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Sample records for hemorraagiline tbi ehk

  1. TBI Endpoints Development

    Science.gov (United States)

    2015-10-01

    therapy , and early mild physical activity, which result in fewer symptoms, lower mean severity of symptoms, less social disability, and fewer days off work...developing more precise TBI diagnostic tools, clinical endpoints, and effective therapies . We designed and executed an interactive program that combined...surgery, neuropsychology, neuroradiology, psychiatry, neurology, sports medicine, pediatrics, geriatrics , health economics, biostatistics, and informatics

  2. 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,…

  3. Traumatic Brain Injury (TBI) Data and Statistics

    Science.gov (United States)

    ... TBI Online Concussion Training Press Room Guide to Writing about TBI in News and Social Media Living with TBI HEADS UP to Brain Injury Awareness Get Email Updates To receive email updates about this topic, ...

  4. Traumatic Brain Injury (TBI) in Kids

    Science.gov (United States)

    ... Information Share Facebook Twitter Pinterest Email Print Traumatic Brain Injury (TBI): Condition Information What is TBI? TBI ... external force that affects the functioning of the brain. It can be caused by a bump or ...

  5. 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.

  6. 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...

  7. 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

  8. Phase composition of EhK 990-ID steel

    International Nuclear Information System (INIS)

    Rabinovich, A.V.; Milova, I.M.; Zaslavskij, Yu.B.; Neklyudov, I.M.; Chernyj, B.P.; Vanzha, A.F.; Zejdlits, M.P.; Kurasov, A.N.; Shmelev, Yu.S.

    1990-01-01

    The microstructure and phase composition of EhK99 steel have been investigated. It is shown that the scandium absolute concentration in solid solution of hot-deformed metal is directly proportional to their total content. It was established that the ratio between the scandium concentration in solid solution and the total content [Sc] ss/[Sc] s is not the function of the latter and constitutes (24.5±5.5) rel.%. The limiting scandium solubility in the EhK99 steel at temperature 1270 deg C was determined. It constitutes 0.07±0.005 mass%. In this paper proposed is the mechanism of intermetallide-and-second phase nucleation and growth during crystallization and homogenizing annealing. The recommendation for regimes of homogenizing annealing (1270 deg C, 12 hours) are given. It is shown that the homogenizing vacuum annealing may have an appreciable influence on the technique plasticity and production of good tubes of EhK99 steel with scandium content no more than 0.07wt%. 2 refs., 10 figs., 2 tabs

  9. Mild TBI Diagnosis and Management Strategies

    Data.gov (United States)

    Department of Veterans Affairs — The Mild Traumatic Brain Injury (TBI) Diagnosis and Management Strategies will assist in the study of TBI issues, such as the Influence of Concussion on Persistent...

  10. 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

  11. 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

  12. Aja sõltlased - kes kus : Elmo Nüganeni 'Pianoola ehk Mehhaaniline klaver' Tallinna Linnateatris / Lauri Kärk

    Index Scriptorium Estoniae

    Kärk, Lauri, 1954-

    1996-01-01

    Anton Tšehhovi - Aleksandr Adabashjani - Nikita Mihhalkovi 'Pianoola ehk Mehhaaniline klaver' Tallinna Linnateatris, lav. E. Nüganen. Võrdlus N. Mihhalkovi filmiga 'Lõpetamata pala pianoolale' (1977)

  13. Role of metabolomics in TBI research

    Science.gov (United States)

    Wolahan, Stephanie M.; Hirt, Daniel; Braas, Daniel; Glenn, Thomas C.

    2016-01-01

    Synopsis Metabolomics is an important member of the omics community in that it defines which small molecules may be responsible for disease states. This article reviews the essential principles of metabolomics from specimen preparation, chemical analysis, and advanced statistical methods. Metabolomics in TBI has so far been underutilized. Future metabolomics based studies focused on the diagnoses, prognoses, and treatment effects, need to be conducted across all types of TBI. PMID:27637396

  14. Mission Connect Mild TBI Translational Research Consortium

    Science.gov (United States)

    2010-08-31

    using magneto - Investigators A. Papanicolaou, PhD – PI J. Breier, PhD E. Castillo, PhD T. Kent, MD Project Summary Introduction: The aim of this...secondary insults such as hemorrhagic hypotension. Antioxidant therapies have had limited success in treating mTBI. We identified carbon nanomaterials... therapies for TBI using nanomaterials that are capable of addressing, for the first time, key components of the “neurovascular unit”. If the PEG-HCCs

  15. TBI parameters and relapse of acute leukemia

    International Nuclear Information System (INIS)

    Sugawara, Tadashi; Inoue, Toshihiko; Mori, Tomoyuki.

    1994-01-01

    The purpose of this study, which involved 240 acute leukemia patients (ALL: 115, ANL: 125) who received an allogeneic bone marrow transplantation (BMT) with preconditioning by total body irradiation (TBI) and chemotherapy, was to examine retrospectively the TBI factors that may have influenced a leukemic relapse. The patients were divided into two groups: 124 patients who had received their BMT within a diagnosis-transplantation period of 9 months or less (DTP9 group), and 116 patients who had received their BMT within a diagnosis-transplantation period of 10 months or more (DTP10 group). It was concluded that: (1) the higher the TBI dose, the fewer the relapse rates in DTP9 group; (2) the longer the TBI period, the greater the increase in the relapse rate in DTP10 group. It was thus speculated that an effective TBI regimen for acute leukemia patients may vary depending on the length of time that has elapsed from the diagnosis of leukemia to the BMT. (author)

  16. 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

  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. 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

  19. Advanced MRI in Acute Military TBI

    Science.gov (United States)

    2013-09-01

    having high levels of clustering and a short path length for efficient global and local communications (Latora and Marchiori, 2001; Watts and Strogatz ...Warden, D.L., 2006. Military TBI during the Iraq and Afghanistan wars. J. Head Trauma Rehabil. 21, 398–402. Watts, D.J., Strogatz , S.H., 1998. Collective

  20. 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.

  1. Enhanced Cognitive Rehabilitation to Treat Comorbid TBI and PTSD

    Science.gov (United States)

    2015-10-01

    injury (TBI) and posttraumatic stress disorder ( PTSD ) benefit fully from interventions for both conditions. PTSD and TBI occur together frequently in...veterans with comorbid traumatic brain injury and posttraumatic stress disorder : study protocol for a randomized controlled trial. CONCLUSION: In...moderate TBI (mTBI) and PTSD . Emotional symptoms are likely a main cause of the persistence of post -concussive symptoms while thinking problems

  2. Neutrophils in traumatic brain injury (TBI): friend or foe?

    Science.gov (United States)

    Liu, Yang-Wuyue; Li, Song; Dai, Shuang-Shuang

    2018-05-17

    Our knowledge of the pathophysiology about traumatic brain injury (TBI) is still limited. Neutrophils, as the most abundant leukocytes in circulation and the first-line transmigrated immune cells at the sites of injury, are highly involved in the initiation, development, and recovery of TBI. Nonetheless, our understanding about neutrophils in TBI is obsolete, and mounting evidences from recent studies have challenged the conventional views. This review summarizes what is known about the relationships between neutrophils and pathophysiology of TBI. In addition, discussions are made on the complex roles as well as the controversial views of neutrophils in TBI.

  3. Mission Connect Mild TBI Translational Research Consortium

    Science.gov (United States)

    2013-08-01

    global volumetry using tensor-based morphometry, tissue microstructural integrity using diffusion tensor imaging (DTI), and T2-weighted images for...GM and CSF volumetry were not different between controls and mTBI. Consistent with a previous report (3), subtle changes in WM microstructure due...function is warranted. Figure 1. Representative scatter plots of global volumetry of (A) sulcal CSF, (B) neocortical GM and bar graphs of regional coronal

  4. Targeting Epigenetic Mechanisms in Pain due to Trauma and TBI

    Science.gov (United States)

    2017-10-01

    disability after trauma, particularly in the setting of TBI. This objective is closely in alignment with the pain management focus area of the CRMRP... management of acute and chronic pain under the care of a clinician in non-deployed settings (specifically in patients with TBI), and 3) research...distant from the head after TBI. This constitutes a fundamental contribution to the discipline. What was the impact on other disciplines? The field

  5. Backscatter Correction Algorithm for TBI Treatment Conditions

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez-Nieto, B.; Sanchez-Doblado, F.; Arrans, R.; Terron, J.A. [Dpto. Fisiología Médica y Biofísica, Universidad de Sevilla, Avda. Sánchez Pizjuán, 4. E-41009, Sevilla (Spain); Errazquin, L. [Servicio Oncología Radioterápica, Hospital Univ.V. Macarena. Dr. Fedriani, s/n. E-41009, Sevilla (Spain)

    2015-01-15

    The accuracy requirements in target dose delivery is, according to ICRU, ±5%. This is so not only in standard radiotherapy but also in total body irradiation (TBI). Physical dosimetry plays an important role in achieving this recommended level. The semi-infinite phantoms, customarily used for dosimetry purposes, give scatter conditions different to those of the finite thickness of the patient. So dose calculated in patient’s points close to beam exit surface may be overestimated. It is then necessary to quantify the backscatter factor in order to decrease the uncertainty in this dose calculation. The backward scatter has been well studied at standard distances. The present work intends to evaluate the backscatter phenomenon under our particular TBI treatment conditions. As a consequence of this study, a semi-empirical expression has been derived to calculate (within 0.3% uncertainty) the backscatter factor. This factor depends lineally on the depth and exponentially on the underlying tissue. Differences found in the qualitative behavior with respect to standard distances are due to scatter in the bunker wall close to the measurement point.

  6. Total body irradiation (TBI) of chronic lymphocytic leukemia (CLL)

    Energy Technology Data Exchange (ETDEWEB)

    Ruehl, U; Johnson, R E

    1975-01-01

    80 patients with previously untreated CLL have been admitted to the Radiation Oncology Branch of the NCI. Fourteen of these patients have remained classified as 'indolent' until the present time and have not received any treatment. 48 patients with 'active' CLL were treated with TBI and were compared with 18 patients treated with chemotherapy and/or local irradiation. Our series of patients primarily treated with TBI have twice the median survival (57 months) measured from first therapy of the concurrent chemotherapy series (27 months). One third of the TBI group have experienced a complete or nearly complete remission and these patients showed a definite longer survival, with a median survival well in excess of five years until now. However, patients with a less complete remission failed to demonstrate a prolonged survival time with TBI in comparison to other modes of treatment. These results indicate that TBI can induce complete remissions which improve the prognosis in patients with active CLL.

  7. Autobiographical memory and structural brain changes in chronic phase TBI.

    Science.gov (United States)

    Esopenko, Carrie; Levine, Brian

    2017-04-01

    Traumatic brain injury (TBI) is associated with a range of neuropsychological deficits, including attention, memory, and executive functioning attributable to diffuse axonal injury (DAI) with accompanying focal frontal and temporal damage. Although the memory deficit of TBI has been well characterized with laboratory tests, comparatively little research has examined retrograde autobiographical memory (AM) at the chronic phase of TBI, with no prior studies of unselected patients drawn directly from hospital admissions for trauma. Moreover, little is known about the effects of TBI on canonical episodic and non-episodic (e.g., semantic) AM processes. In the present study, we assessed the effects of chronic-phase TBI on AM in patients with focal and DAI spanning the range of TBI severity. Patients and socioeconomic- and age-matched controls were administered the Autobiographical Interview (AI) (Levine, Svoboda, Hay, Winocur, & Moscovitch, 2002) a widely used method for dissociating episodic and semantic elements of AM, along with tests of neuropsychological and functional outcome. Measures of episodic and non-episodic AM were compared with regional brain volumes derived from high-resolution structural magnetic resonance imaging (MRI). Severe TBI (but not mild or moderate TBI) was associated with reduced recall of episodic autobiographical details and increased recall of non-episodic details relative to healthy comparison participants. There were no significant associations between AM performance and neuropsychological or functional outcome measures. Within the full TBI sample, autobiographical episodic memory was associated with reduced volume distributed across temporal, parietal, and prefrontal regions considered to be part of the brain's AM network. These results suggest that TBI-related distributed volume loss affects episodic autobiographical recollection. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. 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"

  9. 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

  10. Mixed Reality for PTSD/TBI Assessment.

    Science.gov (United States)

    Fidopiastis, Cali; Hughes, Charles E; Smith, Eileen

    2009-01-01

    Mixed Reality (MR) refers to the blending of virtual content into the real world. Using MR, we create contextually meaningful scenarios in which users carry out tasks encountered in the presence of visual and aural distracters. Visual distracters can include subtle ones - people walking; and more abrupt ones - cartons falling. Aural distracters can include gentle ones - fans whirring; and more aggressive ones - automobiles backfiring. The intensity of these distracters can be dynamically controlled by a therapist or software that takes into account the patient's perceived level of stress. Intensity can also be controlled between experiences. For example, one may increase the stress level in a subsequent session, attempting to improve a person's tolerance. Assessment of progress includes psychophysical metrics (stress indicators) and the performance of tasks (accuracy and adherence to time constraints). By accurately capturing a patient's interaction with the environment in the context of simulation events, we can use MR as a tool for assessment and rehabilitation planning for individuals with stress-related injuries. This paper reports on the MR environment we have developed and its efficacy (realized and potential) for the assessment of post-traumatic stress disorder (PTSD) with or without traumatic brain injury (TBI).

  11. 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.

  12. Automated Comprehensive Evaluation of mTBI Visual Dysfunction

    Science.gov (United States)

    2017-04-01

    of the NODe . Subtask 1: Statistical analysis of NODe data from controls and mTBI patients: COMPLETED Data Processing : Automated data analyses are...order visual processing dysfunctions on a large population of Warfighters with acute mTBI as compared to healthy age-matched controls . This study also... controls ) military personnel will be recruited from the patient population at Womack Army Medical Center (WAMC). The central hypothesis is that a NODe test

  13. 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...COVERED 25 Sep 2014 - 24 Sep 2015 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Mechanistic Links Between PARP, NAD , and Brain Inflammation After TBI 5b. GRANT...efficacy of veliparib and NAD as agents for suppressing inflammation and improving outcomes after traumatic brain injury. The animal models include

  14. 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

  15. 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.

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

    Science.gov (United States)

    2016-05-01

    determine the validity and reliability of an Android device-based mTBI (mild traumatic brain injury) screening test app for assessing motor function. The...individuals and those with clinically confirmed mTBI in both a civilian and military population. 15. SUBJECT TERMS- 16. SECURITY CLASSIFICATION OF: 17...8 5. Changes/ Problems 9 6. Products 11 7. Participants & Other Collaborating Organizations 14 8. Special Reporting Requirements 16 9. Appendices

  17. Treatment of TBI with Hormonal and Pharmacological Support, Preclinical Validation Using Diffuse and Mechanical TBI Animal Models

    Science.gov (United States)

    2016-05-01

    Award Number: PT075653 (grant) W81XWH-08-2-0153 (contract) TITLE: Treatment of TBI with Hormonal and Pharmacological Support, Preclinical...TITLE AND SUBTITLE 5a. CONTRACT NUMBER W81XWH-08-2-0153 Treatment of TBI with Hormonal and Pharmacological Support, Preclinical Validation Using...rats. Our in vivo tests also included MRI imaging, focusing on edema resolution and reduction of diffuse axonal damage (fractional anisotropy

  18. 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

  19. Legacy Clinical Data from the Mission Connect Mild TBI Translational Research Consortium

    Science.gov (United States)

    2017-10-01

    AWARD NUMBER: W81XWH-16-2-0026 TITLE: Legacy Clinical Data from the Mission Connect Mild TBI Translational Research Consortium PRINCIPAL...2017 4. TITLE AND SUBTITLE Legacy Clinical Data from the Mission Connect Mild TBI Translational Research 5a. CONTRACT NUMBER Consortium 5b. GRANT...mTBI) Translational Research Consortium was to improve the diagnosis and treatment of mTBI. We enrolled a total of 88 mTBI patients and 73 orthopedic

  20. 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

  1. 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)

  2. 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

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

    Science.gov (United States)

    ... sleep habits Behavior or mood changes Trouble with memory, concentration, attention, or thinking Loss of consciousness lasting a few ... may have caused a TBI should seek medical attention. 4 ... Traumatic brain injury information page . Retrieved May 4, 2018, from https://www. ...

  4. Defining the Pathophysiological Role of Tau in Experimental TBI

    Science.gov (United States)

    2017-10-01

    neurodegenerative disorder ; and (iii) novel biomarkers for neurodegeneration are non-invasive blood measures of brain dysfunction valuable for the...dissociated from microtubules, aggregated, and mislocalized within cell bodies and proximal dendrites instead of axonal processes, abnormalities that... disorder , and TBI induced by inertial forces, concussive blows, or blast will sometimes lead to chronic, progressive brain atrophy and cognitive

  5. An audit of traumatic brain injury (TBI) in a busy developing-world ...

    African Journals Online (AJOL)

    Committee in Neurotraumatology.[7] Four years later, at the ... the resources necessary to manage severe TBI according to interna- ... An audit of traumatic brain injury (TBI) in a busy .... The danger with this approach is that it risks becoming a.

  6. 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...

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

    OpenAIRE

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

    2015-01-01

    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 individua...

  8. Advancing Clinical Outcomes, Biomarkers and Treatments for Severe TBI

    Science.gov (United States)

    2017-08-01

    including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing this...determining the neurobehavioral and neural effects of repetitive transcranial magnetic stimulation (rTMS), which is a non-invasive technique to stimulate the...TERMS Disability Rating Scale (DRS), Neurobehavioral, Repetitive Transcranial Magnetic Stimulation (rTMS), Traumatic Brain Injury (TBI), Vegetative

  9. Novel Treatment for Patients with Traumatic Brain Injury (TBI)

    Science.gov (United States)

    2016-06-01

    equieffectiv e dose of phenylephri ne (PE)? 18 Does AVP maintain brain and muscle tissue 02 during CPP managemen t after TBI relative to an... Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any...discuss the meeting dates. I can be reached by telephone or email as listed below. K nnet 1·0 t ,. ti .. P ofessor of Surgery Leonard M. Miller

  10. Enhanced Cognitive Rehabilitation to Treat Comorbid TBI and PTSD

    Science.gov (United States)

    2017-12-01

    S) Amy Jak 5d. PROJECT NUMBER 5e. TASK NUMBER E-Mail: ajak@ucsd.edu 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES...points during the study. The investigation sought to improve treatment outcomes for combat- related psychological health and develop an evidence-based...focused on helping Iraq and Afghanistan Veterans who have a history of mild to moderate traumatic brain injury (TBI) and posttraumatic stress

  11. Enhanced Cognitive Rehabilitation to Treat Comorbid TBI and PTSD

    Science.gov (United States)

    2017-12-01

    PTSD in which CPT is interwoven with compensatory cognitive rehabilitation principles (CogSMART) to create a hybrid treatment, SMART-CPT. The...symptoms resulting from mild to moderate TBI. These practice standards have been organized into a manualized treatment, Cognitive Symptom Management ...tested a modification of CPT in which CPT was enhanced with compensatory cognitive rehabilitation principles detailed in CogSMART. The enhanced CPT

  12. Regional CBF in chronic stable TBI treated with hyperbaric oxygen.

    Science.gov (United States)

    Barrett, K F; Masel, B; Patterson, J; Scheibel, R S; Corson, K P; Mader, J T

    2004-01-01

    To investigate whether Hyperbaric Oxygen Therapy (HBO2) could improve neurologic deficits and regional cerebral blood flow (rCBF) in chronic traumatic brain injuries (TBI), the authors employed a nonrandomized control pilot trial. Five subjects, at least three years post head injury, received HBO2. Five head injured controls (HIC) were matched for age, sex, and type of injury. Five healthy subjects served as normal controls. Sixty-eight normal volunteers comprised a reference data bank against which to compare SPECT brain scans. HBO2 subjects received 120 HBO2 in blocks of 80 and 40 treatments with an interval five-month break. Normal controls underwent a single SPECT brain scan, HBO2, and repeat SPECT battery. TBI subjects were evaluated by neurologic, neuropsychometric, exercise testing, and pre and post study MRIs, or CT scans if MRI was contraindicated. Statistical Parametric Mapping was applied to SPECT scans for rCBF analysis. There were no significant objective changes in neurologic, neuropsychometric, exercise testing, MRIs, or rCBF. In this small pilot study, HBO2 did not effect clinical or regional cerebral blood flow improvement in TBI subjects.

  13. Selling the story: narratives and charisma in adults with TBI.

    Science.gov (United States)

    Jones, Corinne A; Turkstra, Lyn S

    2011-01-01

    To examine storytelling performance behaviours in adults with traumatic brain injury (TBI) and relate these behaviours to perceived charisma and desirability as a conversation partner. Seven adult males with traumatic brain injury (TBI) told their accident narratives to a male confederate. Ten male undergraduate students rated 1-minute video clips from the beginning of each narrative using the Charismatic Leadership Communication Scale (CLCS). Raters also indicated whether or not they would like to engage in conversation with each participant. Of the performative behaviours analysed, gestures alone significantly influenced CLCS ratings and reported likelihood of engaging in future conversation with the participant. Post-hoc analysis revealed that speech rate was significantly correlated with all of the preceding measures. There was a significant correlation between self- and other-ratings of charisma. The findings suggest that aspects of non-verbal performance, namely gesture use and speech rate, influence how charismatic an individual is perceived to be and how likely someone is to engage in conversation with that person. Variability in these performance behaviours may contribute to the variation in social outcomes seen in the TBI population.

  14. [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)

  15. 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

  16. 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”

  17. Pupillometry and Saccades as Objective mTBI Biomarker

    Science.gov (United States)

    2016-10-01

    football , hockey, soccer, and rugby [5,6,12,13]. All of 306 D.V. Walsh et al. / Journal of the Neurological Sciences 370 (2016) 305–309these studies have...and multiple sclero- sis [16], not acutemTBI as seen in the present study. But a recent KD test study on subjects recruited from an emergency ...Silverberg, T.M. Luoto, J. Ohman, G.L. Iverson, Assessment of mild traumatic brain injury with the King-Devick Test in an emergency department sample

  18. Pupillometry and Saccades as Objective mTBI Biomark

    Science.gov (United States)

    2017-06-01

    Parkinson’s disease , Parkinsonism Relat. Disord. 20 (2) (2014) 226–229, http://dx.doi.org/10.1016/j.parkreldis.2013.10.009 (PubMed PMID: 24269283...The views, opinions and/or findings contained in this report are those of the author( s ) and should not be construed as an official Department of the...Saccades as Objective mTBI Biomark 5a. CONTRACT NUMBER W81XWH-14-C-0048 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR( S ) LTC Jose E

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

    Science.gov (United States)

    2016-10-01

    1 Award Number: W81XWH-11-1-0796 TITLE: Neural Markers and Rehabilitation of Executive Functioning in Veterans with TBI and PTSD PRINCIPAL...30Sept2015 - 29Sept2016 4. TITLE AND SUBTITLE: Neural Markers and Rehabilitation of Executive Functioning in Veterans with TBI and PTSD 5a. CONTRACT... met criteria for TBI during military service, 48.8% of whom reported multiple head injuries. The most common mechanisms of injury included blast

  20. Ubiquinol treatment for TBI in male rats: Effects on mitochondrial integrity, injury severity, and neurometabolism.

    Science.gov (United States)

    Pierce, Janet D; Gupte, Raeesa; Thimmesch, Amanda; Shen, Qiuhua; Hiebert, John B; Brooks, William M; Clancy, Richard L; Diaz, Francisco J; Harris, Janna L

    2018-06-01

    Following traumatic brain injury (TBI), there is significant secondary damage to cerebral tissue from increased free radicals and impaired mitochondrial function. This imbalance between reactive oxygen species (ROS) production and the effectiveness of cellular antioxidant defenses is termed oxidative stress. Often there are insufficient antioxidants to scavenge ROS, leading to alterations in cerebral structure and function. Attenuating oxidative stress following a TBI by administering an antioxidant may decrease secondary brain injury, and currently many drugs and supplements are being investigated. We explored an over-the-counter supplement called ubiquinol (reduced form of coenzyme Q10), a potent antioxidant naturally produced in brain mitochondria. We administered intra-arterial ubiquinol to rats to determine if it would reduce mitochondrial damage, apoptosis, and severity of a contusive TBI. Adult male F344 rats were randomly assigned to one of three groups: (1) Saline-TBI, (2) ubiquinol 30 minutes before TBI (UB-PreTBI), or (3) ubiquinol 30 minutes after TBI (UB-PostTBI). We found when ubiquinol was administered before or after TBI, rats had an acute reduction in brain mitochondrial damage, apoptosis, and two serum biomarkers of TBI severity, glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase-L1 (UCH-L1). However, in vivo neurometabolic assessment with proton magnetic resonance spectroscopy did not show attenuated injury-induced changes. These findings are the first to show that ubiquinol preserves mitochondria and reduces cellular injury severity after TBI, and support further study of ubiquinol as a promising adjunct therapy for TBI. © 2018 Wiley Periodicals, Inc.

  1. Can Post mTBI Neurological Soft Signs Predict Postconcussive and PTSD Symptoms : A Pilot Study

    Science.gov (United States)

    2014-02-01

    disorders , including post - traumatic stress disorder ( PTSD ), but they have scarcely been studied in TBI. The present study measured NSS in the...including post - traumatic stress disorder ( PTSD ), but they have scarcely been studied in TBI. The present study measured NSS in the acute aftermath of...Can Post mTBI Neurological Soft Signs Predict Postconcussive and PTSD Symptoms?: A Pilot Study 5a. CONTRACT NUMBER E-Mail:

  2. Delivery of mental health treatment to combat veterans with psychiatric diagnoses and TBI histories.

    Directory of Open Access Journals (Sweden)

    Shannon R Miles

    Full Text Available Traumatic brain injury (TBI and mental health (MH disorders are prevalent in combat veterans returning from Afghanistan and/or Iraq (hereafter referred to as returning veterans. Accurate estimates of service utilization for veterans with and without TBI exposure (referred to as TBI history are imperative in order to provide high quality healthcare to returning veterans. We examined associations between TBI history and MH service utilization in a subsample of returning veterans who were newly diagnosed with posttraumatic stress disorder (PTSD, depression, and/or anxiety in the 2010 fiscal year (N = 55,458. Data were extracted from the Veterans Health Administration (VHA National Patient Care Database. Veterans with MH diagnoses and TBI histories attended significantly more psychotherapy visits, (M = 8.32 visits, SD = 17.15 and were more likely to attend at least 8 psychotherapy visits, (15.7% than veterans with MH diagnoses but no TBI history (M = 6.48 visits, SD = 12.12; 10.1% attended at least 8 sessions. PTSD and TBI history, but not depression or anxiety, were associated with a greater number of psychotherapy visits when controlling for demographic and clinical variables. PTSD, anxiety, depression, and TBI history were associated with number of psychotropic medication-management visits. TBI history was related to greater MH service utilization, independent of MH diagnoses. Future research should examine what MH services are being utilized and if these services are helping veterans recover from their disorders.

  3. 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...

  4. 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...

  5. Survival and Injury Outcome After TBI: Influence of Pre- and Post-Exposure to Caffeine

    Science.gov (United States)

    2012-10-01

    10-1-0757 TITLE: Survival and Injury Outcome After TBI: Influence of Pre- and Post- Exposure to Caffeine PRINCIPAL INVESTIGATOR...Lusardi, Ph.D. Survival and Injury Outcome After TBI: Influence of Pre- and Post- Exposure to Caffeine 33 Legacy Emanual Hospital & Health Center...Phase 1: Study the prophylactic effects of caffeine exposure prior to FPI

  6. 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.

  7. 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…

  8. Pilot production of the wedge filter for the TBI (total body irradiation)

    International Nuclear Information System (INIS)

    Ikezaki, Hiromi; Ikeda, Ikuo; Maruyama, Yasushi; Nako, Yasunobu; Tonari, Ayako; Kusuda, Junko; Takayama, Makoto

    2007-01-01

    Total body irradiation (TBI) is performed by various methods, such as a long SSD method and a translational couch method. For patient safety in carrying out TBI, the patient should be placed on the supine position and prone position near the floor. TBI is performed from 2 opposite ports (AP/PA) with a linear accelerator (10 MV X-ray). We experimented with a wedge filter for TBI created by us, which makes dose distribution to a floor uniform. The wedge filter, made of iron alloy, was attached to the linear accelerator. In designing the wedge filter, thickness of the lead-made wedge filter can be calculated numerically from the ratio of linear attenuation coefficient of iron alloy and lead. In measuring the dose profile for a phantom of 20 cm thick, dose homogeneity less than 10% was proved by the wedge filter for TBI. (author)

  9. Caregiver functioning following early childhood TBI: do moms and dads respond differently?

    Science.gov (United States)

    Wade, Shari L; Walz, Nicolay C; Cassedy, Amy; Taylor, H Gerry; Stancin, Terry; Yeates, Keith Owen

    2010-01-01

    Research suggests that pediatric TBI results in injury-related stress and burden and psychological distress for parents. However, existing studies have focused almost exclusively on mothers, so that we know relatively little about the impact of childhood TBI on fathers. The aims were to prospectively examine differences in maternal and paternal response to early childhood TBI over time relative to a comparison cohort of mothers and fathers of children with orthopedic injuries (OI). The concurrent cohort/prospective research design involved repeated assessments of children aged 3-6 years with TBI or OI requiring hospitalization and their families. Shortly after injury and at 6, 12, and 18 months post injury, parents of 48 children with TBI (11 severe and 37 moderate) and 89 with OI completed standardized assessments of injury-related stress and burden, parental distress, and coping strategies. Mixed models analyses and Generalized Estimating Equations examined differences in maternal versus paternal burden, distress, and coping over time. The analyses included interactions of parent sex with group (severe TBI, moderate TBI, OI) and time since injury, to examine the moderating effects of injury severity on parental response to injury over time. Fathers were more likely than mothers to use denial to cope following moderate and severe TBI, but not OI. Conversely, mothers were more likely to prefer acceptance and emotion-focused strategies than fathers regardless of the type of injury. The use of active coping strategies varied as a function of injury type, parent sex, and time since injury. Fathers reported greater injury-related stress and distress than mothers over time, with pronounced differences in the severe TBI and OI groups. Mothers and fathers appear to respond differently following TBI. The different types of responses may serve to exacerbate emerging family dysfunction.

  10. 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...

  11. Indicators of complicated mild TBI predict MMPI-2 scores after 23 years.

    Science.gov (United States)

    Hessen, Erik; Nestvold, Knut

    2009-03-01

    Research suggests that post-concussive syndrome may become persistent after mild traumatic brain injury (mTBI). The aim of this study was to investigate determinants of subjective complaints, characteristic for post-concussive syndrome, 23 years after mTBI. The study was a follow-up after a prospective head injury study at a general hospital in Norway. Ninety-seven patients were assessed with the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) 23 years after sustaining primarily mTBI. A good overall outcome was found with scores close to the normative mean, average length of education and normal employment rate. However, the patients that sustained complicated mTBI showed somewhat more pathological scores, well-matched with mild post-concussive syndrome. The most important predictors of poor outcome were a combination of post-traumatic amnesia >30 minutes and EEG pathology within 24 hours after TBI. No influence of pre- and post-injury risk factors on current MMPI-2 profiles was found. The results are in line with previous research findings and support the notion of potentially differential impact of uncomplicated vs. complicated mTBI. The findings suggest that complicated mTBI may cause subtle chronic symptoms typical of post-concussive syndrome.

  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. 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 SPECT separated PTSD from 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

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

    Science.gov (United States)

    2013-07-22

    and Post-TBI Psychiatric Disorders 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK...in (282–285)]. Based on a review of the literature, Graham and Cardon reported that substance abuse rates decline following TBI, including mild TBI...preva- lence and outcomes research (1994-2004). Neuropsychol Rehabil (2006) 16(5):537–60. doi:10.1080/09602010500231875 285. Graham DP, Cardon AL. An

  15. 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.

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

    Science.gov (United States)

    2018-01-25

    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

  17. Psychological and marital adjustment in couples following a traumatic brain injury (TBI): a critical review.

    Science.gov (United States)

    Blais, Marie Claude; Boisvert, Jean-Marie

    2005-12-20

    The first part of this paper examines current data describing the psychological and marital adjustment of couples following a traumatic brain injury (TBI). Although these findings reveal some discrepancies, they highlight that adjustment following a TBI represents a genuine challenge for those involved in the process. The second part moves toward the examination of factors associated with psychological and marital adjustment in both couple partners. Here again, there exists a large diversity in empirical data and theoretical models informing this emerging area of interest. Nevertheless, cognitive variables such as coping skills are commonly seen as critical variables to explain the adjustment level in people with TBI and their spouse/caregivers. Concurrently with the discussion of the methodological issues and pitfalls encountered in this area of research, the conclusion provides suggestions of further steps to undertake in this endeavour toward a better understanding of the adjustment process following TBI.

  18. 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...

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

    Science.gov (United States)

    2017-10-01

    Approved OMB No. 0704-0188 Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for...magnetic stimulation (rTMS), which is a non-invasive technique to stimulate the brain. The evidence of therapeutic efficacy from the literature in non-TBI...Transcranial Magnetic Stimulation (rTMS), Traumatic Brain Injury (TBI), Vegetative (VS), Minimally Conscious (MCS) 16. SECURITY CLASSIFICATION OF

  20. Home-based, Online Mindfulness and Cognitive Training for Soldiers and Veterans with TBI

    Science.gov (United States)

    2017-10-01

    AWARD NUMBER: W81XWH-16-1-0685 TITLE: Home-based, Online Mindfulness and Cognitive Training for Soldiers and Veterans with TBI PRINCIPAL...TITLE AND SUBTITLE Home-based, Online Mindfulness and Cognitive Training for Soldiers and Veterans with TBI 5a. CONTRACT NUMBER 5b. GRANT NUMBER...individuated brain training program (cognitive training + mindfulness /stress- reduction training) with caregiver support portal and lifestyle monitor is

  1. A Randomized Controlled Trial of the Group-Based Modified Story Memory Technique in TBI

    Science.gov (United States)

    2017-10-01

    major task was to coordinate the study staff for the clinical trial. This is also a time- consuming processing that involves hiring the appropriate...for improving NLM in individuals with Multiple Sclerosis (MS) and TBI across three realms of functioning, objective behavior , brain functioning and...improving new learning and memory in individuals with Multiple Sclerosis (MS) and TBI across three realms of functioning, objective behavior , brain

  2. 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.

  3. 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.

  4. Effects of categorization training in patients with TBI during postacute rehabilitation: preliminary findings.

    Science.gov (United States)

    Constantinidou, Fofi; Thomas, Robin D; Scharp, Victoria L; Laske, Kate M; Hammerly, Mark D; Guitonde, Suchita

    2005-01-01

    Previous research suggests that traumatic brain injury (TBI) interferes with the ability to extract and use attributes to describe objects. This study explored the effects of a systematic Categorization Program (CP) in participants with TBI and noninjured controls. Ten persons with moderate to severe TBI who received comprehensive postacute rehabilitation services and 13 matched noninjured controls participated in the study. All participants received CP training for 3 to 5 hours per week for 10 to 12 weeks that consisted of 8 levels and targeted concept formation, object categorization, and decision-making abilities. The Mayo-Portland Adaptability Inventory-3 (MPAI-3) and the Community Integration Questionnaire (CIQ). Two Categorization Tests (administered pretraining and posttraining) and 3 Probe Tasks (administered at specified intervals during training) assessed skills relating to categorization. Both groups showed significant improvement in categorization performance after the CP training on the 2 Categorization Tests related to the CP. They also were able to generalize and apply categorization and sorting skills in new situations (as measured by the Probe Tasks). Participants with TBI had improved functional outcome performance measured by the MPAI-3 and the CIQ. The systematic and hierarchical structure of the CP is beneficial to participants with TBI during postacute rehabilitation. This study contributes to the growing body of evidence supporting cognitive rehabilitation after moderate to severe TBI.

  5. Trajectories of life satisfaction after TBI: Influence of life roles, age, cognitive disability, and depressive symptoms

    Science.gov (United States)

    Juengst, Shannon B.; Adams, Leah M.; Bogner, Jennifer A.; Arenth, Patricia M.; O’Neil-Pirozzi, Therese M.; Dreer, Laura E.; Hart, Tessa; Bergquist, Thomas F.; Bombardier, Charles H.; Dijkers, Marcel P.; Wagner, Amy K.

    2015-01-01

    Objectives 1) Identify life satisfaction trajectories after moderate to severe traumatic brain injury (TBI), 2) establish a predictive model for these trajectories across the first 5 years post-injury, and 3) describe differences in these life satisfaction trajectory groups, focusing on age, depressive symptoms, disability, and participation in specific life roles,. Research Method Analysis of the longitudinal TBI Model Systems National Database was performed on data collected prospectively at 1, 2, and 5 years post-TBI. Participants (n=3,012) had a moderate to severe TBI and were 16 years old and older. Results Four life satisfaction trajectories were identified across the first 5 years post-injury, including: Stable Satisfaction, Initial Satisfaction Declining, Initial Dissatisfaction Improving, and Stable Dissatisfaction. Age, depressive symptoms, cognitive disability, and life role participation as a worker, leisure participant, and/ or religious participant at one year post-injury significantly predicted trajectory group membership. Life role participation and depressive symptoms were strong predictors of life satisfaction trajectories across the first 5 years post TBI. Conclusions The previously documented loss of life roles and prevalence of depression after a moderate to severe TBI make this a vulnerable population for whom low or declining life satisfaction is a particularly high risk. Examining individual life role participation may help to identify relevant foci for community-based rehabilitation interventions or supports. PMID:26618215

  6. 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

    2008-09-01

    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 TBI and comparison group was fitted with a custom-made artificial acrylic palate that recorded lingual palatal contact during target consonant production in sentence- and syllable-repetition tasks at a habitual rate and loudness level. Analysis of temporal parameters between the comparison and TBI groups revealed prolonged durations of the various phases of consonant production, which were attributed to articulatory slowness, impaired speech motor control, impaired accuracy, and impaired coordination of articulatory movements in the dysarthric speakers post-TBI. For the spatial measurements, quantitative analysis, as well as visual inspection of the tongue-to-palate contact diagrams, indicated spatial aberrations in dysarthric speech post-TBI. Both the spatial and temporal aberrations may have at least partially caused the perceptual judgement of articulatory impairments in the dysarthric speakers.

  7. 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.

  8. Factors modifying the toxicity of total body irradiation (TBI) with bone marrow transplant

    International Nuclear Information System (INIS)

    Fish, B.L.; Moulder, J.E.

    1987-01-01

    In defined-flora, barrier-maintained rats, radiation nephritis is the principle late toxicity seen after single dose, high dose rate TBI with bone marrow transplant. Shielding the kidneys eliminates this late toxicity. If rats are exposed to a conventional microbiological environment during and after TBI and bone marrow transplant, the principle late toxicity is pneumonitis. Low dose rate TBI gives similar renal toxicity but at doses twice as large. Clinically, TBI and bone marrow transplant is preceded by intensive drug treatment, typically with cyclophosphamide (Cytoxan) and cytosine arabinoside (ara-C). Pretreatment with a standard cytoxan/ara-C regimen, has no effect on the gastrointestinal toxicity of TBI, but results in a decrease in marrow toxicity. Late renal toxicity still occurs when bone marrow transplants are given, but it is to early to determine whether drug treatment has affected late renal tolerance. Experiments are also underway to determine the effects of fractionated TBI (3, 6 and 9 fractions in 60 hours) on acute tolerance and on late tolerance after bone marrow transplantation

  9. Metabolic alterations in patients who develop traumatic brain injury (TBI)-induced hypopituitarism.

    Science.gov (United States)

    Prodam, F; Gasco, V; Caputo, M; Zavattaro, M; Pagano, L; Marzullo, P; Belcastro, S; Busti, A; Perino, C; Grottoli, S; Ghigo, E; Aimaretti, G

    2013-08-01

    Hypopituitarism is associated with metabolic alterations but in TBI-induced hypopituitarism data are scanty. The aim of our study was to evaluate the prevalence of naïve hypertension, dyslipidemia, and altered glucose metabolism in TBI-induced hypopituitarism patients. Cross-sectional retrospective study in a tertiary care endocrinology center. 54 adult patients encountering a moderate or severe TBI were evaluated in the chronic phase (at least 12 months after injury) after-trauma. Presence of hypopituitarism, BMI, hypertension, fasting blood glucose and insulin levels, oral glucose tolerance test (if available) and a lipid profile were evaluated. The 27.8% of patients showed various degrees of hypopituitarism. In particular, 9.3% had total, 7.4% multiple and 11.1% isolated hypopituitarism. GHD was present in 22.2% of patients. BMI was similar between the two groups. Hypopituitaric patients presented a higher prevalence of dyslipidemia (phypopituitaric patients. In particular, triglycerides (phypopituitaric TBI patients. We showed that long-lasting TBI patients who develop hypopituitarism frequently present metabolic alterations, in particular altered glucose levels, insulin resistance and hypertriglyceridemia. In view of the risk of premature cardiovascular death in hypopituitaric patients, major attention has to been paid in those who encountered a TBI, because they suffer from the same comorbidities and may present other deterioration factors due to complex pharmacological treatments and restriction in participation in life activities and healthy lifestyle. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. 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.

  11. Investigating social functioning after early mild TBI: the quality of parent-child interactions.

    Science.gov (United States)

    Lalonde, Gabrielle; Bernier, Annie; Beaudoin, Cindy; Gravel, Jocelyn; Beauchamp, Miriam H

    2018-03-01

    The young brain is particularly vulnerable to injury due to inherent physiological and developmental factors, and even mild forms of traumatic brain injury (mTBI) can sometimes result in cognitive and behavioural difficulties. Despite the high prevalence of paediatric mTBI, little is known of its impact on children's social functioning. Parent-child relationships represent the centre of young children's social environments and are therefore ideal contexts for studying the potential effects of mTBI on children's social functioning. The aim of this study was to assess the quality of parent-child interactions after mTBI using observational assessment methods and parental report. The sample included 130 children (18-60 months at recruitment) divided into three groups: children with uncomplicated mTBI (n = 47), children with orthopaedic injury (OI, n = 27), and non-injured children (NI, n = 56). The quality of parent-child interactions was assessed 6 months post-injury using the Mutually Responsive Orientation (MRO) scale, an observational measure which focuses on the dyadic nature of parent-child exchanges, and the Parental Stress Index questionnaire (Parent-Child Dysfunctional Interaction (PCDI) domain). Significant differences with medium effect sizes were found between the mTBI group and the NI group on the MRO, but not between the OI group and the other two groups. PCDI scores did not differ across groups, suggesting that observational measures may be more sensitive to changes in parent-child interactions after TBI. The current findings have implications for children's post-injury social development and highlight the importance of monitoring social outcomes even after minor head injuries. © 2016 The British Psychological Society.

  12. Head injuries (TBI) to adults and children in motor vehicle crashes.

    Science.gov (United States)

    Viano, David C; Parenteau, Chantal S; Xu, Likang; Faul, Mark

    2017-08-18

    This is a descriptive study. It determined the annual, national incidence of head injuries (traumatic brain injury, TBI) to adults and children in motor vehicle crashes. It evaluated NASS-CDS for exposure and incidence of various head injuries in towaway crashes. It evaluated 3 health databases for emergency department (ED) visits, hospitalizations, and deaths due to TBI in motor vehicle occupants. Four databases were evaluated using 1997-2010 data on adult (15+ years old) and child (0-14 years old) occupants in motor vehicle crashes: (1) NASS-CDS estimated the annual incidence of various head injuries and outcomes in towaway crashes, (2) National Hospital Ambulatory Medical Care Survey (NHAMCS)-estimated ED visits for TBI, (3) National Hospital Discharge Survey (NHDS) estimated hospitalizations for TBI, and (4) National Vital Statistics System (NVSS) estimated TBI deaths. The 4 databases provide annual national totals for TBI related injury and death in motor vehicle crashes based on differing definitions with TBI coded by the Abbreviated Injury Scale (AIS) in NASS-CDS and by International Classification of Diseases (ICD) in the health data. Adults: NASS-CDS had 16,980 ± 2,411 (risk = 0.43 ± 0.06%) with severe head injury (AIS 4+) out of 3,930,543 exposed adults in towaway crashes annually. There were 49,881 ± 9,729 (risk = 1.27 ± 0.25%) hospitalized with AIS 2+ head injury, without death. There were 6,753 ± 882 (risk = 0.17 ± 0.02%) fatalities with a head injury cause. The public health data had 89,331 ± 6,870 ED visits, 33,598 ± 1,052 hospitalizations, and 6,682 ± 22 deaths with TBI. NASS-CDS estimated 48% more hospitalized with AIS 2+ head injury without death than NHDS occupants hospitalized with TBI. NASS-CDS estimated 29% more deaths with AIS 3+ head injury than NVSS occupant TBI deaths but only 1% more deaths with a head injury cause. Children: NASS-CDS had 1,453 ± 318 (risk = 0.32 ± 0.07%) with severe head injury (AIS 4+) out of 454,973 exposed

  13. Social reintegration of TBI patients: a solution to provide long-term support.

    Science.gov (United States)

    Bulinski, Leszek

    2010-01-01

    This article evaluates the effectiveness of a workable long-term program to provide social support for TBI patients, based on the "Academy of Life" concept. Disability after TBI causes numerous disruptions of normal life, which affect the patient, the family, and society. The patient needs the particular kind of support the program was designed to provide. The study involved 200 married couples with a TBI spouse previously enrolled in the "Academy of Life." The methods included documentation analysis, clinical interviews, the Family Bonds Scale, the Social Isolation Scale, and the Social Functions subscale from a battery used to evaluate QOL after TBI. The subjects were examined before and after completing the program. In the first examination all types of family bonds were found to be severely weakened; there was deep social isolation, loneliness, sadness, a feeling of being surrounded by hostility, and no purposeful social activity. The most common form of support from significant others was pity and unwanted interference, accompanied by lack of understanding and social ostracism. In the second examination there was selective improvement of all parameters, significantly greater in patients without PTSD symptoms. The best effects were achieved in the reduction of social dysfunctions, the growth of purposeful social activity, and improvement in the type of support received, and a reduction of selected parameters of social isolation. The program here described is selectively effective for the social reintegration of TBI-patients, especially those without PTSD symptoms.

  14. Contemporary imaging of mild TBI: the journey toward diffusion tensor imaging to assess neuronal damage.

    Science.gov (United States)

    Fox, W Christopher; Park, Min S; Belverud, Shawn; Klugh, Arnett; Rivet, Dennis; Tomlin, Jeffrey M

    2013-04-01

    To follow the progression of neuroimaging as a means of non-invasive evaluation of mild traumatic brain injury (mTBI) in order to provide recommendations based on reproducible, defined imaging findings. A comprehensive literature review and analysis of contemporary published articles was performed to study the progression of neuroimaging findings as a non-invasive 'biomarker' for mTBI. Multiple imaging modalities exist to support the evaluation of patients with mTBI, including ultrasound (US), computed tomography (CT), single photon emission computed tomography (SPECT), positron emission tomography (PET), and magnetic resonance imaging (MRI). These techniques continue to evolve with the development of fractional anisotropy (FA), fiber tractography (FT), and diffusion tensor imaging (DTI). Modern imaging techniques, when applied in the appropriate clinical setting, may serve as a valuable tool for diagnosis and management of patients with mTBI. An understanding of modern neuroanatomical imaging will enhance our ability to analyse injury and recognize the manifestations of mTBI.

  15. 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. © 2014 Wiley Periodicals, Inc.

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

    OpenAIRE

    Sebastian, Veronica; Diallo, Aissatou; Ling, Douglas S. F.; Serrano, Peter A.

    2013-01-01

    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 r...

  17. Immunosuppression prior to marrow transplantation for sensitized aplastic anemia patients: comparison of TLI with TBI

    International Nuclear Information System (INIS)

    Shank, B.; Brochstein, J.A.; Castro-Malaspina, H.; Yahalom, J.; Bonfiglio, P.; O'Reilly, R.J.

    1988-01-01

    From May 1980 through July 1986, 26 patients with severe aplastic anemia, sensitized with multiple transfusions of blood products, were treated on either of two immunosuppressive regimens in preparation for bone marrow transplantation from a matched donor. There were 10 patients treated with total body irradiation (TBI), 200 cGy/fraction X 4 daily fractions (800 cGy total dose), followed by cyclophosphamide, 60 mg/kg/d X 2 d. An additional 16 patients were treated with total lymphoid irradiation (TLI) [or, if they were infants, a modified TLI or thoracoabdominal irradiation (TAI)], 100 cGy/fraction, 3 fractions/d X 2 d (600 cGy total dose), followed by cyclophosphamide, 40 mg/kg/d X 4 d. The extent of immunosuppression was similar in both groups as measured by peripheral blood lymphocyte depression at the completion of the course of irradiation (5% of initial concentration for TBI and 24% for TLI), neutrophil engraftment (10/10 for TBI and 15/16 for TLI), and time to neutrophil engraftment (median of 22 d for TBI and 17 d for TLI). Marrow and peripheral blood cytogenetic analysis for assessment of percent donor cells was also compared in those patients in whom it was available. 2/2 patients studied with TBI had 100% donor cells, whereas 6/11 with TLI had 100% donor cells. Of the five who did not, three were stable mixed chimeras with greater than or equal to 70% donor cells, one became a mixed chimera with about 50% donor cells, but became aplastic again after Cyclosporine A cessation 5 mo post-transplant, and the fifth reverted to all host cells by d. 18 post-transplant. Overall actuarial survival at 2 years was 56% in the TLI group compared with 30% in the TBI group although this was not statistically significant. No survival decrement has been seen after 2 years in either group

  18. The incidence of ARDS and associated mortality in severe TBI using the Berlin definition.

    Science.gov (United States)

    Aisiku, Imoigele P; Yamal, Jose-Miguel; Doshi, Pratik; Rubin, Maria Laura; Benoit, Julia S; Hannay, Julia; Tilley, Barbara C; Gopinath, Shankar; Robertson, Claudia S

    2016-02-01

    The incidence of adult respiratory distress syndrome (ARDS) in severe traumatic brain injury (TBI) is poorly reported. Recently, a new definition for ARDS was proposed, the Berlin definition. The percentage of patients represented by TBI in the Berlin criteria study is limited. This study describes the incidence and associated mortality of ARDS in TBI patients. The study was an analysis of the safety of erythropoietin administration and transfusion threshold on the incidence of ARDS in severe TBI patients. Three reviewers independently assessed all patients enrolled in the study for acute lung injury/ARDS using the Berlin and the American-European Consensus Conference (AECC) definitions. A Cox proportional hazards model was used to assess the relationship between ARDS and mortality and 6-month Glasgow Outcome Scale (GOS) score. Two hundred patients were enrolled in the study. Of the patients, 21% (41 of 200) and 26% (52 of 200) developed ARDS using the AECC and Berlin definitions, respectively, with a median time of 3 days (interquartile range, 3) after injury. ARDS by either definition was associated with increased mortality (p = 0.04) but not with differences in functional outcome as measured by the GOS score at 6 months. Adjusted analysis using the Berlin criteria showed an increased mortality associated with ADS (p = 0.01). Severe TBI is associated with an incidence of ARDS ranging from 20% to 25%. The incidence is comparable between the Berlin and AECC definitions. ARDS is associated with increased mortality in severe TBI patients, but further studies are needed to validate these findings. Epidemiologic study, level II.

  19. 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

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

    Science.gov (United States)

    2015-06-01

    5] J.M. Seelig, D.P. Becker, J.D. Miller, R.P. Greenberg, J.D. Ward, S.C. Choi, Traumatic acute subdural hematoma : major mortality reduction in...the field. This results in a delay in quantifi- cation of the type and extent of TBI – epidural, subdural , versus intra-parenchymal bleeds; diffuse...example, surgical evacuation of epidural and subdural bleeds within hours of TBI immediately reduces the chance of exposure of brain to blood products

  1. Hydrocephalus during rehabilitation following severe TBI. Relation to recovery, outcome, and length of stay

    DEFF Research Database (Denmark)

    Linnemann, Mia; Tibæk, Maiken; Kammersgaard, Lars Peter

    2014-01-01

    BACKGROUND: Post traumatic hydrocephalus (PTH) is a frequent complication during rehabilitation following severe TBI. However, the diagnosis of PTH is not straightforward and despite shunting recovery may be delayed. OBJECTIVE: To study the influence of PTH on recovery and outcome during rehabili......BACKGROUND: Post traumatic hydrocephalus (PTH) is a frequent complication during rehabilitation following severe TBI. However, the diagnosis of PTH is not straightforward and despite shunting recovery may be delayed. OBJECTIVE: To study the influence of PTH on recovery and outcome during...

  2. Improving Balance in TBI Using a Low-Cost Customized Virtual Reality Rehabilitation Tool

    Science.gov (United States)

    2016-10-01

    quality of life , and cognitive function. This design will allow us to assess the efficacy of IQ as a customizable balance treatment in TBI, and to...VANJHCS.  As  such,  we  have   explored  additional  avenues  and  are   working  closely  with  the  dedicated...AWARD NUMBER: W81XWH-14-2-0150 TITLE: Improving Balance in TBI Using a Low-Cost Customized Virtual Reality Rehabilitation Tool PRINCIPAL

  3. Deep pockets or blueprint for change: traumatic brain injury (TBI) proactive strategy.

    Science.gov (United States)

    Wood, D W; Pohl, S; Lawler, S; Okamoto, G

    1998-09-01

    The Pacific Conference scheduled for October 1-3, 1988, is a critical event in the development of an integrated community-based plan for a comprehensive continuum of services to address the "silent epidemic," Traumatic Brain Injured (TBI). This paper provides insights of the complex nature and the special problems faced by the TBI survivors; their families, natural supports and caregivers, as well as the health, social and educational care providers in Hawaii. Process for the development of the community plan is presented.

  4. Predictive factors for 1-year outcome of a cohort of patients with severe traumatic brain injury (TBI): results from the PariS-TBI study.

    Science.gov (United States)

    Jourdan, C; Bosserelle, V; Azerad, S; Ghout, I; Bayen, E; Aegerter, P; Weiss, J J; Mateo, J; Lescot, T; Vigué, B; Tazarourte, K; Pradat-Diehl, P; Azouvi, P

    2013-01-01

    To assess outcome and predicting factors 1 year after a severe traumatic brain injury (TBI). Multi-centre prospective inception cohort study of patients aged 15 or older with a severe TBI in the Parisian area, France. Data were collected prospectively starting the day of injury. One-year evaluation included the relatives-rating of the Dysexecutive Questionnaire (DEX-R), the Glasgow Outcome Scale-Extended (GOSE) and employment. Univariate and multivariate tests were computed. Among 257 survivors, 134 were included (mean age 36 years, 84% men). Good recovery concerned 19%, moderate disability 43% and severe disability 38%. Among patients employed pre-injury, 42% were working, 28% with no job change. DEX-R score was significantly associated with length of education only. Among initial severity measures, only the IMPACT prognostic score was significantly related to GOSE in univariate analyses, while measures relating to early evolution were more significant predictors. In multivariate analyses, independent predictors of GOSE were length of stay in intensive care (LOS), age and education. Independent predictors of employment were LOS and age. Age, education and injury severity are independent predictors of global disability and return to work 1 year after a severe TBI.

  5. Brain-Derived Neurotrophic Factor in TBI-related mortality: Interrelationships between Genetics and Acute Systemic and CNS BDNF Profiles

    Science.gov (United States)

    Failla, Michelle D.; Conley, Yvette P.; Wagner, Amy K.

    2015-01-01

    Background Older adults have higher mortality rates after severe traumatic brain injury (TBI) compared to younger adults. Brain derived neurotrophic factor (BDNF) signaling is altered in aging and is important to TBI given its role in neuronal survival/plasticity and autonomic function. Following experimental TBI, acute BDNF administration has not been efficacious. Clinically, genetic variation in BDNF (reduced signaling alleles: rs6265, Met-carriers; rs7124442, C-carriers) were protective in acute mortality. Post-acutely, these genotypes carried lower mortality risk in older adults, and greater mortality risk among younger adults. Objective Investigate BDNF levels in mortality/outcome following severe TBI in the context of age and genetic risk. Methods CSF and serum BDNF were assessed prospectively during the first week following severe TBI (n=203), and in controls (n=10). Age, BDNF genotype, and BDNF levels were assessed as mortality/outcome predictors. Results CSF BDNF levels tended to be higher post-TBI (p=0.061) versus controls and were associated with time until death (p=0.042). In contrast, serum BDNF levels were reduced post-TBI versus controls (pBDNF serum and gene*age interactions were mortality predictors post-TBI in the same multivariate model. CSF and serum BDNF tended to be negatively correlated post-TBI (p=0.07). Conclusions BDNF levels predicted mortality, in addition to gene*age interactions, suggesting levels capture additional mortality risk. Higher CSF BDNF post-TBI may be detrimental due to injury and age-related increases in pro-apoptotic BDNF target receptors. Negative CSF and serum BDNF correlations post-TBI suggest blood-brain barrier transit alterations. Understanding BDNF signaling in neuronal survival, plasticity, and autonomic function may inform treatment. PMID:25979196

  6. 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

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

    Directory of Open Access Journals (Sweden)

    Vanessa Fimreite

    2016-10-01

    Conclusions: 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.

  8. Alpha desynchronization/synchronization during working memory testing is compromised in acute mild traumatic brain injury (mTBI).

    Science.gov (United States)

    Arakaki, Xianghong; Shoga, Michael; Li, Lianyang; Zouridakis, George; Tran, Thao; Fonteh, Alfred N; Dawlaty, Jessica; Goldweber, Robert; Pogoda, Janice M; Harrington, Michael G

    2018-01-01

    Diagnosing and monitoring recovery of patients with mild traumatic brain injury (mTBI) is challenging because of the lack of objective, quantitative measures. Diagnosis is based on description of injuries often not witnessed, subtle neurocognitive symptoms, and neuropsychological testing. Since working memory (WM) is at the center of cognitive functions impaired in mTBI, this study was designed to define objective quantitative electroencephalographic (qEEG) measures of WM processing that may correlate with cognitive changes associated with acute mTBI. First-time mTBI patients and mild peripheral (limb) trauma controls without head injury were recruited from the emergency department. WM was assessed by a continuous performance task (N-back). EEG recordings were obtained during N-back testing on three occasions: within five days, two weeks, and one month after injury. Compared with controls, mTBI patients showed abnormal induced and evoked alpha activity including event-related desynchronization (ERD) and synchronization (ERS). For induced alpha power, TBI patients had excessive frontal ERD on their first and third visit. For evoked alpha, mTBI patients had lower parietal ERD/ERS at the second and third visits. These exploratory qEEG findings offer new and non-invasive candidate measures to characterize the evolution of injury over the first month, with potential to provide much-needed objective measures of brain dysfunction to diagnose and monitor the consequences of mTBI.

  9. Balancing act: the influence of adaptability and cohesion on satisfaction and communication in families facing TBI in Mexico.

    Science.gov (United States)

    Lehan, Tara J; Stevens, Lillian Flores; Arango-Lasprilla, Juan Carlos; Díaz Sosa, Dulce María; Espinosa Jove, Irma Guadalupe

    2012-01-01

    Much of what is known about family functioning in the face of traumatic brain injury (TBI) is based on research conducted in the United States. The purpose of this study was to (1) describe the levels of family adaptability, cohesion, communication, and satisfaction as reported by Mexican TBI survivors and their family caregivers, (2) test the hypothesis of the Circumplex Model that balanced families would exhibit better communication and greater satisfaction, and (3) explore how TBI survivors' and their family caregivers' perceptions of family adaptability and cohesion influenced their own and the other's perceptions of family communication and satisfaction. In the majority of dyads, both the TBI survivor and the family caregiver endorsed balanced family adaptability and cohesion. Both TBI survivors and their family caregivers reported a relatively high level of family communication and satisfaction. TBI survivors and family caregivers who reported greater levels of family adaptability and cohesion also endorsed better family communication and greater family satisfaction. In addition, individuals with TBI whose family caregiver endorsed balanced family adaptability and cohesion reported better family communication. Further, family caregivers of TBI survivors who reported balanced family adaptability and cohesion reported better family communication. Implications for research and practice are discussed.

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

    Science.gov (United States)

    2017-06-01

    working memory load effects after mild traumatic brain injury. Neuroimage, 2001. 14(5): p. 1004-12. 2. Chen, J.K., et al., Functional abnormalities in...report. 10 Supporting Data None. Integrated Eye Tracking and Neural Monitoring for Enhanced Assessment of Mild TBI Psychological Health

  11. School Psychologists' Knowledge and Self-Efficacy in Working with Students with TBI

    Science.gov (United States)

    Glang, Ann E.; McCart, Melissa; Moore, Christabelle L.; Davies, Susan

    2017-01-01

    Approximately 145,000 U.S. children experience lasting effects of traumatic brain injury (TBI) that manifest in social, behavioural, physical, and cognitive challenges in the school setting. School psychologists have an essential role in identifying students who need support and in determining eligibility under the Individuals with Disabilities…

  12. Towards systemic sustainable performance of TBI care systems: emergency leadership frontiers.

    Science.gov (United States)

    Caro, Denis H J

    2010-11-10

    Traumatic brain injuries (TBIs) continue as a twenty-first century subterranean and almost invisible scourge internationally. TBI care systems provide a safety net for survival, recovery, and reintegration into social communities from this scourge, particularly in Canada, the European Union, and the USA. This paper examines the underlying issues of systemic performance and sustainability of TBI care systems, in the light of decreasing care resources and increasing demands for services. This paper reviews the extant literature on TBI care systems, systems reengineering, and emergency leadership literature. This paper presents a seven care layer paradigm, which forms the essence of systemic performance in the care of patients with TBIs. It also identifies five key strategic drivers that hold promise for the future systemic sustainability of TBI care systems. Transformational leadership and engagement from the international emergency medical community is the key to generating positive change. The sustainability/performance care framework is relevant and pertinent for consideration internationally and in the context of other emergency medical populations.

  13. Prospective evaluation of delayed central nervous system (CNS) toxicity of hyperfractionated total body irradiation (TBI)

    International Nuclear Information System (INIS)

    Wenz, Frederik; Steinvorth, Sarah; Lohr, Frank; Fruehauf, Stefan; Wildermuth, Susanne; Kampen, Michael van; Wannenmacher, Michael

    2000-01-01

    Purpose: Prospective evaluation of chronic radiation effects on the healthy adult brain using neuropsychological testing of intelligence, attention, and memory. Methods and Materials: 58 patients (43 ± 10 yr) undergoing hyperfractionated total body irradiation (TBI) (TBI, 14.4 Gy, 12 x 1.2 Gy in 4 days) before bone marrow or peripheral blood stem cell transplantation were prospectively included. Twenty-one recurrence-free long-term survivors were re-examined 6-36 months (median 27 months) after completion of TBI. Neuropsychological testing included assessment of general intelligence, attention, and memory using normative, standardized psychometric tests. Mood status was controlled, as well. Test results are given as IQ scores (population mean 100) or percentiles for attention and memory (population mean 50). Results: The 21 patients showed normal baseline test results of IQ (101 ± 13) and attention (53 ± 28), with memory test scores below average (35 ± 21). Test results of IQ (98 ± 17), attention (58 ± 27), and memory (43 ± 28) showed no signs of clinically measurable radiation damage to higher CNS (central nervous system) functions during the follow-up. The mood status was improved. Conclusion: The investigation of CNS toxicity after hyperfractionated TBI showed no deterioration of test results in adult recurrence-free patients with tumor-free CNS. The median follow-up of 27 months will be extended.

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

    Science.gov (United States)

    Zhu, Yuhong; He, Zhaojian; Chen, Shi-Jie

    2015-01-01

    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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

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

    Science.gov (United States)

    2017-10-01

    Unclassified c. THIS PAGE Unclassified Unclassified 9 19b. TELEPHONE NUMBER (include area code) Email : cgawards@ncire.org Table of Contents...analyze and interpret the results, comparing the biomarker profiles of veterans with TBI, controls, and veterans with mild AD, and write them up for

  20. 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.

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

    Science.gov (United States)

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

    2014-10-13

    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 differ from those of the matched normal population. 25 patients long-term childhood lymphoblastic and myeloid acute leukaemia survivors followed at Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital (Turin, Italy) were retrospectively analysed for assessing the influence of TBI on their longitudinal growth and for validating a new method to estimate the GH therapy effects. Six were treated with GH therapy after a GHD diagnosis. We show that when TBI was performed before puberty overall growth and pubertal duration were significantly impaired, but such growth limitations were completely reverted in the small sample (6 over 25) of children who underwent GH replacement therapies. Since in principle the model could account for any additional growth 'spurt' induced by therapy, it may become a useful 'simulation' tool for paediatricians for comparing the predicted therapy effectiveness depending on its timing and dosage.

  2. 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.

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

    Science.gov (United States)

    Sebastian, Veronica; Diallo, Aissatou; Ling, Douglas S F; Serrano, Peter A

    2013-01-01

    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 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 four baited and four unbaited arms. Subjects were given 10 daily trials for 6 days followed by a memory retrieval test 2 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 2 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.

  4. Modeling, planning and XiO R CMS validation of TBI treatment (extended SSD 400 cm)

    International Nuclear Information System (INIS)

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

    2011-01-01

    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 LUT 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.

  5. 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.

  6. Mild-moderate TBI: clinical recommendations to optimize neurobehavioral functioning, learning, and adaptation.

    Science.gov (United States)

    Chen, Anthony J-W; Loya, Fred

    2014-11-01

    Traumatic brain injury (TBI) can result in functional deficits that persist long after acute injury. The authors present a case study of an individual who experienced some of the most common debilitating problems that characterize the chronic phase of mild-to-moderate TBI-difficulties with neurobehavioral functions that manifest via complaints of distractibility, poor memory, disorganization, poor frustration tolerance, and feeling easily overwhelmed. They present a rational strategy for management that addresses important domain-general targets likely to have far-ranging benefits. This integrated, longitudinal, and multifaceted approach first addresses approachable targets and provides an important foundation to enhance the success of other, more specific interventions requiring specialty intervention. The overall approach places an emphasis on accomplishing two major categories of clinical objectives: optimizing current functioning and enhancing learning and adaptation to support improvement of functioning in the long-term for individuals living with brain injury. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  7. Traumatic brain injury (TBI) outcomes in an LMIC tertiary care centre and performance of trauma scores.

    Science.gov (United States)

    Samanamalee, Samitha; Sigera, Ponsuge Chathurani; De Silva, Ambepitiyawaduge Pubudu; Thilakasiri, Kaushila; Rashan, Aasiyah; Wadanambi, Saman; Jayasinghe, Kosala Saroj Amarasiri; Dondorp, Arjen M; Haniffa, Rashan

    2018-01-08

    This study evaluates post-ICU outcomes of patients admitted with moderate and severe Traumatic Brain Injury (TBI) in a tertiary neurocritical care unit in an low middle income country and the performance of trauma scores: A Severity Characterization of Trauma, Trauma and Injury Severity Score, Injury Severity Score and Revised Trauma Score in this setting. Adult patients directly admitted to the neurosurgical intensive care units of the National Hospital of Sri Lanka between 21st July 2014 and 1st October 2014 with moderate or severe TBI were recruited. A telephone administered questionnaire based on the Glasgow Outcome Scale Extended (GOSE) was used to assess functional outcome of patients at 3 and 6 months after injury. The economic impact of the injury was assessed before injury, and at 3 and 6 months after injury. One hundred and one patients were included in the study. Survival at ICU discharge, 3 and 6 months after injury was 68.3%, 49.5% and 45.5% respectively. Of the survivors at 3 months after injury, 43 (86%) were living at home. Only 19 (38%) patients had a good recovery (as defined by GOSE 7 and 8). Three months and six months after injury, respectively 25 (50%) and 14 (30.4%) patients had become "economically dependent". Selected trauma scores had poor discriminatory ability in predicting mortality. This observational study of patients sustaining moderate or severe TBI in Sri Lanka (a LMIC) reveals only 46% of patients were alive at 6 months after ICU discharge and only 20% overall attained a good (GOSE 7 or 8) recovery. The social and economic consequences of TBI were long lasting in this setting. Injury Severity Score, Revised Trauma Score, A Severity Characterization of Trauma and Trauma and Injury Severity Score, all performed poorly in predicting mortality in this setting and illustrate the need for setting adapted tools.

  8. Neuromodulation and Neurorehabilitation for Treatment of Functional Deficits after TBI Plus PTSD

    Science.gov (United States)

    2017-10-01

    average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and...by determining the neurobehavioral and neural effects of repetitive transcranial magnetic stimulation (rTMS), which is a non-invasive technique to... stimulate the brain. The evidence of therapeutic efficacy from the literature in non-TBI related neurologic populations combined with our preliminary

  9. Characterizing brain structures and remodeling after TBI based on information content, diffusion entropy.

    Science.gov (United States)

    Fozouni, Niloufar; Chopp, Michael; Nejad-Davarani, Siamak P; Zhang, Zheng Gang; Lehman, Norman L; Gu, Steven; Ueno, Yuji; Lu, Mei; Ding, Guangliang; Li, Lian; Hu, Jiani; Bagher-Ebadian, Hassan; Hearshen, David; Jiang, Quan

    2013-01-01

    To overcome the limitations of conventional diffusion tensor magnetic resonance imaging resulting from the assumption of a Gaussian diffusion model for characterizing voxels containing multiple axonal orientations, Shannon's entropy was employed to evaluate white matter structure in human brain and in brain remodeling after traumatic brain injury (TBI) in a rat. Thirteen healthy subjects were investigated using a Q-ball based DTI data sampling scheme. FA and entropy values were measured in white matter bundles, white matter fiber crossing areas, different gray matter (GM) regions and cerebrospinal fluid (CSF). Axonal densities' from the same regions of interest (ROIs) were evaluated in Bielschowsky and Luxol fast blue stained autopsy (n = 30) brain sections by light microscopy. As a case demonstration, a Wistar rat subjected to TBI and treated with bone marrow stromal cells (MSC) 1 week after TBI was employed to illustrate the superior ability of entropy over FA in detecting reorganized crossing axonal bundles as confirmed by histological analysis with Bielschowsky and Luxol fast blue staining. Unlike FA, entropy was less affected by axonal orientation and more affected by axonal density. A significant agreement (r = 0.91) was detected between entropy values from in vivo human brain and histologically measured axonal density from post mortum from the same brain structures. The MSC treated TBI rat demonstrated that the entropy approach is superior to FA in detecting axonal remodeling after injury. Compared with FA, entropy detected new axonal remodeling regions with crossing axons, confirmed with immunohistological staining. Entropy measurement is more effective in distinguishing axonal remodeling after injury, when compared with FA. Entropy is also more sensitive to axonal density than axonal orientation, and thus may provide a more accurate reflection of axonal changes that occur in neurological injury and disease.

  10. 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...and Anticipated problems 3 OVERALL PROJECT SUMMARY Trough activation of LXR/RXR transcription factors this ligand causes up regulation of Abca1 and

  11. Finding What Works in a Complicated Transition: Considerations for Soldiers with PTSD and mTBI

    Science.gov (United States)

    2014-06-13

    transition into civilian life, while simultaneously dealing with TBI and or PTSD. Background “Regardless of gender or combat occupation specialty, today’s...to the Nation when they volunteer to serve, we incur an equally binding pledge to return them to society as better citizens. We must safeguard...Assistant Secretary of Defense for Health Affairs should standardize the policies of PTSD psychotherapies in order to promote parity across all

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

    Science.gov (United States)

    2016-09-01

    impulse) range at 10 discrete levels (60, 100, 130, 160, 190, 230, 250, 290, 350 and 420 kPa) and determined 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...8-98) Prescribed by ANSI Std. Z39.18 28 Table of Contents 1. INTRODUCTION

  13. Characterizing Brain Structures and Remodeling after TBI Based on Information Content, Diffusion Entropy

    Science.gov (United States)

    Fozouni, Niloufar; Chopp, Michael; Nejad-Davarani, Siamak P.; Zhang, Zheng Gang; Lehman, Norman L.; Gu, Steven; Ueno, Yuji; Lu, Mei; Ding, Guangliang; Li, Lian; Hu, Jiani; Bagher-Ebadian, Hassan; Hearshen, David; Jiang, Quan

    2013-01-01

    Background To overcome the limitations of conventional diffusion tensor magnetic resonance imaging resulting from the assumption of a Gaussian diffusion model for characterizing voxels containing multiple axonal orientations, Shannon's entropy was employed to evaluate white matter structure in human brain and in brain remodeling after traumatic brain injury (TBI) in a rat. Methods Thirteen healthy subjects were investigated using a Q-ball based DTI data sampling scheme. FA and entropy values were measured in white matter bundles, white matter fiber crossing areas, different gray matter (GM) regions and cerebrospinal fluid (CSF). Axonal densities' from the same regions of interest (ROIs) were evaluated in Bielschowsky and Luxol fast blue stained autopsy (n = 30) brain sections by light microscopy. As a case demonstration, a Wistar rat subjected to TBI and treated with bone marrow stromal cells (MSC) 1 week after TBI was employed to illustrate the superior ability of entropy over FA in detecting reorganized crossing axonal bundles as confirmed by histological analysis with Bielschowsky and Luxol fast blue staining. Results Unlike FA, entropy was less affected by axonal orientation and more affected by axonal density. A significant agreement (r = 0.91) was detected between entropy values from in vivo human brain and histologically measured axonal density from post mortum from the same brain structures. The MSC treated TBI rat demonstrated that the entropy approach is superior to FA in detecting axonal remodeling after injury. Compared with FA, entropy detected new axonal remodeling regions with crossing axons, confirmed with immunohistological staining. Conclusions Entropy measurement is more effective in distinguishing axonal remodeling after injury, when compared with FA. Entropy is also more sensitive to axonal density than axonal orientation, and thus may provide a more accurate reflection of axonal changes that occur in neurological injury and disease

  14. Underbody Blast Models of TBI Caused by Hyper-Acceleration and Secondary Head Impact

    Science.gov (United States)

    2017-10-01

    brain injury (TBI), with most of these head injuries caused by explosive munitions such as bombs , land mines, improvised explosive devices and missiles...with most of these injuries caused by explosive munitions such as bombs , land mines, improvised explosive devices (IEDs), and missiles.1,2 Little is...Neurosurg. 2008;108: 124–131. 21. Richards EM , Fiskum G, Rosenthal RE, Hopkins I, McKenna MC. Hyperoxic reperfusion after global ischemia decreases

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

    Science.gov (United States)

    2017-09-01

    acute hemorrhage characterized by partial filling of small groups of alveoli by blood . 240 kPa: Mild multifocal pools of acute hemorrhage which...Neurotrauma, Blast TBI, Primary blast brain injury, Blast overpressure, Blood -brain barrier, Neuroinflammation, Oxidative stress, Neuroproteomics 16...stress, neuroinflammation and BBB damage as a result of blast overpressure in the acute phase (0, 4 and 24 hours post-exposure). Our group

  16. 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.

  17. High Resolution Diffusion Tensor Imaging of Cortical-Subcortical White Matter Tracts in TBI

    Science.gov (United States)

    2011-12-01

    advertisements on Craig’s List and through the University email system to also include placing advertisements on the public transportation systems (both...being 107 months for all TBI subjects. Subjects were recruited from the University of Illinois Medical Center and via advertisements . Eighteen healthy...cognition. Tests included the Tower of London (Shallice, 1982; Culbertson and Zilmer, 2001), Stroop Colour –Word Test (Stroop, 1935; Jensen and Rohwer

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

    Science.gov (United States)

    2016-10-01

    after incision and TBI, and the relationship of those changes to CXCR2 expression ST4.1 Establish spinal cord sites and cell types displaying...we plan to use oral preparations of these drugs and establish dose-response relationships as these will be pharmacologically useful and make the...Anesthesiology Annual Awards Dinner . Palo Alto, CA, June, 2016. 4. Epigenetic Regulation of Chronic Pain after Traumatic Brain Injury. De-Yong

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

    International Nuclear Information System (INIS)

    Lozares, S; Gracia, M; Olasolo, J; Gallardo, N; Fuentemilla, N; Pellejero, S; Miquelez, S; Maneru, F; Martin, M; Bragado, L; Rubio, A

    2015-01-01

    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

  20. Neurocognitive and Biomarker Evaluation of Combination mTBI from Blast Overpressure and Traumatic Stress

    Science.gov (United States)

    2014-11-01

    previously used such procedures to evaluate the effects of drugs , toxins and ischemic injury (Genovese et al., 1988, 1992, 1993, 2006). Moreover, TBI, from...Lee JLC, Dickinson A, Everitt BJ (2005) Conditioned suppression and freezing as measures of aversive Pavlovian conditioning: effects of discreet...freezing and instrumental suppression in Pavlovian fear conditioning. Behav Brain Res 211:111–117. McDannald MA, Galarce EM (2011) Measuring Pavlovian

  1. The ties that bind: the relationship between caregiver burden and the neuropsychological functioning of TBI survivors.

    Science.gov (United States)

    Lehan, Tara; Arango-Lasprilla, Juan Carlos; de los Reyes, Carlos José; Quijano, María Cristina

    2012-01-01

    Advances in medical and assistive technology have increased the likelihood of survival following a traumatic brain injury (TBI). Consequently, families frequently must provide care to individuals with TBI. Because they are rarely prepared for the associated demanding medical needs and financial burden, family caregivers are at risk for physical and emotional problems, which can negatively influence their individual and family functioning. Whereas scholars have examined the influence of survivor functioning on caregiver burden, few have explicitly recognized that caregiver burden also influences survivor functioning. Results of a multivariate linear regression suggest that, in a sample of 51 pairs of TBI survivors and their caregivers living in Colombia, survivors receiving care from a family member who reported a higher level of burden had poorer objective neuropsychological functioning than those receiving care from a family member who reported a lower level of burden, after controlling for survivor education and history of occupational therapy. Therefore, a family-focused approach might maximize intervention effectiveness, especially for Latin American and Hispanic families, which tend to be characterized by a strong sense of familism. The emphasis on family can create problems in a healthcare system that views the individual as the primary unit.

  2. 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.

  3. 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.

  4. Clinical Utility and Psychometric Properties of the Traumatic Brain Injury Quality of Life Scale (TBI-QOL) in US Military Service Members.

    Science.gov (United States)

    Lange, Rael T; Brickell, Tracey A; Bailie, Jason M; Tulsky, David S; French, Louis M

    2016-01-01

    To examine the clinical utility and psychometric properties of the Traumatic Brain Injury Quality of Life (TBI-QOL) scale in a US military population. One hundred fifty-two US military service members (age: M = 34.3, SD = 9.4; 89.5% men) prospectively enrolled from the Walter Reed National Military Medical Center and other nationwide community outreach initiatives. Participants included 99 service members who had sustained a mild traumatic brain injury (TBI) and 53 injured or noninjured controls without TBI (n = 29 and n = 24, respectively). Participants completed the TBI-QOL scale and 5 other behavioral measures, on average, 33.8 months postinjury (SD = 37.9). Fourteen TBI-QOL subscales; Neurobehavioral Symptom Inventory; Posttraumatic Stress Disorder Checklist-Civilian version; Alcohol Use Disorders Identification Test; Combat Exposure Scale. The internal consistency reliability of the TBI-QOL scales ranged from α = .91 to α = .98. The convergent and discriminant validity of the 14 TBI-QOL subscales was high. The mild TBI group had significantly worse scores on 10 of the 14 TBI-QOL subscales than the control group (range, P quality of life in a mild TBI military sample. Additional research is recommended to further evaluate the clinical utility of the TBI-QOL scale in both military and civilian settings.

  5. Behavioral and pathophysiological outcomes associated with caffeine consumption and repetitive mild traumatic brain injury (RmTBI) in adolescent rats

    OpenAIRE

    Yamakawa, Glenn R.; Lengkeek, Connor; Salberg, Sabrina; Spanswick, Simon C.; Mychasiuk, Richelle

    2017-01-01

    Given that caffeine consumption is exponentially rising in adolescents and they are at increased risk for repetitive mild traumatic brain injury (RmTBI), we sought to examine the pathophysiological outcomes associated with early life caffeine consumption and RmTBI. Adolescent male and female Sprague Dawley rats received either caffeine in the drinking water or normal water and were then randomly assigned to 3 mild injuries using our lateral impact device or 3 sham procedures. Following injury...

  6. Parallel Human and Animal Models of Blast- and Concussion-Induced Tinnitus and Related Traumatic Brain Injury (TBI)

    Science.gov (United States)

    2014-01-01

    Andersson G (2009) The role of anxiety sensitivity and behavioral avoidance in tinnitus disability. IntJAudiol 48:295-299. Hiller W, Goebel G (1999...Parallel Human and Animal Models of Blast- and Concussion-Induced Tinnitus and Related Traumatic Brain Injury (TBI) PRINCIPAL INVESTIGATOR...Induced Tinnitus and Related Traumatic Brain Injury (TBI) 5b. GRANT NUMBER W81XWH-11-2-0031 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S

  7. Review of the literature on the use of social media by people with traumatic brain injury (TBI).

    Science.gov (United States)

    Brunner, Melissa; Hemsley, Bronwyn; Palmer, Stuart; Dann, Stephen; Togher, Leanne

    2015-01-01

    To review the literature relating to use of social media by people with a traumatic brain injury (TBI), specifically its use for social engagement, information exchange or rehabilitation. A systematic review with a qualitative meta-synthesis of content themes was conducted. In June 2014, 10 databases were searched for relevant, peer-reviewed research studies in English that related to both TBI and social media. Sixteen studies met the inclusion criteria, with Facebook™ and Twitter™ being the most common social media represented in the included studies. Content analysis identified three major categories of meaning in relation to social media and TBI: (1) risks and benefits; (2) barriers and facilitators; and (3) purposes of use of social media. A greater emphasis was evident regarding potential risks and apparent barriers to social media use, with little focus on facilitators of successful use by people with TBI. Research to date reveals a range of benefits to the use of social media by people with TBI however there is little empirical research investigating its use. Further research focusing on ways to remove the barriers and increase facilitators for the use of social media by people with TBI is needed.

  8. Technology and its role in rehabilitation for people with cognitive-communication disability following a traumatic brain injury (TBI).

    Science.gov (United States)

    Brunner, Melissa; Hemsley, Bronwyn; Togher, Leanne; Palmer, Stuart

    2017-01-01

    To review the literature on communication technologies in rehabilitation for people with a traumatic brain injury (TBI), and: (a) determine its application to cognitive-communicative rehabilitation, and b) develop a model to guide communication technology use with people after TBI. This integrative literature review of communication technology in TBI rehabilitation and cognitive-communication involved searching nine scientific databases and included 95 studies. Three major types of communication technologies (assistive technology, augmentative and alternative communication technology, and information communication technology) and multiple factors relating to use of technology by or with people after TBI were categorized according to: (i) individual needs, motivations and goals; (ii) individual impairments, activities, participation and environmental factors; and (iii) technologies. While there is substantial research relating to communication technologies and cognitive rehabilitation after TBI, little relates specifically to cognitive-communication rehabilitation. Further investigation is needed into the experiences and views of people with TBI who use communication technologies, to provide the 'user' perspective and influence user-centred design. Research is necessary to investigate the training interventions that address factors fundamental for success, and any impact on communication. The proposed model provides an evidence-based framework for incorporating technology into speech pathology clinical practice and research.

  9. 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

  10. Premorbid IQ Predicts Postconcussive Symptoms in OEF/OIF/OND Veterans with mTBI.

    Science.gov (United States)

    Stewart-Willis, Jada J; Heyanka, Daniel; Proctor-Weber, Zoe; England, Heather; Bruhns, Maya

    2018-03-01

    Extant literature has demonstrated that symptoms of postconcussive syndrome (PCS) persist well beyond the expected 3-month post-injury recovery period in a minority of individuals with mild traumatic brain injury (mTBI). Suboptimal performance on validity measures and pre- and post-injury psychosocial stressors - rather than actual mTBI or current cognitive functioning - have been identified as predictors of chronic PCS. Whether premorbid IQ has any influence on chronic PCS has been understudied, in the context of established psychogenic etiologies. The sample included 31 veterans, who underwent mTBI neuropsychological evaluations six or more months post-injury in a VA outpatient neuropsychology clinic. A two-step multiple linear regression was conducted to examine the effects on the outcome variable, PCS (Neurobehavioral Symptom Inventory), of the following predictors: cognitive functioning (Repeatable Battery for the Assessment of Neuropsychological Status; Attention, Immediate Memory, and Delayed Memory Indices), performance validity, depression (Beck Depression Inventory-Second Edition), posttraumatic stress disorder (PTSD Checklist, Civilian Version), quality of sleep (Pittsburgh Sleep Quality Index), pain (Brief Pain Inventory), education, and Premorbid IQ (Wechsler Test of Adult Reading). The overall regression model containing all nine predictor variables was statistically significant. Depression (p IQ (p IQ and greater endorsed symptoms of depression were associated with higher PCS scores. In Step 2 of the multiple linear regression, the WTAR explained an additional 6.7% of the variance in PCS after controlling for psychosocial stressors and current cognitive ability. The findings support premorbid IQ as a unique and relevant predictor of chronic PCS, with significance variance accounted for beyond education, cognitive functioning, and psychosocial variables. Given the predictive relationship between premorbid IQ and PCS, adapting postconcussive

  11. Tc-99m-hexakis(t-butylisonitrile)-technetium(I) (Tc-99m-TBI)

    International Nuclear Information System (INIS)

    Angelberger, P.; Dudczak, R.; Jones, A.G.; Lister-James, J.; Wagner-Loffler, M.; Buchheit, O.; Fally, F.

    1986-01-01

    The potassium analog (Tl-201)/sup +/ is widely used in nuclear cardiology but has inferior scintigraphic (80 keV photons), dosimetric and economic properties as compared to Tc-99m. Therefore considerable efforts have been made to develop a Tc-compound that would accumulate in the myocardium in relation to regional blood flow. This study was aimed at optimizing the preparation of Tc-TBI with n.c.a. Tc-99m, analyze and purify the product with HPLC, verify biodistribution in mice and undertake a clinical evaluation

  12. ANAM4 TBI Reaction Time-Based Tests have Prognostic Utility for Acute Concussion

    Science.gov (United States)

    2013-07-01

    7:767. 2013 ANAM4 TBI Reaction Time-Based Tests Have Prognostic Utility for Acute Concussion LT Jacob N. Norris, MSC USN*; LCDR Waiter Carr, MSC USN...CDR Thomas Herzig, MSC USNf; CDR D. Waiter Labrie, MSC USNf; CDR Richard Sams, MC USN§ ABSTRACT The Concussion Restoration Care Center has used the...Work Unit No. N24LB. REFERENCES 1. Department of Defense: DoD Poiicy Guidance for Management of Mild Traumatic Brain Injury/Concussion in the Deployed

  13. Role of APOE Isoforms in the Pathogenesis of TBI induced Alzheimer’s Disease

    Science.gov (United States)

    2016-10-01

    gene networks correlated to the traits (age / injury / genotype) in response to TBI. The results clearly demonstrate segregation by injury status...7 7. Participants & Other Collaborating Organizations….……………...…8 8. Figures ……………………………………………………………………10 1 1...entire maze is raised 40 cm off the ground . The elevated plus maze tests anxiety-related behavior by utilizing rodent’s fear of open and elevated

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

    Science.gov (United States)

    2014-03-01

    of the head then application of a lotion hair remover. Prior to surgery, lidocaine (1 mg/kg) was injected subcutaneously to the surgery site. For...resonance imaging (MRI) are capable of identifying TBI, their logistics make them ineffective diagnostic tools in the field, where rapid triage can...Dwight Co, INC., Princeton, NJ, USA). Following epilation, subcutaneous lidocaine (0.08 mL, 20 mg/mL) and bupivicaine (0.08 mL, 0.32 mg/mL) were

  15. Assessment and Rehabilitation of Central Sensory Impairments for Balance in mTBI

    Science.gov (United States)

    2016-10-01

    date will help establish normative values as we begin to recruit more mTBI subjects in the upcoming year. Our current enrollment includes 8 men , 11... women with a mean age of 26.4 years. Fifteen people reported ethnicity as non-hispanic/Latino and 4 as hispanic/Latino. Seventeen people reported as...SD Average ± SD Video Head Impulse Test (vHIT) Right Horizontal Gain 0.96 ± 0.07 1.00 ± 0.02 Left Horizontal Gain 0.87 ± 0.15 0.92 ± 0.04

  16. A study on dose attenuation in bone density when TBI using diode detector and TLD

    International Nuclear Information System (INIS)

    Im, Hyun Sil; Lee, Jung Jin; Jang, Ahn Ki; KIm, Wan Sun

    2003-01-01

    Uniform dose distribution of the whole body is essential factor for the total body irradiation(TBI). In order to achieved this goal, we used to compensation filter to compensate body contour irregularity and thickness differences. But we can not compensate components of body, namely lung or bone. The purpose of this study is evaluation of dose attenuation in bone tissue when TBI using diode detectors and TLD system. The object of this study were 5 patients who undergo TBI at our hospital. Dosimetry system were diode detectors and TLD system. Treatment method was bilateral and delivered 10 MV X-ray from linear accelerator. Measurement points were head, neck, pelvis, knees and ankles. TLD used two patients and diode detectors used three patients. Results are as followed. All measured dose value were normalized skin dose. TLD dosimetry : Measured skin dose of head, neck, pelvis, knees and ankles were 92.78±3.3, 104.34±2.3, 98.03±1.4, 99.9±2.53, 98.17±0.56 respectably. Measured mid-depth dose of pelvis, knees and ankles were 86±1.82, 93.24±2.53, 91.50±2.84 respectably. There were 6.67%-11.65% dose attenuation at mid-depth in pelvis, knees and ankles. Diode detector : Measured skin dose of head, neck, pelvis, knees and ankles were 95.23±1.18, 98.33±0.6, 93.5±1.5, 87.3±1.5, 86.90±1.16 respectably. There were 4.53%-12.6% dose attenuation at mid-depth in pelvis, knees and ankles. We concluded that dose measurement with TLD or diode detector was inevitable when TBI treatment. Considered dose attenuation in bone tissue, We must have adequately deduction of compensator thickness that body portion involved bone tissue.

  17. Efficacy and acceptability of a home-based, family-inclusive intervention for veterans with TBI: A randomized controlled trial.

    Science.gov (United States)

    Winter, Laraine; Moriarty, Helene J; Robinson, Keith; Piersol, Catherine V; Vause-Earland, Tracey; Newhart, Brian; Iacovone, Delores Blazer; Hodgson, Nancy; Gitlin, Laura N

    2016-01-01

    Traumatic brain injury (TBI) often undermines community re-integration, impairs functioning and produces other symptoms. This study tested an innovative programme for veterans with TBI, the Veterans' In-home Programme (VIP), delivered in veterans' homes, involving a family member and targeting the environment (social and physical) to promote community re-integration, mitigate difficulty with the most troubling TBI symptoms and facilitate daily functioning. Interviews and intervention sessions were conducted in homes or by telephone. Eighty-one veterans with TBI at a VA polytrauma programme and a key family member. This was a 2-group randomized controlled trial. Control-group participants received usual-care enhanced by two attention-control telephone calls. Follow-up interviews occurred up to 4 months after baseline interview. VIP's efficacy was evaluated using measures of community re-integration, target outcomes reflecting veterans' self-identified problems and self-rated functional competence. At follow-up, VIP participants had significantly higher community re-integration scores and less difficulty managing targeted outcomes, compared to controls. Self-rated functional competence did not differ between groups. In addition, VIP's acceptability was high. A home-based, family-inclusive service for veterans with TBI shows promise for improving meaningful outcomes and warrants further research and clinical application.

  18. Behavioral and pathophysiological outcomes associated with caffeine consumption and repetitive mild traumatic brain injury (RmTBI) in adolescent rats.

    Science.gov (United States)

    Yamakawa, Glenn R; Lengkeek, Connor; Salberg, Sabrina; Spanswick, Simon C; Mychasiuk, Richelle

    2017-01-01

    Given that caffeine consumption is exponentially rising in adolescents and they are at increased risk for repetitive mild traumatic brain injury (RmTBI), we sought to examine the pathophysiological outcomes associated with early life caffeine consumption and RmTBI. Adolescent male and female Sprague Dawley rats received either caffeine in the drinking water or normal water and were then randomly assigned to 3 mild injuries using our lateral impact device or 3 sham procedures. Following injury induction, behavioral outcomes were measured with a test battery designed to examine symptoms consistent with clinical manifestation of PCS (balance and motor coordination, anxiety, short-term working memory, and depressive-like behaviours). In addition, pathophysiological outcomes were examined with histological measures of volume and cellular proliferation in the dentate gyrus, as well as microglia activation in the ventromedial hypothalamus. Finally, modifications to expression of 12 genes (Adora2a, App, Aqp4, Bdnf, Bmal1, Clock, Cry, Gfap, Orx1, Orx2, Per, Tau), in the prefrontal cortex, hippocampus, and/or the hypothalamus were assessed. We found that chronic caffeine consumption in adolescence altered normal developmental trajectories, as well as recovery from RmTBI. Of particular importance, many of the outcomes exhibited sex-dependent responses whereby the sex of the animal modified response to caffeine, RmTBI, and the combination of the two. These results suggest that caffeine consumption in adolescents at high risk for RmTBI should be monitored.

  19. Behavioral and pathophysiological outcomes associated with caffeine consumption and repetitive mild traumatic brain injury (RmTBI in adolescent rats.

    Directory of Open Access Journals (Sweden)

    Glenn R Yamakawa

    Full Text Available Given that caffeine consumption is exponentially rising in adolescents and they are at increased risk for repetitive mild traumatic brain injury (RmTBI, we sought to examine the pathophysiological outcomes associated with early life caffeine consumption and RmTBI. Adolescent male and female Sprague Dawley rats received either caffeine in the drinking water or normal water and were then randomly assigned to 3 mild injuries using our lateral impact device or 3 sham procedures. Following injury induction, behavioral outcomes were measured with a test battery designed to examine symptoms consistent with clinical manifestation of PCS (balance and motor coordination, anxiety, short-term working memory, and depressive-like behaviours. In addition, pathophysiological outcomes were examined with histological measures of volume and cellular proliferation in the dentate gyrus, as well as microglia activation in the ventromedial hypothalamus. Finally, modifications to expression of 12 genes (Adora2a, App, Aqp4, Bdnf, Bmal1, Clock, Cry, Gfap, Orx1, Orx2, Per, Tau, in the prefrontal cortex, hippocampus, and/or the hypothalamus were assessed. We found that chronic caffeine consumption in adolescence altered normal developmental trajectories, as well as recovery from RmTBI. Of particular importance, many of the outcomes exhibited sex-dependent responses whereby the sex of the animal modified response to caffeine, RmTBI, and the combination of the two. These results suggest that caffeine consumption in adolescents at high risk for RmTBI should be monitored.

  20. Effect of binasal occlusion (BNO) on the visual-evoked potential (VEP) in mild traumatic brain injury (mTBI).

    Science.gov (United States)

    Ciuffreda, Kenneth J; Yadav, Naveen K; Ludlam, Diana P

    2013-01-01

    The purpose of the experiment was to assess the effect of binasal occlusion (BNO) on the visually-evoked potential (VEP) in visually-normal (VN) individuals and in those with mild traumatic brain injury (mTBI) for whom BNO frequently reduces their primary symptoms related to abnormally-increased visual motion sensitivity (VMS). Subjects were comprised of asymptomatic VN adults (n = 10) and individuals with mTBI (n = 10) having the symptom of VMS. Conventional full-field VEP testing was employed under two conditions: without BNO and with opaque BNO which blocked regions on either side of the VEP test stimulus. Subjective impressions were also assessed. In VN, the mean VEP amplitude decreased significantly with BNO in all subjects. In contrast, in mTBI, the mean VEP amplitude increased significantly with BNO in all subjects. Latency was normal and unaffected in all cases. Repeat VEP testing in three subjects from each group revealed similar test-re-test findings. Visuomotor activities improved, with reduced symptoms, with BNO in the mTBI group. It is speculated that individuals with mTBI habitually attempt to suppress visual information in the near retinal periphery to reduce their abnormal VMS, with addition of the BNO negating the suppressive influence and thus producing a widespread disinhibition effect and resultant increase in VEP amplitude.

  1. Sleep quality affects cognitive functioning in returning combat veterans beyond combat exposure, PTSD, and mild TBI history.

    Science.gov (United States)

    Martindale, Sarah L; Morissette, Sandra B; Rowland, Jared A; Dolan, Sara L

    2017-01-01

    The purpose of this study was to determine how sleep quality affects cognitive functioning in returning combat veterans after accounting for effects of combat exposure, posttraumatic stress disorder (PTSD), and mild traumatic brain injury (mTBI) history. This was a cross-sectional assessment study evaluating combat exposure, PTSD, mTBI history, sleep quality, and neuropsychological functioning. One hundred and nine eligible male Iraq/Afghanistan combat veterans completed an assessment consisting of a structured clinical interview, neuropsychological battery, and self-report measures. Using partial least squares structural equation modeling, combat experiences and mTBI history were not directly associated with sleep quality. PTSD was directly associated with sleep quality, which contributed to deficits in neuropsychological functioning independently of and in addition to combat experiences, PTSD, and mTBI history. Combat experiences and PTSD were differentially associated with motor speed. Sleep affected cognitive function independently of combat experiences, PTSD, and mTBI history. Sleep quality also contributed to cognitive deficits beyond effects of PTSD. An evaluation of sleep quality may be a useful point of clinical intervention in combat veterans with cognitive complaints. Improving sleep quality could alleviate cognitive complaints, improving veterans' ability to engage in treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

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

    Directory of Open Access Journals (Sweden)

    Annemarie C Visser-Keizer

    Full Text Available 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.

  3. 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.

  4. 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)

    2015-10-01

    AWARD NUMBER: W81XWH-08-2-0196 TITLE: Reintegrating Troops with Mild Traumatic Brain Injury (mTBI) into Their Communities: Understanding the...REPORT TYPE Final 3. DATES COVERED (From - To) 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Reintegrating troops with mild traumatic brain injury...n=6), TBI (n=12), PTSD (n=7), and dual diagnosis (TBI/PTSD) n=19. Additional comparisons were made between 28 Family /Friends matched to their SMs

  5. 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.

  6. 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.

  7. 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.

  8. Active-duty military service members' visual representations of PTSD and TBI in masks.

    Science.gov (United States)

    Walker, Melissa S; Kaimal, Girija; Gonzaga, Adele M L; Myers-Coffman, Katherine A; DeGraba, Thomas J

    2017-12-01

    Active-duty military service members have a significant risk of sustaining physical and psychological trauma resulting in traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). Within an interdisciplinary treatment approach at the National Intrepid Center of Excellence, service members participated in mask making during art therapy sessions. This study presents an analysis of the mask-making experiences of service members (n = 370) with persistent symptoms from combat- and mission-related TBI, PTSD, and other concurrent mood issues. Data sources included mask images and therapist notes collected over a five-year period. The data were coded and analyzed using grounded theory methods. Findings indicated that mask making offered visual representations of the self related to individual personhood, relationships, community, and society. Imagery themes referenced the injury, relational supports/losses, identity transitions/questions, cultural metaphors, existential reflections, and conflicted sense of self. These visual insights provided an increased understanding of the experiences of service members, facilitating their recovery.

  9. Neuro-, Trauma -, or Med/Surg-ICU: Does it matter where polytrauma patients with TBI are admitted? Secondary analysis of AAST-MITC decompressive craniectomy study

    Science.gov (United States)

    Scalea, Tom; Sperry, Jason; Coimbra, Raul; Vercruysse, Gary; Jurkovich, Gregory J; Nirula, Ram

    2016-01-01

    Introduction Patients with non-traumatic acute intracranial pathology benefit from neurointensivist care. Similarly, trauma patients with and without TBI fare better when treated by a dedicated trauma team. No study has yet evaluated the role of specialized neurocritical (NICU) and trauma intensive care units (TICU) in the management of TBI patients, and it remains unclear which TBI patients are best served in NICU, TICU, or general (Med/Surg) ICU. Methods This study is a secondary analysis of The American Association for the Surgery of Trauma Multi-Institutional Trials Committee (AAST-MITC) decompressive craniectomy study. Twelve Level 1 trauma centers provided clinical data and head CT scans of patients with Glasgow Coma Scale (GCS) ≤13 and CT evidence of TBI. Non-ICU admissions were excluded. Multivariate logistic regression was performed to measure the association between ICU-type and survival and calculate the probability of death for increasing ISS. Polytrauma patients (ISS > 15) with TBI and isolated TBI patients (other AIS polytrauma patients admitted to a TICU had improved survival across increasing ISS (Fig1). Survival for isolated TBI patients was similar between TICU and NICU. Med/Surg ICU carried the greatest probability of death. Conclusion Polytrauma patients with TBI have lower mortality risk when admitted to a Trauma ICU. This survival benefit increases with increasing injury severity. Isolated TBI patients have similar mortality risk when admitted to a Neuro ICU compared to a Trauma ICU. Med/Surg ICU admission carries the highest mortality risk. PMID:28225527

  10. Impact of TBI on late effects in children treated by megatherapy for Stage IV neuroblastoma. A study of the French Society of Pediatric oncology

    International Nuclear Information System (INIS)

    Flandin, Isabelle; Hartmann, Olivier; Michon, Jean; Pinkerton, Ross; Coze, Carole; Stephan, Jean Louis; Fourquet, Bernard; Valteau-Couanet, Dominique; Bergeron, Christophe; Philip, Thierry; Carrie, Christian

    2006-01-01

    Purpose: To determine the contribution of total body irradiation (TBI) to late sequelae in children treated with high-dose chemotherapy and autologous bone marrow transplantation for Stage IV neuroblastoma. Patients and Methods: We compared two populations that were similar with regard to age, stage, pre-autologous bone marrow transplantation chemotherapy (CT) regimen, period of treatment, and follow-up (12 years). The TBI group (n = 32) received TBI as part of the megatherapy procedure (1982-1993), whereas the CT group (n 30) received conditioning without TBI (1985-1992). Analysis 12 years later focused on growth, weight and corpulence (body mass index) delay; hormonal deficiencies; liver, kidney, heart, ear, eye, and dental sequelae; school performance; and the incidence of secondary tumors. Results: Impact of TBI was most marked in relation to growth and weight delay, although the mean delay was not severe, probably because of treatment with growth hormones. Other consequences of TBI were thyroid insufficiency, cataracts, and a high incidence of secondary tumors. Hearing loss and dental agenesis were more prominent in the group treated with CT alone. No differences were observed in school performance. Conclusion: The most frequent side effects of TBI were cataracts, thyroid insufficiency, and growth delay, but more worrying is the risk of secondary tumors. Because of the young mean age of patients and the toxicity of TBI regimens without any survival advantage, regimens without TBI are preferable in the management of Stage IV neuroblastoma

  11. TH-EF-BRB-09: Total Body Irradiation with Uniform MU and Modulated Arc Segments, UMMS-TBI

    Energy Technology Data Exchange (ETDEWEB)

    Yi, B; Chung, H; Mutaf, Y; Prado, K [University of Maryland School of Medicine, Baltimore, MD (United States)

    2016-06-15

    Purpose: To test a novel total body irradiation (TBI) system using conformal partial arc with patient lying on the stationary couch which is biologically equivalent to a moving couch TBI. This improves the scanning field TBI, which is previously presented. Methods: The Uniform MU Modulated arc Segments TBI or UMMS-TBI scans the treatment plane with a constant machine dose rate and a constant gantry rotation speed. A dynamic MLC pattern which moves while gantry rotates has been designed so that the treatment field moves same distance at the treatment plane per each gantry angle, while maintaining same treatment field size (34cm) at the plane. Dose across the plane varies due to the geometric differences including the distance from the source to a point of interest and the different attenuation from the slanted depth which changes the effective depth. Beam intensity is modulated to correct the dose variation across the plane by assigning the number of gantry angles inversely proportional to the uncorrected dose. Results: Measured dose and calculated dose matched within 1 % for central axis and 3% for off axis for various patient scenarios. Dose from different distance does not follow the inverse square relation as it is predicted from calculation. Dose uniformity better than 5% across 180 cm at 10cm depth is achieved by moving the gantry from −55 to +55 deg. Total treatment time for 2 Gy AP/PA fields is 40–50 minutes excluding patient set up time, at the machine dose rate of 200 MU/min. Conclusion: This novel technique, yet accurate but easy to implement enables TBI treatment in a small treatment room with less program development preparation than other techniques. The VMAT function of treatment delivery is not required to modulate beams. One delivery pattern can be used for different patients by changing the monitor units.

  12. 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.

  13. Correspondence of the Boston Assessment of Traumatic Brain Injury-Lifetime (BAT-L) clinical interview and the VA TBI screen.

    Science.gov (United States)

    Fortier, Catherine Brawn; Amick, Melissa M; Kenna, Alexandra; Milberg, William P; McGlinchey, Regina E

    2015-01-01

    Mild traumatic brain injury is the signature injury of Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND), yet its identification and diagnosis is controversial and fraught with challenges. In 2007, the Department of Veterans Affairs (VA) implemented a policy requiring traumatic brain injury (TBI) screening on all individuals returning from deployment in the OEF/OIF/OND theaters of operation that lead to the rapid and widespread use of the VA TBI screen. The Boston Assessment of TBI-Lifetime (BAT-L) is the first validated, postcombat semistructured clinical interview to characterize head injuries and diagnose TBIs throughout the life span, including prior to, during, and post-military service. Community-dwelling convenience sample of 179 OEF/OIF/OND veterans. BAT-L, VA TBI screen. Based on BAT-L diagnosis of military TBI, the VA TBI screen demonstrated similar sensitivity (0.85) and specificity (0.82) when administered by research staff. When BAT-L diagnosis was compared with historical clinician-administered VA TBI screen in a subset of participants, sensitivity was reduced. The specificity of the research-administered VA TBI screen was more than adequate. The sensitivity of the VA TBI screen, although relatively high, suggests that it does not oversample or "catch all" possible military TBIs. Traumatic brain injuries identified by the BAT-L, but not identified by the VA TBI screen, were predominantly noncombat military injuries. There is potential concern regarding the validity and reliability of the clinician administered VA TBI screen, as we found poor correspondence between it and the BAT-L, as well as low interrater reliability between the clinician-administered and research-administered screen.

  14. 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.E. 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 (Marc); 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

  15. Counselor-Assisted Problem Solving (CAPS) Improves Behavioral Outcomes in Older Adolescents with Complicated Mild to Severe TBI

    Science.gov (United States)

    Wade, Shari L.; Stancin, Terry; Kirkwood, Michael; Brown, Tanya Maines; Rochester, Mayo Clinic; McMullen, Kendra M.; Taylor, H. Gerry

    2013-01-01

    Objective To test the efficacy of Counselor-Assisted Problem Solving (CAPS) versus an internet resources comparison (IRC) condition in reducing behavior problems in adolescents following traumatic brain injury (TBI). Design Randomized clinical trial with interviewers naïve to treatment condition. Setting Three large tertiary children's hospitals and two general hospitals with pediatric commitment. Participants 132 children ages 12-17 years hospitalized during the previous 6 months for moderate to severe TBI. Interventions Participants in CAPS (n = 65) completed 8-12 online modules providing training in problem solving, communication skills, and self-regulation and subsequent synchronous videoconferences with a therapist. Participants in the IRC group (n = 67) received links to internet resources about pediatric TBI. Main Outcome Measures Child Behavior Checklist (CBCL) administered before and after completion of treatment (i.e., approximately six months after treatment initiation). Results Post hoc analysis of covariance (ANCOVA), controlling for pre-treatment scores, was used to examine group differences in behavior problems in the entire sample and among older (n=59) and younger adolescents (n=53). Among older but not younger adolescents, CAPS resulted in greater improvements on multiple dimensions of externalizing behavior problems than did IRC. Conclusion Online problem-solving therapy may be effective in reducing behavior problems in older adolescent survivors of moderate-severe TBI. PMID:23640543

  16. Neuropsychological recovery and quality-of-life in children and adolescents with growth hormone deficiency following TBI: a preliminary study.

    Science.gov (United States)

    Wamstad, Julia B; Norwood, Kenneth W; Rogol, Alan D; Gurka, Matthew J; Deboer, Mark D; Blackman, James A; Buck, Marcia L; Kuperminc, Michelle N; Darring, Jodi G; Patrick, Peter D

    2013-01-01

    To compare neurocognition and quality-of-life (QoL) in a group of children and adolescents with or without growth hormone deficiency (GHD) following moderate-to-severe traumatic brain injury (TBI). Thirty-two children and adolescents were recruited from the TBI clinic at a children's hospital. Growth hormone (GH) was measured by both spontaneous overnight testing and following arginine/glucagon stimulation administration. Twenty-nine subjects participated in extensive neuropsychological assessment. GHD as measured on overnight testing was significantly associated with a variety of neurocognitive and QoL measures. Specifically, subjects with GHD had significantly (p  0.05). GHD noted in response to provocative testing was not associated with any neurocognitive or QoL measures. GHD following TBI is common in children and adolescents. Deficits in neurocognition and QoL impact recovery after TBI. It is important to assess potential neurocognitive and QoL changes that may occur as a result of GHD. It is also important to consider the potential added benefit of overnight GH testing as compared to stimulation testing in predicting changes in neurocognition or QoL.

  17. VA/DoD Clinical Practice Guideline for Management of Concussion/Mild Traumatic Brain Injury (mTBI)

    Science.gov (United States)

    2009-04-01

    responsibilities, and teaching compensatory strategies and environmental modifications. Most patients with symptoms following a single concussion...better outcomes in individuals with mTBI-related symptoms? 5. Are there compensatory strategies /techniques that have been shown to result in better...with increased environmental stimulation • Squinting/closing one eye during activities • Difficulty standing in midline or noted head tilt

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

    NARCIS (Netherlands)

    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

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

    NARCIS (Netherlands)

    Visser-Keizer, A.C.; Westerhof-Evers, H.J.; Gerritsen, M.J.P.; Naalt, J. van der; Spikman, J.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

  20. 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).

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

    Science.gov (United States)

    2013-10-01

    Examining the psycho - metric properties of the MFIS in TBI is important for researchers and clinicians who may wish to use this scale to evaluate...limited in regions with more complex architecture (eg, where crossing fibers exist within a single voxel), and thus the measured FA may be attenuated in

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

    International Nuclear Information System (INIS)

    Gerstein, Johanna; Meyer, Andreas; Fruehauf, Joerg; Karstens, Johann H.; Bremer, Michael; Sykora, Karl-Walter

    2009-01-01

    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.)

  3. The effects of single dose TBI on hepatic and renal function in non-human primates and patients

    International Nuclear Information System (INIS)

    Broerse, J.J.; Bakker, B.; Davelaar, J.; Leer, J.W.H.; Niemer-Tucker, M.M.B.; Noordijk, E.M.

    1996-01-01

    Total body irradiation (TBI) and bone marrow transplantation (BMT) are common procedures in the treatment of severe combined immune deficiency syndromes, leukemia, non-Hodgkin lymphoma and other hematological disorders. Improved results following TBI and BMT have increased the number of patients in long term follow up. Late detrimental effects of TBI have been investigated in non-human primates and patients with emphasis on vital organs like liver and kidney. The response of monkeys to radiation is not significantly different from that in man. Long term effects of TBI could be studied by keeping 84 monkeys of different ages under continuous observation for a period up to 25 years. Effects on hepatic and renal function were demonstrated using serological and histological parameters. The values of the liver function parameters such as alkaline phosphatase and gamma glutamyl transferase in the irradiated group are significantly increased after TBI. Also the parameters of kidney dysfunction, e.g., Ht and urea show a significant change in the irradiated old aged cohort with respect to the controls. Between 1967 and 1993, 336 bone marrow transplantations were performed at the University Hospital Leiden. The present Study was restricted to those patients who survived at least 18 months after transplantation. This retrospective analysis consequently amounts to 120 patients. The monkey data indicated subclinical organ damage for postirradiation intervals exceeding 15 years. However, up to the present time, the human data do not support these findings since the follow up time is still restricted to a median survival of 4,5 years. Detrimental effects in liver and kidney function at a later stage can not be excluded yet, and careful examinations of the patients remain indicated

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

    Directory of Open Access Journals (Sweden)

    Shiyang Wang

    Full Text Available 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.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.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.The present studies

  5. The Community Balance and Mobility Scale: A Pilot Study Detecting Impairments in Military Service Members With Comorbid Mild TBI and Psychological Health Conditions.

    Science.gov (United States)

    Pape, Marcy M; Williams, Kathy; Kodosky, Paula N; Dretsch, Michael

    2016-01-01

    To compare the capacity of the Community Balance and Mobility Scale (CB&M) to identify balance and mobility deficits in Service Members (SMs) with mild traumatic brain injury and comorbid psychological health conditions (mTBI/PH) to other commonly used balance assessments. A clinical research institute that provides a 4-week, outpatient, interdisciplinary program for active-duty SMs with mTBI/PH. A nonrandomized, cross-sectional design that compared multiple measures between 2 groups-active duty SMs with (n = 8) and without (n = 8) the dual diagnosis of mTBI/PH. Gait speed, Activities-specific Balance Confidence scale (ABC), Functional Gait Assessment (FGA), and CB&M to assess functional balance among the community-dwelling, TBI population. Across all measures, the mTBI/PH group performed significantly worse (P ≤ .01) with the exception of the FGA. The abilities of all objective measures to distinguish participants with mTBI/PH from healthy controls ranged from fair to excellent (area under the curve [AUC] = 0.66-0.94). However, the CB&M showed the largest group differences in effect size (d = 2.6) and had the highest discriminate ability (AUC = 0.98; sensitivity 100%; specificity 88%). The CB&M appears to have higher sensitivity and specificity than other measures of balance in SMs with mTBI/PH. A higher cut score for the CB&M is needed for this population.

  6. DTI measures identify mild and moderate TBI cases among patients with complex health problems: A receiver operating characteristic analysis of U.S. veterans.

    Science.gov (United States)

    Main, Keith L; Soman, Salil; Pestilli, Franco; Furst, Ansgar; Noda, Art; Hernandez, Beatriz; Kong, Jennifer; Cheng, Jauhtai; Fairchild, Jennifer K; Taylor, Joy; Yesavage, Jerome; Wesson Ashford, J; Kraemer, Helena; Adamson, Maheen M

    2017-01-01

    Standard MRI methods are often inadequate for identifying mild traumatic brain injury (TBI). Advances in diffusion tensor imaging now provide potential biomarkers of TBI among white matter fascicles (tracts). However, it is still unclear which tracts are most pertinent to TBI diagnosis. This study ranked fiber tracts on their ability to discriminate patients with and without TBI. We acquired diffusion tensor imaging data from military veterans admitted to a polytrauma clinic (Overall n  = 109; Age: M  = 47.2, SD  = 11.3; Male: 88%; TBI: 67%). TBI diagnosis was based on self-report and neurological examination. Fiber tractography analysis produced 20 fiber tracts per patient. Each tract yielded four clinically relevant measures (fractional anisotropy, mean diffusivity, radial diffusivity, and axial diffusivity). We applied receiver operating characteristic (ROC) analyses to identify the most diagnostic tract for each measure. The analyses produced an optimal cutpoint for each tract. We then used kappa coefficients to rate the agreement of each cutpoint with the neurologist's diagnosis. The tract with the highest kappa was most diagnostic. As a check on the ROC results, we performed a stepwise logistic regression on each measure using all 20 tracts as predictors. We also bootstrapped the ROC analyses to compute the 95% confidence intervals for sensitivity, specificity, and the highest kappa coefficients. The ROC analyses identified two fiber tracts as most diagnostic of TBI: the left cingulum (LCG) and the left inferior fronto-occipital fasciculus (LIF). Like ROC, logistic regression identified LCG as most predictive for the FA measure but identified the right anterior thalamic tract (RAT) for the MD, RD, and AD measures. These findings are potentially relevant to the development of TBI biomarkers. Our methods also demonstrate how ROC analysis may be used to identify clinically relevant variables in the TBI population.

  7. Concussion in the Military: an Evidence-Base Review of mTBI in US Military Personnel Focused on Posttraumatic Headache.

    Science.gov (United States)

    Holtkamp, Matthew D; Grimes, Jamie; Ling, Geoffrey

    2016-06-01

    Traumatic brain injury (TBI) is defined as an alteration in brain function caused by an external force. Mild TBI or concussion is now well recognized to be a risk of military service as well as participation in athletic sports such as football. Posttraumatic headache (PTH) is the most common symptom after mTBI in US service members. PTH most commonly presents with migraine-like headache features. The following is an overview of the epidemiology, pathophysiology, clinical course, prognosis, complications, and treatment of mTBI and associated comorbidities with a focus on PTH. There is a particular emphasis on emerging evidence-based clinical practice. One important medical consequence of the recognition that mTBI is a highly prevalent among military service members is that the Department of Defense (DoD) is dedicating significant financial and intellectual resources to better understanding and developing treatments for TBI. The identification of the importance of TBI among the US military population has had the added benefit of increasing awareness of this condition among civilian populations, particularly those engaged in both professional and youth sports. The NIH and NSF are also supporting important TBI research. President Obama's Brain Initiative is also providing additional impetus for these efforts. Unfortunately, the understanding of the acute and chronic effects of mTBI on the brain remains limited. Gratefully, there is hope that through innovative research, there will be advances in elucidating the underlying pathophysiology, which will lead to clinical and prognostic indicators, ultimately resulting in new treatment options for this very complicated set of disorders.

  8. Influence of Mild Traumatic Brain Injury (TBI) and Posttraumatic Stress Disorder (PTSD) on Pain Intensity Levels in OEF/OIF/OND Veterans.

    Science.gov (United States)

    Stojanovic, Milan P; Fonda, Jennifer; Fortier, Catherine Brawn; Higgins, Diana M; Rudolph, James L; Milberg, William P; McGlinchey, Regina E

    2016-11-01

    Mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) are common among US veterans of Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND). We postulated that these injuries may modulate pain processing in these individuals and affect their subjective pain levels. Cross-sectional. 310 deployed service members of OEF/OIF/OND without a lifetime history of moderate or severe TBI were included in this study. All participants completed a comprehensive evaluation for Blast Exposure, mTBI, PTSD, and Pain Levels. The Boston Assessment of TBI-Lifetime Version (BAT-L) was used to assess blast exposure and potential brain injury during military service. The Clinician-Administered PTSD Scale (CAPS) characterized presence and severity of PTSD. The Visual Analog Scale (VAS) was used to assess pain intensity over the previous month before the interview, with higher scores indicative of worse pain. Statistical analysis was performed by ANOVA and results were adjusted for co-morbidities, clinical characteristics and demographic data. In comparison to control participants (veterans without mTBI or current PTSD), veterans with both current PTSD and mTBI reported the highest pain intensity levels, followed by veterans with PTSD only (P Pain levels in veterans with mTBI only were comparable to control participants. Comorbid PTSD and mTBI is associated with increased self-reported pain intensity. mTBI alone was not associated with increased pain. Published by Oxford University Press on behalf of the American Academy of Pain Medicine 2016. This work is written by US Government employees and is in the public domain in the US.

  9. 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.

  10. 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.

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

    International Nuclear Information System (INIS)

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

    2015-01-01

    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.

  12. Technical problems of TBI in case of the moving couch method

    Energy Technology Data Exchange (ETDEWEB)

    Tsuda, Masayuki (Tokai Univ., Isehara, Kanagawa (Japan). Hospital)

    1991-12-01

    In Tokai University Hospital ever since 1982, TBI for bone marrow transplantation has been performed by the moving couch method. In this method, the patient is irradiated from the opposite direction of A-P and P-A in a comfortable supine position as is. This technique has been well studied and greatly improved. For example, the moving speed of the couch is automatically varied depending on the dose rate deviation of the electron linear accelerator, function having variable speed with the dose rate (VSDR). Another function in variable speed with division (VSDV). In addition it has a self-recording function for the actual condition for the dose and couch movement. In such small areas as the eyes and gonad, the shielding effect cannot be effectively used. For the lungs, but it is able to shield and compensate to a sufficient extent. It applied to actual treatment resulting from data obtained from the measurements using a phantom. During the irradiation we must check the reproducibility of the systems which are dose rate, couch position, and so on. This is one reasonable concept of the dose monitor. (author).

  13. 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.

  14. 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.

  15. Tribes and tribulations: interdisciplinary eHealth in providing services for people with a traumatic brain injury (TBI).

    Science.gov (United States)

    Hines, M; Brunner, M; Poon, S; Lam, M; Tran, V; Yu, D; Togher, L; Shaw, T; Power, E

    2017-11-21

    eHealth has potential for supporting interdisciplinary care in contemporary traumatic brain injury (TBI) rehabilitation practice, yet little is known about whether this potential is being realised, or what needs to be done to further support its implementation. The purpose of this study was to explore health professionals' experiences of, and attitudes towards eHealth technologies to support interdisciplinary practice within rehabilitation for people after TBI. A qualitative study using narrative analysis was conducted. One individual interview and three focus groups were conducted with health professionals (n = 17) working in TBI rehabilitation in public and private healthcare settings across regional and metropolitan New South Wales, Australia. Narrative analysis revealed that participants held largely favourable views about eHealth and its potential to support interdisciplinary practice in TBI rehabilitation. However, participants encountered various issues related to (a) the design of, and access to electronic medical records, (b) technology, (c) eHealth implementation, and (d) information and communication technology processes that disconnected them from the work they needed to accomplish. In response, health professionals attempted to make the most of unsatisfactory eHealth systems and processes, but were still mostly unsuccessful in optimising the quality, efficiency, and client-centredness of their work. Attention to sources of disconnection experienced by health professionals, specifically design of, and access to electronic health records, eHealth resourcing, and policies and procedures related to eHealth and interdisciplinary practice are required if the potential of eHealth for supporting interdisciplinary practice is to be realised.

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

    Science.gov (United States)

    2014-10-01

    domains based on the Caplan and colleagues26 factor analytic study with soldiers who sus- tained a mild to severe TBI. A full listing of symptoms assessed...in the NSI, categorized according to the Caplan et al26 suggested symptom groupings, can be found in Table 2. Statistical analyses Differences in... Caplan LJ, Ivins B, Poole JH, Vanderploeg R, Jaffee MS, Schwab K. The structure of postconcussive symptoms in 3 US military samples. J Head Trauma

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

    OpenAIRE

    Ustinova, Ksenia I; Leonard, Wesley A; Cassavaugh, Nicholas D; Ingersoll, Christopher D

    2011-01-01

    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...

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

    Science.gov (United States)

    Ustinova, Ksenia I; Leonard, Wesley A; Cassavaugh, Nicholas D; Ingersoll, Christopher D

    2011-10-31

    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. 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. 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. These results support the feasibility of using the custom-made 3D

  19. Deficits in Visual System Functional Connectivity after Blast-Related Mild TBI are Associated with Injury Severity and Executive Dysfunction

    Science.gov (United States)

    2016-08-24

    W. Jung. 2003. Long-term potentiation in visual cortical projections to the medial prefrontal cortex of the rat . Neuroscience 120:283–289. Kim, J., J...functional connec- tivity (FC) of four key nodes within the visual system: lateral geniculate nucleus (LGN), primary visual cortex (V1), lateral...related TBI may be accompanied by involvement of the visual system through optic nerve injury, diffuse or focal cerebral injury, or ocular motor

  20. 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.

  1. 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.E. 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 (Marc); 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); C.M.A.A. 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)

  2. Dose rate-dependent marrow toxicity of TBI in dogs and marrow sparing effect at high dose rate by dose fractionation.

    Science.gov (United States)

    Storb, R; Raff, R F; Graham, T; Appelbaum, F R; Deeg, H J; Schuening, F G; Sale, G; Seidel, K

    1999-01-01

    We evaluated the marrow toxicity of 200 and 300 cGy total-body irradiation (TBI) delivered at 10 and 60 cGy/min, respectively, in dogs not rescued by marrow transplant. Additionally, we compared toxicities after 300 cGy fractionated TBI (100 cGy fractions) to that after single-dose TBI at 10 and 60 cGy/min. Marrow toxicities were assessed on the basis of peripheral blood cell count changes and mortality from radiation-induced pancytopenia. TBI doses studied were just below the dose at which all dogs die despite optimal support. Specifically, 18 dogs were given single doses of 200 cGy TBI, delivered at either 10 (n=13) or 60 (n=5) cGy/min. Thirty-one dogs received 300 cGy TBI at 10 cGy/min, delivered as either single doses (n=21) or three fractions of 100 cGy each (n=10). Seventeen dogs were given 300 cGy TBI at 60 cGy/min, administered either as single doses (n=5) or three fractions of 100 cGy each (n=10). Within the limitations of the experimental design, three conclusions were drawn: 1) with 200 and 300 cGy single-dose TBI, an increase of dose rate from 10 to 60 cGy/min, respectively, caused significant increases in marrow toxicity; 2) at 60 cGy/min, dose fractionation resulted in a significant decrease in marrow toxicities, whereas such a protective effect was not seen at 10 cGy/min; and 3) with fractionated TBI, no significant differences in marrow toxicity were seen between dogs irradiated at 60 and 10 cGy/min. The reduced effectiveness of TBI when a dose of 300 cGy was divided into three fractions of 100 cGy or when dose rate was reduced from 60 cGy/min to 10 cGy/min was consistent with models of radiation toxicity that allow for repair of sublethal injury in DNA.

  3. 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

    2018-04-01

    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

  4. Variation in Structure and Process of Care in Traumatic Brain Injury: Provider Profiles of European Neurotrauma Centers Participating in the CENTER-TBI Study.

    Directory of Open Access Journals (Sweden)

    Maryse C Cnossen

    Full Text Available 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 the existing variation. The aim of current study is to quantify variation in general structural and process characteristics among centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI study.We designed a set of 11 provider profiling questionnaires with 321 questions about various aspects of TBI care, chosen based on literature and expert opinion. After pilot testing, questionnaires were disseminated to 71 centers from 20 countries participating in the CENTER-TBI study. Reliability of questionnaires was estimated by calculating a concordance rate among 5% duplicate questions.All 71 centers completed the questionnaires. Median concordance rate among duplicate questions was 0.85. The majority of centers were academic hospitals (n = 65, 92%, designated as a level I trauma center (n = 48, 68% and situated in an urban location (n = 70, 99%. The availability of facilities for neuro-trauma care varied across centers; e.g. 40 (57% had a dedicated neuro-intensive care unit (ICU, 36 (51% had an in-hospital rehabilitation unit and the organization of the ICU was closed in 64% (n = 45 of the centers. In addition, we found wide variation in processes of care, such as the ICU admission policy and intracranial pressure monitoring policy among centers.Even among high-volume, specialized neurotrauma centers there is substantial variation in structures and processes of TBI care. This variation provides an opportunity to study effectiveness of specific aspects of TBI care and to identify best practices with CER approaches.

  5. A study on the mechanism by which MDMA protects against dopaminergic dysfunction after minimal traumatic brain injury (mTBI) in mice.

    Science.gov (United States)

    Edut, S; Rubovitch, V; Rehavi, M; Schreiber, S; Pick, C G

    2014-12-01

    Driving under methylenedioxymethamphetamine (MDMA) influence increases the risk of being involved in a car accident, which in turn can lead to traumatic brain injury. The behavioral deficits after traumatic brain injury (TBI) are closely connected to dopamine pathway dysregulation. We have previously demonstrated in mice that low MDMA doses prior to mTBI can lead to better performances in cognitive tests. The purpose of this study was to assess in mice the changes in the dopamine system that occurs after both MDMA and minimal traumatic brain injury (mTBI). Experimental mTBI was induced using a concussive head trauma device. One hour before injury, animals were subjected to MDMA. Administration of MDMA before injury normalized the alterations in tyrosine hydroxylase (TH) levels that were observed in mTBI mice. This normalization was also able to lower the elevated dopamine receptor type 2 (D2) levels observed after mTBI. Brain-derived neurotrophic factor (BDNF) levels did not change following injury alone, but in mice subjected to MDMA and mTBI, significant elevations were observed. In the behavioral tests, haloperidol reversed the neuroprotection seen when MDMA was administered prior to injury. Altered catecholamine synthesis and high D2 receptor levels contribute to cognitive dysfunction, and strategies to normalize TH signaling and D2 levels may provide relief for the deficits observed after injury. Pretreatment with MDMA kept TH and D2 receptor at normal levels, allowing regular dopamine system activity. While the beneficial effect we observe was due to a dangerous recreational drug, understanding the alterations in dopamine and the mechanism of dysfunction at a cellular level can lead to legal therapies and potential candidates for clinical use.

  6. Fatigue - but not mTBI history, PTSD, or sleep quality - directly contributes to reduced prospective memory performance in Iraq and Afghanistan era Veterans.

    Science.gov (United States)

    Rau, Holly K; Hendrickson, Rebecca; Roggenkamp, Hannah C; Peterson, Sarah; Parmenter, Brett; Cook, David G; Peskind, Elaine; Pagulayan, Kathleen F

    2017-10-13

    Memory problems that affect daily functioning are a frequent complaint among Veterans reporting a history of repetitive mild traumatic brain injury (mTBI), especially in cohorts with comorbid PTSD. Here, we test the degree to which subjective sleep impairment and daytime fatigue account for the association of PTSD and self-reported mTBI history with prospective memory. 82 Veterans with and without personal history of repeated blast-related mTBI during deployment were administered the Clinician Administered PTSD Scale (CAPS), Memory for Intentions Test (MIST), Patient Health Questionnaire-9 (PHQ-9), Neurobehavioral Symptom Inventory (NSI), and the Pittsburgh Sleep Quality Index (PSQI). Relationships between self-reported mTBI, PTSD, self-reported poor sleep and daytime fatigue, and MIST performance were modeled using partial least squares structural equation modeling (PLS-SEM). Reported daytime fatigue was strongly associated with poorer prospective memory performance. Poor subjective sleep quality was strongly and positively associated with reported daytime fatigue, but had no significant direct effect on prospective memory performance. PTSD diagnosis and self-reported mTBI history were only associated with prospective memory via their impact on subjective sleep quality and daytime fatigue. Results suggest that daytime fatigue may be a mediating factor by which both mTBI and PTSD can interfere with prospective memory. Additional attention should be given to complaints of daytime fatigue, independent of subjective sleep quality, in the clinical care of those with a self-reported history of mTBI, and/or PTSD. Further research into whether interventions that decrease daytime fatigue lead to improvement in prospective memory and subjective cognitive functioning is warranted.

  7. Facial emotion recognition deficits following moderate-severe Traumatic Brain Injury (TBI): re-examining the valence effect and the role of emotion intensity.

    Science.gov (United States)

    Rosenberg, Hannah; McDonald, Skye; Dethier, Marie; Kessels, Roy P C; Westbrook, R Frederick

    2014-11-01

    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 this "valence effect" might be an artifact of the wide use of static facial emotion stimuli (usually full-blown expressions) which differ in difficulty rather than a real consequence of brain impairment. This study aimed to investigate the valence effect in TBI, while examining emotion recognition across different intensities (low, medium, and high). Twenty-seven individuals with TBI and 28 matched control participants were tested on the Emotion Recognition Task (ERT). The TBI group was more impaired in overall emotion recognition, and less accurate recognizing negative emotions. However, examining the performance across the different intensities indicated that this difference was driven by some emotions (e.g., happiness) being much easier to recognize than others (e.g., fear and surprise). Our findings indicate that individuals with TBI have an overall deficit in facial emotion recognition, and that both people with TBI and control participants found some emotions more difficult than others. These results suggest that conventional measures of facial affect recognition that do not examine variance in the difficulty of emotions may produce erroneous conclusions about differential impairment. They also cast doubt on the notion that dissociable neural pathways underlie the recognition of positive and negative emotions, which are differentially affected by TBI and potentially other neurological or psychiatric disorders.

  8. Independent validation of the MMPI-2-RF Somatic/Cognitive and Validity scales in TBI Litigants tested for effort.

    Science.gov (United States)

    Youngjohn, James R; Wershba, Rebecca; Stevenson, Matthew; Sturgeon, John; Thomas, Michael L

    2011-04-01

    The MMPI-2 Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008) is replacing the MMPI-2 as the most widely used personality test in neuropsychological assessment, but additional validation studies are needed. Our study examines MMPI-2-RF Validity scales and the newly created Somatic/Cognitive scales in a recently reported sample of 82 traumatic brain injury (TBI) litigants who either passed or failed effort tests (Thomas & Youngjohn, 2009). The restructured Validity scales FBS-r (restructured symptom validity), F-r (restructured infrequent responses), and the newly created Fs (infrequent somatic responses) were not significant predictors of TBI severity. FBS-r was significantly related to passing or failing effort tests, and Fs and F-r showed non-significant trends in the same direction. Elevations on the Somatic/Cognitive scales profile (MLS-malaise, GIC-gastrointestinal complaints, HPC-head pain complaints, NUC-neurological complaints, and COG-cognitive complaints) were significant predictors of effort test failure. Additionally, HPC had the anticipated paradoxical inverse relationship with head injury severity. The Somatic/Cognitive scales as a group were better predictors of effort test failure than the RF Validity scales, which was an unexpected finding. MLS arose as the single best predictor of effort test failure of all RF Validity and Somatic/Cognitive scales. Item overlap analysis revealed that all MLS items are included in the original MMPI-2 Hy scale, making MLS essentially a subscale of Hy. This study validates the MMPI-2-RF as an effective tool for use in neuropsychological assessment of TBI litigants.

  9. Sci-Thur PM - Colourful Interactions: Highlights 08: ARC TBI using Single-Step Optimized VMAT Fields

    International Nuclear Information System (INIS)

    Hudson, Alana; Gordon, Deborah; Moore, Roseanne; Balogh, Alex; Pierce, Greg

    2016-01-01

    Purpose: This work outlines a new TBI delivery technique to replace a lateral POP full bolus technique. The new technique is done with VMAT arc delivery, without bolus, treating the patient prone and supine. The benefits of the arc technique include: increased patient experience and safety, better dose conformity, better organ at risk sparing, decreased therapist time and reduction of therapist injuries. Methods: In this work we build on a technique developed by Jahnke et al. We use standard arc fields with gantry speeds corrected for varying distance to the patient followed by a single step VMAT optimization on a patient CT to increase dose inhomogeneity and to reduce dose to the lungs (vs. blocks). To compare the arc TBI technique to our full bolus technique, we produced plans on patient CTs for both techniques and evaluated several dosimetric parameters using an ANOVA test. Results and Conclusions: The arc technique is able reduce both the hot areas to the body (D2% reduced from 122.2% to 111.8% p<0.01) and the lungs (mean lung dose reduced from 107.5% to 99.1%, p<0.01), both statistically significant, while maintaining coverage (D98% = 97.8% vs. 94.6%, p=0.313, not statistically significant). We developed a more patient and therapist-friendly TBI treatment technique that utilizes single-step optimized VMAT plans. It was found that this technique was dosimetrically equivalent to our previous lateral technique in terms of coverage and statistically superior in terms of reduced lung dose.

  10. Sci-Thur PM - Colourful Interactions: Highlights 08: ARC TBI using Single-Step Optimized VMAT Fields

    Energy Technology Data Exchange (ETDEWEB)

    Hudson, Alana; Gordon, Deborah; Moore, Roseanne; Balogh, Alex; Pierce, Greg [Tom Baker Cancer Centre (Canada)

    2016-08-15

    Purpose: This work outlines a new TBI delivery technique to replace a lateral POP full bolus technique. The new technique is done with VMAT arc delivery, without bolus, treating the patient prone and supine. The benefits of the arc technique include: increased patient experience and safety, better dose conformity, better organ at risk sparing, decreased therapist time and reduction of therapist injuries. Methods: In this work we build on a technique developed by Jahnke et al. We use standard arc fields with gantry speeds corrected for varying distance to the patient followed by a single step VMAT optimization on a patient CT to increase dose inhomogeneity and to reduce dose to the lungs (vs. blocks). To compare the arc TBI technique to our full bolus technique, we produced plans on patient CTs for both techniques and evaluated several dosimetric parameters using an ANOVA test. Results and Conclusions: The arc technique is able reduce both the hot areas to the body (D2% reduced from 122.2% to 111.8% p<0.01) and the lungs (mean lung dose reduced from 107.5% to 99.1%, p<0.01), both statistically significant, while maintaining coverage (D98% = 97.8% vs. 94.6%, p=0.313, not statistically significant). We developed a more patient and therapist-friendly TBI treatment technique that utilizes single-step optimized VMAT plans. It was found that this technique was dosimetrically equivalent to our previous lateral technique in terms of coverage and statistically superior in terms of reduced lung dose.

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

    Directory of Open Access Journals (Sweden)

    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

  12. Proceedings of the 2011 AFMS Medical Research Symposium. Volume 6. Traumatic Brain Injury (TBI) & Psychological Health Track

    Science.gov (United States)

    2011-08-02

    million effort to study imagrtg d TBI in th e military Started af Walter Reed end USU 2 yea-s ago Advanced Imaging Study in ifiated St:andzud MRI ...Imaging-some MRI techniques are useful: OTI, SWI 4. Physiological-focus of this IPT (Non--Invasive Neurodiagnostic IPT) Three step approach to...the e ye a re d etected with i1frared sensors • In addition to the helmet a l.llptop complier (or tablet ) is attached • Developers are marketing as

  13. Effect of binasal occlusion (BNO) and base-in prisms on the visual-evoked potential (VEP) in mild traumatic brain injury (mTBI).

    Science.gov (United States)

    Yadav, Naveen K; Ciuffreda, Kenneth J

    2014-01-01

    To assess quantitatively the effect and relative contribution of binasal occlusion (BNO) and base-in prisms (BI) on visually-evoked potential (VEP) responsivity in persons with mild traumatic brain injury (mTBI) and the symptom of visual motion sensitivity (VMS), as well as in visually-normal (VN) individuals. Subjects were comprised of 20 VN adults and 15 adults with mTBI and VMS. There were four test conditions: (1) conventional pattern VEP, which served as the baseline comparison condition; (2) VEP with BNO alone; (3) VEP with 2 pd BI prisms before each eye; and (4) VEP with the above BNO and BI prism combination. In mTBI, the mean VEP amplitude increased significantly in nearly all subjects (∼90%) with BNO alone. In contrast, in VN, it decreased significantly with BNO alone in all subjects (100%), as compared to the other test conditions. These objective findings were consistent with improvements in visual impressions and sensorimotor tasks in the group with mTBI. Latency remained within normal limits under all test conditions in both groups. Only the BNO condition demonstrated significant, but opposite and consistent, directional effects on the VEP amplitude in both groups. The BNO-VEP test condition may be used clinically for the objectively-based, differential diagnosis of persons suspected of having mTBI and VMS from the VNs.

  14. In vitro radiation studies on Ewing's sarcoma cell lines and human bone marrow: application to the clinical use of total body irradiation (TBI)

    International Nuclear Information System (INIS)

    Kinsella, T.J.; Mitchell, J.B.; McPherson, S.; Miser, J.; Triche, T.; Glatstein, E.

    1984-01-01

    Patients with Ewing's sarcoma who present with a central axis or proximal extremity primary and/or with metastatic disease have a poor prognosis despite aggressive combination chemotherapy and local irradiation. In this high risk group of patients, total body irradiation (TBI) has been proposed as a systemic adjuvant. To aid in the design of a clinical TBI protocol, the authors have studied in the in vitro radiation response of two established cell lines of Ewing's sarcoma and human bone marrow CFUc. The Ewing's lines showed a larger D 0 and anti-n compared to the bone marrow CFU. No repair of potentially lethal radiation damage (PLDR) was found after 4.5 Gy in plateau phase Ewing's sarcoma cells. A theoretical split dose survival curve for both the Ewing's sarcoma lines and human bone marrow CFUc using this TBI schedule shows a significantly lower surviving fraction (10 -4 -10 -5 ) for the bone marrow CFUc. Based on these in vitro results, two 4.0 Gy fractions separated by 24 hours is proposed as the TBI regimen. Because of the potentially irreversible damage to bone marrow, autologous bone marrow transplantation following the TBI is felt to be necessary. The details of this clinical protocol in high risk Ewing's sarcoma patients are outlined

  15. Acute central nervous system (CNS) toxicity of total body irradiation (TBI) measured using neuropsychological testing of attention functions

    International Nuclear Information System (INIS)

    Wenz, Frederik; Steinvorth, Sarah; Lohr, Frank; Hacke, Werner; Wannenmacher, Michael

    1999-01-01

    Purpose: The purpose of this study was to investigate acute normal tissue damage of low irradiation doses to the healthy, adult central nervous system (CNS) using neuropsychological testing of attention functions. Methods and Materials: Neuropsychological testing (IQ, attention [modified Trail-Making Test A, Digit Symbol Test, D2 Test, Wiener Determination Machine]) was used to examine 40 patients (43 ± 10 years) before and immediately after the first fraction (1.2 Gy) of hyperfractionated total body irradiation (TBI) at the University of Heidelberg. The patients received antiemetic premedication. Test results are given as mean percentiles ± standard deviation, with 50 ± 34 being normal. Thirty-eight control patients (53 ± 15 years) were studied to quantify the influence of hospitalization, stress, and repeated testing. Results: The patients showed normal baseline test results (IQ = 101 ± 14, attention = 54 ± 28) and no decrease in test results after 1.2 Gy TBI. Attention functions improved (66 ± 25) corresponding to a practice effect of repeated testing that was seen in the control group, although alternate versions of the tests were used (IQ = 104 ± 10, attention before = 42 ± 29, attention after = 52 ± 31). Conclusion: Our data show no deterioration of neuropsychologic test results acutely after 1.2 Gy whole body exposure in adult patients without CNS disease receiving antiemetic medication

  16. A multidisciplinary TBI inpatient rehabilitation programme for active duty service members as part of a randomized clinical trial.

    Science.gov (United States)

    Braverman, S E; Spector, J; Warden, D L; Wilson, B C; Ellis, T E; Bamdad, M J; Salazar, A M

    1999-06-01

    To design and describe an effective rehabilitation programme for use in an ongoing trial on the efficacy of multidisciplinary brain injury rehabilitation for moderately head injury military service members. Treatment arm of a randomized control trial. US military tertiary care hospital inpatient rehabilitation programme. Sixty seven active duty military with moderate to severe TBI who were randomized to the treatment arm of the protocol. Eight week rehabilitation programme combining group and individual therapies with an inpatient milieu-oriented neuropsychological focus. Group therapies included fitness, planning and organization, cognitive skills, work skills, medication, and milieu groups, and community re-entry outings. Individual therapy included neuropsychology, work therapy, occupational therapy, and speech and language pathology. Successful return to work and return to duty. At 1 year follow-up, 64 patients returned to work (96%) and 66% (44/67) returned to duty. The described rehabilitation programme demonstrates one successful effort to rehabilitate active duty military service members with TBI who have the potential to return to duty.

  17. Assessment of the role of intracranial hypertension and stress on hippocampal cell apoptosis and hypothalamic-pituitary dysfunction after TBI.

    Science.gov (United States)

    Tan, Huajun; Yang, Weijian; Wu, Chenggang; Liu, Baolong; Lu, Hao; Wang, Hong; Yan, Hua

    2017-06-19

    In recent years, hypopituitarism caused by traumatic brain injury (TBI) has been explored in many clinical studies; however, few studies have focused on intracranial hypertension and stress caused by TBI. In this study, an intracranial hypertension model, with epidural hematoma as the cause, was used to explore the physiopathological and neuroendocrine changes in the hypothalamic-pituitary axis and hippocampus. The results demonstrated that intracranial hypertension increased the apoptosis rate, caspase-3 levels and proliferating cell nuclear antigen (PCNA) in the hippocampus, hypothalamus, pituitary gland and showed a consistent rate of apoptosis within each group. The apoptosis rates of hippocampus, hypothalamus and pituitary gland were further increased when intracranial pressure (ICP) at 24 hour (h) were still increased. The change rates of apoptosis in hypothalamus and pituitary gland were significantly higher than hippocampus. Moreover, the stress caused by surgery may be a crucial factor in apoptosis. To confirm stress leads to apoptosis in the hypothalamus and pituitary gland, we used rabbits to establish a standard stress model. The results confirmed that stress leads to apoptosis of neuroendocrine cells in the hypothalamus and pituitary gland, moreover, the higher the stress intensity, the higher the apoptosis rate in the hypothalamus and pituitary gland.

  18. SU-F-T-413: Calculation Accuracy of AAA and Acuros Using Cerrobend Blocks for TBI at 400cm

    International Nuclear Information System (INIS)

    Lamichhane, N; Studenski, M

    2016-01-01

    Purpose: It is essential to assess the lung dose during TBI to reduce toxicity. Here we characterize the accuracy of the AAA and Acuros algorithms when using cerrobend lung shielding blocks at an extended distance for TBI. Methods: We positioned a 30×30×30 cm3 solid water slab phantom at 400 cm SSD and measured PDDs (Exradin A12 and PTW parallel plate ion chambers). A 2 cm thick, 10×10 cm2 cerrobend block was hung 2 cm in front of the phantom. This geometry was reproduced in the planning system for both AAA and Acuros. In AAA, the mass density of the cerrobend block was forced to 9.38 g/cm3 and in Acuros it was forced to 8.0 g/cm3 (limited to selecting stainless steel). Three different relative electron densities (RED) were tested for each algorithm; 4.97, 6.97, and 8.97. Results: PDDs from both Acuros and AAA underestimated the delivered dose. AAA calculated that depth dose was higher for RED of 4.97 as compared to 6.97 and 8.97 but still lower than measured. There was no change in the percent depth dose with changing relative electron densities for Acuros. Conclusion: Care should be taken before using AAA or Acuros with cerrobend blocks as the planning system underestimates dose. Acuros limits the ability to modify RED when compared to AAA.

  19. The Relatives' Big Five Personality Influences the Trajectories of Recovery of Patients After Severe TBI: A Multilevel Analysis.

    Science.gov (United States)

    Haller, Chiara S

    2017-08-01

    This study examines the influence of the personality of relatives on the trajectories of recovery of patients with severe traumatic brain injury (TBI). The present subsample (N = 376) of a larger population-based, prospective, 12-month multicenter cohort study in Switzerland (2007-2011) consists of patients with severe TBI (age ≥ 16) and their relatives. The predictors are the NEO Five-Factor Inventory and time (trajectory of functioning of the patient over time). The outcomes are the patients' (a) neurological functioning; (b) reported emotional, interpersonal, cognitive, and total functioning post-injury; and (c) health-related quality of life (HRQoL). The covariates included Abbreviated Injury Scale score of the head region and age. Results for patients > 50 are (a) relatives' Extraversion influenced patients' total, interpersonal, and cognitive functioning; (b) relatives' Agreeableness influenced patients' interpersonal functioning; and (c) relatives' Conscientiousness influenced patients' physical HRQoL (ps personality traits of the relative covary with the functioning of the patient, and psychological adaptation to the loss of function may progress at a later stage after physical health improvements have been achieved. Thus, a biopsychosocial perspective on the rehabilitation process is needed. © 2016 Wiley Periodicals, Inc.

  20. SU-F-T-413: Calculation Accuracy of AAA and Acuros Using Cerrobend Blocks for TBI at 400cm

    Energy Technology Data Exchange (ETDEWEB)

    Lamichhane, N; Studenski, M [University of Miami, Miami, FL (United States)

    2016-06-15

    Purpose: It is essential to assess the lung dose during TBI to reduce toxicity. Here we characterize the accuracy of the AAA and Acuros algorithms when using cerrobend lung shielding blocks at an extended distance for TBI. Methods: We positioned a 30×30×30 cm3 solid water slab phantom at 400 cm SSD and measured PDDs (Exradin A12 and PTW parallel plate ion chambers). A 2 cm thick, 10×10 cm2 cerrobend block was hung 2 cm in front of the phantom. This geometry was reproduced in the planning system for both AAA and Acuros. In AAA, the mass density of the cerrobend block was forced to 9.38 g/cm3 and in Acuros it was forced to 8.0 g/cm3 (limited to selecting stainless steel). Three different relative electron densities (RED) were tested for each algorithm; 4.97, 6.97, and 8.97. Results: PDDs from both Acuros and AAA underestimated the delivered dose. AAA calculated that depth dose was higher for RED of 4.97 as compared to 6.97 and 8.97 but still lower than measured. There was no change in the percent depth dose with changing relative electron densities for Acuros. Conclusion: Care should be taken before using AAA or Acuros with cerrobend blocks as the planning system underestimates dose. Acuros limits the ability to modify RED when compared to AAA.

  1. 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

  2. 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

  3. 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.

  4. 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

  5. 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.

  6. Care management of the agitation or aggressiveness crisis in patients with TBI. Systematic review of the literature and practice recommendations.

    Science.gov (United States)

    Luauté, Jacques; Plantier, David; Wiart, Laurent; Tell, Laurence

    2016-02-01

    The agitation crisis in the awakening phase after traumatic brain injury (TBI) is one of the most difficult behavioral disorders to alleviate. Current treatment options are heterogeneous and may involve excessive sedation. Practice guidelines are required by professionals in charge of TBI patients. Few reviews were published but those are old and based on expert opinions. The purpose of this work is to propose evidence-based guidelines to treat the agitation crisis. The elaboration of these guidelines followed the procedure validated by the French health authority for good practice recommendations, close to the Prisma statement. Guidelines were elaborated on the basis of a systematic and critical review of the literature. Twenty-eight articles concerning 376 patients were analyzed. Recommendations are: when faced with an agitation crisis, the management strategy implies to search for an underlying factor that should be treated such as pain, acute sepsis, and drug adverse effect (expert opinion). Physical restraints should be discarded when possible (expert opinion). Neuroleptic agent with a marketing authorization can be used in order to obtain a quick sedation so as to protect the patient from himself, closed ones or the healthcare team but the duration should be as short as possible (expert opinion). The efficacy of beta-blockers and antiepileptics with mood regulation effects like carbamazepine and valproate yield the most compelling evidence and should be preferably used when a background regimen is envisioned (grade B for beta-blocker and C for antiepileptics). Neuroleptics, antidepressants, benzodiazepines, buspirone may be prescribed but are considered second-line treatments (expert opinion). This study provides a strategy for treating the agitation crisis based on scientific data and expert opinion. The level of evidence remains low and published data are often old. New studies are essential to validate results from previous studies and test new drugs and

  7. 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.

  8. Influence of refractive error on pupillary dynamics in the normal and mild traumatic brain injury (mTBI populations

    Directory of Open Access Journals (Sweden)

    James Q. Truong

    2018-04-01

    Full Text Available Purpose: There have been several studies investigating static, baseline pupil diameter in visually-normal individuals across refractive error. However, none have assessed the dynamic pupillary light reflex (PLR. In the present study, both static and dynamic pupillary parameters of the PLR were assessed in both the visually-normal (VN and the mild traumatic brain injury (mTBI populations and compared as a function of refractive error. Methods: The VN population comprised 40 adults (22–56 years of age, while the mTBI population comprised 32 adults (21–60 years of age over a range of refractive errors (−9.00 D to +1.25 D. Seven pupillary parameters (baseline static diameter, latency, amplitude, and peak and average constriction and dilation velocities were assessed and compared under four white-light stimulus conditions (dim pulse, dim step, bright pulse, and bright step. The Neuroptics, infrared, DP-2000 binocular pupillometer (30 Hz sampling rate; 0.05 mm resolution was used in the monocular (right eye stimulation mode. Results: For the majority of pupillary parameters and stimulus conditions, a Gaussian distribution best fit the data, with the apex centered in the low myopic range (−2.3 to −4.9D. Responsivity was reduced to either side of the apex. Conclusions: Over a range of dynamic and static pupillary parameters, the PLR was influenced by refractive error in both populations. In cases of high refractive error, the PLR parameters may need to be compensated for this factor for proper categorization and diagnosis. Resumen: Objetivo: Existen diversos estudios que han investigado el diámetro pupilar estático y basal en individuos con visión normal en todo el espectro de errores refractivos. Sin embargo, ninguno de ellos ha evaluado el reflejo dinámico pupilar a la luz (RPL. En el presente estudio, se evaluaron tanto los parámetros pupilares estáticos como los dinámicos en poblaciones con visión normal (VN y en las afectadas

  9. Amelioration of rCBF and PbtO2 following TBI at high altitude by hyperbaric oxygen pre-conditioning.

    Science.gov (United States)

    Hu, Shengli; Li, Fei; Luo, Haishui; Xia, Yongzhi; Zhang, Jiuquan; Hu, Rong; Cui, Gaoyu; Meng, Hui; Feng, Hua

    2010-03-01

    Hypobaric hypoxia at high altitude can lead to brain damage and pre-conditioning with hyperbaric oxygen (HBO) can reduce ischemic/hypoxic brain injury. This study investigates the effects of high altitude on traumatic brain injury (TBI) and examines the neuroprotection provided by HBO preconditioning against TBI. Rats were randomly divided into four groups: HBO pre-conditioning group (HBOP, n=10), high altitude group (HA, n=10), plain control group (PC, n=10) and plain sham operation group (sham, n=10). All groups were subjected to head trauma by weight drop device except for the sham group. Rats from each group were examined for neurological function, regional cerebral blood flow (rCBF) and brain tissue oxygen pressure (PbtO(2)) and were killed for analysis by transmission electron microscope. The score of neurological deficits in the HA group was highest, followed by the HBOP group and the PC group, respectively. Both rCBF and PbtO(2) were the lowest in the HA group. Brain morphology and structure seen via the transmission electron microscope was diminished in the HA group, while fewer pathological injuries occurred in the HBOP and PC groups. High altitude aggravates TBI significantly and HBO pre-conditioning can attenuate TBI in rats at high altitude by improvement of rCBF and PbtO(2). Pre-treatment with HBO might be beneficial for people traveling to high altitude locations.

  10. 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

  11. Evaluating the impact of treatment for sleep/wake disorders on recovery of cognition and communication in adults with chronic TBI.

    Science.gov (United States)

    Wiseman-Hakes, Catherine; Murray, Brian; Moineddin, Rahim; Rochon, Elizabeth; Cullen, Nora; Gargaro, Judith; Colantonio, Angela

    2013-01-01

    To longitudinally examine objective and self-reported outcomes for recovery of cognition, communication, mood and participation in adults with traumatic brain injury (TBI) and co-morbid post-traumatic sleep/wake disorders. Prospective, longitudinal, single blind outcome study. Community-based. Ten adults with moderate-severe TBI and two adults with mild TBI and persistent symptoms aged 18-58 years. Six males and six females, who were 1-22 years post-injury and presented with self-reported sleep/wake disturbances with onset post-injury. Individualized treatments for sleep/wake disorders that included sleep hygiene recommendations, pharmacological interventions and/or treatments for sleep apnea with follow-up. Insomnia Severity Index, Beck Depression and Anxiety Inventories, Latrobe Communication Questionnaire, Speed and Capacity of Language Processing, Test of Everyday Attention, Repeatable Battery for the Assessment of Neuropsychological Status, Daily Cognitive-Communication and Sleep Profile. Group analysis revealed positive trends in change for each measure and across sub-tests of all measures. Statistically significant changes were noted in insomnia severity, p = 0.0003; depression severity, p = 0.03; language, p = 0.01; speed of language processing, p = 0.007. These results add to a small but growing body of evidence that sleep/wake disorders associated with TBI exacerbate trauma-related cognitive, communication and mood impairments. Treatment for sleep/wake disorders may optimize recovery and outcomes.

  12. Parents and teachers reporting on a child's emotional and behavioural problems following severe traumatic brain injury (TBI): the moderating effect of time.

    Science.gov (United States)

    Silberg, Tamar; Tal-Jacobi, Dana; Levav, Miriam; Brezner, Amichai; Rassovsky, Yuri

    2015-01-01

    Gathering information from parents and teachers following paediatric traumatic brain injury (TBI) has substantial clinical value for diagnostic decisions. Yet, a multi-informant approach has rarely been addressed when evaluating children at the chronic stage post-injury. In the current study, the goals were to examine (1) differences between parents' and teachers' reports on a child's emotional and behavioural problems and (2) the effect of time elapsed since injury on each rater's report. A sample of 42 parents and 42 teachers of children following severe TBI completed two standard rating scales. Receiver Operating Characteristic (ROC) curves were used to determine whether time elapsed since injury reliably distinguished children falling above and below clinical levels. Emotional-behavioural scores of children following severe TBI fell within normal range, according to both teachers and parents. Significant differences were found between parents' reports relatively close to the time of injury and 2 years post-injury. However, no such differences were observed in teachers' ratings. Parents and teachers of children following severe TBI differ in their reports on a child's emotional and behavioural problems. The present study not only underscores the importance of multiple informants, but also highlights, for the first time, the possibility that informants' perceptions may vary across time.

  13. Comparative binding characteristics of Tc-CPI, Tc-TBI, and Tc-MIBI in cultured heart cells: Correlation with biochemical analysis and animal images

    International Nuclear Information System (INIS)

    Piwnica-Worms, D.; Kronauge, J.F.; Holman, B.L.; Davison, A.; Jones, A.G.

    1987-01-01

    Hexakis (isonitrile)technetium (I) complexes are a new class of cationic, lipophilic myocaridal perfusion imaging agents. To better understand their cellular mechanisms of uptake and washout, chick heart cells grown in culture were used as a model myocardial system. Tc-MIBI showed uptake to a plateau at a rate similar to Tc-CPI (t1/2 = 4.1 +- 0.7 minutes); however, the plateau was 63% greater. Tc-TBI uptake approached a plateau 900% greater than Tc-CPI binding. Heart cell studies showed washout of Tc-CPI>Tc-TBI>Tc-MIBI, which correlated with kinetic analysis of rabbit myocardial images. Biochemical in vitro analysis in human plasma demonstrated 75% enzymatic ester hydrolysis of Tc-CPI by 3 minutes, but no hydrolysis of Tc-TBI and Tc-MIBI. The results suggest that metabolism of the ester function of Tc-CPI following myocardial uptake may in part account for the more rapid cellular washout rates of Tc-CPI compared with Tc-TBI and Tc-MIBI

  14. 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.

  15. "Help seniors live better, longer: prevent brain injury": an overview of CDC's education initiative to prevent fall-related TBI among older adults.

    Science.gov (United States)

    Sarmiento, Kelly; Langlois, Jean A; Mitchko, Jane

    2008-01-01

    Falls are the leading cause of traumatic brain injury (TBI) among older adults aged 75 and older. Despite this burden, many older adults, their caregivers, and professionals are not aware of the importance of TBI as an outcome of falls among older adults. To address this important public health problem, the Centers for Disease Control and Prevention (CDC) developed the "Help Seniors Live Better, Longer: Prevent Brain Injury" initiative to help raise awareness about methods to prevent, recognize and respond to fall-related TBIs among older adults aged 75 and older. The initiative was launched in March 2008, in collaboration with 26 participating organizations, and included a multipronged outreach strategy to help blanket the country with the messages of the initiative at the national, state, and local levels. Adherence to a logical, comprehensive health-education approach has proven to be highly effective in furthering the initial goals of the project.

  16. Traumatic Brain Injury: A Guide for Caregivers of Service Members and Veterans: Becoming a Family Caregiver for a Service Member/Veteran with TBI. Module 3

    Science.gov (United States)

    2010-04-01

    in fiber from whole grains, fruits, and vegetables, and includes lean cuts of meat , poultry , eggs and other protein sources. A healthy diet also...5 - Helping Your Children Cope with TBI32 “When Tim was starting to read and do word finding, those games were fun activities for the kids to do with...like playing board games , taking a walk or run, or baking cookies. Find activities where everyone in the family can play a role. • In addition to

  17. 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.

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

    International Nuclear Information System (INIS)

    Lee, M; Suh, T; Han, B; Xing, L; Jenkins, C

    2015-01-01

    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

  19. Contribution of brain or biological reserve and cognitive or neural reserve to outcome after TBI: A meta-analysis (prior to 2015).

    Science.gov (United States)

    Mathias, Jane L; Wheaton, Patricia

    2015-08-01

    Brain/biological (BR) and cognitive/neural reserve (CR) have increasingly been used to explain some of the variability that occurs as a consequence of normal ageing and neurological injuries or disease. However, research evaluating the impact of reserve on outcomes after adult traumatic brain injury (TBI) has yet to be quantitatively reviewed. This meta-analysis consolidated data from 90 studies (published prior to 2015) that either examined the relationship between measures of BR (genetics, age, sex) or CR (education, premorbid IQ) and outcomes after TBI or compared the outcomes of groups with high and low reserve. The evidence for genetic sources of reserve was limited and often contrary to prediction. APOE ∈4 status has been studied most, but did not have a consistent or sizeable impact on outcomes. The majority of studies found that younger age was associated with better outcomes, however most failed to adjust for normal age-related changes in cognitive performance that are independent of a TBI. This finding was reversed (older adults had better outcomes) in the small number of studies that provided age-adjusted scores; although it remains unclear whether differences in the cause and severity of injuries that are sustained by younger and older adults contributed to this finding. Despite being more likely to sustain a TBI, males have comparable outcomes to females. Overall, as is the case in the general population, higher levels of education and pre-morbid IQ are both associated with better outcomes. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  20. Wake-promoting actions of median nerve stimulation in TBI-induced coma: An investigation of orexin-A and orexin receptor 1 in the hypothalamic region.

    Science.gov (United States)

    Zhong, Ying-Jun; Feng, Zhen; Wang, Liang; Wei, Tian-Qi

    2015-09-01

    A coma is a serious complication, which can occur following traumatic brain injury (TBI), for which no effective treatment has been established. Previous studies have suggested that neural electrical stimulation, including median nerve stimulation (MNS), may be an effective method for treating patients in a coma, and orexin‑A, an excitatory hypothalamic neuropeptide, may be involved in wakefulness. However, the exact mechanisms underlying this involvement remain to be elucidated. The present study aimed to examine the arousal‑promoting role of MNS in rats in a TBI‑induced coma and to investigate the potential mechanisms involved. A total of 90 rats were divided into three groups, comprising a control group, sham‑stimulated (TBI) group and a stimulated (TBI + MNS) group. MNS was performed on the animals, which were in a TBI‑induced comatose state. Changes in the behavior of the rats were observed following MNS. Subsequently, hypothalamic tissues were extracted from the rats 6, 12 and 24 h following TBI or MNS, respectively. The expression levels of orexin‑A and orexin receptor‑1 (OX1R) in the hypothalamus were examined using immunohistochemistry, western blotting and an enzyme‑linked immunosorbent assay. The results demonstrated that 21 rats subjected to TBI‑induced coma exhibited a restored righting reflex and response to pain stimuli following MNS. In addition, ignificant differences in the expression levels of orexin‑A and OXIR were observed among the three groups and among the time‑points. Orexin‑A and OX1R were upregulated following MNS. The rats in the stimulated group reacted to the MNS and exhibited a re‑awakening response. The results of the present study indicated that MNS may be a therapeutic option for TBI‑induced coma. The mechanism may be associated with increasing expression levels of the excitatory hypothalamic neuropeptide, orexin-A, and its receptor, OX1R, in the hypothalamic region.

  1. 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

    MRI ]) afterwards. More severe TBI symptoms may last from a few days to multiple years following the injurious event, and repeated TBIs may result...touch-screen tablet computer that provides administrative capabilities to the tester, a virtual reality goggle visor with motion detection (see Figure 6...Evidence from functional MRI and neurogenetics. Journal of Neurotrauma, 23(10), 1450-1467. Mirksy, A. F. & van Buren, J. M. (1965). On the nature of

  2. 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.

  3. The item level psychometrics of the behaviour rating inventory of executive function-adult (BRIEF-A) in a TBI sample.

    Science.gov (United States)

    Waid-Ebbs, J Kay; Wen, Pey-Shan; Heaton, Shelley C; Donovan, Neila J; Velozo, Craig

    2012-01-01

    To determine whether the psychometrics of the BRIEF-A are adequate for individuals diagnosed with TBI. A prospective observational study in which the BRIEF-A was collected as part of a larger study. Informant ratings of the 75-item BRIEF-A on 89 individuals diagnosed with TBI were examined to determine items level psychometrics for each of the two BRIEF-A indexes: Behaviour Rating Index (BRI) and Metacognitive Index (MI). Patients were either outpatients or at least 1 year post-injury. Each index measured a latent trait, separating individuals into five-to-six ability levels and demonstrated good reliability (0.94 and 0.96). Four items were identified that did not meet the infit criteria. The results provide support for the use of the BRIEF-A as a supplemental assessment of executive function in TBI populations. However, further validation is needed with other measures of executive function. Recommendations include use of the index scores over the Global Executive Composite score and use of the difficulty hierarchy for setting therapy goals.

  4. Patterns of post-acute health care utilization after a severe traumatic brain injury: Results from the PariS-TBI cohort.

    Science.gov (United States)

    Jourdan, Claire; Bayen, Eleonore; Darnoux, Emmanuelle; Ghout, Idir; Azerad, Sylvie; Ruet, Alexis; Vallat-Azouvi, Claire; Pradat-Diehl, Pascale; Aegerter, Philippe; Weiss, Jean-Jacques; Azouvi, Philippe

    2015-01-01

    To assess brain injury services utilization and their determinants using Andersen's model. Prospective follow-up of the PariS-TBI inception cohort. Out of 504 adults with severe traumatic brain injury (TBI), 245 survived and 147 received a 4-year outcome assessment (mean age 33 years, 80% men). Provision rates of medical, rehabilitation, social and re-entry services and their relations to patients' characteristics were assessed. Following acute care discharge, 78% of patients received physiotherapy, 61% speech/cognitive therapy, 50% occupational therapy, 41% psychological assistance, 63% specialized medical follow-up, 21% community re-entry assistance. Health-related need factors, in terms of TBI severity, were the main predictors of services. Provision of each therapy was significantly associated with corresponding speech, motor and psychological impairments. However, care provision did not depend on cognitive impairments and cognitive therapy was related to pre-disposing and geographical factors. Community re-entry assistance was provided to younger and more independent patients. These quantitative findings illustrate strengths and weaknesses of late brain injury care provision in urban France and highlight the need to improve treatment of cognitive impairments.

  5. Advanced Sensors for TBI

    Science.gov (United States)

    2016-12-01

    SMD-VAC- GP, Virtual Industries) with plastic tip. Then the chip was covered with silicone open-cell foam (0.062” thick, HT -870, Stockwell...the build. 26 We discussed with a sub- contractor in Livermore who might be able to perform the packaging assembly work. Dr. Kotovsky...worked with the sub- contractor on practice assemblies anticipating the new upcoming build. Working through an outside contractor represents an enormous

  6. Opioid Use after TBI

    Science.gov (United States)

    2013-07-01

    hippocampal formation. b. Cresyl violet histochemistry Cresyl violet histological processing of tissue stains Nissl substance, which is composed mostly of...for:  Reactive glial response is being determined by measuring the luminance intensity of GFAP staining  Necrotic and apoptotic cell death by

  7. Opioid Abuse after TBI

    Science.gov (United States)

    2015-09-01

    analysis. Cresyl violet histochemistry Cresyl violet histological processing of tissue stains Nissl substance, which is composed mostly of rough...dried overnight before staining . Sections were dehydrated through graded alcohol to xylene for two changes of 5 min each, and then rehydrated through...four minutes, followed by differentiation in 95% ethanol with 0.2% HCl for 14    five minutes. Differentiation was timed such that both Nissl

  8. 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

  9. Single center experience with total body irradiation and melphalan (TBI-MEL) myeloablative conditioning regimen for allogeneic stem cell transplantation (SCT) in patients with refractory hematologic malignancies.

    Science.gov (United States)

    Bhatnagar, Bhavana; Rapoport, Aaron P; Fang, Hong-Bin; Ilyas, Can; Marangoz, Deniz; Akbulut, Vinil; Ruehle, Kathleen; Badros, Ashraf; Yanovich, Saul; Akpek, Görgün

    2014-04-01

    We retrospectively evaluated the tolerability and efficacy of fractionated total body irradiation (TBI) (1,200 cGy) and melphalan (MEL) (100-110 mg/m(2)) myeloablative conditioning in 48 patients with nonremission AML (n = 14), ALL (n = 10), NHL (n = 18), and other refractory hematologic malignancies (n = 6) who received allogeneic stem cell transplantation (SCT) between 2002 and 2011. Median age was 48 years (22 to 68); 14 out of 26 leukemia patients (54 %) had circulating blasts at transplant, 20 (50 %) evaluable patients had poor-risk cytogenetics, 12 (25 %) had prior SCT, and 10 (21 %) received stem cells from a mismatch donor. All patients received tacrolimus with or without methotrexate for GVHD prophylaxis. At the time of analysis, 13 patients (27 %) were alive and disease free. Engraftment was complete in all patients. The median time to ANC recovery (>500) was 12 days (range, 6-28). The most common grade III and IV toxicities were mucositis and infections. Eighteen patients (43 %) developed grade II-IV acute GVHD, and eight (26 %) had extensive chronic GVHD. Of 44 evaluable patients for response, 28 (64 %) achieved a complete remission (CR), and seven (15 %) had a partial remission after the transplant. With a median follow-up of 30 months (4 to 124 months) for surviving patients, the cumulative incidence of relapse was 45 % at 1 year, and the probability of overall survival (OS) at 5 years was 22.5 %. Multivariate analysis showed that platelet count (500 IU/L) at SCT were associated with relapse. Age less than 53 years and CR after SCT were associated with better OS. Our data suggest that TBI-MEL can result in CR in two thirds, durable remission in one third, and 5-year survival in about one quarter of patients with nonremission hematologic malignancies. Further studies with TBI-MEL in standard risk transplant patients are warranted.

  10. Using information from the electronic health record to improve measurement of unemployment in service members and veterans with mTBI and post-deployment stress.

    Directory of Open Access Journals (Sweden)

    Christina Dillahunt-Aspillaga

    Full Text Available 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.Retrospective cohort study using data from selected progress notes stored in the EHR.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.Service members and Veterans with TBI who participated in the PREP program (N = 60.Documentation of employment status, goals, and work-related challenges reported by service members and recorded in the EHR.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.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.

  11. 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...... 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....

  12. 'The biggest thing is trying to live for two people': Spousal experiences of supporting decision-making participation for partners with TBI.

    Science.gov (United States)

    Knox, Lucy; Douglas, Jacinta M; Bigby, Christine

    2015-01-01

    To understand how the spouses of individuals with severe TBI experience the process of supporting their partners with decision-making. This study adopted a constructivist grounded theory approach, with data consisting of in-depth interviews conducted with spouses over a 12-month period. Data were analysed through an iterative process of open and focused coding, identification of emergent categories and exploration of relationships between categories. Participants were four spouses of individuals with severe TBI (with moderate-severe disability). Spouses had shared committed relationships (marriage or domestic partnerships) for at least 4 years at initial interview. Three spouses were in relationships that had commenced following injury. Two main themes emerged from the data. The first identified the saliency of the relational space in which decision-making took place. The second revealed the complex nature of decision-making within the spousal relationship. Spouses experience decision-making as a complex multi-stage process underpinned by a number of relational factors. Increased understanding of this process can guide health professionals in their provision of support for couples in exploring decision-making participation after injury.

  13. 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.

  14. "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

  15. Lastedisain ehk kodumaine disainerlooming lastele / Dagmar Reinolt

    Index Scriptorium Estoniae

    Reinolt, Dagmar

    2015-01-01

    Eesti disainerite poolt toodetud lastepärased esemed - võileivaalus (VarmCountry), tapeet "Värvi ise" (Anni Varm), söögitool "Mari" (Julia Maria Künnap), nööpsadul (Liisa Elken), öökullipadi (Ann Lutter), kiikhobu "Fox" (Maile Grünberg), KuKuJuKu helkurid (Okeiko) ja Dadamora lasteriided (Mariliis Oksaar,Tõnis Kenkmaa)

  16. 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

  17. 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

  18. 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

  19. Vene faktor ehk poloonium 210 / Andres Herkel

    Index Scriptorium Estoniae

    Herkel, Andres, 1962-

    2007-01-01

    Autor mõtestab lahti nn pärsitud kriitika sündroomi, mille järgi Mihhail Gorbatshovist alates on Vene võimu saatnud üks kustumatu müüt: Vene võimuga peab leppima, sest olukord on plahvatusohtlik ja uus, mis tuleb, on kindlasti hullem

  20. 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

  1. 'I kind of figured it out': the views and experiences of people with traumatic brain injury (TBI) in using social media-self-determination for participation and inclusion online.

    Science.gov (United States)

    Brunner, Melissa; Palmer, Stuart; Togher, Leanne; Hemsley, Bronwyn

    2018-06-05

    Social media can support people with communication disability to access information, social participation and support. However, little is known about the experiences of people with traumatic brain injury (TBI) who use social media to determine their needs in relation to social media use. To determine the views and experiences of adults with TBI and cognitive-communication disability on using social media, specifically: (1) the nature of their social media experience; (2) barriers and facilitators to successful use; and (3) strategies that enabled their use of social media. Thirteen adults (seven men, six women) with TBI and cognitive-communication disability were interviewed about their social media experiences, and a content thematic analysis was conducted. Participants used several social media platforms including Facebook, Twitter, Instagram and virtual gaming worlds. All but one participant used social media several times each day and all used social media for social connection. Five major themes emerged from the data: (1) getting started in social media for participation and inclusion; (2) drivers to continued use of social media; (3) manner of using social media; (4) navigating social media; and (5) an evolving sense of social media mastery. In using platforms in a variety of ways, some participants developed an evolving sense of social media mastery. Participants applied caution in using social media, tended to learn through a process of trial and error, and lacked structured supports from family, friends or health professionals. They also reported several challenges that influenced their ability to use social media, but found support from peers in using the social media platforms. This information could be used to inform interventions supporting the use of social media for people with TBI and directions for future research. Social media offers adults with TBI several opportunities to communicate and for some to develop and strengthen social relationships

  2. Application of ERPs neuromarkers for assessment and treatment of a patient with chronic crossed aphasia after severe TBI and long-term coma - Case Report.

    Science.gov (United States)

    Chantsoulis, Marzena; Półrola, Paweł; Góral-Półrola, Jolanta; Hajdukiewicz, Anna; Supiński, Jan; Kropotov, Juri D; Pachalska, Maria

    2017-03-31

     Objective. The study aimed to evaluate the application of ERPs neuromarkers for the assessment and treatment of a patient with chronic crossed aphasia after severe TBI and a long-term coma. An ambidextrous female patient, aged 29, suffered from posttraumatic chronic crossed aphasia, severe TBI and a prolonged coma after a car accident. The patient took part in two differentiated rehabilitation programmes of neurotherapy included 20 sessions of relative beta training and 20 sessions of rTMS; both programmes were combined with behavioural training. The patient was tested 3 times: before the experiment, after completion of programme A, and after completion of programme B. In the 1st recording, the neuromarker of aphasia was found - an excess of the P2 wave over the left temporal area. There was a cognitive control deficit - an excess of omission errors and an increase of RT variability - all indexes of sporadic ADHD. In the 2nd recording, slight improvements in cognitive control, and language functions were found. In the 3rd recording, after the rTMS sessions most of her cognitive dysfunctions had been resolved, including language functions. It should be stressed that the activation (especially the increase in the ERP potential of the right side over the frontal lobe) was found. The neuromarker of aphasia did not change, only the location had slightly moved frontally. The application of ERP neuromarkers assists in the diagnosis, treatment, and academic success of an ambidextrous patient with chronic posttraumatic aphasia and sporadic ADHD. ERPs can be used to assess the functional brain changes induced by neurotherapeutical programmes.

  3. 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

  4. TH-EF-BRB-06: Implementation of a Modulated-Arc Total Body Irradiation (TBI) Technique Using the RayStation Treatment Planning System

    Energy Technology Data Exchange (ETDEWEB)

    Phillips, J; Cheung, J; Held, M; Han, D; Morin, O [UCSF, San Francisco, CA (United States)

    2016-06-15

    Purpose: To develop a clinical workflow for delivering a modulated-arc total body irradiation (TBI) with RayStation scripting. This technique uses arc fields with the patient lying at floor level on a padded table and is validated through measurements taken on a custom-made TBI phantom. Methods: Treatment planning was performed for a retrospective cohort of eight patients with a diverse range of heights and body types. Each was replanned using an open-field dual arc method, with the patient in supine and prone positions on the floor of the vault. All plans were optimized using Raystation Planning 4.7.2.5 (RaySearch Laboratories, Stockholm, Sweden), with 200 cGy prescribed to the 95% of the body contour − 5mm. This results in an open-field beam that sweeps craniocaudally across the length of the patient. The technique is validated with measurements at 10 cm intervals in a custom-milled, 5 cm thick acrylic phantom. A centrally located CC13 ion chamber and a Mobile MOSFET (Best Medical Canada, Ottawa, ON) detector array were used to measure dose. Supine and prone arcs for each patient were consecutively delivered, and the aggregate dose at each point was compared to the planned dose calculated in the phantom. Results: The ion chamber measurements differed from the planned dose by an average of .5%, with a standard deviation of 2.1%. All measured data for the MOSFETS were within 10% of the corresponding planned dose except for two outlying points. The standard deviation of dose differences across the entire cohort was 4.0%. Most significant discrepancies occurred either in inhomogeneous regions with large gradients, or at inferior points where beam angle was steepest. Conclusion: We have confirmed that the planned dose is well matched to our measurements within 10% for this method of planning and delivery. We are currently incorporating this technique into our clinical workflow. This work is supported by RaySearch.

  5. Clinical utility of the mBIAS and NSI validity-10 to detect symptom over-reporting following mild TBI: A multicenter investigation with military service members.

    Science.gov (United States)

    Armistead-Jehle, Patrick; Cooper, Douglas B; Grills, Chad E; Cole, Wesley R; Lippa, Sara M; Stegman, Robert L; Lange, Rael T

    2018-04-01

    Self-report measures are commonly relied upon in military healthcare environments to assess service members following a mild traumatic brain injury (mTBI). However, such instruments are susceptible to over-reporting and rarely include validity scales. This study evaluated the utility of the mild Brain Injury Atypical Symptoms scale (mBIAS) and the Neurobehavioral Symptom Inventory Validity-10 scale to detect symptom over-reporting. A total of 359 service members with a reported history of mTBI were separated into two symptom reporting groups based on MMPI-2-RF validity scales (i.e., non-over-reporting versus symptom over-reporting). The clinical utility of the mBIAS and Validity-10 as diagnostic indicators and screens of symptom over-reporting were evaluated by calculating sensitivity, specificity, positive test rate, positive predictive power (PPP), and negative predictive power (NPP) values. An mBIAS cut score of ≥10 was optimal as a diagnostic indicator, which resulted in high specificity and PPP; however, sensitivity was low. The utility of the mBIAS as a screening instrument was limited. A Validity-10 cut score of ≥33 was optimal as a diagnostic indicator. This resulted in very high specificity and PPP, but low sensitivity. A Validity-10 cut score of ≥7 was considered optimal as a screener, which resulted in moderate sensitivity, specificity, NPP, but relatively low PPP. Owing to low sensitivity, the current data suggests that both the mBIAS and Validity-10 are insufficient as stand-alone measures of symptom over-reporting. However, Validity-10 scores above the identified cut-off of ≥7should be taken as an indication that further evaluation to rule out symptom over-reporting is necessary.

  6. 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.

  7. Virtual Environment TBI Screen (VETS)

    Science.gov (United States)

    2014-10-01

    and waited for final approval which did not come until late July. We were able to begin recruiting student athletes as soon as the school semester... School : __________________________________________________________________________________________ Sport...a learning disability? Yes ____ Dx___ No ____ *Have you been diagnosed with ADD/ ADHD

  8. Virtual Environment TBI Screen (VETS)

    Science.gov (United States)

    2016-12-01

    Burrows H, Pinto R, et al. Evidence of central and peripheral vestibular pathology in blast-related trau- matic brain injury. Otol Neurotol. 2011;32:571... Burrows , H., Pinto, R., Littlefield, P., French, L.M., Tarbett, A.K., and Schubert, M.C. (2011). Evidence of central and peripheral vestibular pathology in...Please!contact!the!NPS!IRB!Chair!Dr.! Larry !Shattuck! (lgshattu@nps.edu)!with!any!questions!regarding!your!rights!as!a!participant.!!! APPENDIX D

  9. TBI Symptoms, Diagnosis, Treatment, Prevention

    Science.gov (United States)

    ... lightheadedness, dizziness, blurred vision, ringing in the ears, bad taste in the mouth, fatigue (including changed sleep patterns), behavior or mood swings, trouble with memory and concentration. Moderate or severe: As above, but headache worsens ...

  10. 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

  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. 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

  13. Ajalugu liigub spiraalina ehk uutest ja vanadest riigijuhtidest / Toomas Alatalu

    Index Scriptorium Estoniae

    Alatalu, Toomas, 1942-

    2006-01-01

    Ilmunud ka: Hiiu Leht 14. märts lk. 2, Meie Maa 15. märts lk. 2, Za Narod nr. 4 lk. 1, Teataja : Eestimaa Rahvaliidu ajaleht nr. 4 apr. lk. 1. Autori hinnangul minnakse uuele ühiskondlikule korrale üldjuhul üle mõne eelmise korra tähtsa tegelase juhtimisel, näiteid ajaloost

  14. 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

  15. 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"

  16. 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

  17. 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

  18. 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

  19. 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

  20. 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

  1. 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

  2. "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

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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"

  8. 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

  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. 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)

  11. 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

  12. 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

  13. 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

  14. Jõuluks koju ehk Saksamaa aina suurema surve all / Kaivo Kopli

    Index Scriptorium Estoniae

    Kopli, Kaivo

    2011-01-01

    Soome rahandusministri Jutta Urpilaineni hinnangul võiks mõelda Euroopa Keskpanga rolli tugevdamisele. Ühiseid eurovõlakirju toetava Austria peaministri Werner Faymanni sõnul võiks Euroopa Keskpank ise osta riikide võlakirju. Saksamaa kaalub kuue AAA-reitinguga euroala riigi ühiste võlakirjade väljaandmist

  15. 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

  16. "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

  17. 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

  18. '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

  19. 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

  20. 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

  1. 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

  2. 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

  3. Advanced MRI in Acute Military TBI

    Science.gov (United States)

    2015-11-01

    N Engl J Med 358:453-463. 413 10. Kennedy, J.E., Cullen , M.A., Amador, R.R., Huey, J.C., and Leal, F.O. 2010. Symptoms in military service members...Neurosurg Psychiatry 77:1180-1184. 502 44. Dempsey, K.E., Dorlac, W.C., Martin, K., Fang, R., Fox, C., Bennett, B., Williams , K., and Flaherty, S. 2009. 503

  4. Advanced MRI in Blast-related TBI

    Science.gov (United States)

    2012-07-01

    local communications (Latora and Marchiori, 2001; Watts and Strogatz , 1998). Early studies of graph theoretic analysis in clinical populations have...Head Trauma Rehabil 21: 398–402. Watts, D. J., and S. H. Strogatz . 1998. “Collective Dynamics of ‘small-world’ Networks.” Nature 393: 440–442

  5. 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...thought to play roles in the regulation of extracellular concentrations of water, potassium and other ions, and glutamate and other transmitters and

  6. Advanced MRI in Acute Military TBI

    Science.gov (United States)

    2014-09-01

    4.76 ± 1.16 A 4.59 ± 1.17 (Motor Strength, Balance, Coordination) Conners ’ Continuous Performance Test II Omission Errors (T-score): 48.29...guidelines for their use. Journal of neurotrauma. 1998;15(8):573-585. 3. Conners C, Staff. M. Conners ’ Continuous Performance Test II: Computer...JOURNAL OF NEUROTRAUMA 31:889–898 (May 15, 2014) ª Mary Ann Liebert, Inc. DOI: 10.1089/neu.2013.3173 889 returned to the United States. Few of them

  7. Neurophysiological Outcomes of mTBI

    Science.gov (United States)

    2017-03-28

    15. Conte A, Khan N, Defazio G, Rothwell JC, Berardelli A. Pathophysiology of somatosensory abnormalities in Parkinson disease . Nature Reviews...Hattori N, Kitazawa S . Effects of aging and idiopathic Parkinson’s disease on tactile temporal order judgment. PloS one. 2015 Mar 11; 1 0(3) :e0118331...Day. 201 0;26(1 ):439-44. · Righ i S , Gronchi G, Paganini M, Piacentini S , Viggiano MP. Huntington’s Disease and Scalar Expectancy Theory: A Memory

  8. Traumatic Brain Injury service (TBI) Service

    Data.gov (United States)

    Department of Veterans Affairs — This Service provides access to Tramatic Brain injury patient data consult notes. The service also provides one write service method writeNote. The Service supports...

  9. 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

  10. 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

  11. 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

  12. 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)

  13. 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

  14. 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"

  15. Nimed olümpiavormil ehk Ilvese peidetud bränd / Hannes Tamme

    Index Scriptorium Estoniae

    Tamme, Hannes, 1957-

    2002-01-01

    AS Ilves-Extra juht ja põhiomanik Arvo Kivikas ettevõtte arengust läbi aegade, rahvusvahelisest koostööst ning oma tegevusest ja eesmärkidest firma juhina. Tabel: AS Ilves-Extra omanikud, aktsiakapital, töötajad ja majandusnäitajad

  16. Ilma tahtmata ja teadmata paradiisi ehk Arhetüüp eesti moodi / Rein Tootma

    Index Scriptorium Estoniae

    Tootma, Rein

    2006-01-01

    Lühimängufilm "Vanameeste paradiis" : stsenaristid Ove Musting (ka idee autor), Urmas Lennuk : režissöör Ove Musting : operaator Mait Mäekivi : helilooja Arian Levin : kunstnik Eva-Marina Gramanovski : näitlejad Tõnu Aav, Aleksander Eelmaa, Tõnu Oja, Ants Ander, Henry Kõrvits : Downtown Pictures 2005

  17. 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

  18. Ühe imago anatoomia ehk pilk kinokriitika kööki / Ilmar Raag

    Index Scriptorium Estoniae

    Raag, Ilmar, 1968-

    1996-01-01

    Walt Disney kompanii esitles Pariisis täispikka muusikalist joonisfilmi 'Jumalaema kiriku kellamees' (Victor Hugo romaani 'Jumalaema kirik Pariisis' ainetel "The Hunchback of Notre Dame", režissöörid Gary Trousdale, Kirk Wise, USA 1996)

  19. 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

  20. Kiirus 2 ehk kunsti võimalustest ajupesu ühiskonnas / Katrin Kivimaa

    Index Scriptorium Estoniae

    Kivimaa, Katrin, 1969-

    1998-01-01

    Maanteenäitus 'Kiirus 2'. Kuraator Mari Sobolev. Osalejad loetletud. K. Putki, P. Alliku, J. Zoova, M. Laimre, M. Mäetamme, Sütevaka Andrese, P. Pajose, E. Müürsepa, T. Laamannni töödest. Pikemalt Andrus Joonase tööst 'Artist Kills the Beast' 1997. a. näituselt 'Kõike korraga ja palju'.

  1. 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

  2. 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

  3. Bits and Pieces ehk kolumna. White Label : No More Rokkstars. Kuula / DJ Pickney Tiger

    Index Scriptorium Estoniae

    DJ Pickney Tiger, pseud., 1970-

    2008-01-01

    Popmuusikauudised. Ansamblist No More Rockstars. Heliplaatidest: "Nigeria 70 Lagos Jump" Foxboro Hot Tubs "Stop Drop and Roll!!!", Maikameikers "Kriminaalne Elevant "Kuul", Vaiko Eplik ja Eliit "3. Kosmoseodüsseia", Zetod "Lätsi tarrõ tagasi", Konono NO 1 "Live at Coleur Cafe", Hadouken! "Music for an accelerated culture", "Quiet Village - Silent Movie"

  4. 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

  5. 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

  6. 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

  7. Maksukohustuse täitmise preventiivne tagamine ehk kuidas õigusriigile kohaselt ennustada / Kaido Künnapas

    Index Scriptorium Estoniae

    Künnapas, Kaido, 1985-

    2018-01-01

    Euroopa Inimõiguste Kohtu kujundatud miinimumstandardid maksude tasumise tagamiseks omandisse sekkumisel, preventiivsete tõkendite süsteemist Eestis ja Ameerika Ühendriikides, riigivastutuse probleemidest preventiivsete tõkendite puhul. Artikkel põhineb autori doktoritööl "Maksukohustuse täitmise preventiivne tagamine enne maksukohustuse tuvastamist: ettevaatuspõhimõte maksumenetluses"

  8. 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)

  9. Minu isamajakene linnupesa sarnane ehk kui kaua kestab kodu? / Oliver Orro

    Index Scriptorium Estoniae

    Orro, Oliver, 1982-

    2013-01-01

    Arhitektuuriteadlane Oliver Orro kirjutab: "Vahel tundub, et isegi anonüümsele nõukogude inimesele mõeldud, rangelt standardiseeritud hruštsovkad ja paneelikad oma näilises jäikuses on tegelikult võimalusterohkemad kui paljud praegu kavandatud majad ja korterid"

  10. 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

  11. Taani kunst ehk räägi minuga! / Andreas Trossek

    Index Scriptorium Estoniae

    Trossek, Andreas, 1980-

    2003-01-01

    Taani kaasaegse kunsti näitusest "Projekt" Tallinna Kunstihoones. Kaasa teevad ka eesti ja läti kunstitudengid. Mads Lynnerupi, Lise Sattrupi, Lene Degetti, Carsten Schmidt-Olseni, rühmituse N55, Vibeke Mejlvangi ja Sofie Hesselholdti projektidest

  12. 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

  13. 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.

  14. Tartu ehk unbewusste Ängste / Rauno Thomas Moss ; interv. Harry Liivrand

    Index Scriptorium Estoniae

    Moss, Rauno Thomas, 1977-

    2008-01-01

    Rauno Thomas Mossi (1977) näitus "Silent Tartu aka Clinical" Vaal galeriis. Kunstniku eluloolisi andmeid, loomingust, alasti mehekeha kujutamisest. Töötab Tartu Ülikoolis joonistamise ja plastilise anatoomia õppejõuna. Tema lemmikkunstnikud

  15. 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"

  16. 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

  17. Säärane meer ehk sada vakka heinaseemet / Kaarel Tarand

    Index Scriptorium Estoniae

    Tarand, Kaarel, 1966-

    2006-01-01

    Haljasaladest Tallinna vanalinnas, haljasala rajamisest Harju tänava äärde, ehitustegevuse planeerimisest kaitseala põhimääruse järgi haljasalaks ettenähtud Skoone bastionile. Harju tänav tuleks hoonestada

  18. 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

  19. 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"

  20. Arnold Rüütel superstar ehk kevadine veinituur Gruusiasse / Raul Ranne

    Index Scriptorium Estoniae

    Ranne, Raul

    2006-01-01

    President Arnold Rüütli visiidist Gruusiasse. Vt. samas lk. A14 intervjuud presidendi kaaskonnas olnud suurettevõtja Urmas Sõõrumaaga. Sõõrumaa: "Ma soovitan Gruusiat!". Vabariigi Presidendi ametlik visiit Gruusia Vabariiki 9.-13.05.2006

  1. 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

  2. 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

  3. 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

  4. 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

  5. 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"

  6. 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

  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. 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

  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. Hoiakud tõlkimise kohta ehk kuidas defineeritakse tõlkimist / Triin van Doorslaer

    Index Scriptorium Estoniae

    Doorslaer, Triin van

    2015-01-01

    Artiklis keskendutakse tõlkimise defineerimisele tõlkijahariduse seisukohalt. Uuringust, milles osalesid TLÜ kirjaliku tõlke magistriprogrammi tudengid, tudengikandidaadid ja professionaalsed tõlkijad

  11. 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

  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. 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"

  14. 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"

  15. 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

  16. Sure ära ehk Ka kriitiku käes on ligimese saatus / Silver Vahtre

    Index Scriptorium Estoniae

    Vahtre, Silver

    2006-01-01

    Vastuseks 2005. aasta sõnalavastuste žürii otsusele Tiit Palu lavastusele "Mis värvi on vabadus" Endlas. Oma mõtteid avaldab lavastuse kunstnik Silver Vahtre. (7. apr. "Sirbi" intervjuu Reet Neimari ja Madis Kolgiga)

  17. 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

  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. 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

  20. 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

  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. Eesti Hollywood ehk nädala jooksul tehakse kuut kodumaist filmi

    Index Scriptorium Estoniae

    2004-01-01

    Toimetus ja Eesti Filmi Sihtasutuse peaekspert Jaak Lõhmus töös olevatest mängufilmidest : Peeter Simmi "Kontserdireis", Peeter Urbla "Stiilipidu", Rene Vilbre "Röövlirahnu Martin", Õ-Fraktsiooni "Malev" (režissöör Kaaren Kaer)

  3. Bits and Pieces ehk kolumna. White Label : Bombillaz - Pumm. Kuula / DJ Pickney Tiger

    Index Scriptorium Estoniae

    DJ Pickney Tiger, pseud., 1970-

    2008-01-01

    Popmuusikauudised. Laulust. Heliplaatidest: Kris Kristofferson "This Old Road", Rulers of the Deep (M. Meri, P. Julm) "Ready To Go Overground", Ry Cooder "I, Flathead. The Songs of Kash Buk and the Klowns", Svjata Vatra "Kalyna", The Streets "Everything Is Borroved", The Offspring "Rise and Fall, Race and Grace", Kerli Kõiv "Love Is Dead", "Mamma Mia! The Movie Soundtrack"

  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. Riiast kulda toomas ehk tähelepanekuid Balti kommunikatsiooniauhindade jagamisest / Kristel Abel

    Index Scriptorium Estoniae

    Abel, Kristel, 1974-

    2017-01-01

    Märtsi algul Riias peetud üritusel "Mi:t&Links Baltic Communication Awards 2017" jagati kommunikatsiooniauhindu. Võistlusel esile tõusnud projektidest. Strateegilisele mõtlemisele pühendatud konverentsist

  6. Pallas kuuvalgel ehk Lõpetamata peatükk eesti kunstis / Enn Lillemets

    Index Scriptorium Estoniae

    Lillemets, Enn, 1958-

    2009-01-01

    Pallase kunstikooli 90. aastapäeva tähistav näitus "Lõpetamata Pallas" Tartu Linnamuuseumis 31. oktoobrini. Loetletud 19 osalejat. Väljapaneku autoritel jäi Pallase kool lõpetamata, näituse aines on valitud peamiselt Teise maailmasõja aastaist 1940-1945. Pikemalt Varmo Pirgi ja Herman Aunapuu töödest

  7. Eestlased vigu parandamas ehk väikevormidest suurvormini, disainist reekviemini / Märt Kubo

    Index Scriptorium Estoniae

    Kubo, Märt, 1944-

    2007-01-01

    Eesti Kultuurfilmis valminud Juhan Aare (produtsent, autor) dokumentaalfilm NSVL rahvasaadikute kongressil 1989-1991 tegutsenud Eesti saadikute tegevusest ja iseseisvuse eest võitlemisest "Eestlased Kremlis" (režissöör Toomas Lepp)

  8. 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

  9. 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

  10. 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"

  11. 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)

  12. 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

  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. Kas meist saavad balti baskid ehk kuidas olla esindatud? / Jaan Undusk

    Index Scriptorium Estoniae

    Undusk, Jaan, 1958-

    2002-01-01

    Teksti aluseks on ettekanne 8. Balti vaimse koostöö konverentsil 16. juunil 2001 Tallinnas: Are we Basques of Baltic? The Problem of how to be Represented. Rmt.: 8th Baltic Conference on Inettectual Co-operation. 15-16 June 2001, Tallinn, Estonia. Tln., 2002

  15. Baltokas on lobisema hakanud ehk Kuhu näitleja kadus? / Rait Avestik

    Index Scriptorium Estoniae

    Avestik, Rait, 1974-

    2006-01-01

    Baltoscandal 2006 huvitavamaid esinejaid : Houkka Bros. Soomest "elutoamuusikaliga" "Lapsi, linde ja lillekesi", Rabih Mroue "Otsides kadunud töötajat", Rui Horta "Set Up", Mark Ravenhilli "Produkt", Amir Reza Koohestani Mehr Theatrical Group "Recent Experiences". (Ajalehe rubriigipealdis "SIRP eri : Festivaliteater")

  16. Piiramine, populism ja näidispoomine ehk Tallinna kasiino sõda / Koit Brinkmann

    Index Scriptorium Estoniae

    Brinkmann, Koit

    2008-01-01

    Tallinna keskerakondliku linnavalitsuse uus poliitika on kasiinode arvu kontrolli all hoidmine, kasiinode esindajad näevad otsuste taga poliitilist populismi. Küsimustele vastavad Tallinna linnapea Edgar Savisaar ja abilinnapea Taavi Aas. Vt. samas: Trahv veel avamata kasiino eest; Mitu meetrit on vahetu lähedus; Sel aastal lõpevad hasartmängu korraldusload Tallinnas

  17. 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

  18. Kõrkküla ehk vene bojaari Rosladini kivirist / Valdur Ohmann

    Index Scriptorium Estoniae

    Ohmann, Valdur, 1958-

    2012-01-01

    Vassili Rosladin oli Ivan Julma repressioonide eest pagenud vene bojaar, kes oli kanda kinnitanud Eestis. Järgnenud lahingutegevuses Virumaal osales ta rootslaste poolel. Kõrkküla rist on püstitatud kohale, kus ta lahingu käigus hukkus

  19. Õhuloss ehk tuletorni juurde / Tiina Käesel ; kommenteerinud Tamara Luuk

    Index Scriptorium Estoniae

    Käesel, Tiina, 1943-

    2011-01-01

    Ehtekunstinäitus "Õhuloss" Tallinna Põhjatuletornis 25. septembrini 2011. Näitusega kaasneb raamat "Castle in the Air - Jewellery from Estonia - Õhuloss", koostajad Kadri Mälk ja Tanel Veenre. Rühmitusse "õhuLoss" kuuluvad Kadri Mälk, Piret Hirv, Eve Margus-Villems, Kristiina Laurits, Villu Plink, Tanel Veenre, Katrin Sipelgas

  20. 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

  1. Kuhu kadus antropoloogia? : ehk vajadus "inimloomuse" järele / Maurice Bloch ; tlk. Maarja Kaaristo

    Index Scriptorium Estoniae

    Bloch, Maurice

    2007-01-01

    Antropoloogia kui distsipliini akadeemilisest ajaloost, sotsiaal- ja kultuuriantropoloogia hariduse puudujääkidest. Antropoloogia põhilistest uurimisteemadest ja uurimisteooriatest: difusionismist, evolutsionismist ning funktsionalismist

  2. 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

  3. 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

  4. 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.

  5. La régulation par des tâches médiatisées et scénarisées dans un dispositif hybride utilisant le TBI Regulation through mediated and didactised tasks in a blended learning course in which an interactive whiteboard is used

    Directory of Open Access Journals (Sweden)

    Sandrine Aguerre

    2011-12-01

    Full Text Available L'auteure présente un dispositif hybride de "formation à distance enrichie par le présentiel" dans lequel le temps en présentiel a pour fonction spécifique la régulation. Cette régulation concerne aussi bien le versant apprentissage que le versant enseignement de la situation. Elle s'attache notamment à situer les tâches et les sous-tâches par rapport à la réalisation d'une tâche globale et par rapport à l'apprentissage, notamment par un travail de décontextualisation et recontextualisation de ces tâches. L'utilisation du TBI lors du temps en présentiel a un effet non seulement sur la médiatisation pendant cette séance, mais aussi sur la scénarisation et la médiatisation (tant dans son aspect humain que technologique des tâches réalisées à distance, en permettant à l'apprenant de prendre part à la scénarisation et à la médiation.The author presents a blended-learning environment in which most learning activities are e-learning activities, and face to face situation is dedicated to regulation. Regulation is a mean to adapt learning as well as teaching; it aims particularly at considering tasks and sub-tasks in relation to a global task, and to learning. This control allows decontextualization and re-contextualization of the tasks. The use of the interactive whiteboard during face to face situation has an effect on task setting and task mediation (technological as well as human, making possible for the learner to take part in these.

  6. Rapid Isolation and Detection for RNA Biomarkers for TBI Diagnostics

    Science.gov (United States)

    2016-10-01

    isolation of glioblastoma exosomes from 50 µL of un-diluted plasma in fifteen to twenty minutes. We also showed tri- color fluorescent detection of the...serious short-term implications, but also may progress to chronic and debilitating long-term physiological and psychological problems for soldiers and...major impact on the patient’s long-term psychological health. This has significant negative effects on family members and is costly to society in

  7. Therapeutic Targeting of P2X7 after TBI

    Science.gov (United States)

    2012-11-16

    brain. Brain Behav Immun, 22(2), 234-244. Mitka, M. (2010). Reports of concussions from youth sports rise along with awareness of the problem. JAMA...E. (1998). The epidemiology of sports - related traumatic brain injuries in the United States: recent developments. J Head Trauma Rehabil, 13(2), 1-8...hemorrhage in mice. Antioxid Redox Signal, 11(1), 35-45. Wakade, C., Sukumari-Ramesh, S., Laird, M. D., Dhandapani, K. M., & Vender, J. R. Delayed

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

    Science.gov (United States)

    2015-10-01

    the Tampa VAMC and San Antonio VAMC, which both host Polytrauma Rehabilitation Centers. In addition, we plan to work with the Alabama Brain Injury...sites with those funds, e.g., the Tampa VAMC and San Antonio VAMC, which both host Polytrauma Rehabilitation Centers. In addition, we are seeking

  9. Aspects of radioprotection in whole body irradiation treatments (TBI)

    International Nuclear Information System (INIS)

    Pinella, Yuliana M. Ayala; Chavez, Cesar Picon

    2013-01-01

    Radiation protection occupationally exposed personnel and the public is considered in this study. It was done the experimental determination of the exposure rates at critical points in the area of radiotherapy and it was evaluated the staff dosimetry

  10. Psychological Outcome in Young Survivors of Severe TBI

    DEFF Research Database (Denmark)

    Doser, Karoline; Poulsen, Ingrid; Norup, Anne

    2015-01-01

    withdrawal, attention, and intrusive and internalizing problems. Good or excellent levels of agreement were found between the self-rating and the proxy-rating in overt areas such as somatic complaints and aggressive and intrusive behavior. Fair or poor levels of agreement were found in nonovert areas......, regarding the good to excellent levels of agreement. However, in nonovert domains, such as withdrawal and attention, an additional proxy-rating from a SO could provide supplementary information and build a more complete objective assessment....

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

    Science.gov (United States)

    2016-10-01

    occasions, magnetic resonance imaging ( MRI ), diffusion tensor imaging (DTI), and functional MRI (fMRI) of the brain will be carried out to determine changes...to which types of neuroplasticity-inducing pharmacological agents, when combined with CI therapy, are most likely to yield a superior treatment...were negotiated with the Birmingham VAMC, Denver VAMC, and Richmond VAMC. • The option of collecting MRI data using a 1.5T scanner was added for

  12. How Do Health Care Providers Diagnose Traumatic Brain Injury (TBI)?

    Science.gov (United States)

    ... NICHD Research Information Find a Study More Information Pharmacology Condition Information NICHD Research Information Find a Study ... the brain, bruised brain tissue, and other damage. Magnetic resonance imaging (MRI). MRI uses magnets and radio waves to ...

  13. 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

  14. Rapid Isolation and Detection for RNA Biomarkers for TBI Diagnostics

    Science.gov (United States)

    2015-10-01

    cervical adenocarcinoma) were obtained. • Primers were designed and tested for brain-specific mRNA targets: FABP, GFAP, NSE, MBP, S100B...Both of these values are generally painful to compute by hand, but trivial to evaluate in MATLAB once the data matrix is established in the tool...RNA from blood, plasma, and other samples. 100%/12 cal mos Tsukasa Takahashi Graduate student researcher/Staff Research Associate – helped obtain

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

    Science.gov (United States)

    2017-05-01

    Evaluation (MACE), smartphone , TARGET, military, civilian, validity, reliability 3 What was accomplished under these goals? For this reporting period describe...North American Society for the Psychology of Sport and Physical Activity, June 2016  Military Health System Research Symposium, August 2016...informational session and had some questions regarding the status of our smartphone as an investigational device vs purely a data collection tool. Their

  16. Nähtamatuse saladus paljastatud / Allar Viik

    Index Scriptorium Estoniae

    Viik, Allar

    2006-01-01

    Teadlased töötavad välja mitut nähtamatuks tegemise meetodit. Tuntumad neist on active camouflage ehk aktiivne maskeering, optical camouflage ehk aktiivne maskeering ja optical camouflage ehk optiline maskeering

  17. Eesti kõrgharidus institutsionaalse akrediteerimise tulemuste taustal ehk Mida juhid peaksid teadma / Maiki Udam, Riin Seema, Heli Mattisen

    Index Scriptorium Estoniae

    Udam, Maiki

    2015-01-01

    2014. aastal Eesti Kõrghariduse Kvaliteediagentuuris tehtud kõrghariduse institutsionaalse akrediteerimise hindamisaruannete kvalitatiivsest analüüsist, millega selgitati välja kõrgkoolide peamised tugevad ja nõrgad küljed

  18. Multikulti lõpp ehk immigratsiooni müütide ajastu hakkab otsa saama / Heiki Suurkask

    Index Scriptorium Estoniae

    Suurkask, Heiki, 1972-

    2011-01-01

    Euroopa on hakanud endasse sulguma, sest ei tea enam, kuidas immigrantide massiga toime tulla. Sallimatust immigrantide vastu Euroopas küll on, kuid see pole üheski riigis valdavaks muutunud. Immigrantidega seotud probleemidest

  19. Hüpates üle varju ehk Eesti millenniuminäitused / Henno Väri

    Index Scriptorium Estoniae

    Väri, Henno

    1999-01-01

    Ülevaatenäitused 'XX sajandi eesti kunstniku mälestuseks' (kuraator Eha Komissarov, üldkujundaja Jaan Toomik) Eesti Kunstimuuseumi Rüütelkonna hoones ja 'Hingeaeg 1900-2000' (kuraatorid Tiiu Talvistu, Mare Joonsalu) Tartu Kunstimuuseumi Kivisilla Pildigaleriis.

  20. Las koerad hauguvad, karavan liigub ikka edasi ehk Maanteeamet ja MTA "ruulivad" vaatamata Riigikohtu juhistele edasi / Vahur Kivistik, Janar Urres

    Index Scriptorium Estoniae

    Kivistik, Vahur

    2016-01-01

    Riigikohtu lahendist 3-3-1-69-15 seoses Maksu- ja Tolliameti (MTA) ja Maanteeameti (MNT) koostööga eesmärgiga pidurdada 2009. a toodetud ja uuemate autode maaletoomisel toimuvaid käibemaksupettusi

  1. Lossist lossiks ehk ajaloo paradoks = From a palace into a palace, or a historical paradox / Harry Liivrand

    Index Scriptorium Estoniae

    Liivrand, Harry, 1961-

    2012-01-01

    Berliinis ülesehitatavast kuningalossist, mille ametlikuks nimeks saab Berliini loss/Humboldt-Foorum (rekonstruktsiooniprojekti autor Francesco Stella). Lammutati Vabariigi Palee (Palast der Republik), mis ehitati aastail 1973-1976, peaarhitekt Heinz Graffunder

  2. Bits and Pieces ehk kolumna. White Label : Music For Your Plants - Air Koryo. Kuula / DJ Pickney Tiger

    Index Scriptorium Estoniae

    DJ Pickney Tiger, pseud., 1970-

    2008-01-01

    Popmuusikauudised. Laulust. Heliplaatidest: Virre "Kolmas. Folk rokib", Paabel "Loomine", Luarvik-Luarvik "Enigma variatsioonid", Maikameikers "8Hz", Asian Dub Foundation "Punkara", Everlast "Love, War and the Ghost of Whitey Ford", Pat Metheny & Anna Maria Jopek "Upojenie", Pat Metheny, Roy Hayness and Dave Holland "Questions and Answers", Kosmikud "Ainus, mis jääb, on beat", Metallica "Death Magnetic", Natty "Man Like I", 42Go "Miljonäri poeg"

  3. Bits and Pieces ehk kolumna. White label : Chungin & The Strap-On Faggots. Kuula / DJ Pickney Tiger

    Index Scriptorium Estoniae

    DJ Pickney Tiger, pseud., 1970-

    2008-01-01

    Popmuusikauudised. Punk-ansamblist. Heliplaatidest: Sigur Ros "Hvart", Waylon Jennings "The Essential", "Eesti Rock Antoloogia", The Dynamics "Version Excursion", Pat Metheny "Secret Story", Raadio Maria "Siin Tallinn", Killers "Sawdust", "Electric Cypsyland 2: A Crammed Discs"

  4. Olge mõnusad ja kinnitage turvavöö : ehk Kirjanduslikud visiitkaardid / Pille-Riin Larm

    Index Scriptorium Estoniae

    Larm, Pille-Riin, 1981-

    2017-01-01

    Erinevatest trükistest, mida poest ei leia: ajakiri "ELM", festivali HeadRead kogumik "Lõpmatuse lävel", festivali Prima Vista kogumik "Metsik Sõna", Eesti Instituudi kogumik "Nippernaati", Jaan Malini koostatud kogumik "Pilt ja sõna" ja Valdur Mikita "Tartu tähestik"

  5. Karistusseadustiku § 119¹ ehk tõenduslike probleemide ületamine materiaalõiguse abil / Anneli Soo, Birgit Sisask

    Index Scriptorium Estoniae

    Soo, Anneli, 1984-

    2015-01-01

    1. jaanuaril 2015 jõustus karistusseadustikus rida muudatusi, sh lisandus § 119¹, mis käsitleb kakluses osalemist. Karistusõiguslikest ja põhiseaduslikest põhimõtetest, millega § 119¹ läheb vastuollu

  6. Iäkkäiden henkilöiden kaatumistapaturmat – Opas murtumien ja kaatumisten ehkäisyyn

    DEFF Research Database (Denmark)

    Mänty, Minna Regina; Sihvonen, Sanna; Hulkko, Terhi

    2010-01-01

    Falls are the most common type of injury among Finnish older adults. Due to fallrelated injuries many older adults are in high-risk for loosing their independence and may need institutional care. Moreover, during past decades the amount of fall-related deaths among older adults has increased...... the amount of fall injuries has been estimated to increase since the number and proportion of older adults is growing. The prevention of falls and fall-related injuries among older adults should be a high priority area. Often risk factors for falls include both intrinsic personal factors and external factors...... that are related to the living environment. Fall risk can be reduced by identifying potential risk factors individually and eliminating and reducing them. Falls prevention programs targeted simultaneously to multiple risk factors have been shown to be the most effective interventions. Falls prevention programs...

  7. Lauli mi, tuvi' toro sisse, kalli kramahvoona sisse... ehk Neiu surm & suured saajad / Marju Torp-Kõivupuu

    Index Scriptorium Estoniae

    Torp-Kõivupuu, Marju, 1960-

    2004-01-01

    Rets. rmt.: The Maiden's Death Song & The Great Wedding : Anne Vabarna's oral twin epic written down by A. O. Väisanen / by Lauri Honko in collaboration with Anneli Honko and Paul Hagu. Helsinki, 2003. Setu rahvalauliku Anne Vabarna kaksikeeposest "Suured saajad. Neiu koolulaul"

  8. Isamaaline tundmus : Eesti ja Soome kirjamees Jüri Tilk ehk Yrjö Virula / Anu Pallas

    Index Scriptorium Estoniae

    Pallas, Anu, 1960-

    2010-01-01

    Avaliku elu tegelasest, ajakirjanikust ja karskuskirjanduse rajajast Jüri Tilgast, kes 19. sajandi lõpul töötas aktiivselt üldtuntud rahvajuhtide kõrval, olles ka Ado Grenzsteini lähim aatekaaslane

  9. Veebist, ülepildistamisest, muuseumiaastast ja rahvast ehk teeme ometi talgud ja jätame jalgratta leiutamata! / Vahur Puik

    Index Scriptorium Estoniae

    Puik, Vahur

    2008-01-01

    Ajalooliste kohafotode väärtusest, nende ülepildistamisest, veebikeskkonda laadimisest, mäluasutuste tööst selles vallas. Fotojagamiskeskkonnas Flickr on loodud mäluasutuste jaoks alajaotus "the Commons", mille eesmärk on kaasata inimesi avalike fotokogude kirjeldamisse

  10. Siil-udus-strateegia ehk kuidas määramatus keskkonnas koju jõuda / Jüri Sakkeus

    Index Scriptorium Estoniae

    Sakkeus, Jüri

    2005-01-01

    Strateegilisest planeerimisest muutlikus keskkonnas kirjeldab London Business Schooli professor Donald N. Sull. Ärikeskkonna arengu jälgimiseks kasutatavast PEST analüüsist. Jätkusuutlikust arengust Viljandi Metall näitel. Lisad. Graafik. Skeemid

  11. Mintuleasa tänavas : lugu K.-st ehk kohtade kehastumisest ja kultuurilisest kapitalist / Indrek Peil

    Index Scriptorium Estoniae

    Peil, Indrek, 1973-

    2005-01-01

    Kehastunud ruumilistest suhetest linnas, vanade tööstushoonete taaskasutamisest, Tallinna tselluloosivabrikust, kultuurivabrikust, Raivo Kotovi ja Andrus Kõresaare Tallinna tselluloosivabriku otsa projekteeritavast pealeehitusest (elu- ja ärihoone Fahle Maja, KOKO Arhitektuuristuudio, 2004-2005) jm.

  12. Enesessetõmbumine ehk Ungari välispoliitika argipäevad / Anita Orban ; tõlk. Ivar Sinimets

    Index Scriptorium Estoniae

    Orban, Anita

    2006-01-01

    Autor leiab, et Ungari välispoliitika on toodud sisepoliitikale ohvriks ja seetõttu suudetakse saavutada ainult murdosake sellest, mida tegelikult tuleks ja saaks teha. Ungari diplomaatia pole võimeline pärast liitumisläbirääkimisi ELiga välja töötama või ellu viima Ungari huve hõlmavat kontseptsiooni. Ülevaade riigi poliitilisest olukorrast

  13. Bits and Pieces ehk kolumna. White Label : P.W.A. - Work together. Kuula / DJ Pickney Tiger

    Index Scriptorium Estoniae

    DJ Pickney Tiger, pseud., 1970-

    2008-01-01

    Popmuusikauudised. Rockansambli Preserve White Aryans videost. Laulust. Heliplaatidest: Beyond The Horizon", "Only Yazoo. The Best Of", Kaiser Chiefs "Off With Their Heads", "Weezer", Marianne Faithfull "Easy Come Easy Go", The Ry Cooder Anthology "The Ufo has landed",T Bone Burnett "Tooth of Crime", Lonely Drifter Karen "Grass Is Singing", Kim Herold "Drunksoberlovemusic"

  14. Kaks Molière'i tõlgendust ehk "Tartuffe'i" kiituseks ja "Ihnuri" laituseks / Gitta Nazarova

    Index Scriptorium Estoniae

    Nazarova, Gitta

    1999-01-01

    Viljandi Kultuurikolledži teatrikateedri II lennu diplomietendus Molière' i "Tartuffe ", lavastaja Kalju Komissarov ja Eesti Muusikaakadeemia Kõrgema Lavakunstikooli XIX lennu diplomietendus Molière' i "Ihnur", lavastaja Ingo Normet

  15. Toetusrühm on toetuseks ehk maalitud seinast, kuldvõtmekesest ja tegelikust elust / Avo Üprus

    Index Scriptorium Estoniae

    Üprus, Avo, 1954-

    2005-01-01

    Autor leiab, et valitsus saab juhtida oma programme ka kodanikeühenduste koostöövõrgu kaudu ning lihtsustada nii riigi ülesehitust. Muutuvas maailmas võib kaasamise kaudu kasvatada usaldust ja vastutust

  16. Bits and pieces ehk kolumna. White label : Semia Napasov - nervnõe kletki. Kuula / DJ Pickney Tiger

    Index Scriptorium Estoniae

    DJ Pickney Tiger, pseud., 1970-

    2008-01-01

    Popmuusikasündmustest. Vene hiphop: Kõrgepingerajoon - 2 lugu. Heliplaatidest: Echo And The Bunnymen "The Works - A3 CD Retrispective", Morrissey "Greatest Hits", The Hold Steady "Boys and Girls in America", Dreamtheater "Greatest Hits", "Eesti Drum'n'Bass Vol. 2", Raisk "Transilvaania Krahvid", "Eesti Rock Antoloogia. Blacky", Teräsbetoni "Myrskyntuoja",Tiken Jah Fakoly "The African", Sild "Tro", Duffy "Rockferry", Adele "19"

  17. "Avamaa" ehk Kuidas kasutada ära meie maaelu võimalusi? / Evelyn Müürsepp

    Index Scriptorium Estoniae

    Müürsepp, Evelyn

    2008-01-01

    Kunstisümpoosion "Avamaa" Mooste Kunsti- ja Sotsiaalpraktika Keskuses 18.-23. VIII. Tero Nauha, Siim Angerpiku, rühmituse Lahe Atmosfäär, Patrick McGinley ja John Grzinichi kureeritud töötubadest. 23. VIII eksperimentaalse folkmuusika kontserdil "Mesi kõrvadele" esinesid Launau, Lauhkeat Lampaat ja Kuupuu Soomest, Michele Spanghero Itaaliast, Riho Kall, Vaikuse Koosolek (Anna Hints, Helen Kõmmus, Maria Rõhu, Marja-Liisa Plats, Tanel Kaupan), Mari Kalkun ja Tanel Kadalipp Eestist ning Bernu Rits Lätist

  18. Maamesilasena maailmas ehk lihtsalt Jüri Talveti meetodist / On Jüri Talvet’s Comparative Method

    Directory of Open Access Journals (Sweden)

    Arne Merilai

    2016-12-01

    Full Text Available Teesid: Artikkel defineerib maailmakirjanduse professor Jüri Talveti komparativistlikku meetodit nii maamesilase metafoori kui ka tema poolt tutvustatud mõistete edaphos (’pind’ ja episteme (’teadmine’ kaudu. Võrdleva kirjandusteadlase ülesanne on kahesuunaline: tutvustada eesti kirjandust maailmas ja vahendada mujal loodut meie kultuurile. Kuigi õpetlaste teoreetiline metasüsteem ja mõistevõrk – episteme – võib areneda väga keeruliseks, peab see alati juurduma edaphos’es kui toitvas pinnases, mille loovad sõnakunstiteosed ja rahvuslikud kirjanduslood. Avardades võrdlevat edaphos’t, aktiveerime ja rikastame ka maailma episteme’t.   The article aims at defining the comparative method of Jüri Talvet, professor of comparative literature. This can be carried out by an application of Talvet’s own metaphor for himself – a bumble bee, or via two concepts elaborated by him – edaphos (base and episteme (knowledge. The bumble bee, by nature more reclusive and peaceful but somehow more attractive looks than a regular bee flies out from its modest sod nest across blooming meadows, disseminating homely pollen among the leaves of grass of the wide world. Then it faithfully returns with nourishing nectar that feeds its family. As chairman of the Estonian Comparative Literature Association, and founder and editor-in-chief of the comparative literature journal Interlitteraria, Talvet has written: “Its purpose is to channel new literary-philosophical ideas from the international area to Estonia and, at the same time, to spread knowledge about Estonian literary and philosophical studies outside Estonia, as well as to let the wider world have some idea of Estonian literature itself which, because of the language barrier, has belonged traditionally to the majority of “silent” literatures of the world, unjustly ignored by the area of the dominant Western languages.” Yet, no matter how complex our theoretical meta-systems and conceptual framework – episteme – might develop, it always needs to be firmly based on edaphos as its foundation, that is, on works of literature and national literary histories. By extending the comparative edaphos, we also enrich the world’s episteme. It is therefore not surprising that, as a scholar with extensive knowledge of world literature, Talvet has great affinity for tellurism, an aesthetic concept used in Hispanic cultures that is largely unknown to the English-speaking world.

  19. Kust see laps need laulud võtab ehk keeleline sisend ja väljund luubi all

    Directory of Open Access Journals (Sweden)

    Helen Kõrgesaar

    2016-05-01

    Full Text Available "Where does the child get those songs: Linguistic input and output under the microscope" The article discusses the qualitative and functional peculiarities of caregiver speech and child speech, the importance of the way in which children are spoken to, and whether input language has an important role in speech development. Also, an overview is provided of the nature and essential features of input language, presenting the similarities and differences between input and output and describing the ways in which different factors affect the way in which children are interacted with, including child-directed speech. As children acquire language in a speech community, with different social situations and with interlocutors whose language exhibits varying degrees of phonological, morphological, syntactic and semantic competence, child-directed speech is dynamic and changes as the child matures. The form of child-directed speech is considered to play an important role in children’s language development, and a number of linguistic features that appear during certain time periods in child-directed speech are also reflected in the child’s own speech. However, there are also linguistic features that, while present in adult speech, do not appear at all in child speech.

  20. Põhuteater ehk Salto arhitektide must monoliit = Straw Theatre or the Black Monolith by the Salto Architects / Risto Kozer

    Index Scriptorium Estoniae

    Kozer, Risto

    2011-01-01

    Tallinnas 2011. a. valminud NO99 Põhuteatrist. Arhitektid: Maarja Kask, Karli Luik, Ralf Lõoke, Pelle-Sten Viiburg (Salto AB). Projekt: 2010. Loodud ajaperioodiks 30.04.-01.10.2011. Skoone bastionist enne Põhuteatrit

  1. Kaks mõrva ühes mesilasperes ehk laibarida ei tule / Lauri Tabur ; interv. Enno Tammer

    Index Scriptorium Estoniae

    Tabur, Lauri, 1974-

    2005-01-01

    Keskkriminaalpolitsei ülem vastab küsimustele, mis puudutavad Tallinna koolitüdruku Veronika Dari, eestikeelse allilma väidetava liidri Kalev Kure ning ärimees Kauri Koppeli mõrvu Tallinnas. Lisa: Kiirarvamus

  2. Hiigelämblik kanali kohal ehk Kuidas ERMi uus hoone lõi kired lõkkele / Tarmo Michelson

    Index Scriptorium Estoniae

    Michelson, Tarmo, 1975-

    2006-01-01

    Eesti Rahva muuseumi uue hoone arhitektuurikonkursi võidutööst "Memory Field" (autorid itaalia arhitekt Dan Dorell, liibanoni arhitekt Lina Ghotmeh, jaapani arhitekt Tsuyoshi Tane). Kommenteerivad Jaanus Plaat, Tõnis Lukas, Karin Hallas-Murula, Raivo Palmaru, Laine Jänes, Marika Valk

  3. 296 kilomeetrit vabariigi presidendini ehk Kuidas Misso valla valijamees Ere Käis riigipea paika pani / Rainer Kerge

    Index Scriptorium Estoniae

    Kerge, Rainer, 1977-

    2006-01-01

    Kuigi Misso valla volikogu andis oma valijamehele, Misso Keskkooli direktorile Ere Käisele mandaadi hääletada president Arnold Rüütli poolt, ei avalikusta valijamees, kumba kandidaadi poolt ta oma hääle andis. Kaart: Misso valla valijamehe tee Estoniasse - 296 kilomeetrit

  4. Low-tech-video ehk naivistide, amatööride ja videokunstnike audiovisuaalne kunst / Raivo Kelomees

    Index Scriptorium Estoniae

    Kelomees, Raivo, 1960-

    2001-01-01

    Varajasest videokunstist ja videokunstist muutunud kontekstis. Vene kunstniku Oleg Mavromatti videotest "Võbljadki" ja "Roheline elevandike". Rael Arteli, Valdek Alberi, Kristin Kalamehe ja Allan Tõnissoo töödest. Trash-videost. Marko Siguse videotest-filmidest. Taave Tuutma, Mari Sobolevi, Hanno Soansi ja Katrin Kivimaa planeeritud aktsioonide dokumentatsioonidest. Ilmunud ka kogumikus "Ekraan kui membraan". Tartu, 2007, lk. 195-198

  5. Eelisaktsiate kajastamisest ehk milles Raamatupidamise Toimkond ja PricewaterhouseCoopers eksivad ja eelmisel Raamatupidamise Toimkonnal siiski õigus oli / Jaan Alver

    Index Scriptorium Estoniae

    Alver, Jaan, 1949-

    2004-01-01

    Autor selgitab eelisaktsiate olemust, toob välja eelisaktsia ning lihtaktsia ja pikaajalise võlakirja peamised erinevused ning teeb ülevaate rahvusvahelises standardis IAS 32 eelisaktsiate klassifitseerimise kohta sisalduvast. Tabelid: Lihtaktsiate ja eelisaktsiate võrdlus; Pikaajaliste võlakirjade ja eelisaktsiate võrdlus

  6. Varjatud ajalugu ehk kuidas eksiilkunst kodu leidis = Hidden history, or how an exiled art found a home / Steven Mansbach

    Index Scriptorium Estoniae

    Mansbach, Steven, 1950-

    2009-01-01

    Euroopa 20. saj. kunsti ajaloo õpetamisest Ameerikas. Pärast Teist maailmasõda Ameerikasse emigreerunud kunstiteadlaste tegevusest. Ignoreerivast suhtumisest Ida-Euroopa maade kunsti. Geograafiliste, ajaliste ja kultuuriliste eripärade ületamise vajadusest

  7. Teo Krüüner: ranget lennukeeeldu ehk polnuks vaja / Teo Krüüner ; intervjueerinud Priit Simson

    Index Scriptorium Estoniae

    Krüüner, Teo, 1943-

    2010-01-01

    Intervjuu Eesti lennuväeakadeemia õppejõu, õhuväe endise ülemaga vulkaanilise tuhaga seotud riskist lennukitele, tuha erinevast mõjust eri lennukitele, ulatuslikust lennupiirangust Euroopas, Tu-154 tüüpi lennuki usaldusväärsusest

  8. Aspects of radioprotection in whole body irradiation treatments (TBI); Aspectos de proteccion radiologica en tratamientos de irradiacion de cuerpo total (TBI)

    Energy Technology Data Exchange (ETDEWEB)

    Pinella, Yuliana M. Ayala, E-mail: yayala@crlima.com [Centro de Radioterapia de Lima S.A., Lima (Peru); Chavez, Cesar Picon, E-mail: cesarpicon@yahoo.com [Universidad Nacional de Ingenieria (UNI), Lima (Peru)

    2013-11-01

    Radiation protection occupationally exposed personnel and the public is considered in this study. It was done the experimental determination of the exposure rates at critical points in the area of radiotherapy and it was evaluated the staff dosimetry.

  9. Molecular Signatures and Diagnostic Biomarkers of Cumulative Blast-Graded Mild TBI

    Science.gov (United States)

    2014-12-01

    experiment: to assign rat ID #404-430 (the last rat examined was 403). Provided rats arrive Monday or Tuesday , Jun 10-11. 30 days post-blast endpoint...and 36.6 kPa 6, 24 h and 1 week Single or 12 blasts (24 h at 36.6 kPa) Three body orientation (sideway, facing away vs. frontal) Morris water maze task...0.5, 3, 6, and 10 h and 1, 2, 3, 5, and 7 days Single Morris water maze: impaired cognitive function: 48 h post injury Dose-dependent rise in

  10. Investigation of Prognostic Ability of Novel Imaging Markers for Traumatic Brain Injury (TBI)

    Science.gov (United States)

    2011-10-01

    at delivery; (g) amniotic fluid obtained at the time of rupture of the membrane prior to or during labor; (h) supra- and subgingival dental plaque and... calculus , provided the collection procedure is not more invasive than routine prophylactic scaling of the teeth and the process is accomplished in

  11. High Resolution Diffusion Tensor Imaging of Cortical-Subcortical White Matter Tracts in TBI

    Science.gov (United States)

    2010-10-01

    and advances it by testing the theory that damage to the thalamus and brain stem result in both structural and physiological alterations...by the individual (e.g., car full of lettuce ) or words that share phonemic qualities (e.g., chair/cat; sofa/soup). The observed bidirectional...subjective clustering score minus the expected subjective clustering score. An example is if the word pair car/ lettuce (subjective observed score of 1) is

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

    Science.gov (United States)

    2015-10-01

    Contribution to Project: Dr. Kenney provides neurological expertise and oversees the data collection and neurological battery at the AFRH site... Glucose Regulation, Cognitive & Brain Changes in Elders (Yaffe: PI) Time Commitment: .36 calendar months Supporting Agency: American Health Assistance

  13. Underbody Blast Models of TBI Caused by Hyper-Acceleration and Secondary Head Impact

    Science.gov (United States)

    2016-02-01

    function (balance beam and composite neuroscore), cognition and memory (novel object recognition), and anxiety (forced swim test). Following either...inch can on a full sized vehicle. Adding such a considerable height to the vehicle has many negative effects, including a higher center of gravity and...set-up 5 Specific equipment is also necessary for dynamic testing using a pressurized gas gun. A high-pressure gas gun from a Split -Hopkinson

  14. Genetic Variation Underlying Traumatic Brain injury (TBI) and Late Onset Alzheimer’s Disease (LOAD)

    Science.gov (United States)

    2017-10-01

    Stable trajectory, Decliners were more likely women , older, less educated, from non-White ancestry population and APOE-ε4 carriers. The highest annual...with slightly higher rates for women compared to males (rates= 4.0 versus 3.8) and the highest rates achieved by subjects with a Caribbean-Hispanic... Single nucleotide polymorphism (dbSNP) Deoxyribonucleic acid (DNA) The Department of Defense and Veterans Brain Injury Center (DVBIC) Genome

  15. TBI-Induced Formation of Toxic Tau and Its Biochemical Similarities to Tau in AD Brains

    Science.gov (United States)

    2016-10-01

    neurofibrillary tangles (NFTs), the classical histopathological hallmark of AD consisting of insoluble aggregated tau, have been reported in multiple...and reversible NR1 knockout reveals crucial role of the NMDA receptor in preserving remote memories in the brain. Neuron, 2004. 41(5): p. 781-93. 6

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

    Science.gov (United States)

    2012-10-01

    deficits , such as attention deficit hyperactivity disorder ( ADHD ), substance abuse...Peretz, J., & Pratt, H. (2011). Dis-regulation of response inhibition in adult Attention Deficit Hyperactivity Disorder ( ADHD ): An ERP study. Clinical... disorders such as attention - deficit / hyperactivity disorder ( ADHD ), borderline personality disor- der, substance abuse, and the manic phase of

  17. Cognitive and emotional consequences of TBI: intervention strategies for vocational rehabilitation.

    Science.gov (United States)

    Mateer, Catherine A; Sira, Claire S

    2006-01-01

    The effects of a traumatic brain injury on vocational outcome can be predicted on the basis of several factors. Environmental factors such as a supportive work environment, and person specific factors, including the client's age, premorbid occupation, injury variables, level of awareness, psychosocial adjustment, coping skills, and cognitive deficits have all been found to predict return to work following a traumatic brain injury. Some of these factors are amenable to treatment, and clinicians can impact clients' likelihood of returning to work by intervening in various ways. Through case studies and a literature review on the effectiveness of cognitive rehabilitation interventions, we have outlined specific strategies and recommendations for interventions. Cognitive rehabilitation strategies that address attention, memory and executive deficits can improve clients' abilities to manage workplace tasks and demands. Many clients continue to experience problems with social and emotional adjustment following a brain injury that impact return to work. Cognitive behavioural therapy is well suited for improving coping skills, helping clients to manage cognitive difficulties, and addressing more generalized anxiety and depression in the context of a brain injury.

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

    Science.gov (United States)

    2016-04-01

    Advertisements have also been sent out electronically via the WRNMMC Intranet , and various list servs at NIH and UMCP. The study team conducts biweekly... implemented based upon feedback received at this meeting. Begin preliminary data analyses for Study #1 (Primary). Preliminary data analyses for the

  19. Physics of IED blast shock tube simulations for mTBI research

    NARCIS (Netherlands)

    Mediavilla Varas, J.; Philippens, M.M.G.M.; Meijer, S.R.; Berg, A.C. van den; Sibma, P.C.; Bree, J.L.M.J. van; Vries, D.V.W.M. de

    2011-01-01

    Shock tube experiments and simulations are conducted with a spherical gelatin filled skull- brain surrogate, in order to study the mechanisms leading to blast induced mild traumatic brain injury. A shock tube including sensor system is optimized to simulate realistic impro-vised explosive device

  20. Blast Concussion mTBI, Hypopituitarism, and Psychological Health in OIF/OEF Veterans

    Science.gov (United States)

    2014-06-01

    Both hypoprolactinemia and hyperprolactinemia are associated with sexual and reproductive dysfunction including erectile dysfunction and...Jasovic- Gasic, M., and Popovic, V. (2010). Psychiatric and neuropsychologi - cal changes in growth hormone- deficient patients after traumatic brain injury...License, which per- mits non-commercial use, distribution, and reproduction in other forums, pro- vided the original authors and source are credited

  1. Bright Light Therapy for Treatment of Sleep Problems Following Mild TBI

    Science.gov (United States)

    2015-10-01

    the likelihood that they will recover more quickly, benefit more extensively from other forms of therapy, and build emotional and cognitive...vacation in the woods, you decide to go hiking in an unfamiliar and thickly wooded area without a map or guide. What is the likelihood that YOU will

  2. Non-Impact, Blast-Induced Mild TBI and PTSD: Concepts and Caveats

    Science.gov (United States)

    2011-07-01

    wave, volumetric blood surge, cerebrovascular insults Introduction Unlike previous wars, improved body armour and helmets now successfully reduce the...by violent personal assaults, natural- or human-caused disasters and accidents . Combat- related stressors (such as insomnia, fear, fatigue, stress...might be a result of large- scale cerebrovascular insults that occur globally throughout the brain. Cerebral oedema, hyperemia, haemorrhage and vasospasm

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

    Science.gov (United States)

    2015-10-01

    R&D Program, Psychological Health/Traumatic Brain Injury Research Program, Congressionally Directed Medical Research Programs, Clinical and...resistant epilepsy . Specific Aims: Aim 1: Characterizing the time-frequency dynamics of odor coding and categorization. Aim 2: Characterizing the

  4. Does Environmental Enrichment Exposure Prior to Injury Influence Biomarkers Associated with Chronic Stage TBI?

    Science.gov (United States)

    2012-12-01

    release; distribution unlimited. 88 ABW/PA Cleared 03/25/2013; 88ABW-2013-1398. enrichment (Grundy et al., 2000; Kohara et al., 2001). BDNF is an...learning and Memory. 69(3):274-289 Kohara , K., Kitamura, A., Morishima, M., Tsumoto, T. (2001). Activity- dependent transfer of brain-derived

  5. Multimodal Approach to Testing the Acute Effects of Mild Traumatic Brain Injury (mTBI)

    Science.gov (United States)

    2015-03-01

    magnetoencephalography, MEG, MRI, blood biomarkers, actigraphy 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a...all participants in the study. B. EEG and MEG Recordings and Signal Preprocessing Subjects were asked to remain as still as possible during the...electrode EEG system (Wearable Sensing, San Diego, CA). The system includes 21 channels for EEG and two additional channels to record EOG and EKG activity

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

    Science.gov (United States)

    2013-03-01

    up calcified stones within the kidney and gallbladder , standard applications create a short acoustic wave train whose shape is far from sinusoidal...for each mouse brain. This feature extraction analysis was performed 3 times for each image in a blinded fashion to ensure that there was no operator

  7. Orientation and magnetic properties of the thick multilayered [NdFeBxTby]n films

    International Nuclear Information System (INIS)

    Liu, Weifang; Suzuki, Shunji; Machida, Kenichi

    2007-01-01

    Multilayered [NdFeB x /Tb y ] n films were prepared by a three-demensional sputtering system. From the thickness of NdFeB layer dependence on the orientation and magnetic properties of multilayered [NdFeB (xμm)/Tb (50nm)] n films with 7.2μm as a total thickness of NdFeB layers, it was found that the orientation of NdFeB grains was maintained. However, the coercivity was enhanced with decreasing the thickness of each NdFeB thin layer. The (BH) max value of 240kJ/m 3 was obtained on the layered [NdFeB (1.2μm)/Tb (50 nm)] 6 film as an optimal value. For the multilayered [NdFeB (1.2μm)/Tb (50 nm)] n films with various multiple layer sets (n), the coercivity value increased with the film thickness without any deterioration of the c-axis texture and consequently, multilayered NdFeB/Tb film magnets with total thickness values around 70μm showed the superior magnetic properties (H cj approx. = 1360kA/m, I r approx.= 1.05T, and (BH) max approx.= 202kJ/m 3 ). (author)

  8. The indication and the point at issue in total body irradiation (TBI)

    International Nuclear Information System (INIS)

    Kikuchi, Yuzo; Nishino, Shigeo.

    1992-01-01

    The role of radiation in the cause of interstitial pneumonitis (IP) was analysed here. Also optimal dose fractionation was discussed about total absorbed lung dose, dose rate and fractionation in spect of IP. After all optimal time schedule was recommended 3, 4 and 6 fraction of ≤ 4 Gy of fraction size using conventional and hyperfractionated irradiation. In the end the present condition and the point at issue in the irradiation of blood for prevention GVHD were discussed. (author)

  9. 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

    in process and clinical care. Results will be integrated with living systematic reviews in a process of knowledge transfer. The study initiation was from October to December 2014, and the recruitment period was for 18 to 24 months. EXPECTED OUTCOMES: Collaborative European NeuroTrauma Effectiveness Research...

  10. An Interactive Visualization Framework to Support Exploration and Analysis of TBI/PTSD Clinical Data

    Science.gov (United States)

    2017-05-01

    to (1) extend our interactive visual analytic framework which combines multiple clinical measurements to allow it to be used to explore large...18. NUMBER OF PAGES 16 19a. NAME OF RESPONSIBLE PERSON a. REPORT b. ABSTRACT c. THIS PAGE 19b. TELEPHONE NUMBER (include area code) jmolstre...stress disorder (PTSD) and complex comorbid conditions. See attached paper for more information about VISXplore. Figure 1: Screenshot of our VisXplore

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

    Science.gov (United States)

    2016-10-01

    proper approvals through the VA to approach and screen for potential inclusion . What opportunities for training and professional development has...quarter, we may experience difficulty enrolling more than one person per site given bed availability during the holiday season. We are working with

  12. National Intrepid Center of Excellence: Cutting Edge Interdisciplinary Care for TBI & PH

    Science.gov (United States)

    2011-01-26

    training • Autogenic Training : Heart Math • Pain Control: Acupuncture, Relaxation • Family Therapy: FOCUS • Wellness: Yoga, Nutrition, Rec, Art... training venue for the dissemination of next generation standards of care and resilience to providers as well as Service Members and families  An...on the NICoE Website (Currently under development) 8 • NICoE’s Training and Education (T&E) mission is to serve as: – An education catalyst for

  13. Blast Testing Issues and TBI; Experimental Models that Lead to Wrong Conclusions

    Directory of Open Access Journals (Sweden)

    Charles E. Needham

    2015-04-01

    Full Text Available Over the past several years we have noticed an increase in the number of blast injury studies published in peer-reviewed biomedical journals that have utilized improperly conceived experiments. Data from these studies will lead to false conclusions and more confusion than advancement in the understanding of blast injury, particularly blast neurotrauma. Computational methods to properly characterize the blast environment have been available for decades. These methods, combined with a basic understanding of blast wave phenomena enable researchers to extract useful information from well documented experiments. This basic understanding must include the differences and interrelationships of static pressure, dynamic pressure, reflected pressure, and total or stagnation pressure in transient shockwave flows, how they relate to loading of objects, and how they are properly measured. However, it is critical that the research community effectively overcomes the confusion that has been compounded by a misunderstanding of the differences between the loading produced by a free field explosive blast and loading produced by a conventional shock tube. The principles of blast scaling have been well established for decades and when properly applied will do much to repair these problems.This paper provides guidance regarding proper experimental methods and offers insights into the implications of improperly designed and executed tests. Through application of computational methods, useful data can be extracted from well documented historical tests, and future work can be conducted in a way to maximize the effectiveness and use of valuable biological test data.

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

    Science.gov (United States)

    2015-09-01

    only expect a decrease in cell numbers (Fig. 25). This effect was not seen on the number of Nissl - stained neurons, indicating that it is due to a...decrease in TH staining not cell death. Table 2. LFP injury did not significantly affect the number of TH+ or Nissl + neurons in the ipsilateral...of toxicity consisting of red staining around the nostrils. The veterinarian consulted indicated that rats did not need to be euthanized prematurely

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

    Science.gov (United States)

    2013-10-01

    and 7 days post injury time point. Figure 20 shows the typical lesion pattern following our protocol. Figure 21 shows Nissl stain at different...diameter. Figure 21. Light microscopy images of Nissl stain displaying lesion area 1 week following impact in WT (Stat3-LoxP) and KO (Stat3-LoxP-Cre...cryoprotectant solution pending further processing. Every third section was collected to quantify infarct volumes using cresyl violet ( Nissl ) stain (Ohab et

  16. Evaluation of Clinically Relevant Prognostic Indicators in a Model of Mild TBI/Concussion

    Science.gov (United States)

    2017-10-01

    construed as an official Department of the Army position, policy or decision unless so designated by other documentation. REPORT DOCUMENTATION PAGE...memory task at either 1 month or 3 months following PCI (Fig. 8). Experiment 1.2.3 Anxiety and Motivation : Anxiety behavior was assessed...anatomy of the rat olfactory bulbs within the skull, with their protruding nature likely making them particularly vulnerable to the coup countercoup

  17. Analysis of sports related mTBI injuries caused by elastic wave propagation through brain tissue

    Directory of Open Access Journals (Sweden)

    D Case

    2016-10-01

    Full Text Available Repetitive concussions and sub-concussions suffered by athletes have been linked to a series of sequelae ranging from traumatic encephalopathy to dementia pugilistica. A detailed finite element model of the human head was developed based on standard libraries of medical imaging. The model includes realistic material properties for the brain tissue, bone, soft tissue, and CSF, as well as the structure and properties of a protective helmet. Various impact scenarios were studied, with a focus on the strains/stresses and pressure gradients and concentrations created in the brain tissue due to propagation of waves produced by the impact through the complex internal structure of the human head. This approach has the potential to expand our understanding of the mechanism of brain injury, and to better assess the risk of delayed neurological disorders for tens of thousands of young athletes throughout the world.

  18. Blast Concussion mTBI, Hypopituitarism, and Psychological Health in OIF/OEFVeterans

    Science.gov (United States)

    2014-06-01

    anxiety, depression, insomnia , cognitive dysfunction, and deleterious changes in body composition and cardiovascular function. However, the...1995. 37. McCann BS, Benjamin GAH, Wilkinson CW, Carter J, Retzlaff BM, Knopp RH: Examination stress and plasma lipids in law students . Ann...SA, Carpenter LL, Tyrka AR, Wilkinson CW, Price LH: Eszopiclone treatment and decreased cortisol levels in adults with primary insomnia . 17th

  19. Molecular Signatures and Diagnostic Biomarkers of Cumulative, Blast-Graded Mild TBI

    Science.gov (United States)

    2013-10-01

    ischemic stroke. Neurol. Res. 30, 783–793. 35. Wang, H.C., Lin, W.C., Lin, Y.J., Rau, C.S., Lee, T.H., Chang, W.N., Tsai, N.W., Cheng, B.C., Kung , C.T., and...J.K., Shen, C.A., Yin, H.N., Zhou, X.F., Lu, W., Hu, Q.G., Chi, Y.F., Ma, L., 22  Deng, H.P., Zhang, X.B., Sun, T.J., and Han , Y.F. (2010). [Early

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

    Science.gov (United States)

    2014-09-29

    objective of this project is to determine the conditions conducive for cavitation in cerebrospinal fluid (CSF) and corresponding tissue injury in 2-D brain...the radius of an isolated spherical bubble in an infinite, incompressible liquid is given by Where, R is the instantaneous bubble radius, which can...by the pressure transducer placed in the test chamber, and PR is the pressure in the liquid at the boundary of the bubble. The measurable bubble

  1. Improving Balance in TBI Using a Low-Cost Customized Virtual Reality Rehabilitation Tool

    Science.gov (United States)

    2017-10-01

    Journal publications. Larkin, M. (2017). Exploring...virtual environments for cognitive and physical rehabilitation. The Journal on Active Aging. 16(5): 44-51.] § Books or other non-periodical, one...Memory, and Immersion and PTSD! Keynote Address at the Annual Conference of the Institute for Functional Medicine. Los Angeles, California, June,

  2. Brain and Plasma Molecular Characterization of the Pathogenic TBI-AD Interrelationship in Mouse Models

    Science.gov (United States)

    2015-10-01

    encephalopathy in the elderly: clinical expression and structural substrates. Neuropathol Appl Neurobiol 37, 570 -584. Crawford, F., Crynen, G., Reed, J...Beaulieu-Abdelahad, D., Lin, Y., Jin, C., Crawford, F., and Mullan, M. (2014). The Spleen Tyrosine Kinase (syk) Regulates Alzheimer’s Aβ

  3. TBI-Induced Formation of Toxic Tau and Its Biochemical Similarities to Tau in AD Brains

    Science.gov (United States)

    2017-10-01

    produces high quantities of protein (0.1-1.5mg tau from 1.5g of frozen tissue), preserves tau phosphorylation, and removes the vast majority of...disease This project seeks to establish extracellular soluble species of tau as major toxic species responsible for reduction of synaptic...competitive renewal grant is to optimize ultrasound parameters for non- invasive opening of the BBB. Dr. Lewis Brown 5R01MH098786-02 (Andrew J. Dwork

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

    Science.gov (United States)

    2015-12-01

    30 s). These animals showed 1-8 seizures/day (range). Nine hours after injury, one mouse developed status epilepticus (Figure 2) which continued for...3 days resulting in the animal’s death. Figure 3: Electrographic recording of a CCI-injured mouse in status epilepticus . Upper trace is an EEG...recording of 4 h of status epilepticus while the lower traces represent portions of the EEG within the 10 dashed boxes at an expanded timescale

  5. Changing the Odds A North Carolina family's search to help those with TBI

    Science.gov (United States)

    ... Issue Past Issues Cover Story: Traumatic Brain Injury Changing the Odds A North Carolina family's search to ... his mother, Carolyn. "But we had an unshakable belief that Phillip would have hope and a future." ...

  6. Assessment and Rehabilitation of Central Sensory Impairments for Balance in mTBI

    Science.gov (United States)

    2017-10-01

    The Pain Location Inventory draft has been received by FITBIR and is still pending (awaiting publication status). Data elements for the Short...0.001 Short Form 36 – General Health 60.79 20.57 80.98 13.14 20.19 ɘ.001 Pain Location Inventory 5.89 5.40 0.46 0.84 5.43 ɘ.001 Symptom Impact...controls, when the cervical muscle is tested (i.e. cVEMP), but not when ocular muscles are tested (i.e. oVEMP; See Table 3). No key differences emerged

  7. Tee endale teene - saada kliendid konkurentide juurde / Frederick F. Reichheld

    Index Scriptorium Estoniae

    Reichheld, Frederick F.

    2003-01-01

    Autor leiab, et kulude vähendamiseks ja tulude suurendamiseks on vaja valida õigeid kliente. Vt. samas: Kuidas võita lojaalseid kliente ehk takjaid? ; Kuidas vältida ebalojaalseid kliente ehk liblikaid? ; Lojaalsus on kahesuunaline

  8. Ott Sepp ohverdab rolli nimel juuksed? / Liina Metsküla

    Index Scriptorium Estoniae

    Metsküla, Liina

    2007-01-01

    Madis Kõivu näidend "Catrozza ehk Illusionist" Võru Teatriateljee suvelavastusena. Lavastaja Taago Tubin. Külalisnäitlejad on Ott Sepp ja Leino Rei. Lisaks tutvustus "Müstiline mees ja illusionist ehk Castozza lugu"

  9. Mäluravi / Jaanus Adamson

    Index Scriptorium Estoniae

    Adamson, Jaanus, 1966-

    2009-01-01

    Mäletamise paradigma ehk suulise traditsiooni vahetumisest unustamise paradigma ehk kirjaliku traditsiooniga, psühhoanalüüs kui selle muutuse tulemusel tekkinud viis minevikku meenutamise asemel korrata

  10. Pildimängude dünaamika : Tommy & Laurentsius Matti Miliuse kunstikogust / Mariann Raisma

    Index Scriptorium Estoniae

    Raisma, Mariann, 1974-

    1998-01-01

    Retrospektiivnäitus Tartu Kunstimajas. Kunstnikud jätkavad ka praegu nn. kunstnike tandemi traditsiooni, Laurentsius ehk Lauri Sillak Anna-Daniela Saalistega, Tommy ehk Toomas Tõnissoo Kadri Kangilaskiga.

  11. Kui neid kapitulatsioone ees ei oleks...? : ehk õiguse moderniseerimise takistused Vene impeeriumi Läänemere-provintsides 19. sajandil / Marju Luts

    Index Scriptorium Estoniae

    Luts, Marju, 1966-

    2006-01-01

    Tartu Keiserliku Ülikooli õigusteaduse õppejõudude iseloomustusi 19. sajandi esimesel poolel kehtinud kohaliku õiguse kohta, kodifikatsioonitülist Balti moodi. Õigusteaduse ärkamisajast 1838-1851, kodifikatsioonidest 1854-1864

  12. Ettevõtte ostu- või müügieelne finants- ja maksuanalüüs ehk due diligence / Anneli Simm

    Index Scriptorium Estoniae

    Simm, Anneli

    2008-01-01

    Deloitte Advisory AS finantskonsultatsioonide osakonna juhataja käsitleb ettevõtte ostueelset finants- ja maksuanalüüsi ning ütleb, et see keskendub peamiselt ostetava ettevõtte ajaloolisele finantsaruandlusele ja raamatupidamisele

  13. Kuidas kurat Niguliste kirikut vaatas ehk põnevad leiud Tallinnas Niguliste 6 / Jüri Türkei, Kaarel Truu

    Index Scriptorium Estoniae

    Türkei, Jüri

    2016-01-01

    Niguliste 6 on Tallinna vanalinnale omane mitmes järgus ehitatud kaupmeheelamu. 2015. aasta uuringute käigus avati uuesti kõik huvipakkuvad piikonnad. Taasavastati dornse paarisakna sillust toetanud paesammas, millel on voluutidest välja kasvav kuradinägu

  14. Propaganda ehk "kui sõna ei löö, siis ei löö ka kaigas" / Heiki Raudla

    Index Scriptorium Estoniae

    Raudla, Heiki, 1949-

    2001-01-01

    Propaganda kujunemisest läbi ajaloo, erinevatest teooriatest, reeglitest ja võtetest. Propagandaalasest tegevusest Eestis 1924-1940, Riikliku propaganda talituse (RPT) loomisest 27.09.1935 ja selle juhist Edgar Kigastest

  15. Igal puul oma õunad ehk Kõnekäände mitmel teemal : [uusi raamatuid rahvapärastest ütlustest] / Asta Õim

    Index Scriptorium Estoniae

    Õim, Asta, 1943-

    2002-01-01

    Arvustus: Tere, tere, teid ma tunnen ...: Soove, tervitusi, tänamisi / koost. Anne Hussar. Tallinn, 2002 ; Elevant voodi all, voodi lae all : keerdküsimusi loomadest / koost. Piret Voolaid. Tallinn, 2002 ; Mis sa soiud, võta soodat! : Sajatusi, osatusi, parastamisi / koost. Anneli Baran. Tallinn, 2002

  16. Suur Teatriõhtu 2006 ehk Nike kliendikaardiga Vanapaganast, Eurovisioonile pääsenud vaeslapsest, roosades rõivastes printsist ja paljust muust

    Index Scriptorium Estoniae

    2006-01-01

    Kuressaare Gümnaasiumi Suurest Teatriõhtust. Ürituse üle mõtisklevad žürii liige Aarne Mägi, vilistlane Mihkel Miller, peakorraldaja Eve Paomees ja teatriõhtu traditsiooni looja ja ürituse peakorraldaja Marit Tarkin

  17. ehká víla z bahna rybníků - puchýřka útlá

    Czech Academy of Sciences Publication Activity Database

    Šumberová, Kateřina; Ducháček, M.

    2014-01-01

    Roč. 61, č. 6 (2014), s. 265-271 ISSN 0044-4812 R&D Projects: GA AV ČR KJB600050803 Institutional support: RVO:67985939 Keywords : threatened species * wetlands * fishpond management Subject RIV: EF - Botanics

  18. Ya basta ehk kes mõistab hukka kapitalismi kuriteod? = Ya basta or who will condemn the crimes of capitalism? / Anders Härm

    Index Scriptorium Estoniae

    Härm, Anders, 1977-

    2009-01-01

    1994. aasta Põhja-Ameerika Vabakaubandusleping keelustas kohalike elanike farmide subsideerimise, millele astusid vastu Chiapa elanikud Mehhikos ning moodustasid Zapatistliku Hea Valitsuse Hunta eesotsas subcomandante Marcosega, kehtestades haldamise detsentraliseerimise

  19. Kuidas kommunikatsiooniga raha kaasata ehk sõna saab härra ühisrahastus / Henri Laupmaa ; intervjueerinud Dea Martinjonis

    Index Scriptorium Estoniae

    Laupmaa, Henri

    2015-01-01

    Intervjuu IT-ettevõtja, kodanikuühiskonna arendaja ning toetusplatvormi Hooandja ühe käivitaja Henri Laupmaaga Hooandja platvormi õnnestunud projektidest, uuest ühisrahastusplatvormist Fundwise, kommunikatsioonist ühisrahastusprojektide ellu viimisel

  20. Joonised, tähendused ja unistused, ehk enklaavi eelised = From drawings to meanings and dreams: the advantage of remaining an enclave / Lilia del Rio

    Index Scriptorium Estoniae

    Rio, Lilia del

    2011-01-01

    Pirita tee alguse piirkonnast, mis oli vaatluse all 15. ja 16. juunil 2010. aastal toimunud Tallinna III linnafoorumil. Linnaruumi tegelikkusest ja Tallinna ruumilistest prioriteetidest. Rahvuspargist, rahvapargist, linnaparkidest. Plaanidest ja joonistest planeerimisprotsesside ja otstarveteni. Tallinna tulevikust

  1. Wŏ shuō hànyŭ, nĭne? ehk Mina räägin hiina keelt, aga sina? / Piret Lakson

    Index Scriptorium Estoniae

    Lakson, Piret, 1989-

    2012-01-01

    Hiina keele õpetamisest Eestis ja Mustamäe gümnaasiumi noorest hiina keele õpetajast Wang Weist. Eesti koolidesse hiina keele õpetajate hankimine käib Tallinna ülikooli juurde loodud Konfutsiuse instituudi kaudu

  2. Arhitektuur kui vastuolude distsipliin : dialoogiline praktika ehk Stereomõtlemise poole = Architecture as a Discipline of Contradictions : Dialogical Practices, or Towards a Stereo-Identity / Indrek Peil

    Index Scriptorium Estoniae

    Peil, Indrek, 1973-

    2005-01-01

    Analoogilise ja kriitilise dialektika linnaruumis. Arhitektuur kui vastuolude distsipliin. Identiteetide kokkupõrgete kaudu linnaliku sallivuse ja stereofooniliste mudeliteni. Hübriidide lõhestamine. Ettearvamatus - süsteemi ja vea dialektika. Bibliograafia lk. 55. Artikkel põhineb 2004. a. Berliinis toimunud konverentsil "Architecture and Identity" peetud ettekandel

  3. Everything should be made as simple as possible, but not simpler ehk kuidas protsesside lihtsustamine võib maksimeerida ettevõtja kasu / Katrin Avloi

    Index Scriptorium Estoniae

    Avloi, Katrin

    2013-01-01

    Uuest ettevõtete elektroonilisest andmevahetuskanalist Danske LiveGate. Näiteid, milliste pangateenuste kasutamist Danske LiveGate võimaldab ning kuidas protsesside automatiseerimine integreeritud lahenduse kaudu ettevõttele kasu toob

  4. 14. X avati graafikatriennaali noortenäituse [tingimisi olemas][tingimisi olematu] neljas ehk viimane alanäitus Viljandis Kilpkonna galeriis

    Index Scriptorium Estoniae

    2001-01-01

    Kuraator Rael Artel. Väljas on Laura Kallasvee "I love labels", Maiu Kurvitsa kontseptuaalne projekt "Odav jutt", Peeter Lauritsa "Paabeli torn" (1991), tundmatu kunstniku tekstiilist käsitöötoode.

  5. Tallinna linna- ja gümnaasiumi trükikoda ehk 380 aastat trükikunsti Tallinnas / Aija Sakova-Merivee

    Index Scriptorium Estoniae

    Sakova-Merivee, Aija, 1980-

    2015-01-01

    Alanud aasta alguses esitlesid Tallinna Ülikooli Akadeemiline Raamatukogu ja Tallinna Linnaarhiiv ühist trükist „Tallinna linna- ja gümnaasiumi trükikoda (1634–1828). Näituse kataloog”. Autor annab ülevaate nii näitusest kui selle kataloogist

  6. "Kohtuniku ees seisab kaks jumalat, kaks õigust ja kibe tarvidus ühte kui teist ehk mõlemaid korraga teenida." / Olja Kivistik

    Index Scriptorium Estoniae

    Kivistik, Olja, 1989-

    2012-01-01

    20. saj. alguses kohaldatud kriminaalseadustikest Tsaari-Venemaal (ka Eestis), nendes sätestatud usuvastaste süütegude koosseisude rakendamisest. Tsaariaegse Tallinna Ringkonnakohtu lahenditest ajal, kui kehtisid samaaegselt vana ja uus nuhtlusseadustik

  7. Veel kord õigusest sõnumite saladusele ehk kuidas 20. sajandi tehnoloogia mõjutab põhiseaduse tõlgendusi / Uno Lõhmus

    Index Scriptorium Estoniae

    Lõhmus, Uno, 1952-

    2016-01-01

    Põhiseaduse §-st 43 ja selle tõlgendamisest, privaatsuse kaitse ja terminoloogia erinevustest põhiseaduse, Euroopa inimõiguste ja põhivabaduste kaitse konventsiooni ning Euroopa Liidu põhiõiguste harta vahel, komplikatsioonidest Eesti rahvusvaheliste kohustuste täitmisel. Sisaldab asjakohast kohtupraktikat

  8. Andres Puustusmaa - mees nagu jalgratas ehk Seitseteist kevadist hetke enne Moskva rongi väljumist / Andres Puustusmaa ; interv. Margus Mikomägi

    Index Scriptorium Estoniae

    Puustusmaa, Andres

    2008-01-01

    Venemaal tegutseva Eestist pärit režissööri Andres Puustusmaa mängufilm "18-14" esilinastub 10. jaanuaril Eestis. Lisaks tõlge filmi tutvustavast tekstist (www.1814.ru) : "Tsarskoje Selo Kõrilõikaja ja lütseumi kasvandikud". Artikkel rubriigis "Teatriküljed 1/25"

  9. Ka Vanapagan on inimene ehk analyze that : Eesti kõige levinum teatrivorm on trikiteater, mis kasutab inimeste lõbustamiseks trikke / Kaur Kender

    Index Scriptorium Estoniae

    Kender, Kaur, 1971-

    1999-01-01

    Trikkidest, palaganist ja heast huumorist Eesti teatris. Meeldejäävate hea huumori näidete hulgas on nimetatud John Patrikcu" Grupipilti", Eino Baskini lavastuses Vanalinnastuudios (1983), esile toodud Vello Jansoni mängu;Thomas Bernhardi "Harjumuse jõudu"(1998) Eesti Draamateatris, lavastaja Lembit Peterson, esile toodud Aarne Üksküla mängu, ja A. H. Tammsaare järgi tehtud lavastust "Põrgupõhja uus Vanapagan" Eesti Humanitaarinstituudi teatriõppetooli üliõpilaste esituses Kirjanike Majas

  10. Taskurätt või Viagra ehk Kellele jätkub tuleviku Eestis tööd? / Riho Laurisaar

    Index Scriptorium Estoniae

    Laurisaar, Riho

    2008-01-01

    Majandusministeeriumi tööhõive prognoos 2014. aastani näeb ette töökohtade hulga kasvu, samal ajal näitavad Eesti vähene tootlikkus ning odava tööjõu puudumine aga vastupidist tendentsi. Diagramm: Meie maal kõik tööd on head. Graafik: Töötuskindlustushüvitise saajad; Mõne ala keskmised brutopalgad. Lisad: Millest elada ümberõppe ajal?; Paratamatus või sundkäik?; Mis on tegelik Eesti keskmine palk? Tublidus on tööl suhteline

  11. Lotte ning ta sõbrad ja sugulased ehk Kas vägivallatus võib olla põnev / Leelo Tungal

    Index Scriptorium Estoniae

    Tungal, Leelo, 1947-

    2001-01-01

    Joonisfilmid "Lotte" ja "Lotte reis lõunamaale" : stsenaristid Andrus Kivirähk, Janno Põldma, Heiki Ernits : kunstnik Heiki Ernits : lavastajad Leo Lätti, Ebe Tramberg : helilooja Olav Ehala : Eesti Joonisfilm 2000. Lisa : S. Teinemaa koostatud J. Põldma ja H. Ernitsa filmograafia

  12. Rohelise pildi taga ehk kuidas näidata arhitektuuri = Behind the green image or how to exhibit architecture / Triin Ojari

    Index Scriptorium Estoniae

    Ojari, Triin, 1974-

    2013-01-01

    5. Oslo arhitektuuritriennaalist, kuraatorinäitusest "Rohelise ukse taga", mille põhiteemaks oli jätkusuutlikkus. Kuraatoritest Maarten Gielenist ja Lionel Devliegerist (arhitektuuribüroo Rotor, Belgia), uuest kureerimisest, Rotori varasematest projektidest. Vestlus Maarten Gieleniga. Kuidas jätkusuutlikkuse mõiste maailmas toimib ja seda aktiivselt muudab

  13. Georgia uued sõbrad vs. Georgia (vanad) sõbrad ehk väikeriikide söakas vastandumine suurriikidele / Toomas Alatalu

    Index Scriptorium Estoniae

    Alatalu, Toomas, 1942-

    2012-01-01

    Gruusia Sõprade (FOG) - Prantsusmaa, Saksamaa, Ühendkuningriigi, Venemaa ja USA diplomaatilisest foorumist. Selle alternatiivne grupp e. nn. Uued Sõbrad (NFOG): Eesti, Läti, Poola, Rumeenia, Bulgaaria

  14. Fotorealismi pool sajandit ehk ühe "-ismi" mitu lainet = Half a century of photorealism, or several waves of one "-ism" / Tiiu Parbus

    Index Scriptorium Estoniae

    Parbus, Tiiu, 1989-

    2016-01-01

    Rahvusvaheline näitus "Fotorealism. 50 aastat hüperrealistlikku maali" Kumus eksponeerib algupärase fotorealismi superstaare. Koostanud Tübingeni Kultuurivahetuse Instituut, kuraator Otto Letze. Eesti hüperrealismi seoseid Ameerika algupärandiga

  15. Äri uued mängureeglid : Kui vastutustundlikust ärist pole pääsu, siis ehk tasub sellega kaasa minna?

    Index Scriptorium Estoniae

    2015-01-01

    Oma kogemusi vastutustundlikust ettevõtlusest jagavad Ragn-Sellsi juhatuse esimees Rain Vääna, Loodusvägi OÜ juhatuse liige ja tegevjuht Ahto Vegmann, BaltCapi juhtivpartner Martin Kõdar ja Viru Keemia Grupi juhatuse esimees Priit Rohumaa

  16. Düreri maal Eestis ehk Ristija Johannese eksirännakud = Dürer's painting in Estonia - St. John the Baptist's misguided travels / Kadi Polli

    Index Scriptorium Estoniae

    Polli, Kadi, 1973-

    2003-01-01

    Saksa maalikunstniku Albrecht Düreri lõpetamata jäänud altarimaalist pärnapuul - "Püha Onufrius" (Bremeni Kunsthalles), "Ristija Johannes" (Eesti Kunstimuuseumis), "Salvator Mundi" (New Yorgi Metropolitani muuseumis)

  17. Make love and war ehk ükssarvede ilmumine Tallinnasse = Make love and war, or the unicorns' advent in Tallinn / Rebeka Põldsam

    Index Scriptorium Estoniae

    Põldsam, Rebeka, 1989-

    2012-01-01

    Tallinna linnainstallatsioonide festivali "LIFT11" installatsioonist "Queer-kleepekavihik". Kuraatorid Anna-Stina Treumund ja Jaanus Samma. Autorid Helin Tikerpuu, Katia Weber Piscitelli, Ly Lestberg, Mare Tralla, Ott Pilipenko, Mae Köömnemägi, Andreas Kalkun, Rebeka Põldsam, Lilli-Krõõt Repnau, Aet Kuusik, Jaanus Samma

  18. Kunst ja käsitöö Eesti hapras filmiühiskonnas ehk Kes määrab rahva maitse / Tarmo Teder

    Index Scriptorium Estoniae

    Teder, Tarmo, 1958-

    2002-01-01

    Probleemidest eesti filmikunstis ja -tootmises kõnelevad produtsent ja režissöör Peeter Urbla, filmikriitik Tiina Lokk, režissöör, stsenarist ja filmikriitik Andres Maimik ning režissöörid Marko Raat ja Rainer Sarnet

  19. "Jumalale meelepärane seletus ehk mõnede südametunnistuse-küsimuste teoloogiline deduktsioon" : vaimulik vs ilmalik 17. sajandi Tallinnas / Lea Kõiv

    Index Scriptorium Estoniae

    Kõiv, Lea

    2008-01-01

    Tallinna sisepingetest 17. sajandil. Linnavõimu ja vaimulike vahelisest konfliktist 1662. aastal. Vaimulike poolt koostatud kirjalikust läkitusest Tallinna Raele. Rae reageeringust deduktsioonile. Konflikti ajast ja oludest. Tallinna kirikukorraldusest 16.-17. sajandil. Ilmalike võimude ja kiriku vahekorrast.

  20. "Rändur udumere kohal" ehk Ida-Viru maastikke otsides = Travellers above the mist - in search for the landscapes of Ida-Virumaa / Henn Runnel, Rait Parts

    Index Scriptorium Estoniae

    Runnel, Henn, 1983-

    2013-01-01

    Ida-Virumaa maastikest. Tööstusalade rekultiveerimisest ja taaskasutusprojektidest (põlevkivi hariduskeskus, Kiviõli seikluspark, Aidu sõudekanal jm.). Emscheri maastikupargist Saksamaal. Autorite sõnul võiks olemasolevate tööstusmaastike jätkuv kasutus ja nende hilisem rekultiveerimine käia piirkonna hilisemat potensiaali arvestavalt ja kujundavalt. Kaevanduste planeerimisel võiksid osaleda maastikuarhitektid