glut1 expression, and calcium level. Astrocytes potentiate these effects on calcium level in cEND cells. Combining both methods to model TBI in vitro shows a promising improvement to currently available models.

  3. Stretch and/or oxygen glucose deprivation (OGD in an in vitro traumatic brain injury (TBI model induces calcium alteration and inflammatory cascade

    Directory of Open Access Journals (Sweden)

    Ellaine eSalvador

    2015-08-01

    Full Text Available The blood-brain barrier (BBB, made up of endothelial cells of capillaries in the brain, maintains the microenvironment of the central nervous system. During ischemia and traumatic brain injury (TBI, cellular disruption leading to mechanical insult results to the BBB being compromised. Oxygen glucose deprivation (OGD is the most commonly used in vitro model for ischemia. On the other hand, stretch injury is currently being used to model TBI in vitro. In this paper, the two methods are used alone or in combination, to assess their effects on cerebrovascular endothelial cells cEND in the presence or absence of astrocytic factors. Applying severe stretch and/or OGD to cEND cells in our experiments resulted to cell swelling and distortion. Damage to the cells induced release of lactate dehydrogenase enzyme (LDH and nitric oxide (NO into the cell culture medium. In addition, mRNA expression of inflammatory markers interleukin (IL-6, IL-1α, chemokine (C-C motif ligand 2 (CCL2 and tumor necrosis factor (TNF-α also increased. These events could lead to the opening of calcium ion channels resulting to excitotoxicity. This could be demonstrated by increased calcium level in OGD-subjected cEND cells incubated with astrocyte-conditioned medium. Furthermore, reduction of cell membrane integrity decreased tight junction proteins claudin-5 and occludin expression. In addition, permeability of the endothelial cell monolayer increased. Also, since cell damage requires an increased uptake of glucose, expression of glucose transporter glut1 was found to increase at the mRNA level after OGD. Overall, the effects of OGD on cEND cells appear to be more prominent than that of stretch with regards to TJ proteins, NO, glut1 expression and calcium level. Astrocytes potentiate these effects on calcium level in cEND cells. Combining both methods to model TBI in vitro shows a promising improvement to currently available models.

  4. Group therapy use and its impact on the outcomes of inpatient rehabilitation following traumatic brain injury: Data from TBI-PBE project

    Science.gov (United States)

    Hammond, Flora M.; Barrett, Ryan; Dijkers, Marcel P.; Zanca, Jeanne M.; Horn, Susan D.; Smout, Randall J.; Guerrier, Tami; Hauser, Elizabeth; Dunning, Megan R.

    2015-01-01

    Objective To describe the amount and content of group therapies provided during inpatient rehabilitation for traumatic brain injury (TBI), and assess the relationships of group therapy with patient, injury, and treatment factors as well as outcomes. Design Prospective observational cohort. Setting Inpatient rehabilitation. Participants 2,130 consecutive admissions for initial TBI rehabilitation at 10 inpatient rehabilitation facilities (9 in US and 1 Canada) from October 2008 to September 2011. Interventions n/a Main Outcome Measure(s) proportion of sessions that were group therapy (two or more patients were treated simultaneously by one or more clinicians); proportion of patients receiving group therapy; type of activity performed and amount of time spent in group therapy, by discipline; rehabilitation length of stay (RLOS); discharge location; FIM Cognitive and Motor scores at discharge. Results 79% of patients received at least 1 session of group therapy, with group therapy accounting for 13.7% of all therapy sessions and 15.8% of therapy hours. On average, patients spent 2.9 hours per week in group therapy. The greatest proportion of treatment time in group format was in Therapeutic Recreation (25.6%), followed by Speech Therapy (16.2%), Occupational Therapy (10.4%), Psychology (8.1%), and Physical Therapy (7.9%). Group therapy time and type of treatment activities varied among admission FIM cognitive subgroups and treatment sites. Several factors appear to be predictive of receiving group therapy, with treatment site being a major influence. However, group therapy as a whole offered little explanation of differences in the outcomes studied. Conclusion(s) Group therapy is commonly used in TBI rehabilitation, to varying degrees among disciplines, sites, and cognitive impairment subgroups. Various therapeutic activities take place in group therapy, indicating its perceived value in addressing many domains of functioning. Variation in outcomes is not explained

  5. Using Information from the Electronic Health Record to Improve Measurement of Unemployment in Service Members and Veterans with mTBI and Post-Deployment Stress

    Science.gov (United States)

    Dillahunt-Aspillaga, Christina; Finch, Dezon; Massengale, Jill; Kretzmer, Tracy; Luther, Stephen L.; McCart, James A.

    2014-01-01

    Objective The purpose of this pilot study is 1) to develop an annotation schema and a training set of annotated notes to support the future development of a natural language processing (NLP) system to automatically extract employment information, and 2) to determine if information about employment status, goals and work-related challenges reported by service members and Veterans with mild traumatic brain injury (mTBI) and post-deployment stress can be identified in the Electronic Health Record (EHR). Design Retrospective cohort study using data from selected progress notes stored in the EHR. Setting Post-deployment Rehabilitation and Evaluation Program (PREP), an in-patient rehabilitation program for Veterans with TBI at the James A. Haley Veterans' Hospital in Tampa, Florida. Participants Service members and Veterans with TBI who participated in the PREP program (N = 60). Main Outcome Measures Documentation of employment status, goals, and work-related challenges reported by service members and recorded in the EHR. Results Two hundred notes were examined and unique vocational information was found indicating a variety of self-reported employment challenges. Current employment status and future vocational goals along with information about cognitive, physical, and behavioral symptoms that may affect return-to-work were extracted from the EHR. The annotation schema developed for this study provides an excellent tool upon which NLP studies can be developed. Conclusions Information related to employment status and vocational history is stored in text notes in the EHR system. Information stored in text does not lend itself to easy extraction or summarization for research and rehabilitation planning purposes. Development of NLP systems to automatically extract text-based employment information provides data that may improve the understanding and measurement of employment in this important cohort. PMID:25541956

  6. Three-year outcome following moderate-to-severe TBI in U.S. military service members: a descriptive cross-sectional study.

    Science.gov (United States)

    Brickell, Tracey A; Lange, Rael T; French, Louis M

    2014-08-01

    This study examined the prospective course of neurobehavioral symptom reporting and health-related quality of life within the first 3 years following moderate-to-severe traumatic brain injury (TBI). Participants were 52 U.S. service members who were evaluated following a moderate-to-severe TBI sustained in the combat theater during Operations Iraqi and Enduring Freedom (90.4%), or from other noncombat-related incidents. Participants completed the Neurobehavioral Symptom Inventory and Post-Traumatic Stress Disorder-Checklist within 3 months postinjury, and at least one follow-up telephone interview at 12 (n = 27), 24 (n = 31), or 36 months (n = 22) postinjury. Approximately half of the sample (41.9%-63.0%) reported "persistent" symptoms from baseline to follow-up. A substantial minority also "improved" (22.2%-31.8%) or "developed" new symptoms (3.7%-16.1%). Ongoing physical and mental health problems were also reported. The number of service members receiving mental health treatment significantly reduced between 12 and 36 months postinjury (48.1%-18.2%), while complaints of bodily pain significantly increased (40.7%-68.2%). Despite ongoing symptom reporting, few reported suicidal/homicidal ideation (6.5%-9.1%), and a substantial majority reported good/excellent health status (74.1%-90.9%) and satisfaction with their life (81.5%-90.9%). Continued support and care for all service members who sustain a combat-related moderate-to-severe TBI is recommended, regardless of the presence or absence of symptom reporting within the first few months postinjury.

  7. Reintegrating Troops with Mild Traumatic Brain Injury (mTBI) into Their Communities: Understanding the Scope and Timeline of Post-Deployment Driving Problems

    Science.gov (United States)

    2009-10-01

    Driving Problems PRINCIPAL INVESTIGATOR: Erica Stern Todd Rockwood CONTRACTING ORGANIZATION: University of Minnesota...TYPE Annual 3. DATES COVERED 15 Sep 2008 – 14 Sep 2009 5a. CONTRACT NUMBER Reintegrating Troops with Mild Traumatic Brain Injury (mTBI) into...fUll .V’!/I./j/ Ii"", dll....’ F’’’’’’’’’ ,nldy IS n«<kd to d<t" mlM ,f"’.. accurat.1y I.Oem til. ltOlld ordlanlIe. 0< ,rdl< d,Ke..".... du.1O

  8. Impact of conditioning with TBI in adult patients with T-cell ALL who receive a myeloablative allogeneic stem cell transplantation

    DEFF Research Database (Denmark)

    Cahu, X; Labopin, M; Giebel, S

    2016-01-01

    Allogeneic hematopoietic stem cell transplantation (allo-SCT) is a therapeutic option for adult patients with T-cell ALL (T-ALL). Meanwhile, few allo-SCT data specific to adult T-ALL have been described thus far. Specifically, the optimal myeloablative conditioning regimen is unknown. In this ret...... patients with T-ALL entitled to receive a myeloablative allo-SCT may benefit from TBI-based regimens.Bone Marrow Transplantation advance online publication, 30 November 2015; doi:10.1038/bmt.2015.278....

  9. Earlier low-dose TBI or DST overcomes CD8+ T-cell-mediated alloresistance to allogeneic marrow in recipients of anti-CD40L.

    Science.gov (United States)

    Takeuchi, Yasuo; Ito, Hiroshi; Kurtz, Josef; Wekerle, Thomas; Ho, Leon; Sykes, Megan

    2004-01-01

    Treatment with a single injection of anti-CD40L (CD154) monoclonal antibody (mAb) and fully mismatched allogeneic bone marrow transplant (BMT) allows rapid tolerization of CD4+ T cells to the donor. The addition of in vivo CD8 T-cell depletion leads to permanent mixed hematopoietic chimerism and tolerance. We now describe two approaches that obviate the requirement for CD8 T-cell depletion by rapidly tolerizing recipient CD8 T cells in addition to CD4 cells. Administration of donor-specific transfusion (DST) to mice receiving 3 Gy total body irradiation (TBI), BMT and anti-CD40L mAb on day 0 uniformly led to permanent mixed chimerism and tolerance, compared with only 40% of mice receiving similar treatment without DST. In the absence of DST, moving the timing of 3 Gy TBI to day -1 or day -2 instead of day 0 led to rapid (by 2 weeks) induction of CD8+ cell tolerance, and also permitted uniform achievement of permanent mixed chimerism and donor-specific tolerance in recipients of anti-CD40L and BMT on day 0. These nontoxic regimens overcome CD8+ and CD4+ T-cell-mediated alloresistance without requiring host T-cell depletion, permitting the induction of permanent mixed chimerism and tolerance.

  10. Rehabilitation of Communicative Abilities in Patients with a History of TBI: Behavioral Improvements and Cerebral Changes in Resting-State Activity

    Science.gov (United States)

    Sacco, Katiuscia; Gabbatore, Ilaria; Geda, Elisabetta; Duca, Sergio; Cauda, Franco; Bara, Bruno G.; Bosco, Francesca M.

    2016-01-01

    A targeted training program for the rehabilitation of communicative abilities—Cognitive Pragmatic Treatment (CPT)—has been developed and previously tested on a sample of patients with traumatic brain injury (TBI), whose performance was found to have improved. Since cortical plasticity has been recognized as the main mechanism of functional recovery, we investigated whether and how behavioral improvements following the training program are accompanied by brain modifications. Eight TBI patients took part in the training program and were behaviorally assessed pre- and post-treatment; six of these patients were also evaluated with pre- and post-treatment resting state (rs) functional magnetic resonance imaging (fMRI). At the end of the rehabilitation program patients showed improvement in overall communicative performance, in both comprehension and production tasks. A follow-up retest revealed the stability of these results 3 months after completing the training program. At the brain level, we found significant increases in the amplitude of low frequency fluctuation (ALFF) index in the bilateral precentral gyrus, in the right middle and superior temporal gyri, in the right cingulate gyrus, and in the left inferior parietal lobule. We discuss these differences of brain activity in terms of their possible contribution to promoting recovery. PMID:27047353

  11. Assessment of Health-Related Quality of Life after TBI: Comparison of a Disease-Specific (QOLIBRI) with a Generic (SF-36) Instrument

    Science.gov (United States)

    von Steinbuechel, Nicole; Covic, Amra; Polinder, Suzanne; Kohlmann, Thomas; Cepulyte, Ugne; Poinstingl, Herbert; Backhaus, Joy; Bakx, Wilbert; Bullinger, Monika; Christensen, Anne-Lise; Formisano, Rita; Gibbons, Henning; Höfer, Stefan; Koskinen, Sanna; Maas, Andrew; Neugebauer, Edmund; Powell, Jane; Sarajuuri, Jaana; Sasse, Nadine; Schmidt, Silke; Mühlan, Holger; von Wild, Klaus; Zitnay, George; Truelle, Jean-Luc

    2016-01-01

    Psychosocial, emotional, and physical problems can emerge after traumatic brain injury (TBI), potentially impacting health-related quality of life (HRQoL). Until now, however, neither the discriminatory power of disease-specific (QOLIBRI) and generic (SF-36) HRQoL nor their correlates have been compared in detail. These aspects as well as some psychometric item characteristics were studied in a sample of 795 TBI survivors. The Shannon H' index absolute informativity, as an indicator of an instrument's power to differentiate between individuals within a specific group or health state, was investigated. Psychometric performance of the two instruments was predominantly good, generally higher, and more homogenous for the QOLIBRI than for the SF-36 subscales. Notably, the SF-36 “Role Physical,” “Role Emotional,” and “Social Functioning” subscales showed less satisfactory discriminatory power than all other dimensions or the sum scores of both instruments. The absolute informativity of disease-specific as well as generic HRQoL instruments concerning the different groups defined by different correlates differed significantly. When the focus is on how a certain subscale or sum score differentiates between individuals in one specific dimension/health state, the QOLIBRI can be recommended as the preferable instrument. PMID:27022207

  12. Exposure to a predator scent induces chronic behavioral changes in rats previously exposed to low-level blast: Implications for the relationship of blast-related TBI to PTSD

    Directory of Open Access Journals (Sweden)

    Georgina Perez-Garcia

    2016-10-01

    Full Text Available Blast-related mild traumatic brain injury (mTBI has been unfortunately common in veterans who served in the recent conflicts in Iraq and Afghanistan. The postconcussion syndrome associated with these mTBIs has frequently appeared in combination with post-traumatic stress disorder (PTSD. The presence of PTSD has complicated diagnosis since clinically PTSD and the postconcussion syndrome of mTBI have many overlapping symptoms. In particular establishing how much of the symptom complex can be attributed to the psychological trauma associated with PTSD in contrast to the physical injury of TBI has proven difficult. Indeed some have suggested that much of what is now being called blast-related postconcussion syndrome is better explained by PTSD. The relationship between the postconcussion syndrome of mTBI and PTSD is complex. Association of the two disorders might be viewed as additive effects of independent psychological and physical traumas suffered in a war zone. However we previously found that rats exposed to repetitive low-level blast exposure in the absence of a psychological stressor developed a variety of anxiety and PTSD-related behavioral traits that were present months following the last blast exposure. Here we show that a single predator scent challenge delivered 8 months after the last blast exposure induces chronic anxiety related changes in blast-exposed rats that are still present 45 days later. These observations suggest that in addition to independently inducing PTSD-related traits, blast exposure sensitizes the brain to react abnormally to a subsequent psychological stressor. These studies have implications for conceptualizing the relationship between blast-related mTBI and PTSD and suggest that blast-related mTBI in humans may predispose to the later development of PTSD in reaction to subsequent psychological stressors.

  13. Whither the "signature wounds of the war" after the war: estimates of incidence rates and proportions of TBI and PTSD diagnoses attributable to background risk, enhanced ascertainment, and active war zone service, active component, U.S. Armed Forces, 2003-2014.

    Science.gov (United States)

    Brundage, John F; Taubman, Stephen B; Hunt, Devin J; Clark, Leslie L

    2015-02-01

    Traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) are "signature wounds" of the Afghanistan/Iraq wars; however, many TBI/PTSD cases are not war related. During the wars, diagnoses of TBI/PTSD among military members increased because risks of TBI/PTSD, and capabilities to detect cases, increased. This report summarizes TBI/PTSD diagnosis experiences of three cohorts of overseas deployers in relation to the natures of their exposures to active war service and enhanced case ascertainment efforts. The findings suggest that, during the war, the proportions of PTSD diagnoses attributable to war zone service decreased from approximately 80% to less than 50%, while the proportions attributable to enhanced case ascertainment increased from less than 10% to nearly 50%. The proportions of TBI diagnoses attributable to war zone service more than tripled from 2003-2005 (13.1%) through 2007-2009 (44.8%); the proportions attributable to enhanced ascertainment also markedly increased, but not until after 2007. By the end of the war, war zone service and enhanced ascertainment accounted for similar proportions of all PTSD and TBI diagnoses. If programs and resources currently focused on TBI and PTSD continue, rates of diagnoses post-war will greatly exceed those pre-war.

  14. Non-spatial pre-training in the water maze as a clinically relevant model for evaluating learning and memory in experimental TBI.

    Science.gov (United States)

    Wagner, Amy K; Brayer, Samuel W; Hurwitz, Max; Niyonkuru, Christian; Zou, Huichao; Failla, Michelle; Arenth, Patricia; Manole, Mioara D; Skidmore, Elizabeth; Thiels, Edda

    2013-11-01

    Explicit and implicit learning and memory networks exist where each network can facilitate or inhibit cognition. Clinical evidence suggests that implicit networks are relatively preserved after traumatic brain injury (TBI). Non-spatial pre-training (NSPT) in the Morris Water Maze (MWM) provides the necessary behavioral components to complete the task, while limiting the formation of spatial maps. Our study utilized NSPT in the MWM to assess implicit and explicit learning and memory system deficits in the controlled cortical impact (CCI) model of TBI. 76 adult male Sprague-Dawley rats were divided: CCI vs. sham surgery, NSPT vs. No-NSPT, and cued vs. non-cued groups. NSPT occurred for 4d prior to surgery (dynamic hidden platform location, extra-maze cues covered, static pool entry point). Acquisition (d14-18), Probe/Visible Platform (d19), and Reversal (d20-21) trials were conducted with or without extra-maze cues. Novel time allocation and search strategy selection metrics were utilized. Results indicated implicit and explicit learning/memory networks are distinguishable in the MWM. In the cued condition, NSPT reduced thigmotaxis, improved place learning, and largely eliminated the apparent injury-induced deficits typically observed between untrained CCI and sham rats. However, among NSPT groups, incorporation of cues into search strategy selection for CCI rats was relatively impaired compared to shams. Non-cued condition performance showed sham/NSPT and CCI/NSPT rats perform similarly, suggesting implicit memory networks are largely intact 2weeks after CCI. Place learning differences between CCI/NSPT and sham/NSPT rats more accurately reflect spatial deficits in our CCI model compared to untrained controls. These data suggest NSPT as a clinically relevant construct for evaluating potential neurorestorative and neuroprotective therapies. These findings also support development of non-spatial cognitive training paradigms for evaluating rehabilitation relevant

  15. Correlation of ABI、color doppler ultrasound spectrum and TBI of lower extremity artery in diabetic patients%ABI与彩超频谱、TBI在糖尿病下肢动脉疾病中相关性研究

    Institute of Scientific and Technical Information of China (English)

    邓迎红; 潘玲; 宋婉华; 肖菁

    2011-01-01

    目的 探讨糖尿病下肢动脉病变踝肱指数(ABI)与超声彩色多普勒频谱、趾肱指数(TBI)相关性分析.方法 采用多功能外周血管检查仪及超声彩色多普勒检查仪对55位糖尿病患者行109例下肢动脉检查,测定ABI、TBI及彩色多普勒血流频谱.结果 A1组(0.9TBI<0.7)TBI和光电容积描记(PPG)波形改变差异有统计学意义P<0.05.结论 ABI测压检查与超声彩色多普勒相结合,避免了单纯使用多普勒测定血流波形的不足和动脉中层钙化对ABI结果的影响.ABI、TBI、PPG波形与彩色多普勒血流频谱等多项检测相结合能早期确定病变.%Objective To investigate the correlation of ankle-brachial index( ABI)., color doppler ultrasound spectrum and toe-brachial index (TBI) of lower extremity artery in diabetic patients. Methods ABI, TBI and color doppler ultrasound spectrum measurement were carried out on 109 lower extremity artery of 55 diabetic patients. Croups were assigned according to ABI and TBI values and the correlation of ABI and color doppler ultrasound spectrum as well as ABI and TBI. Results The changes of ABI and of color doppler ultrasound spectrum in Group A1(0.9TBI in Group A1 and A2. The changes of TBI in group B1 (TBI≥0.7) and B2 (TBI<0.7) and the change of photoplethysmographg(PPG) waveform were statistically significant. Conclusion The limitation of measuring the waveform with dopplor as well as the influence of calcification of artery can be avoided by combining ABI and color doppler ultrasound spectrum measurement. Early diagnosis of pathological changes of diabetic patients can be realized exactly by combing ABI、TBI and color doppler ultrasound spectrum.

  16. 2型糖尿病患者趾臂指数(TBI)与动脉粥样硬化的相关性研究%Association between toe brachial index and atherosclerosis in patients with type 2 diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    侯佳宁; 徐敏; 黄韵; 毕宇芳; 顾卫琼; 李小英; 陈宇红; 宁光

    2010-01-01

    Objective Measurement of ankle brachial index (ABI) is a simple method of assessing lower limb arterial blood supply,while measurement of toe brachial index (TBI)has only been advocated as an alternative.The aim of this study was to obtain information about whether TBI should be taken in type 2 diabetes,even when ABI is normal,and to evaluate the relationship between TBI and atherosclerosis.Methods In a crosssection study,ABI,TBI,and carotid intimal-medial thickness (IMT) were measured on 979 outpatients with type 2 diabetes in Ruijin Hospital.Those with normal ABI (0.9 ≤ABI < 1.3,n = 945) were divided into two groupsnormal TBI group(TBI≥0.6,n=893) and low TBI group(TBI<0.6,n=52),and then the clinical and laboratory data were compared between these two groups.Furthermore,the relationship between TBI and atherosclerosis was investigated.Atherosclerosis was defined as the maximum IMT ≥ 1.1 mm.Results Low ABI and low TBI were detected in 1.3% and 6.6% of the patients,respectively.Comparison of the clinical and laboratory data between the two groups showed that age and HbA1C values were significantly higher in the low TBI group.Furthermore,TBI was inversely associated with IMT(β=-0.217,P<0.01),an indicator for atherosclerosis of the carotid artery.Multiple logistic regression analysis revealed that decline of TBI was an independent risk factor of atherosclerosis (OR=1.30,95% CI 1.01-1.69,P<0.05).Conclusion In type 2 diabetes,the decline of TBI is associated with atherosclerosis,indicating the necessity for diabetic patients to detect TBI,even when ABI is within normal range,in order to detect peripheral artery disease in early stage,and reduce the risk for atherosclerosis.%目的 研究踝臂指数(ABI)正常的2型糖尿病患者趾臂指数(TBI)与动脉粥样硬化的相关性.方法 瑞金医院内分泌代谢病科门诊收集的945例ABI正常(0.9≤ABI<1.3)患者,根据TBI分为正常组(TBI≥0.6,n=893)和降低组(TBI<0.6,n=52).分析TBI与

  17. A Study of TBI Mode in Reading Teaching%基于主题依托教学的阅读教学模式研究

    Institute of Scientific and Technical Information of China (English)

    余方敏

    2015-01-01

    首先构建了一个基于主题依托教学(Theme-based Instruction,简称TBI)阅读教学模式,然后通过教学实验、问卷调查和个人访谈等手段对其有效性进行科学评估。研究发现:TBI阅读教学模式有利于培养学生的英语学习情感,提高其阅读技能和阅读水平,但还存在形式关注不足、阅读量过大等问题。解决的措施为:指导学生学习词汇和处理难句的方法、在查找文章环节给学生提供帮助、培养学生查找资料的能力等。%This paper conducted a survey on the validity of the established TBI mode in reading teaching by means of teaching experiment, questionnaire and interviews. The results showed that the mode is effective in cultivating students’ enthusiasm for English learning, improving students’ reading skills and reading proficiency while issues await resolutions in language form and excessive reading. It suggested that students need assistance in vocabulary and sentence learning techniques as well as articles index and literature research.

  18. Intension of Technology Business Incubator (TBI) Definitions%科技企业孵化器内涵界定的理论梳理

    Institute of Scientific and Technical Information of China (English)

    李恒光

    2007-01-01

    科技企业孵化器(TBI)作为一种发展较快的典型科技中介,它的相关研究可谓是科技中介研究的最佳切入点之一.TBI既不同于科技园区,又不同于一般的生产型和服务型企业,而与在孵企业及毕业企业均存在密切的联系.西方学者强调TBI的创新服务功能,认为TBI主要是培育企业适应市场竞争的能力.国内学者强调TBI的孵化空间,认为TBI是一种减少干扰、具有温室效应的避风港.笔者认为TBI是新生中小企业聚集的拥有企业生存和成长所需的服务的系统空间,是以制度框架与中介体系为根本特征的智能服务产业.

  19. Kuldmedal metsmaasikatele ehk austusavaldus Linnele / Karin Truverk

    Index Scriptorium Estoniae

    Truverk, Karin

    2007-01-01

    Chelsea Flower Show'l kuldmedali pälvinud rootsi maastikuarhitekti Ulf Nordfjelli kujundatud ideeaiast "Austusavaldus Linnele". Erilisele kohale on tõstetud Karl von Linne lemmiktaimed: kirju liilia, metspipar ja harakkuljus. Metallplaatide autoriks on kunstnik Anne-Karin Furunes. Projekt, 6 värv. fotot

  20. Groundlab ehk maastikuurbanismi rakendamisest / Eva Castro

    Index Scriptorium Estoniae

    Castro, Eva

    2011-01-01

    Essee käsitleb rahvusvahelise maastikuurbanismiga tegeleva büroo Groundlab näitel maastikuurbanismi, mis sai alguse Londoni AA (Architectural Association) arhitektuurikooli kursusest MA Landscape Urbanism ning mille tegevusstrateegia on kujunenud läbi konkreetsete projektide

  1. Kunst rahvani ehk Kwangju biennaal / Siram

    Index Scriptorium Estoniae

    Siram, pseud., 1968-

    2004-01-01

    Biennaal "Tolmutera, veetilk" Lõuna-Koreas, avatud kuni 13. XI 2004. Kuraatorid Yongwoo Lee (New York, Soul), Kerry Brougher (Washington-distrikt), Suk-won Chang (Kwangju). City Light Award - Watercio Caldas (Brasiilia), Korea fondi preemia - Jennifer Allora ja Guillermo Calzadilla (Kuuba) jt. Johann Köleri nim. Positivistlik Kunsttööstuskool osales biennaali performance'iprogrammis

  2. TNT ehk noorkirjanduse orgia / Argo Riistan

    Index Scriptorium Estoniae

    Riistan, Argo

    2000-01-01

    Arvustus: Mõned ei tahtnudki / Tallinna Noored Tegijad: Siuts, Hedda Maurer, Raili Ilves, Neeme Põder, Mihkel Bravat, Jana Lepik, Ivar Sild, Marie Myrk, Marko Kivimäe, Wimberg, Jürgen Rooste, Helen Sandström. Tallinn : Kupar, 2000

  3. "Water Cube" ehk Pekingi Rahvuslik veekeskus

    Index Scriptorium Estoniae

    2005-01-01

    2003. a. rahvusvahelise arhitektuurivõistluse võitnud projektis osalesid inseneribüroo Arup, arhitektuurifirma PTW, CSCEC - Hiina riiklik ehitus- ja projekteerimiskorporatsioon ning CSCEC Shenzheni Disainiinstituut. Projektis rakendati ja koordineeriti kaastöid 12-st erinevast teadusharust ja neljast riigist pärit 80 Arupi insenerilt ja spetsialistilt. Konstruktsioonist, tehnoloogiast, tuleohutusest, energia taastootmise süsteemidest. Inseneriteaduse artiklit kommenteerivad arhitekt Kalle Komissarov ja insener Heiki Meos. Kuivõrd saavad eesti arhitektid inseneridelt innovaatilisust oodata. 7 ill

  4. Groundlab ehk maastikuurbanismi rakendamisest / Eva Castro

    Index Scriptorium Estoniae

    Castro, Eva

    2011-01-01

    Essee käsitleb rahvusvahelise maastikuurbanismiga tegeleva büroo Groundlab näitel maastikuurbanismi, mis sai alguse Londoni AA (Architectural Association) arhitektuurikooli kursusest MA Landscape Urbanism ning mille tegevusstrateegia on kujunenud läbi konkreetsete projektide

  5. Kuldmedal metsmaasikatele ehk austusavaldus Linnele / Karin Truverk

    Index Scriptorium Estoniae

    Truverk, Karin

    2007-01-01

    Chelsea Flower Show'l kuldmedali pälvinud rootsi maastikuarhitekti Ulf Nordfjelli kujundatud ideeaiast "Austusavaldus Linnele". Erilisele kohale on tõstetud Karl von Linne lemmiktaimed: kirju liilia, metspipar ja harakkuljus. Metallplaatide autoriks on kunstnik Anne-Karin Furunes. Projekt, 6 värv. fotot

  6. "Water Cube" ehk Pekingi Rahvuslik veekeskus

    Index Scriptorium Estoniae

    2005-01-01

    2003. a. rahvusvahelise arhitektuurivõistluse võitnud projektis osalesid inseneribüroo Arup, arhitektuurifirma PTW, CSCEC - Hiina riiklik ehitus- ja projekteerimiskorporatsioon ning CSCEC Shenzheni Disainiinstituut. Projektis rakendati ja koordineeriti kaastöid 12-st erinevast teadusharust ja neljast riigist pärit 80 Arupi insenerilt ja spetsialistilt. Konstruktsioonist, tehnoloogiast, tuleohutusest, energia taastootmise süsteemidest. Inseneriteaduse artiklit kommenteerivad arhitekt Kalle Komissarov ja insener Heiki Meos. Kuivõrd saavad eesti arhitektid inseneridelt innovaatilisust oodata. 7 ill

  7. Vananemise ilu ehk restaureerimisarhitekti roll / Ove Hidemark

    Index Scriptorium Estoniae

    Hidemark, Ove

    1997-01-01

    Restaureerimisarhitekti ülesannetest - ta ei pea otsustama üksnes tehniliste küsimuste üle, vaid arvestama ka sajandite vältel muutunud maitset, vana käsitöö erilist atmosfääri, toetama ehitisse koondatud ajaloolist elamust, nähes selles aja ja muutumise tervikut ning inimkäe mõju ja ajaloo sünteesi. Artikkel "Att behärska åldrandets skönhet eller om restaureringsarkitektens roll" rootsi ajakirjast "Kulturmiljövård", 1990, nr.4, lk.13-16

  8. Exegi monumentum ehk palee Tallinnas / Siim Sultson

    Index Scriptorium Estoniae

    Sultson, Siim

    2007-01-01

    Tallinnas Narva mnt. 7 endisest Tsentrosojuzprojektist ümber ehitatud Triumph Plazast (arhitektid Vilen Künnapu ja Ain Padrik). Maja kavandati 1981. a. büroohooneks (arhitektid Olga Bruns ja Mart Kalling). Kommenteerivad Mart Port, Dmitri Bruns, Kristiina Möldre ja Ain Padrik

  9. Kunst rahvani ehk Kwangju biennaal / Siram

    Index Scriptorium Estoniae

    Siram, pseud., 1968-

    2004-01-01

    Biennaal "Tolmutera, veetilk" Lõuna-Koreas, avatud kuni 13. XI 2004. Kuraatorid Yongwoo Lee (New York, Soul), Kerry Brougher (Washington-distrikt), Suk-won Chang (Kwangju). City Light Award - Watercio Caldas (Brasiilia), Korea fondi preemia - Jennifer Allora ja Guillermo Calzadilla (Kuuba) jt. Johann Köleri nim. Positivistlik Kunsttööstuskool osales biennaali performance'iprogrammis

  10. Tallinna valguskuppel ehk linnalegendi loomine / Triin Ojari

    Index Scriptorium Estoniae

    Ojari, Triin, 1974-

    2005-01-01

    Zizi & Yoyo alias Veronika Valgu ja Yoko Alenderi toodetud vaatemängust Tallinnas Raekoja platsil. Valguskupli idee pärineb hollandi arhitektilt Winy Maasilt (MVRDV). Valgust projekteerima tulnud Arupi valgustusosakonna juhist Rogier van der Heidest, tema töödest ja tema kommentaar valguskunstist. Sündmust filmis Rein Kotov. 11 värv. ill

  11. TNT ehk noorkirjanduse orgia / Argo Riistan

    Index Scriptorium Estoniae

    Riistan, Argo

    2000-01-01

    Arvustus: Mõned ei tahtnudki / Tallinna Noored Tegijad: Siuts, Hedda Maurer, Raili Ilves, Neeme Põder, Mihkel Bravat, Jana Lepik, Ivar Sild, Marie Myrk, Marko Kivimäe, Wimberg, Jürgen Rooste, Helen Sandström. Tallinn : Kupar, 2000

  12. 神经干细胞移植治疗创伤性脑损伤的研究进展%The Research Progress of Neural Stem Cells in the Traumatic Brain Injury (TBI)

    Institute of Scientific and Technical Information of China (English)

    马明; 杨华林

    2013-01-01

    创伤性脑损伤目前仍然是全世界死亡和致残的最主要原因之一,伤后的功能恢复仍是治疗面临的难题,神经干细胞移植为促进伤后神经功能恢复带来了光明的前景。%Traumatic brain injury (TBI) represents a major cause of neurological mortality and morbidity throughout the world. After the injury the functional recovery is still the dififcult problems in treatment. Neural stem cells therapy is a burgeoning ifeld of experimental treatment that has shown promise in the management of TBI.

  13. Impact of Single-Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) and Positron Emission Tomography/Computed Tomography (PET/CT) in the Diagnosis of Traumatic Brain Injury (TBI): Case Report.

    Science.gov (United States)

    Molina-Vicenty, Irma L; Santiago-Sánchez, Michelaldemar; Vélez-Miró, Iván; Motta-Valencia, Keryl

    2016-09-01

    Traumatic brain injury (TBI) is defined as damage to the brain resulting from an external force. TBI, a global leading cause of death and disability, is associated with serious social, economic, and health problems. In cases of mild-to-moderate brain damage, conventional anatomical imaging modalities may or may not detect the cascade of metabolic changes that have occurred or are occurring at the intracellular level. Functional nuclear medicine imaging and neurophysiological parameters can be used to characterize brain damage, as the former provides direct visualization of brain function, even in the absence of overt behavioral manifestations or anatomical findings. We report the case of a 30-year-old Hispanic male veteran who, after 2 traumatic brain injury events, developed cognitive and neuropsychological problems with no clear etiology in the presence of negative computed tomography (CT) findings.

  14. Structural Studies of Layered Cuprates LnLn'CaBa_2Cu_2Ti_3O_14 (LnLn' = NdY, Tb2, TbY, Dy2 and DyY) by Neutron Powder Diffraction

    Science.gov (United States)

    Hu, Z.; Jorgensen, J. D.; Short, S.; Otzschi, K. D.; Poeppelmeier, K. R.; Vander Griend, D.; Kane, M. H.

    1998-03-01

    In this presentation we report the neutron powder diffraction studies on several compounds in a new family of layered cuprates, LnLn'CaBa_2Cu_2Ti_3O_14 (LnLn' = NdY, Tb2, TbY, Dy2 and DyY). All compounds are found to crystallize in space group P 4/mmm. Strong site preferences of B-action (Cu and Ti) are observed in the NdY, Tb2 and TbY systems where Cu atoms strongly prefer 2g (0 0 0.084) sites. Due to the similar neutron scattering length of Nd, Tb, and Y, it is difficult to determine A-cation distributions in the NdY, Tb2 and TbY systems. In the DyY case, however, Dy atoms are found to strongly prefer site the 1 c (0.5 0.5 0) and do not mix with Y atoms on the (0.5 0.5 0.188) sites. The mechanism for these site preferences will be discussed. The oxygen content is found to be slightly different from the theoretical value for all compounds.

  15. Virtual Environment TBI Screen (VETS)

    Science.gov (United States)

    2014-10-01

    irm F oa m S ta tic SCALE: 2 4 6 8 10 12 14 16 18 20 0. 4 0. 6 0. 8 1. 0 1. 2 1. 4 1. 6 1. 8 2. 0 2. 2 SampEn D ar k SCALE: 2 4 6 8 10 12 14 16 18 20...co nf id en ce in te rv al F irm F oa m S ta tic SCALE: 2 4 6 8 10 12 14 16 18 20 0. 2 0. 4 0. 6 0. 8 1. 0 1. 2 1. 4 1. 6 1. 8 2. 0 ApEn D ar k...in te rv al F irm F oa m S ta tic

  16. CBI教学理念与TBI教学法对医学英语教学的启示%Revelation of CBI Teaching Philosophy and TBI Teaching Method to Medical English Teaching

    Institute of Scientific and Technical Information of China (English)

    张景发; 黄大鹏

    2012-01-01

    CBI(内容型教学理念)和TBI(任务型教学法)是在交际教学法基础上的新发展,给医学专业英语教学带来很好的启示,本文将在内容型教学理念和任务型教学法的理论框架内对医学专业英语教学进行探讨。%CBI (content-based teaching philosophy) and TBI (task-based teaching methods) is a new development on the basis of the communicative approach, bring good inspiration to teaching issues, this article will be in the content-based teaching philosophy and task-based approach theoretical framework to explore the medical professional English teaching.

  17. 造血干细胞移值 TBI治疗中直线加速器参数测试与调校%Measurement and adjustment the line accelerator's parameters for TBI IN HSCT

    Institute of Scientific and Technical Information of China (English)

    牟志坚; 陈渝; 张曦; 陈政颂

    2001-01-01

    在进行造血干细胞移植 (HSCT)病人全身放射治疗 (TBI)前 , 对直线加速器的各项参数作正确、有效地调校是 TBI治疗的关键性环节和基本保证 . 本文介绍了 TBI治疗前瑞典医科达公司 SLi型直线加速器各项参数的测试与调校 , 并根据机器的性能状况和病人的实际情况 , 按 TBI治疗要求合理地安排机器的出束时间 , 力求在减少加速器损耗的同时完成 TBI治疗工作 .

  18. 450例全身照射患者的照射方法及结果分析%Radiation method and result of TBI: Analysis of 450 Cases

    Institute of Scientific and Technical Information of China (English)

    张绍刚; 李高峰; 刘明远; 徐勇刚

    2008-01-01

    Objective To evaluate the radiation method and resuh of 450 patients received TBI(total body irradiation).Methods Single-dose Measurement was used to mark dose of TLD(thermo luminescence dosimeter).The values of actual dose in body midline were evaluated by calculating and correcting mean dose of incidence and emergence.Radiation methods:In four-field Irradiation.diagonals of fields coinside with the longitudinal axis of the patients,patient in supine and lateral positions received two pairs of parallel opposite radiation.Scheme of TBI came from a preparative radiation about one week before,and this four-field and equal-in-dose(about 10%of TBI)preparative radiation offered US the optimal scheme with aminimal dose non-uniformity by adjusting different dose proportion of supine and lateral position.In small field irradiation,patients received one pair of parallel opposite radiation from lateral side sitting on a special stool with backrest,the stool can be rotated CW or CCW,pedals can be move forward or backward and fixed.In opposite lateral irradiation,similar to four-field irradiation,patients received one pair of horizontal opposite radiation only in supine position.Five of these patients received FTBI(Fractional TBI). Results The average non-uniformity in midline of patients in four-field irradiation group(87 patients).small field irradiation group(91patients)and opposite lateral irradiation group(272 patients)is respectively ±8.1%,±7.4% and ±4.9%. Conclusions It iS a important process for QA and Qc to measure the dose of incidence and emergence real-timely with TLD or semiconductor dosimeter.We can adopt small field irradiation when the field iS not large enough to contain the patient from head to foot,and it showed advantages over four-field irradiation in treatment process and outcomes.We found the uniformity in body midline would be much better in supine position with diagonal>180 cm than that in four-field irradiation and small field irradiation with

  19. 基于3C的科技企业孵化器绩效评价实证分析%Empirical Analysis of 3C-based TBI's Performance Evaluation

    Institute of Scientific and Technical Information of China (English)

    李恒光

    2008-01-01

    为了使基于3C的科技企业孵化器绩效评价能够得到迅速的应用与推广.有必要检验并论证该理论与方法的系统性、科学性和有效性.文中实证分析的对象是长三角地区的10个TBI.在对其现状分析的基础上.构建了目标TBI绩效评价人力资源管理委员会,并由该委员会基于本地区及待测TBI的具体特征建立了TBI绩效评价指标体系;实施了待测TBI的数据采集、实际测评及其评价结果分析;给出了基于3C的TBI绩效评价的宏观政策及具体推进建议.

  20. Pilet mustvalgesse paradiisi ehk sügismood / Tanel Veenre

    Index Scriptorium Estoniae

    Veenre, Tanel, 1977-

    2009-01-01

    2009. a. juuli alguses toimunud kõrgmoe nädalast Pariisis. Giorgio Armani, Karl Lagerfeldi (Chanel), Christian Lacroix', John Galliano (Dior), Riccardo Tisci (Givenchy) ja Jean Paul Gaultier' kollektsioonidest

  1. Ilusalt lugemine ehk võistulausumine Linnateatris / Riin Aljas

    Index Scriptorium Estoniae

    Aljas, Riin

    2008-01-01

    Vabariiklikust etlejate konkursist. 4.-6. klasside arvestuses võitis Grand Prix' Markkus Pulk, laureaatideks tulid Maria Pihlak, Kenneth Norden ja Laura Elisabeth Konsand. 7.-9. klasside arvestuses võitis Grand Prix' Anna Talvi, laureaatideks tulid Liisa Saaremäel, Karmen Kozma, Riko Osila. 10.-12. klasside arvestuses võitis Grand Prix' Doris Tääker, laureaatideks tulid Jörgen Liik, Virgo Ernits ja Ilja Massalov

  2. Ilusalt lugemine ehk võistulausumine Linnateatris / Riin Aljas

    Index Scriptorium Estoniae

    Aljas, Riin

    2008-01-01

    Vabariiklikust etlejate konkursist. 4.-6. klasside arvestuses võitis Grand Prix' Markkus Pulk, laureaatideks tulid Maria Pihlak, Kenneth Norden ja Laura Elisabeth Konsand. 7.-9. klasside arvestuses võitis Grand Prix' Anna Talvi, laureaatideks tulid Liisa Saaremäel, Karmen Kozma, Riko Osila. 10.-12. klasside arvestuses võitis Grand Prix' Doris Tääker, laureaatideks tulid Jörgen Liik, Virgo Ernits ja Ilja Massalov

  3. Bits and Pieces ehk kolumna / DJ Pickney Tiger

    Index Scriptorium Estoniae

    DJ Pickney Tiger, pseud., 1970-

    2009-01-01

    Tutvustused: XXI Sajandi Orkester. Kaheksa. Tallinn : XXI Sajandi Orkester, 2006 ; XXI Sajandi Orkester. Üheksa. Tallinn : XXI Sajandi Orkester, 2008 ; Silent Bass. Crosshatched. Germany : Laika, 2008 ; Bullfrog Brown with Steve Lury. 2009

  4. Mobile 1. ehk vaataja haarab kirve / Johannes Saar

    Index Scriptorium Estoniae

    Saar, Johannes, 1965-

    2004-01-01

    Kaarel Kurismaa kureeritud kineetilise kunsti näitusest Mobile 1. Tallinna Kunstihoones, mis on osalt tagasivaade 1960.-1970. aastate kineetilisele kunstile, sulandudes ühtseks tervikuks 1995. aastal valminud installatsioonidega. Ilmunud ka ajalehes "Postimees", 1995, 8. november

  5. Laenu tagamisest munitsipaalmaaga ehk kuidagi ikka saab / Rein Tiivel

    Index Scriptorium Estoniae

    Tiivel, Rein, 1940-

    2006-01-01

    AS Kinnisvaratehingud ja Puulinna Linnavalitsus leppisid kokku linna omandis oleva kinnisasja koormamises kinnisvarafirma kasuks. Esitatud kaasus sisaldas mitmeid kokkuleppeid, mis seadsid kahtluse alla tehingu kehtivuse ja valitud tee otstarbekuse

  6. Õ, ehk, Loovtöötaja kottimine / Sven =Kivisildnik

    Index Scriptorium Estoniae

    Kivisildnik, Sven, pseud., 1964-

    2001-01-01

    Arvustus: Sinijärv, Karl Martin. Towntown & 28 : viies rühm poeese. Tallinn : Varrak, 1999 ; Sinijärv, Karl Martin. Sobimus. Tallinn : Artmiks, 1999 ; Neid vigu me ei korda / Asko Künnap, Jürgen Rooste, Karl Martin Sinijärv. Tallinn : Näo Kirik, 2000

  7. 15 aastat hiljem ehk Karl Ristikivi 90 / Janika Kronberg

    Index Scriptorium Estoniae

    Kronberg, Janika, 1963-

    2003-01-01

    XV Ristikivi päeva tähistamisest Ristikivi muuseumis. Karl Ristikivi Seltsi ja Eesti Võrdleva Kirjandusteaduse Assotsiatsiooni konverentsist "Eesti romaan 21. sajandi algul". Ka meenutusi K. Ristikivi loomingule pühendatud konverentsist 1987. a

  8. Dokumentalistika seis ehk Eesti lood omas mahlas / Maria Ulfsak

    Index Scriptorium Estoniae

    Ulfsak, Maria, 1981-

    2006-01-01

    Eesti lugude projekti raames valminud neli dokumentaalfilmi, mida näeb lähemal ajal ETVs : Mart Arjukese "Koerte näitus", Marianne Kõrveri "Eesti ehitab", Aivo Spitsonoki "Lehmakauplemine" ja Urmas Eero Liivi "Casting"

  9. Mozarti mõõtmed ehk lavastajate kool / Loone Ots

    Index Scriptorium Estoniae

    Ots, Loone, 1965-

    2010-01-01

    17. oktoobril Rahvusooperis Estonia esietendunud Mozarti koomilisest ooperist "Cosi fan tutte ossia La scuola degli amanti", lavastaja Walter Sutcliffe, etenduse muusikaline juht ja dirigent Arvo Volmer

  10. Restitutsioon, ehk, Kerouaci kaitseks / Triinu Pakk-Allmann

    Index Scriptorium Estoniae

    Pakk-Allmann, Triinu

    2004-01-01

    Vastuseks Kalle Käsperi arvustusele Jack Kerouaci "Pilvealuste" kohta "Pilve all lüürikast pornoni", Postimees, 2004, 11. juuni. Vastukaja: Käsper, Kalle. Restitutsioon konnaperspektiivilt // Postimees (2004) 21. aug., lk. 17

  11. Teine nahk ehk Ornament ja meie / Hanno Soans

    Index Scriptorium Estoniae

    Soans, Hanno, 1974-

    2003-01-01

    Arhitekt Adolf Loosi suhtumine ornamenti ja nahakaunistustesse, tattoo tagasitulek käibesse läänes XX sajandi II poolel. EKA nahakunsti eriala diplomandi Kerstin Raidma lõputööst, mis sisaldas seeria levinumaid tätoveeringupiirkondi katvaid nahast ehteid, lühidalt sama eriala lõpetaja Agnetha Kurusoni lõputööst "Kest" ja lõputööde hinnetest

  12. Mobile 1. ehk vaataja haarab kirve / Johannes Saar

    Index Scriptorium Estoniae

    Saar, Johannes, 1965-

    2004-01-01

    Kaarel Kurismaa kureeritud kineetilise kunsti näitusest Mobile 1. Tallinna Kunstihoones, mis on osalt tagasivaade 1960.-1970. aastate kineetilisele kunstile, sulandudes ühtseks tervikuks 1995. aastal valminud installatsioonidega. Ilmunud ka ajalehes "Postimees", 1995, 8. november

  13. Dokumentalistika seis ehk Eesti lood omas mahlas / Maria Ulfsak

    Index Scriptorium Estoniae

    Ulfsak, Maria, 1981-

    2006-01-01

    Eesti lugude projekti raames valminud neli dokumentaalfilmi, mida näeb lähemal ajal ETVs : Mart Arjukese "Koerte näitus", Marianne Kõrveri "Eesti ehitab", Aivo Spitsonoki "Lehmakauplemine" ja Urmas Eero Liivi "Casting"

  14. Kooliteater ehk "kogu maailm on lava..." / Kadri Haavajõe

    Index Scriptorium Estoniae

    Haavajõe, Kadri

    2007-01-01

    Betti Alveri luulepäevadelt tõid kolm Rakvere näitetruppi kuus preemiat. Rakvere reaalgümnaasiumi trupp Karla sai lisaks laureaaditiitlile ka parima meesosatäitja preemia, mille sai Jürgen Gansen. Osatäitmiste eest tunnustati ka Rakvere Linnanoorte Näitetrupi liiget Triinu Sikku ja Rakvere gümnaasiumi Teatriansambli noort Rainer Verner Samolbergi. Küsimusele "Miks ma näitlen" vastavad Jürgen Gansen ja Rainer Verner Samolberg

  15. "Gypsy" ehk killuke Ameerikat meie jaoks / Martin Gorris

    Index Scriptorium Estoniae

    Gorris, Martin

    2001-01-01

    2. dets. esietendus Vanemuises Ameerika vodevillistaari ja striptiisikuninganna Rose Louise Hovicki memuaaridel põhinev Jule Styne'i muusikal "Gypsy", lavastaja Mare Tommingas, osades Silvi Vrait ja Helena Merzin

  16. Teised meist ehk naistega naistest / Kärt Kross

    Index Scriptorium Estoniae

    Kross, Kärt

    2006-01-01

    Prantsuse suursaadik Eestis, tema ekstsellents Chantal de Bormont, USA suursaadik Eestis Aldona Zofia Wos, Jaapani asjur Eestis Toshiko Shimizu, estofiil Eva Lille ja tõlkija Elisabetta Fontana-Kalaus Eesti naistest

  17. Linnainstallatsioonide festival Tallinnas 2011 ehk "Lift11" / Margit Aule

    Index Scriptorium Estoniae

    Aule, Margit

    2011-01-01

    Tallinna linnainstallatsioonide festivalist "LIFT11", konkursist. 10 installatsioonist (nimetatud autorid), millest avlikku ruumi on jõudnud 8 installatsiooni. Intervjuu installatsiooni "Face it", mille sünd on veel kahtluse all, autorite Argo Peeveri ja Margus Tammega

  18. Hüvasti, Eesti! ehk Lahkujad seljatavad tulijad / Juhan Haravee

    Index Scriptorium Estoniae

    Haravee, Juhan, 1957-

    2013-01-01

    Eestist väljarände ja välismaal töötamise teemal avaldavad arvamust Tartu Ülikooli rahvastikuteadur Mare Ainsaar, Tallinna Ülikooli sisekommuni­katsiooni spetsialist Airi Ilisson-Cruzi ja EURES Eesti teenusejuht Marta Traks

  19. Iidamast ja Aadamast ehk "Ahvide planeet" / Jaak Lõhmus

    Index Scriptorium Estoniae

    Lõhmus, Jaak

    2001-01-01

    Taas on ekraanile jõudnud Pierre Boulle'i raamatu ainetel "Ahvide planeet" ("Planet of the Apes") : režissöör Tim Burton : Ameerika Ühendriigid 2001. Autor võrdleb seda 1968.a. filmiga ning Ain Kaalepi näidendiga "Iidamast ja Aadamast"

  20. Biennaal ehk mäng neljale keelele / Johannes Saar

    Index Scriptorium Estoniae

    Saar, Johannes, 1965-

    2001-01-01

    49. Veneetsia biennaali korraldusest, probleemidest, kontseptsioonist. Loetletud preemiasaajad - peapreemiad, rahvuspaviljoni Kuldlõvi, Kuldlõvi tänapäevakunsti meistritele ja noore kunstniku preemiad

  1. 'Tom & Viv' ehk Elulugu kunstiks / Jaak Rähesoo

    Index Scriptorium Estoniae

    Rähesoo, Jaak, 1941-

    1996-01-01

    Mängufilm Thomas Stearns Eliotist Michael Hastingsi näidendi põhjal, stsenaristid Michael Hastings ja Adrian Hodges, re̓issöör Brian Gilbert : Suurbritannia, 1994. Ka autori suhtumisest Madis Kõivu ja Jaan Krossi biograafilistesse teostesse. Järg: 26. jaan., lk. 12

  2. Khan Academy ehk Kuidas õppeaineid integreeriti / Kärt Matiisen

    Index Scriptorium Estoniae

    Matiisen, Kärt

    2012-01-01

    Kose gümnaasiumi 7. klassi matemaatikarühma uute õppemeetodite leidmise projektist ja erinevate õppeainete integreerimisest, mille käigus loodi subtiitrid Khan Academy ingliskeelsetele matemaatika õppetükkidele

  3. Põnevusõpe ehk uutmoodi konverentsid / Anne-Liis Arulo

    Index Scriptorium Estoniae

    Arulo, Anne-Liis

    2005-01-01

    EBS Juhtimiskoolituse Keskuse rahvusvaheliste projektide juht Baltic Development Associatoni 3. aastakonverentsi korraldamisest. Artikkel on valminud koostöös Pathway Guidance Europe asutaja ja partneri Uwe Weissflogiga

  4. "Siberi taibu" ehk soomlaste "M Klubi" / Margot Visnap

    Index Scriptorium Estoniae

    Visnap, Margot, 1959-

    2000-01-01

    Eesti Draamateatri näitleja Jan Uuspõld mängib Soome telekanali YLE 2 teleteatri uues seriaalis "Siberi geenius" ("Siberian nero") peaosa : stsenaristid Mika Ripatti ja Jarmo Lampela : režissöör Jarmo Lampela

  5. Afterwar ehk Täna kolm aastat tagasi / Andri Ksenofontov

    Index Scriptorium Estoniae

    Ksenofontov, Andri, 1962-

    2010-01-01

    Kristina Normani näitus "Me ei ole universumis üksi" Tallinna Kunstihoones 9. maini 2010, kuraator Anders Härm. Näeb lühifilmi "Monoliit", Venezia biennaalil olnud installatsiooni "After-War", videot monumendist UFO-le Padisel jm. Hetkel valitsevast huvipuudusest kaasaegse kunsti vastu

  6. Riik kui tellija ehk avaliku teenindamise kohustus õhutranspordisektoris / Sandor Elias

    Index Scriptorium Estoniae

    Elias, Sandor

    2017-01-01

    Avaliku teenindamise kohustusest õhutranspordi valdkonnas, selle kehtestamise menetlusest ja avaliku teenindamise kohustuse seotusest riigiabi andmise keeluga. Riigiabi andmise keelust Euroopa Liidu toimimise lepingu alusel

  7. Khan Academy ehk Kuidas õppeaineid integreeriti / Kärt Matiisen

    Index Scriptorium Estoniae

    Matiisen, Kärt

    2012-01-01

    Kose gümnaasiumi 7. klassi matemaatikarühma uute õppemeetodite leidmise projektist ja erinevate õppeainete integreerimisest, mille käigus loodi subtiitrid Khan Academy ingliskeelsetele matemaatika õppetükkidele

  8. Kabaree kaminaserval ehk ehisskulptuuri õitseaeg sajandi algul / Mirjam Peil

    Index Scriptorium Estoniae

    Peil, Mirjam, 1939-

    1998-01-01

    Art deco pisiplastikast, millele moodne interjöör pakkus sobivaid paiku. Skulptorite armastatuim tegelane - moodne naine. Materjalidest, meelistehnikast -krüüselelefantiinist. Tegutsenud kunstnikke: saksa skulptor Ferdinand Preiss, Pariisis tegutsenud rumeenlane Dem̊tre Chiparus, belglanna Claire-Jeanne-Roberte Colinet, Marcel Bouraine, austerlane Bruno Zach

  9. Neli linna ehk mängud miljonitega / Andres Lõo

    Index Scriptorium Estoniae

    Lõo, Andres

    2006-01-01

    Cardiffis toimunud arhitektuurikonverentsist "Urban Legacies II", alapealkirjaga "New Babylon". Constanti (1920-2005) installatsioonist "New Babylon", Cardiffist, Tallinnast, ettekannete põhjal Dubaist ja Kinshasast. Konverentsi raames oli Eestist väljas arhitektuuriobjekt "Transparent Black Box" (Veronika Valk, projektiga seotud Kadri Klementi)

  10. Eesti riigi regionaalpoliitika ehk Miks elu koondub Tallinna / Taimo Saan

    Index Scriptorium Estoniae

    Saan, Taimo

    2001-01-01

    Eesti rahvastik on koondunud Harjumaale, Ida-Virumaale ja Tartumaale. Regionaalpoliitika tasakaalustamise võimalusi. Tabel: Raha jagunemine maakonniti. Ilmunud ka: Severnoje Poberezhje : Subbota, 18. aug. 2001, lk. 2; Hiiu Leht, 24. aug. 2001, lk. 6; Nädaline, 25. aug. 2001, lk. 4; Vooremaa, 28. aug. 2001, lk. 2; Pärnu Postimees, 29. aug. 2001, lk. 2; Meie Maa, 29. aug. 2001, lk. 2

  11. Koolitusrahast ehk Makske minu reisid samuti kinni / Margus Maiste

    Index Scriptorium Estoniae

    Maiste, Margus

    2007-01-01

    Õpetajatele mõeldud täienduskoolitustest. Olukorrast, kus omavalitsusametnike reisikulud hüvitatakse, kuid õpetajate reise - silmaringi laiendamiseks, ajalooliste paikade külastamiseks ja koolitundides kasutatava õppematerjali saamiseks - mitte

  12. Pihhtas, põhhjas ehk "Trainspotting" teatrilaval / Karlo Funk

    Index Scriptorium Estoniae

    Funk, Karlo, 1971-

    2000-01-01

    Max Bitter jun. pseudonüümi all esineva vene näitekirjaniku Igor Shpritsi komöödia "Põhhjas" (paroodia Maksim Gorki näidendist "Põhjas") Tallinna Linnateatris, lavastaja Peeter Tammearu, kunstnik Vadim Fomitshev, muusikaline kujundaja Riina Roose. Esietendus 20. dets.

  13. Põrsast kotis ei osteta ehk astmelise tulumaksu kaitseks / Gerd Tarand

    Index Scriptorium Estoniae

    Tarand, Gerd, 1985-

    2006-01-01

    Ilmunud ka: Põhjarannik, Severnoje Poberzhje, Vooremaa 29. lk. 2,2,2, Kesknädal, Meie Maa 30. aug. lk. 6, 2, Maaleht 31. aug. lk. 6, Videvik 7. sept. lk. 2. Ühenduse Noored Sotsiaaldemokraadid peasekretär toob välja astmelise tulumaksu tugevad argumendid

  14. Hea uus Eesti, ehk, Kunstiilma kirjutamine / Virve Sarapik

    Index Scriptorium Estoniae

    Sarapik, Virve, 1961-

    2007-01-01

    Noor-Eesti algperioodi tekstides väljendatud esteetilistest ja ühiskondlikest ideaalidest. Pikemalt Gustav Suitsu programmilistest artiklitest: "Noorte püüded" (1905), "Võitluse päivil" (1905) ja "Kaks ilmavaadet" (1906). Noor-Eesti ja Eesti Kirjanduse Seltsi tegevuste võrdlus

  15. Neli linna ehk mängud miljonitega / Andres Lõo

    Index Scriptorium Estoniae

    Lõo, Andres

    2006-01-01

    Cardiffis toimunud arhitektuurikonverentsist "Urban Legacies II", alapealkirjaga "New Babylon". Constanti (1920-2005) installatsioonist "New Babylon", Cardiffist, Tallinnast, ettekannete põhjal Dubaist ja Kinshasast. Konverentsi raames oli Eestist väljas arhitektuuriobjekt "Transparent Black Box" (Veronika Valk, projektiga seotud Kadri Klementi)

  16. Pilet mustvalgesse paradiisi ehk sügismood / Tanel Veenre

    Index Scriptorium Estoniae

    Veenre, Tanel, 1977-

    2009-01-01

    2009. a. juuli alguses toimunud kõrgmoe nädalast Pariisis. Giorgio Armani, Karl Lagerfeldi (Chanel), Christian Lacroix', John Galliano (Dior), Riccardo Tisci (Givenchy) ja Jean Paul Gaultier' kollektsioonidest

  17. Eesti riigi regionaalpoliitika ehk Miks elu koondub Tallinna / Taimo Saan

    Index Scriptorium Estoniae

    Saan, Taimo

    2001-01-01

    Eesti rahvastik on koondunud Harjumaale, Ida-Virumaale ja Tartumaale. Regionaalpoliitika tasakaalustamise võimalusi. Tabel: Raha jagunemine maakonniti. Ilmunud ka: Severnoje Poberezhje : Subbota, 18. aug. 2001, lk. 2; Hiiu Leht, 24. aug. 2001, lk. 6; Nädaline, 25. aug. 2001, lk. 4; Vooremaa, 28. aug. 2001, lk. 2; Pärnu Postimees, 29. aug. 2001, lk. 2; Meie Maa, 29. aug. 2001, lk. 2

  18. Esimene NAP ehk Noore Arhitekti Preemia / Triin Ojari

    Index Scriptorium Estoniae

    Ojari, Triin, 1974-

    2009-01-01

    2008. a. Eesti Arhitektide Liidu poolt asutatud Noore Arhitekti Preemiast, mille pälvis Siiri Vallner. Arhitektist ja tema loomingust. Žürii koosseis. Preemia kujutab 70000 krooni suurust reisitšekki maailmas rändamiseks, selle panid välja Heldur Meerits ja GO Travel. Siiri Vallnerit õnnitles 12. veebruaril 2009 Tallinnas Kumu kunstimuuseumis ka president Toomas Hendrik Ilves

  19. Laenu tagamisest munitsipaalmaaga ehk kuidagi ikka saab / Rein Tiivel

    Index Scriptorium Estoniae

    Tiivel, Rein, 1940-

    2006-01-01

    AS Kinnisvaratehingud ja Puulinna Linnavalitsus leppisid kokku linna omandis oleva kinnisasja koormamises kinnisvarafirma kasuks. Esitatud kaasus sisaldas mitmeid kokkuleppeid, mis seadsid kahtluse alla tehingu kehtivuse ja valitud tee otstarbekuse

  20. Restitutsioon, ehk, Kerouaci kaitseks / Triinu Pakk-Allmann

    Index Scriptorium Estoniae

    Pakk-Allmann, Triinu

    2004-01-01

    Vastuseks Kalle Käsperi arvustusele Jack Kerouaci "Pilvealuste" kohta "Pilve all lüürikast pornoni", Postimees, 2004, 11. juuni. Vastukaja: Käsper, Kalle. Restitutsioon konnaperspektiivilt // Postimees (2004) 21. aug., lk. 17

  1. Hea uus Eesti, ehk, Kunstiilma kirjutamine / Virve Sarapik

    Index Scriptorium Estoniae

    Sarapik, Virve, 1961-

    2007-01-01

    Noor-Eesti algperioodi tekstides väljendatud esteetilistest ja ühiskondlikest ideaalidest. Pikemalt Gustav Suitsu programmilistest artiklitest: "Noorte püüded" (1905), "Võitluse päivil" (1905) ja "Kaks ilmavaadet" (1906). Noor-Eesti ja Eesti Kirjanduse Seltsi tegevuste võrdlus

  2. Mozarti mõõtmed ehk lavastajate kool / Loone Ots

    Index Scriptorium Estoniae

    Ots, Loone, 1965-

    2010-01-01

    17. oktoobril Rahvusooperis Estonia esietendunud Mozarti koomilisest ooperist "Cosi fan tutte ossia La scuola degli amanti", lavastaja Walter Sutcliffe, etenduse muusikaline juht ja dirigent Arvo Volmer

  3. Kirjanduse kohandumisi 1990. aastatel ehk kauboikapitalismi kultuuriloogika / Piret Viires

    Index Scriptorium Estoniae

    Viires, Piret, 1963-

    2002-01-01

    Summary: Conformity in the literature of the 1990s, or the cultural logic of cowboy capitalism. Lk. 365; Eesti kultuurisituatsioonist 1990-ndatel vastavalt F. Jamesoni postmodernismi käsitlusele, kus postmodernism oli eesti kirjanduses valitsev diskursus. Vt. ka: Viires, Piret. Postmodernism Eesti kirjanduskultuuris : doktoritöö artiklid ; I. Tartu : Tartu Ülikooli Kirjastus, 2006

  4. Põnevusõpe ehk uutmoodi konverentsid / Anne-Liis Arulo

    Index Scriptorium Estoniae

    Arulo, Anne-Liis

    2005-01-01

    EBS Juhtimiskoolituse Keskuse rahvusvaheliste projektide juht Baltic Development Associatoni 3. aastakonverentsi korraldamisest. Artikkel on valminud koostöös Pathway Guidance Europe asutaja ja partneri Uwe Weissflogiga

  5. Peaaegu valmis : ehk kuidas liidrid liiguvad / Dan Ciampa

    Index Scriptorium Estoniae

    Ciampa, Dan

    2007-01-01

    Omadustest, mis on vajalikud tippjuhiks saamiseks ning näiteid tippjuhikandidaatide poolt tehtud vigadest. Tabel: Mis vahe on heal ja parimal kandidaadil. Artikkel ilmus Directori ja Harvard Business Review koostöös, originaalpealkiri "Almost Ready: How Leaders Move Up", HBR 2005 jaanuar

  6. Pihhtas, põhhjas ehk "Trainspotting" teatrilaval / Karlo Funk

    Index Scriptorium Estoniae

    Funk, Karlo, 1971-

    2000-01-01

    Max Bitter jun. pseudonüümi all esineva vene näitekirjaniku Igor Shpritsi komöödia "Põhhjas" (paroodia Maksim Gorki näidendist "Põhjas") Tallinna Linnateatris, lavastaja Peeter Tammearu, kunstnik Vadim Fomitshev, muusikaline kujundaja Riina Roose. Esietendus 20. dets.

  7. 'Tom & Viv' ehk Elulugu kunstiks / Jaak Rähesoo

    Index Scriptorium Estoniae

    Rähesoo, Jaak, 1941-

    1996-01-01

    Mängufilm Thomas Stearns Eliotist Michael Hastingsi näidendi põhjal, stsenaristid Michael Hastings ja Adrian Hodges, re̓issöör Brian Gilbert : Suurbritannia, 1994. Ka autori suhtumisest Madis Kõivu ja Jaan Krossi biograafilistesse teostesse. Järg: 26. jaan., lk. 12

  8. Graafiline betoon ehk kunst otse tehasest / Anneliis Aunapuu

    Index Scriptorium Estoniae

    Aunapuu, Anneliis

    2009-01-01

    Uudse tehnoloogiaga valmistatud betoonist. Esimese graafilise betooni näidiseks Eestis on Maanteemuuseumis valmiv väliala (arhitektuur büroolt Salto), kus seinalementidele on jäädvustatud suurendustena vanad fotod Eestimaa maastikest (kujundus Laika, Belka & Strelka). 28. oktoobril Tallinnas toimunud Betooni Tehnoloogiapäeva seminarist. Küsimustele vastavad E-Betoonelemendi esindajad

  9. EQF kutsehariduses ehk mida me Hollandis õppisime / Anu Vaagen

    Index Scriptorium Estoniae

    Vaagen, Anu, 1971-

    2011-01-01

    Leonardo da Vinci programmi finantseeriva projekti EQF kaudu käisid Luua Metsanduskooli direktor, arendusjuht ja maastikuehituse õpetaja Hollandis kompetentsipõhise õppe ja kooli juhtimise vallas teadmisi omandamas

  10. Bits and Pieces ehk kolumna / DJ Pickney Tiger

    Index Scriptorium Estoniae

    DJ Pickney Tiger, pseud., 1970-

    2009-01-01

    Tutvustused: XXI Sajandi Orkester. Kaheksa. Tallinn : XXI Sajandi Orkester, 2006 ; XXI Sajandi Orkester. Üheksa. Tallinn : XXI Sajandi Orkester, 2008 ; Silent Bass. Crosshatched. Germany : Laika, 2008 ; Bullfrog Brown with Steve Lury. 2009

  11. Kirjanduse kohandumisi 1990. aastatel ehk kauboikapitalismi kultuuriloogika / Piret Viires

    Index Scriptorium Estoniae

    Viires, Piret, 1963-

    2002-01-01

    Summary: Conformity in the literature of the 1990s, or the cultural logic of cowboy capitalism. Lk. 365; Eesti kultuurisituatsioonist 1990-ndatel vastavalt F. Jamesoni postmodernismi käsitlusele, kus postmodernism oli eesti kirjanduses valitsev diskursus. Vt. ka: Viires, Piret. Postmodernism Eesti kirjanduskultuuris : doktoritöö artiklid ; I. Tartu : Tartu Ülikooli Kirjastus, 2006

  12. Peaaegu valmis : ehk kuidas liidrid liiguvad / Dan Ciampa

    Index Scriptorium Estoniae

    Ciampa, Dan

    2007-01-01

    Omadustest, mis on vajalikud tippjuhiks saamiseks ning näiteid tippjuhikandidaatide poolt tehtud vigadest. Tabel: Mis vahe on heal ja parimal kandidaadil. Artikkel ilmus Directori ja Harvard Business Review koostöös, originaalpealkiri "Almost Ready: How Leaders Move Up", HBR 2005 jaanuar

  13. Esimene NAP ehk Noore Arhitekti Preemia / Triin Ojari

    Index Scriptorium Estoniae

    Ojari, Triin, 1974-

    2009-01-01

    2008. a. Eesti Arhitektide Liidu poolt asutatud Noore Arhitekti Preemiast, mille pälvis Siiri Vallner. Arhitektist ja tema loomingust. Žürii koosseis. Preemia kujutab 70000 krooni suurust reisitšekki maailmas rändamiseks, selle panid välja Heldur Meerits ja GO Travel. Siiri Vallnerit õnnitles 12. veebruaril 2009 Tallinnas Kumu kunstimuuseumis ka president Toomas Hendrik Ilves

  14. Hüvasti, Eesti! ehk Lahkujad seljatavad tulijad / Juhan Haravee

    Index Scriptorium Estoniae

    Haravee, Juhan, 1957-

    2013-01-01

    Eestist väljarände ja välismaal töötamise teemal avaldavad arvamust Tartu Ülikooli rahvastikuteadur Mare Ainsaar, Tallinna Ülikooli sisekommuni­katsiooni spetsialist Airi Ilisson-Cruzi ja EURES Eesti teenusejuht Marta Traks

  15. Teine nahk ehk Ornament ja meie / Hanno Soans

    Index Scriptorium Estoniae

    Soans, Hanno, 1974-

    2003-01-01

    Arhitekt Adolf Loosi suhtumine ornamenti ja nahakaunistustesse, tattoo tagasitulek käibesse läänes XX sajandi II poolel. EKA nahakunsti eriala diplomandi Kerstin Raidma lõputööst, mis sisaldas seeria levinumaid tätoveeringupiirkondi katvaid nahast ehteid, lühidalt sama eriala lõpetaja Agnetha Kurusoni lõputööst "Kest" ja lõputööde hinnetest

  16. Grupipilt ehk Lumemehe mängud / Donald Tomberg

    Index Scriptorium Estoniae

    Tomberg, Donald

    2005-01-01

    Animafilmist "Frank ja Wendy" : režissöör David Snowman = loominguline grupp Priit Pärn, Ülo Pikkov, Priit Tender ja Kaspar Jancis : helilooja Margo Kõlar : produtsent Kalev Tamm : Eesti Joonisfilm 2003/2004

  17. Mission Connect Mild TBI Translational Research Consortium

    Science.gov (United States)

    2015-07-01

    Masel Annual Report 2015 Page4 • A paper entitled: The Effects of Growth Hormone Replacement Therapy on Cognition after Traumatic Brain Injury...Hormone Replacement Therapy on Cognition after Traumatic Brain Injury, Journal ofNeurotrauma 27:1565-1585 (September 2010). • Dr. Masel was a co-author...subjects. Total testosterone was tested in male subjects, and 17 P-estradiols was tested in females. As of August 1, 2015, 71 subjects completed the 6

  18. Identifying Concussion / Mild TBI in Service Members

    Science.gov (United States)

    2012-03-22

    more concussions o Median time between concussions equals 40 days o Based on reports from 2004-2008 in Iraq treated at Navy/Marine Corps facilities...Important because multiple concussions are often associated with slower recovery and increased risk of long-term sequelae Reference: *Wilk et...Injury Guidance 35 Screening Challenges for the Military  Concussions that occur in theater occur under unique circumstances: o In the context of

  19. Mission Connect Mild TBI Translational Research Consortium

    Science.gov (United States)

    2012-08-01

    Enduring Freedom and BINT is one of the most common causes of mortality. Even mild BIBI may be associated with chronic cognitive and emotional deficits...The development of effective therapies for BIBI requires experimental models that replicate important features of BINT in humans. Currently

  20. Neurophysiological Outcomes of mTBI

    Science.gov (United States)

    2017-03-28

    drastically increase the severity of the injury . Thus, it is important to establish a method to accurately detect and track progress in order to prevent re...Pan, J, Connolly ID, Dangelmajer S, Kintzing J, Ho AL, Grant G (2016). Sports -related brain injuries : connecting pathology to diagnosis. Neurosurg...Leverenz LJ, Nauman EA, Talavage TM, Dydak U (2014). MR Spectroscopic evidence of brain injury in the non-diagnosed collision sport athlete

  1. Mission Connect Mild TBI Translational Research Consortium

    Science.gov (United States)

    2013-08-01

    and covered with dental acrylic. Isoflurane was discontinued; rats were connected to the trauma device and subjected to a mild 1.0-atm fluid-percussion...return of consciousness in the rat.39,40 Comparison with sham-treated rats allows extrapolating the effects of anesthesia and handling alone; sham

  2. Traumatic Brain Injury (TBI) Data and Statistics

    Science.gov (United States)

    ... The CDC Cancel Submit Search The CDC Traumatic Brain Injury & Concussion Note: Javascript is disabled or is not ... please visit this page: About CDC.gov . Traumatic Brain Injury & Concussion Basic Information Get the Facts Signs and ...

  3. Mission Connect Mild TBI Translational Research Consortium

    Science.gov (United States)

    2013-08-01

    R, Hahn D, Haase A. Fast T1 mapping on a whole-body scanner. Magn. Reson. Med. 1999; 42(1): 206–209. 11. Shah NJ, Zaitsev M, Steinhoff S, Zilles K. A...new method for fast multislice T1 mapping. Neuroimage, 2001; 14(5): 1175–1185. 12. Steinhoff S, Zaitsev M, Zilles K, Shah NJ. Fast T1 mapping with

  4. Advanced MRI in Acute Military TBI

    Science.gov (United States)

    2015-11-01

    major psychiatric disorder, 8) agreement to communicate by telephone or email 255 monthly for 6-12 months and then travel to Washington University for in...social and leisure activities 284 outside the home 3) psychological problems which have frequently resulted in ongoing family disruption or 285...time of follow-up at Washington University. Active duty military subjects were not paid for participation, 356 though travel expenses to Washington

  5. Advanced MRI in Acute Military TBI

    Science.gov (United States)

    2014-09-01

    435 24. Guskiewicz KM, Ross SE, Marshall SW. Postural Stability and Neuropsychological Deficits After 436 Concussion in Collegiate Athletes. Journal...imaging study on the white 454 matter skeleton in individuals with sports-related concussion. Journal of neurotrauma. Feb 455 2011;28(2):189-201...41. 55 The neurological examination consisted of cranial nerve, motor, sensory, coordination, 56 deep tendon reflex, posture and gait assessments

  6. Rapid Isolation and Detection for RNA Biomarkers for TBI Diagnostics

    Science.gov (United States)

    2016-10-01

    detection is very important for enabling future “liquid biopsy ” molecular diagnostics. 4.3 Impact on technology transfer The results of...transfer as it demonstrates overall viability of the DEP technology for a wide variety of diagnostic applications, including liquid biopsy cancer...Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Our project work is focused on using a new dielectrophoresis (DEP) microarray technology for

  7. Mission Connect Mild TBI Translational Research Consortium, Post Traumatic Hypopituitarism

    Science.gov (United States)

    2010-08-01

    10 Aug 2010 4. TITLE AND SUBTITLE The Mission Connect MTBI Translational Research Consortium 5a. CONTRACT NUMBER Post traumatic hypopituitarism 5b...distribution unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT The purpose of this project is to identify the incidence of post traumatic hypopituitarism ...June 21, 2010; however, none have reached the six month milestone for blood testing 15. SUBJECT TERMS post traumatic hypopituitarism 16. SECURITY

  8. Sheep Collisions: the Good, the Bad, and the TBI

    OpenAIRE

    Courtney, Michael; Courtney, Amy

    2007-01-01

    The title page of Chapter 9 in Fundamentals of Physics (Halliday, Resnick, and Walker, 8th Edition, p. 201) shows a dramatic photograph of two Big Horn sheep butting heads and promises to explain how sheep survive such violent clashes without serious injury. However, the answer presented in sample problem 9-4 (p. 213) errs in presuming an interaction time of 0.27 s which results in an unrealistically long stopping distance of 0.62 m. Furthermore, the assertion that the horns provide necessary...

  9. Enhanced Cognitive Rehabilitation to Treat Comorbid TBI and PTSD

    Science.gov (United States)

    2014-10-01

    These practice standards have been organized into a manualized treatment, Cognitive Symptom Management and Rehabilitation Therapy (CogSMART), which...Psychological Association ( APA ) to contribute to a symposium for the APA Convention in August 2014. The 2- hour symposium entitled “Active Recovery

  10. Rapid Isolation and Detection for RNA Biomarkers for TBI Diagnostics

    Science.gov (United States)

    2015-10-01

    CSR = transpose(chol(S)); % Cholesky Square Root of S CSR * transpose( CSR ) - S % Check for round-off errors A = inv( CSR ); % Mahalanobis scaling Z... transport RNA and proteins that promote tumour growth and provide diagnostic biomarkers. Nature cell biology. 2008;10:1470-6. 57

  11. Treatment of TBI and Concomitant Hemorrhage with Ghrelin

    Science.gov (United States)

    2010-07-01

    battlefield setting. 15. SUBJECT TERMS Traumatic brain injury ; hemorrhagic shock; ghrelin; treatment 16. SECURITY CLASSIFICATION OF: U 17...hemorrhagic shock. 2. Ghrelin treatment improves sensorimotor and reflex function after traumatic brain injury and uncontrolled hemorrhagic shock...3. Ghrelin treatment reduces cortical apoptosis after traumatic brain injury and uncontrolled hemorrhagic shock. 4. Ghrelin treatment

  12. Enhanced Cognitive Rehabilitation to Treat Comorbid TBI and PTSD

    Science.gov (United States)

    2015-10-01

    study brochures more widely to other relevant clinics within the VA (e.g., Member Services, Polytrauma , Social Work). The study coordinator 5  has also...In addition, the study coordinator worked closely with the Polytrauma Clinic at the VA to build a more efficient system to reach Veterans who are

  13. Prospective memory rehabilitation using smartphones in patients with TBI.

    Science.gov (United States)

    Evald, Lars

    2017-06-07

    The aim of the present study was to investigate the effectiveness of a prospective memory aid that combines smartphones with Internet-based calendars among community-dwelling patients with traumatic brain injury. An uncontrolled pre- and post-assessment design was employed to study the use of unmodified, low-cost, off-the-shelf smartphones combined with Internet-calendars as a compensatory memory strategy in community-dwelling patients with traumatic brain injury. Thirteen participants received a 6-week group-based intervention with pre-, post- and 2-month follow-up-assessments by questionnaires and by daily assessment of target behaviors for 2-week periods. Participants reported significantly fewer retro- and prospective memory problems on questionnaires after the intervention and at follow-up with large effect sizes. The performance of target behaviors, however, improved insignificantly with moderate effect sizes. There were no changes in quality of life or symptoms of emotional distress. This study adds to a growing body of evidence that smartphones are a useful compensatory aid in rehabilitation of prospective memory that should routinely be considered in rehabilitation of traumatic brain injury patients. Implication for rehabilitation Smartphones are easy-to-use and accessible assistive technology for compensatory memory rehabilitation to most traumatic brain injury patients. By using low-cost, off-the-shelf devices, the technology becomes available to a broader range of patients. By combining smartphones with Internet-based and cross-platform services (e.g., calendars, contacts) the participants are less device-dependent and less vulnerable to data loss. Smartphones should routinely be considered as compensatory aid in rehabilitation of prospective memory of traumatic brain injured patients.

  14. Novel Treatment for Patients with Traumatic Brain Injury (TBI)

    Science.gov (United States)

    2016-06-01

    with pressors after traumatic brain injury. J Am Coll Surg. 2005 Oct;201(4):536-45. 21. Earle SA, de Moya MA, Zuccarelli JE , Norenberg MD, Proctor KG... JE . Impact ofLow- dose Vasopressin on Trauma Outcome: Prospective Randomized Study. World Journal of Surgery. 2011 Feb;35(2):430-9. 30. Andrews PI

  15. EyeRobot TBI unmanned TelePresence reconnaissance mission

    NARCIS (Netherlands)

    Breejen, E. den; Jansen, C.

    2008-01-01

    There is an increasing use of unmanned systems in military operations. Effective use of unmanned ground vehicles (UGVs) for counter IED and reconnaissance tasks under battlefield conditions has been reported. For operations in urban environment, good real time situational awareness for the operator

  16. Mechanistic Links between PARP, NAD, and Brain Inflammation after TBI

    Science.gov (United States)

    2014-10-01

    completely immobilize the head, and in addition placed the diffuser component to mitigate post-blast airflow against the head. Under these...recovery of forelimb function. See 2 panels below: A Scm B ·• c Bihemispheric EcoG Sign.als Bihtmi$pherlc Etecb’ocotti<:ogr’tllpl\\y (E.CoG) RecO

  17. Frontoparietal priority maps as biomarkers for mTBI

    Science.gov (United States)

    2016-10-01

    imaging will allow us to measure (1) integrity in cortical networks in frontal and parietal brain regions responsible for attention allocation and eye ...networks that control attention allocation and eye movements. A combination of functional MRI and diffusion-weighted imaging will allow us to measure (1...integrity in cortical networks in frontal and parietal brain regions responsible for attention allocation and eye -movement planning, (2) integrity in

  18. EyeRobot TBI unmanned TelePresence reconnaissance mission

    NARCIS (Netherlands)

    Breejen, E. den; Jansen, C.

    2008-01-01

    There is an increasing use of unmanned systems in military operations. Effective use of unmanned ground vehicles (UGVs) for counter IED and reconnaissance tasks under battlefield conditions has been reported. For operations in urban environment, good real time situational awareness for the operator

  19. Frontoparietal Priority Maps as Biomarkers for mTBI

    Science.gov (United States)

    2015-10-01

    vision convergence insufficiency ACCOMPLISHMENTS Specific Aim 1: behavioral characterization of convergence insufficiency, tracking in 3D , spatial...studies 3-6 Underway. Phantom studies on 7T scanner to establish QA protocol 7 Delayed to month 15 due to recruitment delays. Milestone Achieved

  20. How Do Health Care Providers Diagnose Traumatic Brain Injury (TBI)?

    Science.gov (United States)

    ... 4 [top] Speech and Language Tests A speech-language pathologist completes a formal evaluation of speech and language skills, including an oral motor evaluation of the strength and coordination of the muscles ...

  1. Therapeutic Targeting of P2X7 after TBI

    Science.gov (United States)

    2012-11-16

    Pradillo, J. M., Hurtado, O., Lorenzo , P., Moro, M. A., & Lizasoain, I. (2007). Toll-like receptor 4 is involved in brain damage and inflammation...management in traumatic brain injury. Emerg Med Australas, 23(6), 665-676. Taupin, V., Toulmond, S., Serrano, A., Benavides, J., & Zavala , F. (1993

  2. Legacy Clinical Data from the Epo TBI Trial

    Science.gov (United States)

    2016-06-01

    impact on other disciplines? Nothing to report What was the impact on technology transfer? Nothing to report What was the impact on society...Robertson, MD CONTRACTING ORGANIZATION: Baylor College of Medicine Houston, Texas 77030 REPORT DATE: June 2016 TYPE OF REPORT: Final PREPARED FOR: U.S...Baylor College of Medicine 8. PERFORMING ORGANIZATION REPORT NUMBER One Baylor Plaza Houston, Texas 77030 9. SPONSORING / MONITORING AGENCY NAME

  3. Pupillometry and Saccades as Objective mTBI Biomark

    Science.gov (United States)

    2015-10-01

    concussive trauma . Consequently, there is a quest for objective markers (e.g., protein, imaging, cognitive, neurosensory) to objectively diagnose...RTD or evacuation. Objectives Introduction 4 • Since approximately 30 areas of the brain, and 7 of the 12 cranial nerves deal with vision, it...of neuropathology and neurological recovery after traumatic brain injury. J Head Trauma Rehabil, 2005. 20(1): p. 76-94. • 10. Khan, F., I.J. Baguley

  4. Pupillometry and Saccades as Objective mTBI Biomark

    Science.gov (United States)

    2017-06-01

    related hospitalizations , emergency department visits, and deaths climbed from a rate of 521.0 per 100,000 in 2001 to a rate of 823.7 per 100,000 in...to accommodation and to prevent 6 recording artifacts by blinking during PLR recordings. The PLR was recorded twice in each eye, alternating

  5. Defining the Pathophysiological Role of Tau in Experimental TBI

    Science.gov (United States)

    2016-10-01

    neurodegenerative condition. 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF RESPONSIBLE PERSON...DARPA award NEU -92-2913 Joshua Duckworth, Principal Investigator Robert Siman, Co-Investigator (1.8 calendar months effort) Period: 7/1/16 – 6/30

  6. TBI Assessment of Readiness Using a Gait Evaluation Test (TARGET): Development of a Portable mTBI Screening Device

    Science.gov (United States)

    2016-05-01

    one-time publications. Report any book, monograph , dissertation, abstract, or the like published as or in a separate publication, rather than a...cell lines, DNA probes, animal models);  clinical interventions;  new business creation; and  other. Nothing to

  7. Treatment of TBI with Hormonal and Pharmacological Support, Preclinical Validation Using Diffuse and Mechanical TBI Animal Models

    Science.gov (United States)

    2016-05-01

    adjacent graph to the right, above, reveals an important aspect of the LFP model, which is the necessity of creating a trephine to allow for the percussion...sagittal sutures as well as the lateral ridges. A 4.8-mm craniectomy was trephined over the right parietal cortex, midway between bregma and lambda

  8. Biohäkkimine : mikrobioloogia kui kunstimeedium, ehk, Küberkoodist biokoodini / Tiia Johannson

    Index Scriptorium Estoniae

    Johannson, Tiia, 1965-2002

    2001-01-01

    Uus kunstnike kommuun üritab loodust üle kavaldada, kasutades molekulaarbioloogiat uut tüüpi interaktiivse kunsti loomiseks: Eduardo Kac'i jäneseprojekt "GFP Bunny" ja transgeneetiline netiinstallatsioon "Genesis"

  9. Keha võõras nahas ehk antropoloogiline eksperimentalism / Aet Annist

    Index Scriptorium Estoniae

    Annist, Aet

    2009-01-01

    Eksperimentidest kunstis ja antropoloogias. Kristina Normani kunstiprojektist kuldse pronkssõduriga ja Ameerika valge ajakirjaniku John H. Griffini eksperimendist veeta kuus nädalat mustanahalisena USA lõunaosariikides

  10. Ettevaatust - advokaat! : ehk ühe apellatsioonikaebuse uskumatud seiklused Tallinna linnas / Virkko Lepassalu

    Index Scriptorium Estoniae

    Lepassalu, Virkko, 1971-

    2010-01-01

    Saksamaal elava keeletadlase Florence Lutkati kohtuasjast Viimsi vallavalitsuse vastu seoses Lutkatile kuuluva maja ja maa erastmisega perek. Klasile. F. Lutkati palgatud advokaadibüroo MAQS puudulikust tööst antud küsimuses

  11. 3 x Griškovets ehk avanemine kildude kaudu / Ireene Viktor

    Index Scriptorium Estoniae

    Viktor, Ireene

    2009-01-01

    Jevgeni Griškovetsi teksti põhjal valminud lavastustest: "Samal ajal", tõlkinud, lavastanud ja mängib Priit Ruttas, esietendus Tartu Athena keskuses 30. juunil 2008. "Linn", lavastaja Lembit Peterson, esietendus Theatrumi saalis 7. juunil 2008. "Vene rännumehe ülestähendused", lavastajad ja kunstnikud Ott Aardam ja Mart Aas, Tartu Uue Teatri esietendus 9. augustil Genialistide klubis

  12. Reis Keukenhofi ehk unelmate lillenäitusel / Aarne Kähr

    Index Scriptorium Estoniae

    Kähr, Aarne, 1946-

    2005-01-01

    Lühidalt ka Keukenhofi ajaloost. Inglise stiilis pargi kavandas 1857. a. maastikuarhitekt Jan David Zocher noorem poja Louis Pauliga. 1949. aastast korraldatakse sibullillede näitusi. Vaatamiseks pakutakse erinevaid aedu ja aiastiile, lilleseadeid. 22 värv. ill

  13. Valge telk, punane nelk, mustad naistekingad ehk Kolm meest frustratsioonis / Pille-Riin Purje

    Index Scriptorium Estoniae

    Purje, Pille-Riin, 1963-

    2003-01-01

    Kolmest tegelaskujust - R. Simmuli ettevõtja Ewbank D. Storey "Pühapäevas" Tallinna Linnateatris, I. Uukkivi tehasetööline Gary G. Burke'i "Gagarini puiestees" Vanalinnastuudios ja R. Rosbergi politseinik Daniel J. Uptoni näidendis "Ashes and Sand" Eesti Riiklikus Nukuteatris

  14. Näitleja teeb vahekokkuvõtte ehk Kuidas lavastatakse aega / Katrin Ruus

    Index Scriptorium Estoniae

    Ruus, Katrin

    2006-01-01

    Von Krahli Teatri kolmest lavastusest: "Erki ja Tiina" (lavastaja Mart Kangro, tantsivad Erki Laur ja Tiina Tauraite), "Faust" (J. W. Goethe ainetel tekst ja lavastus Taavi Eelmaa, muusika ja laulud Chalice, osades Jarek Kasar ja Rein Pakk), "Hamletid" (William Shakespeare'i ainetel kontseptsiooni, lavastuse, koreograafia, kujunduse, valguse autor Sasha Pepeljajev, video- ja helikunstnik Taavet Jansen. Esitaja Juhan Ulfsak)

  15. Sangpomm ei taha lahkuda ehk uuenduslikkust tuleb üritusturundusse visalt / Olavi Andla

    Index Scriptorium Estoniae

    Andla, Olavi, 1970-

    2013-01-01

    Firma suvepäevade korraldamisest, kuhu tehnoloogia kasutamine toob uudseid lahendusi. Lähemalt kahest ürituse formaadist - Action Track ja Amazing Race, mida saab kasutada seiklusmängude korraldamisel

  16. Nakatav teen-tüdrukute naer ehk prozakikuur kõigile / Rael Artel

    Index Scriptorium Estoniae

    Artel, Rael, 1980-

    2002-01-01

    26. I-16. II Kiwa personaalnäitus "Life after prozac. Girl-art ekshibition". Raatuse galeriis. Avamisel olematu bändi Unestapja (Kiwa54 ja A nagu alfa ühisprojekt) performance. Näha saab low-tech videot, badpaintingulaadseid maale.

  17. Mats võib mässama hakata ehk lugusid keskajast / Katrin Roosileht

    Index Scriptorium Estoniae

    Roosileht, Katrin

    2006-01-01

    Viljandi Kultuuriakadeemia teatrikunsti 6. lennu tudengid mängivad Tartu Sadamateatris Dario Fo farssi "Müsteerium buff", lavastaja Peeter Raudsepp, lavakujundus ja kostüüm Peeter Raudsepp ja Kersti Rattus. Esietendus 25. aprillil

  18. Onu Miltie mälestuseks ehk Mis seob New Orleansi ja Keilat? / Katrin Saks

    Index Scriptorium Estoniae

    Saks, Katrin, 1956-

    2008-01-01

    16. novembril sai kaks aastat liberaalse majanduse guru Milton Friedmani surmast. Friedmani šokidoktriinist, katastroofikapitalismist ja pimedast usust erakapitali, ajal, mil Keila linnaisad olid otsustanud, et haridust hakkab munitsipaalkooli asemel edendama sihtasutus

  19. Väike taskuteatmik ehk 10 tegijat NRG-tehingus / Hannes Rumm

    Index Scriptorium Estoniae

    Rumm, Hannes, 1968-

    2000-01-01

    Lühiülevaade NRG-tehinguga seotud kümne tähtsama Eesti-poolse osalise (Mart Laar, Mihkel Pärnoja, Lennart Meri, Edgar Savisaar, Villu Reiljan, Jüri Käo, Toomas Luman, Gunnar Okk, Sandor Liive, Lembit Vali) huvidest, võitlusvahenditest ja nende skoorist

  20. Nakatav teen-tüdrukute naer ehk prozakikuur kõigile / Rael Artel

    Index Scriptorium Estoniae

    Artel, Rael, 1980-

    2002-01-01

    26. I-16. II Kiwa personaalnäitus "Life after prozac. Girl-art ekshibition". Raatuse galeriis. Avamisel olematu bändi Unestapja (Kiwa54 ja A nagu alfa ühisprojekt) performance. Näha saab low-tech videot, badpaintingulaadseid maale.

  1. Plantadores de cidade ehk linnaistutajad : Millennium Village, Briti elamuehituse suurprojekt / Tõnu Laigu

    Index Scriptorium Estoniae

    Laigu, Tõnu

    2002-01-01

    Greenwich Peninsula arendamine. Üldplaneering büroolt Richard Rodgers Partnership. Millennium Village'i, mis on kavas välja arendada 2005. aastaks, planeeringu ja ala ruumilise ettepaneku koostas arhitekt Ralph Erskine koostöös bürooga Hunt Thompson Architects. Ehitatud on R. Erskine 100 korteriga elamu ja arhitekt Proctor Matthews'i lintmajad

  2. Väikesest ja suurest kurjusest, ehk, Inimese valikuvabadusest / Urmas Kiil

    Index Scriptorium Estoniae

    Kiil, Urmas

    2004-01-01

    Autor arutleb Hannah Arendti teose "The origins of Totalitarianism" (New York, 1973) üle ning püüab lahti mõtestada tema teoses "Eichmann in Jerusalem" (New York, 1965) kasutatud terminit "kurjuse banaalsus"

  3. Voldemar ehk Portreed temas ja tema ümber / Kristi Eberhart

    Index Scriptorium Estoniae

    Eberhart, Kristi

    2007-01-01

    Andrus Kivirähki "Voldemar", mis kirjutatud toetudes Voldemar Panso kirjutatud lugudele, päevikule, kirjadele. Lavastaja Merle Karusoo, peaosas Tiit Sukk. Esietendus 25. märtsil Eesti Draamateatris

  4. Valged ööd ja Tallinn Londonis ehk 60 kraadi põhjalaiust / Ann Alari

    Index Scriptorium Estoniae

    Alari, Ann

    2009-01-01

    19. juunist 9. juulini toimub City of London Festival, millel osalevad Põhjamaad. Üheks oodatumaks sündmuseks on 30. juunil St Pauli katedraalis Inglise Rahvusballeti orkestri kontsert ja etendus "Chopiniana", kus tantsivad Age Oks ja Toomas Edur

  5. TSD lahtrimäng ehk maksude arvestamisest ja deklareerimisest / Gaily Kuusik

    Index Scriptorium Estoniae

    Kuusik, Gaily

    2007-01-01

    Tulude deklareerimisest ja maksustamisest seoses palgatulu, juhatuse liikme tasu, välislähetuste, elatise, puhkuste, hüvitiste ja toetustega. Lisatud: MTA juhendmaterjalid tulumaksu kinnipidamise ja sotsiaalmaksu arvutamise kohta

  6. Üliõnnetu mina ehk Mr Snicket soovib parimat / Liina Siib

    Index Scriptorium Estoniae

    Siib, Liina

    2006-01-01

    Arvustus: Snicket, Lemony. Ahastav algus ; Roomajate ruum ; Avar aken : [jutustused] / tõlkinud Maarja Kangro ; Snicket, Lemony. Vilets veski ; Karm kool / tõlkinud Leelo Märjamaa (Draakon ja Kuu, 2003-2006)

  7. Radikaalne realism ehk üleelusuurune ... = Large than life: radical realism as ... / Kalle Komissarov

    Index Scriptorium Estoniae

    Komissarov, Kalle, 1976-

    2011-01-01

    Linnade ajastust. Linnaehitusest ja arhitektuurist. Utoopiatest. Narva utoopiast. Autori sõnul tuleks planeerida protsesse, mitte ruumi, sest protsessid kujundavad iseendale ruumi, mis oleks kohalikele suunatud. Robustsusest, mis sobib väljendama eestilikku linnakeskkonda

  8. Tying up sündroom ehk väsimusmüopaatia : [hobustel] / Anne Rohtla

    Index Scriptorium Estoniae

    Rohtla, Anne

    2010-01-01

    Väsimusmüopaatia on kestvusratsutamishobustel esinev seisund, mida väljendadavad tunnused võivad olla vaevumärgatavad. Samas võib selline seisund areneda eluohlikuks, kui sellese ei sekkuta. Artikkel sisaldab ka refereeringut Melissa Ribley artiklist "Watch for the subtle signs of exertional myopathy"

  9. Fix iT 2014 ehk talgud massidesse / Kai Raku, Vanessa Moreno

    Index Scriptorium Estoniae

    Raku, Kai

    2014-01-01

    Eesti Erinoorsootöö Ühing noOR vahendab ja võõrustab erivajadustega noori vabatahtlikus teenistuses, üheks nende partneriks on Hispaanias asuv Associacion Cultural En-Construccion, mille juht Vanessa Moreno tutvustab Associacion Cultural En-Construccioni tegevust ja puuetega inimeste vabatahtliku teenistuse võimalusi

  10. Kolmikportree eesti kunstist ehk kolm uut kunstifilmi / Riin Kübarsepp

    Index Scriptorium Estoniae

    Kübarsepp, Riin, 1978-

    2005-01-01

    Tallinna Kinomajas esilinastusid 28. okt. kolm uut dokumentaalfilmi eesti kunstnikest, mis valminud Eesti Kunstnike Liidu tellimusel : "F.F.F.F. läheb laiali" (Kuukulgur Film 2005, rezh. Marko Raat), "Mare Vint" (Exitfilm 2005, rezh. Anri Rulkov) ja "Jaan Klõsheiko" (Estonia Film 2005, rezh.-d Eve Ester, Igor Ruus)

  11. Kes on kes ehk Tulgu uus taevas / Ervin Õunapuu

    Index Scriptorium Estoniae

    Õunapuu, Ervin, 1956-

    2002-01-01

    Tuntud tegijad, kes on oma sõnul ateistid, agnostikud või umbuskliku suhtumisega ristiusu kirikusse: William Seward Burroughs, Vincent Van Gogh, Oscar Niemeyer, Sven Alur Reinans, Sir Joshua Reynolds, Diego Rivera, Neil Rogers, John Ruskin, Matt Wagner, Frank Lloyd Wright, Ervin Õunapuu jne. Ilmunud ka kogumikus "Öövöö", lk.109-124

  12. Täiustatud tõde ehk Walter Andersoni rahvajuttude enesekontrolli seadus / Elo-Hanna Seljamaa

    Index Scriptorium Estoniae

    Seljamaa, Elo-Hanna, 1980-

    2007-01-01

    Geograafilis-ajaloolise meetodi lähtealuste ja eesmärkide toel analüüsitakse Walter Andersoni, Tartu Ülikooli esimese folkloristikaprofessori käsitlusi folkloorist ja folkloori uurimisest ning tema tegevust meetodi edasiarendajana

  13. Palju vihjeid vihjest ehk alternatiivne tekstianalüüsi õpik / Jaak Rand

    Index Scriptorium Estoniae

    Rand, Jaak

    2005-01-01

    Arvustus: Mihkelev, Anneli. Vihjamise poeetika. Tallinn : Underi ja Tuglase Kirjanduskeskus, 2005.(Collegium litterarum ; 19). Kättesaadav ka võrguteavikuna: http://www.utlib.ee/ekollekt/diss/dok/2005/b17361230/mihkelev.pdf

  14. Kärbsed meeste pissuaarides ehk nüke / Raimo Ülavere

    Index Scriptorium Estoniae

    Ülavere, Raimo, 1970-

    2014-01-01

    Inimeste käitumise kaudsest suunamisest teatud kindlate valikute suunas. Raamatust: Thaler, Richard H.; Sunstein, Cass R. Nudge : improving decisions about health, wealth, and happiness. New Haven ; London, 2008

  15. Shmigun : ehk olen juba piisavalt vana kala, et pinget mitte tunda / Kristina Shmigun ; interv. Veiko Visnapuu

    Index Scriptorium Estoniae

    Šmigun, Kristina, 1977-

    2005-01-01

    Suusatamise MK-etapil Reit im Winklis 10 km vabatehnikasõidus viienda koha saanud Kristina Šmigun leidis, et loetud päevad enne Oberstdorfi maailmameistrivõistlusi on tal "kõik enam-vähem hästi"

  16. Mustad jõulud Geenivaramus ehk miks tekkis tõrge Eesti võimsaimas teadusprojektis

    Index Scriptorium Estoniae

    2004-01-01

    Sihtasutuste Eesti Geenivaramu ja Eesti Geenikeskus, AS-i EGeen ja EGeen International Inc. tegevusest, Eesti geeniprojektiga seotud investoritest, projekti hetkeseisust ning võimalikest tulevikustsenaariumitest. Tabel ja diagrammid: SA Eesti Geenivaramu kulud 2001-2003; Geenidoonorite arv kvartaalselt. Lisad: Inimgenoomi projekt; Erinevate projektide võrdlus; Eesti Geenivaramu lühike ajalugu; Eesti geeniprojekti SWOT-analüüs

  17. GLEN ehk Eesti noored Aafrikaga tutvust tegemas / Annika Räim

    Index Scriptorium Estoniae

    Räim, Annika

    2008-01-01

    GLEN (Global Education for the Young Europeans) on programm, kus löövad kaasa Euroopa Liidu 12 liikmesmaa mittetulundusühingud ning mis lähetab noori eurooplasi projektide raames kolmeks kuuks arengumaadesse. Artiklis jagavad oma muljeid GLEN-projektis osalenud Kadri Runnel Gruusiast, Kadri Aavik Lõuna-Aafrika Vabariigist, Birgit Rosenberg Sambiast ja Mari Nuga Kamerunist

  18. Kes on kes ehk Tulgu uus taevas / Ervin Õunapuu

    Index Scriptorium Estoniae

    Õunapuu, Ervin, 1956-

    2002-01-01

    Tuntud tegijad, kes on oma sõnul ateistid, agnostikud või umbuskliku suhtumisega ristiusu kirikusse: William Seward Burroughs, Vincent Van Gogh, Oscar Niemeyer, Sven Alur Reinans, Sir Joshua Reynolds, Diego Rivera, Neil Rogers, John Ruskin, Matt Wagner, Frank Lloyd Wright, Ervin Õunapuu jne. Ilmunud ka kogumikus "Öövöö", lk.109-124

  19. Töörahulolu uurimus ehk mille üle nuriseb Eesti politseinik / Liivia Anion

    Index Scriptorium Estoniae

    Anion, Liivia

    2005-01-01

    Politseitööga rahulolust aastatel 1996-2004 läbi viidud politsei rahulolu-uurimuste põhjal. Diagramm: Patrull- ja liikluspolitseinike rahulolematus võrrelduna juhtide ja valvuritega. Vt. samas: Laaneots, Annela. Töörahulolu-uuringu mõtteaine politsei juhtkonnale

  20. Prozaci asemel GTD ehk getting things done / David Allen ; interv. Endrik Randoja

    Index Scriptorium Estoniae

    Allen, David

    2007-01-01

    Konsultant ja koolitaja David Allen oma aja- ja enesejuhtimise meetodist GTD - getting things done. Vt. samas: Väikesed nipid, et tõhusam olla; Milles seisneb Alleni meetod; Kuidas ma oma ülesannet täitsin - logiraamat

  1. See meeletu, meeletu maailm ehk Ära siit! / Rein Tootmaa

    Index Scriptorium Estoniae

    Tootmaa, Rein

    2001-01-01

    IV Pimedate Ööde Filmifestivalil linastunud absurdifilmidest : Prantsusmaa "Harry aitab sind" : režissöör Dominik Moll, Jaapani "Esmaspäev" ("Monday") : režissöör Hiroyuki Tanaka, Horvaatia "Marssal Tito vaim" ("Marshal") : režissöör Vinko Breshan, Taani "Kuningas on elus" ("King Is Alive") : režissöör Kristian Levring, Rootsi "Laulud teiselt korruselt" ("Sånger från andra våningen"): režissöör Roy Andersson, Šveitsi "Kes on järgmine ?" ("Who's Next ?") : režissöör Felix Tissi, Saksamaa "Tuvalu" : režissöör Veit Helmer ja Venemaa ning mitme Euroopa riigi ühisfilm "Kuu isaks" ("Luna papa") : režissöör Bahtijer Hudoinazarov. Kokkuvõte inglise keeles lk. 128

  2. BIO 20 ehk kaasaegse tööstusdisaini trende / Ilona Gurjanova

    Index Scriptorium Estoniae

    Gurjanova, Ilona, 1958-

    2006-01-01

    Muljeid Ljubljanas toimunud tööstusdisaini biennaalilt "BIO 20", loetletud võitjad. Eestit esindasid Sixten Heidmetsa, Igor Volkovi, Pavel Sidorenko ja Tarmo Luisu tööd. Ida- ja Kesk-Euroopa disainikeskuste regionaalsest ümarlauast

  3. Fantastiline näidisprojekt : brooching it diplomatically ehk ebatavaline diplomaatia / Tiina Käesel

    Index Scriptorium Estoniae

    Käesel, Tiina, 1943-

    1999-01-01

    27. veebr.-28. märtsini 1999 on Tallinnas Tarbekunstimuuseumis avatud rändnäitus 'Ehted Madeleine Albrightile', mille koostas ameerika galerist ja kollektsionäär Helen Drutt. Üksikute ehete kirjeldus

  4. Väikesest ja suurest kurjusest, ehk, Inimese valikuvabadusest / Urmas Kiil

    Index Scriptorium Estoniae

    Kiil, Urmas

    2004-01-01

    Autor arutleb Hannah Arendti teose "The origins of Totalitarianism" (New York, 1973) üle ning püüab lahti mõtestada tema teoses "Eichmann in Jerusalem" (New York, 1965) kasutatud terminit "kurjuse banaalsus"

  5. Artiklikogumiku järelsõna ehk kas jutud Homo Economicuse surmast on liialdatud? / Kaire Põder

    Index Scriptorium Estoniae

    Põder, Kaire, 1972-

    2006-01-01

    Artikli sihiks on välja selgitada majandusteooria uurimisobjekt ning otsida kinnitus väitele, et majandusteooria on defineeritud pigem meetodi kaudu. Filosoofiline relativism, individualism, normativism ja positivism majandusteoorias

  6. Surm kevadises Tallinnas ehk Kunstnike valuline reaktsioon meie ajale / Reet Varblane

    Index Scriptorium Estoniae

    Varblane, Reet, 1952-

    2006-01-01

    Mark Soosaare näitus "Aeg" Tallinna Kunstihoone galeriis kuni 23. IV, Jaan Paavle maalinäitus "1 minut" 3.-15. IV Draakoni galeriis, Sandra Jõgeva ja Kristin Kalamehe "Leave like a Lady" Draakoni galerii keldrisaalis 4.-15. IV, Marianne Männi näitus "Paradiis" Hobusepea galeriis 5.-17. IV. Maailma positiivsemale poolusele osutab 20. IV Tallinna Linnagaleriis avatud Mari ja Kaarel Kurismaa ruumiinstallatsioon "Teine süütus"

  7. Inimesed lahinguväljal ehk Karmid pildid tegelikkusest / Enn Mälgand

    Index Scriptorium Estoniae

    Mälgand, Enn

    2005-01-01

    M. Karusoo Afganistani sõja teemaline lavastus "Misjonärid", mis põhineb Dee Browni indiaanisõdade raamatul "Mata mu süda Wounded Knees" ja Afganistanis sõdinud meestega tehtud intervjuudel. Esietendus Rakvere Teatris 24. märtsil 2005

  8. Prozaci asemel GTD ehk getting things done / David Allen ; interv. Endrik Randoja

    Index Scriptorium Estoniae

    Allen, David

    2007-01-01

    Konsultant ja koolitaja David Allen oma aja- ja enesejuhtimise meetodist GTD - getting things done. Vt. samas: Väikesed nipid, et tõhusam olla; Milles seisneb Alleni meetod; Kuidas ma oma ülesannet täitsin - logiraamat

  9. Varjaagide teekond Moskvast Tallinna ehk Vene teatrifestival "Kuldne mask" Eestis / Maris Johannes

    Index Scriptorium Estoniae

    Johannes, Maris, 1959-

    2009-01-01

    6.-13. okt. Tallinnas toimunud Venemaa rahvuslikust teatrifestivalist "Kuldne mask Eestis". Festivali lavastustest - Temur Tšheidze "Onukese unenägu", Declan Donnellan "Kaheteistkümnes öö", Lev Erenburgi "Äike" ja Alvis Hermanise "Šukšini jutustused"

  10. Normani ja Pushwagneri juhtum, bb5, ehk Ühe kunstiametniku komandeeringuaruanne / Andreas Trossek

    Index Scriptorium Estoniae

    Trossek, Andreas, 1980-

    2008-01-01

    Koomiksi- ja filmiteemalised mõtted seoses Berliini 5. kaasaegse kunsti biennaaliga "Kui asjad ei heida varje". Pikemalt eesti kunstniku Kristina Normani animalistlikust videofilmist "Geniaalsuse väli" ja Norra kunstniku Hariton Pushwangeri, kodanikunimega Terje Brofoss, joonistuste sarjast "Soft city"

  11. Bits and Pieces ehk kolumna. White Label : Dub's Don Erickson Takin Dub+. Kuula / DJ Pickney Tiger

    Index Scriptorium Estoniae

    DJ Pickney Tiger, pseud., 1970-

    2008-01-01

    Popmuusikauudised. Kahest dub-mixist. Heliplaatidest: Anal Thunder "4 am illusion", Eli "Paperboy" Reed & The True Loves "Roll With You", B-525 "Funplex", Alko "Reis ümber enda telje", Morten Harket "Letter From The Egypt", Makossa+Megablast "Kunuka", Nerd "Seeing Songs", Kasemahlake "Kadunud süütus"

  12. Tõotatud maa ameerika lastekirjanduses ehk kuidas kasvatada lapsest diktaator / David Ilmar Beecher

    Index Scriptorium Estoniae

    Beecher, David Ilmar

    2015-01-01

    Lastekirjandusest teadusliku allikana ning Maurice Sendaci lasteraamatust "Where the wild things are" (1964) ja Steven Kelloggi lasteraamatust "The island of the Skog" (1976). Tekst põhineb "Õnnekonverentsi" ettekandel, mis peeti 3. mail 2011. aastal

  13. Pühak Tony Blair ehk võit on võit / Maris Lillak

    Index Scriptorium Estoniae

    Lillak, Maris, 1970-

    2004-01-01

    Lord Huttoni raportist, mis selgitas Briti relvaeksperdi David Kelly enesetapu asjaolusid. Raporti mõjust peaminister Tony Blairile ja meediakompaniile BBC. Vt. samas: Süüdi tunnistatud BBCd raputavad tagasiastumised

  14. Ettevaatust - advokaat! : ehk ühe apellatsioonikaebuse uskumatud seiklused Tallinna linnas / Virkko Lepassalu

    Index Scriptorium Estoniae

    Lepassalu, Virkko, 1971-

    2010-01-01

    Saksamaal elava keeletadlase Florence Lutkati kohtuasjast Viimsi vallavalitsuse vastu seoses Lutkatile kuuluva maja ja maa erastmisega perek. Klasile. F. Lutkati palgatud advokaadibüroo MAQS puudulikust tööst antud küsimuses

  15. Uudiste lõpp ehk kuidas Facebook ajakirjanduse alla neelas / Priit Hõbemägi

    Index Scriptorium Estoniae

    Hõbemägi, Priit, 1957-

    2016-01-01

    Priit Hõbemägi refereeris Cambridge ülikooli professori ja Columbia ajakirjanduskooli digitaalse ajakirjanduse keskuse direktori Emily Belli meedia­maailmas laineid löönud kõnet sotsiaalmeedia ettevõtete mõju kasvust uudiste levitamise ja sellega raha teenimise üle

  16. Kärbsed meeste pissuaarides ehk nüke / Raimo Ülavere

    Index Scriptorium Estoniae

    Ülavere, Raimo, 1970-

    2014-01-01

    Inimeste käitumise kaudsest suunamisest teatud kindlate valikute suunas. Raamatust: Thaler, Richard H.; Sunstein, Cass R. Nudge : improving decisions about health, wealth, and happiness. New Haven ; London, 2008

  17. ERP ehk tarkvara, mis teab ja teeb kõike / Kadri Põdra, Randel Uibo, Heiti Kender

    Index Scriptorium Estoniae

    Põdra, Kadri

    2006-01-01

    ERP (Enterprise Resource Planning) on majandustarkvara, mis võimaldab hallata ühtses süsteemis ettevõtte kõiki majandusandmeid ja äriprotsesse. Uuringufirma Faktum & Ariko poolt 2005. a. detsembris tehtud uuringust ERP-süsteemide kasutamise kohta Eesti suurettevõtetes. Lisatud statistilised diagrammid

  18. Re?bus disainivõistlus ehk noored innovaatorid bussirevolutsiooni otsinguil

    Index Scriptorium Estoniae

    2005-01-01

    2005. a. algul agentuuri APCI (Agence pour la Promotion de la Creation Industrielle) poolt korraldatud disainivõistlusest Re?bus. Eestist valiti 30 finalisti hulka büroo ZiZi & YoYo töö. Edukamad võistlustööd olid juuni algul väljas rahvusvahelise ühistranspordi assotsiatsiooni (UITP) 56. kongressil Roomas

  19. Mida lugeja tegelikult ootab ehk kui kaugel oleme ideaalist? / Kristina Pai

    Index Scriptorium Estoniae

    Pai, Kristina, 1967-

    2010-01-01

    Artikli autor palus 2009. aastal infokorraldust magistritasemel õppivatel üliõpilastel kirjeldada oma ideaalraamatukogu. Küsitluse tulemuste kommenteeritud ülevaade. Illustreeriva võrdlusena on kasutatud Tartu Ülikooli Raamatukogu

  20. Kauglabor ehk Üle mere õppimine / Argo Rosin ; intervjueerinud Raivo Juurak

    Index Scriptorium Estoniae

    Rosin, Argo, 1972-

    2011-01-01

    Intervjuu TTÜ elektriajamite ja jõuelektroonika instituudi teaduri Argo Rosinaga kauglaborist, kus Kuressaare kolledži üliõpilased käivitavad TTÜ energeetikamajas üles pandud elektrilisi katseseadmeid Saaremaalt lahkumata

  1. Kultuuridessant Sillamäe aatomilinna ehk Nemad ja meie / Ilja Sundelevitsh

    Index Scriptorium Estoniae

    Sundelevitsh, Ilja

    2006-01-01

    Eleonore de Montesquiou näitust "Aatomilinnad. Paldiski - Sillamäe" tutvustati 8. IX Sillamäe muuseumis, 24. VIII esitleti kunstniku projekti Paldiski muuseumis. Sillamäel käisid E. de Montesquiou, Anne Durez, Reet Varblane, Liina Siib, Eve Kiiler, Jaanika Peerna, Liis Jürgens, Tarmu Tamverk ja Ilja Sundelevitsh

  2. Maalikunsti järjekordne Eesti verstapost ehk Rakvere aiateivas / Andri Ksenofontov

    Index Scriptorium Estoniae

    Ksenofontov, Andri, 1962-

    2011-01-01

    Maalinäitus "Lihtne lugu. Eesti noor maal" Rakvere Näitustemajas 31. detsembrini 2011, kuraator Teet Veispak. Eksponeeritakse Rauno Thomas Mossi (näituse kujundaja), Maarit Murka, Veiko Klemmeri, Merike Estna ja Laura Põllu töid

  3. Radikaalne realism ehk üleelusuurune ... = Large than life: radical realism as ... / Kalle Komissarov

    Index Scriptorium Estoniae

    Komissarov, Kalle, 1976-

    2011-01-01

    Linnade ajastust. Linnaehitusest ja arhitektuurist. Utoopiatest. Narva utoopiast. Autori sõnul tuleks planeerida protsesse, mitte ruumi, sest protsessid kujundavad iseendale ruumi, mis oleks kohalikele suunatud. Robustsusest, mis sobib väljendama eestilikku linnakeskkonda

  4. Haanja 2010 : Endurance ehk eesti keeli kestvusratsutamine on ratsaspordimaailma maraton / Ingrid Randlaht

    Index Scriptorium Estoniae

    Randlaht, Ingrid

    2010-01-01

    21.-23. mail 2010 Haanjas, keskusega Kurgjärve Spordibaasis, toimunud esimestest rahvusvahelistest kestvusratsutamise võistlustest ja Eesti meistrivõistlustest. Lisad: Tõugude tähendus kestvusratsutamises. Eatu sport

  5. Kõik teed viivad Rooma ehk kolm võimalust efektiivsuse tõstmiseks / Meredith Belbin

    Index Scriptorium Estoniae

    Belbin, Meredith

    2008-01-01

    Autor selgitab, kuidas luua efektiivselt toimivat meeskonda, kus töörollid oleksid tasakaalus ning toimuks efektiivne ja kiire tegutsemine. Joonised: Töörollid ja nende sisu; Töörollide värvikaart; Ässa mudel; Organisatsioon nagu lihavõttemuna. Vt. ka Sander Karu. Boonus - enne kokkulepitud eesmärk ja siis tasu lk. 30-31; Eva Palu. Pigista oma ärist maksimum välja lk. 32-34

  6. K9 ehk karvane spetsialist Kässu koos juhiga / Tarmo Riisenberg

    Index Scriptorium Estoniae

    Riisenberg, Tarmo

    2006-01-01

    Kohtuekspertiisi ja Kriminalistika Keskuse koosseisu kuuluvast spanjelist Kässu, kelle ülesanne on tulekahjukohtadelt põlevvedelike jälgede otsimine. Lisa: Statistikat. Vt. samas: Esimene väljakutse: Scotland Yard; Juhtum suvest: jälg jääb alati

  7. Täiustatud tõde ehk Walter Andersoni rahvajuttude enesekontrolli seadus / Elo-Hanna Seljamaa

    Index Scriptorium Estoniae

    Seljamaa, Elo-Hanna, 1980-

    2007-01-01

    Geograafilis-ajaloolise meetodi lähtealuste ja eesmärkide toel analüüsitakse Walter Andersoni, Tartu Ülikooli esimese folkloristikaprofessori käsitlusi folkloorist ja folkloori uurimisest ning tema tegevust meetodi edasiarendajana

  8. Pikaealisuse piirkonnad ehk nn Blue Zone'id / Anne Herm, Michel Poulain

    Index Scriptorium Estoniae

    Herm, Anne

    2016-01-01

    Käimasolevate uuringutega loodetakse paremini mõista looduskeskkonna ja toitumisega seotud tegurite rolli pikaealisuse kujunemisel. Uurimistöö võib anda väärtusliku panuse tervena vananemise mudeli väljatöötamisele

  9. Töölepingu seadus : kuhu edasi ehk turvalisus ja paindlikkus Eesti moodi? / Gaabriel Tavits

    Index Scriptorium Estoniae

    Tavits, Gaabriel, 1972-

    2008-01-01

    Töölepingu seaduse eelnõust: töölepingu sõlmimisest, täitmisest, lubatavusest ja ülesütlemisest. Töölepingu kirjaliku vormi nõuetest, alaealiste tööle võtmisest, töötaja ja tööandja kohustustest

  10. TAB ehk I Tallinna arhitektuuribiennaal / Villem Tomiste, Carl-Dag Lige

    Index Scriptorium Estoniae

    Tomiste, Villem, 1975-

    2011-01-01

    8.-11. septembrini 2011 Tallinnas toimuvast arhitektuuribiennaalist, biennaali kava. Pikemalt põhisündmustest: sümpoosionist "Maastikuurbanism" (kuraator Katrin Koov), näitusest "11 Flirts" (kuraator Villem Tomiste), noortele arhitektidele suunatud visioonivõistlusest "Street 2020", mille võitis USA büroo Warren Techentin Architecture

  11. Mustad jõulud Geenivaramus ehk miks tekkis tõrge Eesti võimsaimas teadusprojektis

    Index Scriptorium Estoniae

    2004-01-01

    Sihtasutuste Eesti Geenivaramu ja Eesti Geenikeskus, AS-i EGeen ja EGeen International Inc. tegevusest, Eesti geeniprojektiga seotud investoritest, projekti hetkeseisust ning võimalikest tulevikustsenaariumitest. Tabel ja diagrammid: SA Eesti Geenivaramu kulud 2001-2003; Geenidoonorite arv kvartaalselt. Lisad: Inimgenoomi projekt; Erinevate projektide võrdlus; Eesti Geenivaramu lühike ajalugu; Eesti geeniprojekti SWOT-analüüs

  12. Seks Vaalas ehk Täna öösel me ei maga / Maarin Ektermann

    Index Scriptorium Estoniae

    Ektermann, Maarin

    2006-01-01

    Noorte kunstnike näitus "Sex" Vaal-galeriis 2.-20. V. Kuraator Andres Lõo. Loetletud 23 osalejat. Arutelud: 3. V "Kunstnik vs kuraator", inspireerituna Jaan Toomiku maalist "Oodates kuraatorit", kõnelesid Karolin Tampere, Rael Artel, Andres Lõo jt.; 19. V "Kes tellib kunsti?", inspireerituna Kumust, Ku-Ku'st ja kunstist, kõnelesid Raoul Kurvitz, Anders Härm jt.

  13. See meeletu, meeletu maailm ehk Ära siit! / Rein Tootmaa

    Index Scriptorium Estoniae

    Tootmaa, Rein

    2001-01-01

    IV Pimedate Ööde Filmifestivalil linastunud absurdifilmidest : Prantsusmaa "Harry aitab sind" : režissöör Dominik Moll, Jaapani "Esmaspäev" ("Monday") : režissöör Hiroyuki Tanaka, Horvaatia "Marssal Tito vaim" ("Marshal") : režissöör Vinko Breshan, Taani "Kuningas on elus" ("King Is Alive") : režissöör Kristian Levring, Rootsi "Laulud teiselt korruselt" ("Sånger från andra våningen"): režissöör Roy Andersson, Šveitsi "Kes on järgmine ?" ("Who's Next ?") : režissöör Felix Tissi, Saksamaa "Tuvalu" : režissöör Veit Helmer ja Venemaa ning mitme Euroopa riigi ühisfilm "Kuu isaks" ("Luna papa") : režissöör Bahtijer Hudoinazarov. Kokkuvõte inglise keeles lk. 128

  14. Tõotatud maa ameerika lastekirjanduses ehk kuidas kasvatada lapsest diktaator / David Ilmar Beecher

    Index Scriptorium Estoniae

    Beecher, David Ilmar

    2015-01-01

    Lastekirjandusest teadusliku allikana ning Maurice Sendaci lasteraamatust "Where the wild things are" (1964) ja Steven Kelloggi lasteraamatust "The island of the Skog" (1976). Tekst põhineb "Õnnekonverentsi" ettekandel, mis peeti 3. mail 2011. aastal

  15. Mustasilmsed kaunitarid ja Bakchose kummardajad ehk pisut Eesti-Ukraina kultuuriloolisi sidemeid / Georgi Särekanno

    Index Scriptorium Estoniae

    Särekanno, Georgi

    2012-01-01

    Jäneda mõisaproua vanavanemate Platon Zakrevski ja Anna Zakrevskaja on Zakrevskite pärusmõisa Berjozovaja Rudka koduloomuuseumi ekspositsiooni kesksed portreed. Tarass Ševtšenko ja Jevgen Grebinka seostest Berjozovaja Rudka mõisarahvaga. Sealkandis tegutsenud ühingust "Общество мочемордия"

  16. Ballywood ehk Balti Küpsis = Ballywood aka Baltic Cookie / Kalle Komissarov

    Index Scriptorium Estoniae

    Komissarov, Kalle, 1976-

    2010-01-01

    Žürii liige Tallinna Ülikooli Loomemaja ja ülikoolilinnaku sisehoovi kavandamiseks korraldatud avalikust arhitektuurivõistlusest, võidutööst. 1. auhinna sai võistlustöö "Küpsis", mille autoriteks on Maarja Kask, Karli Luik ja Ralf Lõoke (Salto). 2. auhind läks võistlustööle "Camera Obscura" (Luhse ja Tuhal), 3. auhind võistlustööle "2. oktoober" (Arhitektuuriagentuur)

  17. Tying up sündroom ehk väsimusmüopaatia : [hobustel] / Anne Rohtla

    Index Scriptorium Estoniae

    Rohtla, Anne

    2010-01-01

    Väsimusmüopaatia on kestvusratsutamishobustel esinev seisund, mida väljendadavad tunnused võivad olla vaevumärgatavad. Samas võib selline seisund areneda eluohlikuks, kui sellese ei sekkuta. Artikkel sisaldab ka refereeringut Melissa Ribley artiklist "Watch for the subtle signs of exertional myopathy"

  18. Säärane mulk, ehk sada vakka etteheiteid / Avo Üprus

    Index Scriptorium Estoniae

    Üprus, Avo, 1954-

    2004-01-01

    Ilmunud ka: Hiiumaa, 24. juuli 2004, lk. 2; Võrumaa Teataja, 24. juuli 2004, lk. 2; Vooremaa, 24. juuli 2004, lk. 2; Meie Maa, 23. juuli 2004, lk. 2; Järva Teataja, 27. juuli 2004, lk. 4; Lääne Elu, 27. juuli 2004, lk. 2; Koit, 27. juuli 2004, lk. 6; Pärnu Postimees, 28. juuli 2004, lk. 15; Virumaa Teataja, 30. juuli 2004, lk. 7; Vali Uudised, 30. juuli 2004, lk. 2; Põhjarannik, 30. juuli 2004, lk. 2; Severnoje Poberezhje, 30. juuli 2004, lk. 2; Hiiu Leht, 3. aug. 2004, lk. 2; Sakala, 3. aug. 2004, lk. 2; Valgamaalane, 12. aug. 2004, lk. 2. Vastuseks Helir-Valdor Seederi art. 17. juuli ajal. Meie Maa. Uus poliitika tähendab üldinimlike väärtuste taasväärtustamise kaudu pidevalt uuenevat riiki.

  19. Veel maavanematest ehk vürstid võivad muutuda ametnikeks / Väino Linde

    Index Scriptorium Estoniae

    Linde, Väino, 1959-

    2004-01-01

    Ilmunud ka: Sakala, 23. jaan. 2004, lk. 2; Põhjarannik, 23. jaan. 2004, lk. 2; Severnoje Poberezhje, 23. jaan. 2004, lk. 2; Meie Maa, 24. jaan. 2004, lk. 2; Koit, 24. jaan. 2004, lk. 6; Hiiu Leht, 27. jaan. 2004, lk. 2; Vooremaa, 27. jaan. 2004, lk. 2; Nädaline, 27. jaan. 2004, lk. 8; Valgamaalane, 27. jaan. 2004, lk. 2; Harjumaa, 30. jaan. 2004, lk. 4; Vali Uudised, 4. veebr. 2004, lk. 2. Maavanemate staatuse muutustest ja selleteemalisest arutelust valitsuses

  20. Mis on hinge hind ehk Imet ei sündinud / Jaanus Kulli

    Index Scriptorium Estoniae

    Kulli, Jaanus, 1955-

    1999-01-01

    Mängufilm "Ristumine peateega" : režissöör ja produtsent Arko Okk : Stsenarist oma näidendi järgi Jaan Tätte : Operaator Dmitri Jermakov : Kunstnik Pille Jänes : Helilooja Jukka Linkola : Acuba Film 1999. Lisa : Arko Oki elu ja loomingu lühikokkuvõte

  1. Veel maavanematest ehk vürstid võivad muutuda ametnikeks / Väino Linde

    Index Scriptorium Estoniae

    Linde, Väino, 1959-

    2004-01-01

    Ilmunud ka: Sakala, 23. jaan. 2004, lk. 2; Põhjarannik, 23. jaan. 2004, lk. 2; Severnoje Poberezhje, 23. jaan. 2004, lk. 2; Meie Maa, 24. jaan. 2004, lk. 2; Koit, 24. jaan. 2004, lk. 6; Hiiu Leht, 27. jaan. 2004, lk. 2; Vooremaa, 27. jaan. 2004, lk. 2; Nädaline, 27. jaan. 2004, lk. 8; Valgamaalane, 27. jaan. 2004, lk. 2; Harjumaa, 30. jaan. 2004, lk. 4; Vali Uudised, 4. veebr. 2004, lk. 2. Maavanemate staatuse muutustest ja selleteemalisest arutelust valitsuses

  2. Säärane mulk, ehk sada vakka etteheiteid / Avo Üprus

    Index Scriptorium Estoniae

    Üprus, Avo, 1954-

    2004-01-01

    Ilmunud ka: Hiiumaa, 24. juuli 2004, lk. 2; Võrumaa Teataja, 24. juuli 2004, lk. 2; Vooremaa, 24. juuli 2004, lk. 2; Meie Maa, 23. juuli 2004, lk. 2; Järva Teataja, 27. juuli 2004, lk. 4; Lääne Elu, 27. juuli 2004, lk. 2; Koit, 27. juuli 2004, lk. 6; Pärnu Postimees, 28. juuli 2004, lk. 15; Virumaa Teataja, 30. juuli 2004, lk. 7; Vali Uudised, 30. juuli 2004, lk. 2; Põhjarannik, 30. juuli 2004, lk. 2; Severnoje Poberezhje, 30. juuli 2004, lk. 2; Hiiu Leht, 3. aug. 2004, lk. 2; Sakala, 3. aug. 2004, lk. 2; Valgamaalane, 12. aug. 2004, lk. 2. Vastuseks Helir-Valdor Seederi art. 17. juuli ajal. Meie Maa. Uus poliitika tähendab üldinimlike väärtuste taasväärtustamise kaudu pidevalt uuenevat riiki.

  3. Bits and Pieces ehk kolumna. White Label : Dub's Don Erickson Takin Dub+. Kuula / DJ Pickney Tiger

    Index Scriptorium Estoniae

    DJ Pickney Tiger, pseud., 1970-

    2008-01-01

    Popmuusikauudised. Kahest dub-mixist. Heliplaatidest: Anal Thunder "4 am illusion", Eli "Paperboy" Reed & The True Loves "Roll With You", B-525 "Funplex", Alko "Reis ümber enda telje", Morten Harket "Letter From The Egypt", Makossa+Megablast "Kunuka", Nerd "Seeing Songs", Kasemahlake "Kadunud süütus"

  4. Tagasisõit minevikku ehk Killuke Eestit ja eestlasi Ukraina steppides / Eli Nevski

    Index Scriptorium Estoniae

    Nevski, Eli

    2009-01-01

    Viieliikmelise reisiseltskonna motomatkast Krimmi. Krasnodarka külast, sealsest eluolust, eesti keele oskusest. Paarkümmend last õpib emakeelt Aleksandrovka keskkoolis eest keele klassis. Eesti seltsi esinaisest Rita Kadilkinast (neiupõlvenimega Kuusk), kelle juures on elanud kohalikus koolis töötavad Eesti õpetajad

  5. Aisteetika, ehk, Miks maailma ei oleks teatrita parem paik / Aare Pilv

    Index Scriptorium Estoniae

    Pilv, Aare, 1976-

    2014-01-01

    Esteetika mõistest, selle etümoloogilisest seosest tajumisega. Madis Kõivu tekstidest (sisaldab Madis Kõivu esseed "Kultuursõna on ülesemiotiseeritud"), Jaan Toomiku purgi-installatsiooni rekonstruktsioonist Tartu Kunstimuuseumis 2012. a., Mihkel Kunnuse mõttekäikudest afektiivsete kunstide kohta, Jacques Rancière'i ideedest kunsti loomuse kohta. Teatri olulisusest afektiivse kunstina

  6. Ettepanek seadusandjale : kriminaliseerida näiline ehk varimaksustamine / Indrek Mandre

    Index Scriptorium Estoniae

    Mandre, Indrek, 1964-

    2005-01-01

    Maksumaksjate sisendkäibemaksu mahaarvamisest. Lisatud: Kukk, Rein. Süütuse presumptsioon versus kriminaalmenetluse libaeesmärgid?, lk. 7 ; Mandre, Indrek. Varimetsandust soodustab ka riik, lk. 6. Vt. ka: http://www.maksumaksjad.ee/modules/smartsection/item.php?itemid=32 ; http://www.maksumaksjad.ee/modules/smartsection/item.php?itemid=30

  7. Vene juudid Ameerikas ehk Nõukogude Liidu Jurassic Park / Boris Fishman ; intervjueerinud Priit Hõbemägi

    Index Scriptorium Estoniae

    Fishman, Boris

    2016-01-01

    Intervjuu Tallinna külastanud ameerika kirjaniku Boris Fishmaniga, kes pidas Tallinna ülikoolis loengu ja vestles ameerika vene-juudi kultuuri teemal. Eesti keeles ilmus tema teos "Asenduselu" 2015. aastal

  8. Inimesed lahinguväljal ehk Karmid pildid tegelikkusest / Enn Mälgand

    Index Scriptorium Estoniae

    Mälgand, Enn

    2005-01-01

    M. Karusoo Afganistani sõja teemaline lavastus "Misjonärid", mis põhineb Dee Browni indiaanisõdade raamatul "Mata mu süda Wounded Knees" ja Afganistanis sõdinud meestega tehtud intervjuudel. Esietendus Rakvere Teatris 24. märtsil 2005

  9. Re?bus disainivõistlus ehk noored innovaatorid bussirevolutsiooni otsinguil

    Index Scriptorium Estoniae

    2005-01-01

    2005. a. algul agentuuri APCI (Agence pour la Promotion de la Creation Industrielle) poolt korraldatud disainivõistlusest Re?bus. Eestist valiti 30 finalisti hulka büroo ZiZi & YoYo töö. Edukamad võistlustööd olid juuni algul väljas rahvusvahelise ühistranspordi assotsiatsiooni (UITP) 56. kongressil Roomas

  10. Valge telk, punane nelk, mustad naistekingad ehk Kolm meest frustratsioonis / Pille-Riin Purje

    Index Scriptorium Estoniae

    Purje, Pille-Riin, 1963-

    2003-01-01

    Kolmest tegelaskujust - R. Simmuli ettevõtja Ewbank D. Storey "Pühapäevas" Tallinna Linnateatris, I. Uukkivi tehasetööline Gary G. Burke'i "Gagarini puiestees" Vanalinnastuudios ja R. Rosbergi politseinik Daniel J. Uptoni näidendis "Ashes and Sand" Eesti Riiklikus Nukuteatris

  11. Fix iT 2014 ehk talgud massidesse / Kai Raku, Vanessa Moreno

    Index Scriptorium Estoniae

    Raku, Kai

    2014-01-01

    Eesti Erinoorsootöö Ühing noOR vahendab ja võõrustab erivajadustega noori vabatahtlikus teenistuses, üheks nende partneriks on Hispaanias asuv Associacion Cultural En-Construccion, mille juht Vanessa Moreno tutvustab Associacion Cultural En-Construccioni tegevust ja puuetega inimeste vabatahtliku teenistuse võimalusi

  12. Selle suve tipphetk, ehk, Neeruti ei ole mäed / Andry Ervald

    Index Scriptorium Estoniae

    Ervald, Andry

    2006-01-01

    Vestlus Lahemaa looduslaagrist Kolga Keskkooli õpilaste K. Kütti ja M. Lainevooga. Kadrina Keskkooli õpilane Mailis Paal ja Rakvere Reaalkooli õpilane Madis Leinakse osalesid Hispaanias Picos de Europa rahvuspargis ranger℗þite (looduse vaht) koolitusel

  13. Kultuuridessant Sillamäe aatomilinna ehk Nemad ja meie / Ilja Sundelevitsh

    Index Scriptorium Estoniae

    Sundelevitsh, Ilja

    2006-01-01

    Eleonore de Montesquiou näitust "Aatomilinnad. Paldiski - Sillamäe" tutvustati 8. IX Sillamäe muuseumis, 24. VIII esitleti kunstniku projekti Paldiski muuseumis. Sillamäel käisid E. de Montesquiou, Anne Durez, Reet Varblane, Liina Siib, Eve Kiiler, Jaanika Peerna, Liis Jürgens, Tarmu Tamverk ja Ilja Sundelevitsh

  14. Põgenemine vabaduse eest ehk Mida venelased mõtlevad ja tahavad / Richard Pipes

    Index Scriptorium Estoniae

    Pipes, Richard

    2004-01-01

    Põhjustest, miks praeguse Venemaa valitsuse demokraatia- ja vabadusevastane tegevus leiab rahva toetust. President Vladimir Putini populaarsus põhineb sellel, et ta on taasloonud Venemaa traditsioonilise valitsusmudeli: autokraatliku riigi, kus kodanikud on vabastatud vastutusest poliitika eest ning kujuteldavaid välisvaenlasi kasutatakse kunstliku ühistunde loomiseks. Arvamusküsitluste tulemustest

  15. Töölepingu seadus : kuhu edasi ehk turvalisus ja paindlikkus Eesti moodi? / Gaabriel Tavits

    Index Scriptorium Estoniae

    Tavits, Gaabriel, 1972-

    2008-01-01

    Töölepingu seaduse eelnõust: töölepingu sõlmimisest, täitmisest, lubatavusest ja ülesütlemisest. Töölepingu kirjaliku vormi nõuetest, alaealiste tööle võtmisest, töötaja ja tööandja kohustustest

  16. Ärimehe ehmatus ehk Kapitalismi kolm irratsionaalsust / Hans H. Luik

    Index Scriptorium Estoniae

    Luik, Hans H., 1961-

    2009-01-01

    Kapitalismi irratsionaalsed küljed Eesti ettevõtja silmade läbi: osaluse jagamine 1990-ndate alguse ettevõtete loomisel; ettevõtte Ekspress Hotline aktsiate müük; ettevõtjate sinisilmsus raha investeerimisel

  17. Haanja 2010 : Endurance ehk eesti keeli kestvusratsutamine on ratsaspordimaailma maraton / Ingrid Randlaht

    Index Scriptorium Estoniae

    Randlaht, Ingrid

    2010-01-01

    21.-23. mail 2010 Haanjas, keskusega Kurgjärve Spordibaasis, toimunud esimestest rahvusvahelistest kestvusratsutamise võistlustest ja Eesti meistrivõistlustest. Lisad: Tõugude tähendus kestvusratsutamises. Eatu sport

  18. Mesikäpast grisli ehk Berlinale Kuldkaru 2010 / Lauri Kärk

    Index Scriptorium Estoniae

    Kärk, Lauri, 1954-

    2010-01-01

    Berliini filmifestivalil 2010 parima filmi Kuldkaru pälvinud režissöör Semih Kaplanoglu filmist "Mesi" (Türgi-Saksamaa, 2010), Hõbekaru saanud režissöör Roman Polanski filmist "Variautor" (Prantsusmaa-Saksamaa-Suurbritannia, 2010). Parima meesnäitleja Hõbekaru said näitlejad Grigori Dobrõgin ja Sergei Puskepalis filmist "Kuidas ma veetsin selle suve" (Venemaa, 2010) ja auhinna operaatoritöö eest sai Pavel Kostomarov režissöör Aleksei Popogrebski filmis "Kuidas ma veetsin selle suve" (Venemaa, 2010)

  19. Valged ööd ja Tallinn Londonis ehk 60 kraadi põhjalaiust / Ann Alari

    Index Scriptorium Estoniae

    Alari, Ann

    2009-01-01

    19. juunist 9. juulini toimub City of London Festival, millel osalevad Põhjamaad. Üheks oodatumaks sündmuseks on 30. juunil St Pauli katedraalis Inglise Rahvusballeti orkestri kontsert ja etendus "Chopiniana", kus tantsivad Age Oks ja Toomas Edur

  20. Voldemar ehk Portreed temas ja tema ümber / Kristi Eberhart

    Index Scriptorium Estoniae

    Eberhart, Kristi

    2007-01-01

    Andrus Kivirähki "Voldemar", mis kirjutatud toetudes Voldemar Panso kirjutatud lugudele, päevikule, kirjadele. Lavastaja Merle Karusoo, peaosas Tiit Sukk. Esietendus 25. märtsil Eesti Draamateatris